Obsessive-compulsive disorder (OCD) is a chronic mental illness that can be associated with significant disability and suffering. Indeed, people with OCD often report serious difficulties in relationships and problems at work. For some people, living with OCD can become overwhelming and can cause them to lose hope and to contemplate or even attempt suicide. If you have a family member or friend with OCD that's exhibiting the potential warning signs of suicide, it's important to know what to do.
Although it has long been known that the risk of suicide is higher for people who are affected by mood disorders and schizophrenia, the relationship between anxiety disorders, such as OCD, and suicide has been less clear. However, recent studies suggest that people with OCD are 10 times more likely to commit suicide than the general population. Actively thinking about suicide (sometimes called suicidal ideation) also appears to be relatively common among people affected by OCD.
Factors that predict whether someone with OCD will attempt suicide include the severity of their OCD symptoms, the co-occurrence of depression, feelings of hopelessness, the presence of a personality disorder such as obsessive-compulsive personality disorder, and a prior history of self-harm, such as cutting. The risk of suicide also goes up if the person with OCD is actively using drugs or alcohol, is unemployed, or is socially isolated.
Increased hopelessness: Your loved one may talk openly and at length about feeling hopeless, helpless, or that she "can't take it anymore."
Speaking of death or suicide: Out-of-character remarks about death, speaking openly about suicide, or an expressed desire to commit suicide should always be taken seriously. In some cases, this may be your loved one's way of asking for help.
Increased depression: Your loved one may exhibit symptoms of depression, such as withdrawing from others, crying all the time, loss of interest in hobbies or activities, disrupted sleep, and lack of appetite.
Preparing for death: People actively contemplating suicide will sometimes take out an insurance policy, adjust and/or create a will, or advise someone close to them of their final wishes.
Changes in behavior: A normally cautious individual may engage in reckless or impulsive behavior and express little fear of the consequences of such behavior. Conversely, someone who is depressed may suddenly act cheerful for no apparent reason.
Giving away possessions: It's not uncommon for individuals who are actively contemplating suicide to give away prized possessions to trusted friends or family members.
Keep communicating: Talk openly and frankly about what your loved one is feeling—talking about suicide doesn't make it more likely that she will harm herself. Don't be afraid to express your own feelings as well. If you're scared and worried about your loved one, then it can be helpful to say so.
Ask questions: Although it can be uncomfortable, frankly asking questions about whether your loved one is thinking of killing or harming himself, as well as other details such as how and when he's considering doing it, whether he has access to a weapon or large amounts of medications, and other relevant concerns, may help ensure that suicide does not become an untouchable subject.
Empathize, don't minimize: As you might imagine, admitting suicidal thoughts or a suicide plan is often an extremely difficult, embarrassing, and painful experience. Simply telling your loved to "stop thinking about it," "think good thoughts," or even to "get over it," may make her feel even more rejected, insecure, and/or depressed. Make sure you let your loved one know that you understand how difficult this experience must be for her.
Get help: Suicide is a very serious problem that often requires hospitalization and the assistance of qualified professionals. In cases where you feel your loved one is an immediate danger to herself, you may want to accompany her to the local hospital emergency department or wait with her until help (e.g., police or ambulance) arrives. In less urgent cases, you may want to help him locate and/or access resources such as a crisis line, support group, or a mental health professional he trusts.
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Balci V, Sevincok L. Suicidal Ideation in Patients With Obsessive-Compulsive Disorder. Psychiatry Research. Jan 30, 2010;175(1-2):104-8. doi:10.1016/j.psychres.2009.03.012.
Fernández de la Cruz L, Rydell M, Runeson B, et al. Suicide in Obsessive-Compulsive Disorder: a Population-Based Study of 36,788 Swedish Patients. Molecular Psychiatry. 2017;22:1626-1632. doi:10.1038/mp.2016.115.