Are you tired and frustrated and angry because you constantly have to prove to others that you have a disease or that you're in pain? Is it wearing you (or the person you're concerned about) down?

You need to know that you are not alone. You are not alone in your disease, your anger, your frustration, your pain, your feelings of helplessness, or your occasional feelings of hopelessness.

Farther down on this page, there will be links to sources of online help. However, hooking up with some of them may take a day or two, so let's address a couple of more immediate things first.

The usual questions and indications given to assess depression in the normal population are almost useless when one is dealing with all the losses that may come during the course of these diseases.

Are you or the person you're concerned about talking or thinking of suicide?

Do you or does your friend have the means to commit suicide? (In other words, does the person you're concerned about have the pills, the gun, or whatever they say they would use?)

Do you or does your friend have the intent? (In other words, does the person you're concerned about speak or think about actually following through with it soon?)

Means and intent are the most important aspects when trying to gauge whether there's an urgency. If there is both a means and an intent, then you or the person you are concerned about must call a doctor or crisis center immediately.

If your concern is about someone online, it is sometimes difficult to assess - without the ability to be face to face and see body language - the "seriousness" of another person's writing or chatting. However, in over thirteen years of being online, I know that when a person has written or spoken of their pain and their hopelessness, someone has always responded to that and attempted to help.

Online Depression Screening Test

From the San Francisco Suicide Prevention Website

Recognize the Signs Of Depression and Possible Suicide Risk

Recent Loss - through death, divorce, separation, broken relationship, loss of job, money, status, self-confidence, self-esteem, loss of religious faith, loss of interest in friends, sex, hobbies, activities previously enjoyed

Change in Personality - sad, withdrawn, irritable, anxious, tired, indecisive, apathetic

Change in Behavior - can't concentrate on school, work, routine tasks

Change in Sleep Patterns - insomnia, often with early waking or oversleeping, nightmares

Change in Eating Habits - loss of appetite and weight, or overeating

Diminished Sexual Interest- impotence, menstrual abnormalities (often missed periods)

Fear of losing control- going crazy, harming self or others

Low self esteem- feeling worthless, shame, overwhelming guilt, self-hatred, "everyone would be better off without me"

No hope for the future - believing things will never get better; that nothing will ever change

Other things to watch for- Suicidal impulses, statements, plans; giving away favorite things; previous suicide attempts, agitation, hyperactivity, restlessness or lethargy.

REMEMBER: The risk of suicide may be greatest as the depression lifts.

From Crisis Resources

If you or someone you care about is suicidal, it is time to act. If someone you know has said once they are going to kill themselves, take them very seriously. If they have said it many times, take them very seriously. People attempt suicide to end unbearable emotional pain caused by a variety of problems. Acute distress is always, and depression is often, a component of suicide attempts. A person attempting suicide is often so depressed that they cannot see any other options. People considering suicide can be helped if we try to understand how they feel and help them to look for better choices.

Suicide attempts are often cries for help. Most suicidal people give warning signs in the hope that someone will catch on; not because they are intent on dying but because they are intent on stopping their emotional pain. Usually the decision to attempt suicide is a last resort, rarely attempted on the spur of the moment. Typical warning signs which are often exhibited by people feeling suicidal include withdrawal from friends and family; depression shown through lost of interest in activities, signs of hopelessness, changes in appetite, weight, sleep patterns; talking and writing about suicide; purposefully putting personal affairs in order. Often drugs and alcohol are present at suicide attempts causing chronic users to be at high risk.

From Community Based Suicide Prevention Program Website

How to Help

If you think a friend might be considering suicide, ask how he or she is feeling. It's even okay to ask if he or she is considering suicide and if he or she has made any plans. (In general, the more specific and more plausible the plan, the greater the risk.) Let the person know you care and you are willing to help him or her get the help needed to find another way to end the pain. Listen, be honest, share feelings and get help. If your friend refuses help, get the advice of a mental health or suicide prevention specialist. (If a person can talk about their feelings, they may be less apt to keep feelings bottled up and more apt to break down the personal barriers that they've created (tunnel vision) and more apt to listen to reason and feel that life is worth living.)

If a person is intoxicated and talking about suicide, do not leave him or her alone. Call or send someone for help. Help is available from a crisis or mental health center or from the police.

Remember, most people who commit or attempt suicide do not want to die. They want to end the pain they are in. With help, most people can find a different way to end the pain. Suicide prevention has to do with helping a person see that suicide is not the only choice, that there are other ways to end the pain and solve the problems. Suicide prevention has to do with getting people the help they need.

Online Resources and Support Groups

The Samaritans Online Crisis Intervention Website

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