Learn more about depression and suicide ideation bystander intervention:
You notice a friend has been very down lately, more so than circumstances might dictate. Friends have also come to you about changes in her behavior.
This person has become withdrawn and is not as active and social as before. You have become concerned. What do you do?
Additional Depression Scenarios
A friend of yours on the gymnastics team suffers a career ending injury. She seemed OK at first but recently she has become more withdrawn and has stopped coming to any team related activities. She also doesn’t want to go out anymore and won’t return phone calls. You know how important her sport was to her and are concerned. What do you do?
A friend calls you on the phone crying hysterically because her boyfriend just broke up with her. You know it was her first serious relationship and they did everything together. She keeps saying, “You just don’t understand, you don’t understand.” Clearly she is distraught. What do you do?
You notice your teammate has been wearing long sleeves lately. It seems a little odd to you because the weather outside is too warm for long sleeves. Lately, he has been withdrawn and at times irritable. He seems to be under a lot of pressure but does not wish to talk about it. During a practice, his sleeve slips just enough for you to see what appears to be a couple of old scars and a few new cuts along his forearm. You are alarmed. What do you do?
- Do you know someone who has thought about suicide or was severely depressed? What were the underlying issues?
- Are there times you wish you could have talked to someone but didn’t because you thought it would be a sign of “weakness”?
- How much of your identity/self worth is tied to being an “athlete”?
- What would you do if you could not play your sport anymore?
- How could this situation impact you and the athletic community?
Athletes many times do not seek help due to the culture of “not showing weakness,” “toughing it out,” or “fighting through the pain.” Depression is NOT a sign of personal weakness. People with depressive symptoms cannot merely “pull themselves together.” Timely treatment can shorten the duration of symptoms and cut off the downward spiral. It is also critical to understand the link between mental and physical health and how one impacts the other.
Depression sometimes follows:
- Significant events – death, divorce, abuse, transitions/life changes, loss of romantic relationship/ friendship – Now what? Who am I?
- Stress/Pressure – Academic, Athletic, Personal, Financial
- Injury – short or long term. Other medical conditions
- Identity as a person – too much of their identity is tied to being an “athlete”
- Failure to live up to personal or external expectations
- Significant change in team status
- Problems with coaches/teammates/roommates
- Substance abuse (individuals may choose to cope by using alcohol or other drugs)
Suicide sometimes follows:
- A sudden lift in spirits following extreme depression
- Talking about suicide; previous attempts
- Physical or psychological abuse
- Fight with family member or loved one
- Embarrassment or humiliation
- Concerns about sexuality – social isolation/alienation
- Suicide of friend, acquaintance or celebrity (copycat suicide)
Also look for:
- Frequency, duration and intensity/severity of symptoms. The higher the number of signs the stronger the case to refer the person to a professional.
- Emotional, cognitive, and behavioral changes: feeling that nothing matters; lack of enthusiasm motivation, sad, withdrawn, tired, apathetic, pessimistic, anxious, irritable, distracted, forgetful, difficulty concentrating, remembering, or making decisions.
- Feelings of worthlessness or guilt; impulsive acts; reckless behavior; mood swings.
- Neglect of personal welfare; deteriorating physical appearance. Significant weight gain or loss.
- Changes in eating and sleeping habits.
- No longer enjoying activities they once liked.
- Feeling misunderstood or rejected.
- Frequent health complaints when no physical ailment exists.
- Obsessive thoughts; All or nothing thinking.
- Marked decrease in performance academically or athletically.
- Giving away possessions.
- Lack of coping skills.
Did you know…?
- Depression can increase a student-athlete’s risk of injury (decrease in concentration, poor decision making and slower reactions).
- Suicide is rarely a spontaneous act.
- Suicide among young adults has increased 150-200% in the last 25 years.
- Suicide is the second leading cause of death among 15-34 year olds.
- Women attempt suicide 3 times more than men; men complete the act 3 times more than women.
- Campus counseling centers have seen around a 25% increase in depression in the last 5 years.
- Take it seriously. Remember – depressive/suicidal behavior is a cry for help.
- Speak with the individuals in private. Voice your concern — let them know you care.
- Do what you can to give the person HOPE.
- Encourage the individuals to get help. It is NOT a sign of weakness to ask for help. In fact, it is a sign of STRENGTH. Offer to go with them to counseling.
- Seek out a mature and compassionate person with whom you can review the situation.
- Use the QPR Method – Question (about whether the individuals plan to harm themselves; Persuade (not to harm themselves) and Refer (to a professional).
- If suicidal, create a “safety agreement” to not harm themselves.
- If suicidal, call 9-1-1: let the individuals know that you will be contacting 9-1-1. Do not leave him or her alone. Engage other bystanders if need be.
- If the individuals say they are going to take their own life, find out their intentions in terms of how they plan on doing it. This gives insights about risks to others, as well as more time and information to plan an intervention. Get as much information as possible.
- Notice actions/behaviors. Be observant of any medication bottles that may be present; note other important information.
- Separate the individuals from any weapons or firearms if possible.
- Be aware of difficult times: holidays, birthdays, major anniversary dates.
- What not to do:
- Don’t assume the problem will take care of itself.
- Don’t act shocked or surprised at what the person says.
- Don’t argue or debate moral issues.
- Don’t challenge or dare the person.
A Word of Caution
You may do your very best to help someone who is depressed or suicidal and your intervention may not be successful. It is a risk that you need to consider before becoming involved. Be sure to take care of yourself in these situations and get any help that you may need.
- Depression Brochure (National Institute of Mental Health)
- Suicidal Warning Signs
- Helping the Suicidal Individual
- Safeguarding Your Students Against Suicide (The Jed Foundation and National Mental Health Association)
- Suicide Fact Sheet
- 9-1-1 or Campus Police
- Counseling & Psychological Services
- Dean of Students
- Gryphons if in the dorms
- NCAA Mental Health Resources – www.ncaa.org/health-safety
- NCAA Mental Health Guide (See your Life Skills Coordinator or Athletic Trainer)
- Nathan’s Story
- Half Of Us – www.halfofus.com
- Help Guide – www.helpguide.org
- Mental Health Screening – www.mentalhealthscreening.org
- American Association of Suicidology – www.suicidology.org
- The Jed Foundation – www.jedfoundation.org
- Depression and Bipolar Support Alliance – www.dbsalliance.org
- Suicide Prevention Hotline – www.suicidepreventionlifeline.org
- QPR – Question, Persuade, Refer – www.qprinstitute.com
- National Mental Health Information Center – www.mentalhealth.samhsa.gov/databases
- SAVE – Suicide Awareness/Voices of Education – www.save.org
- Suicide Hotline – 1-800-SUICIDE
- College of the Overwhelmed – Kadison and DiGeronimo (2005)