If you have not personally experienced suicidal ideation, you most likely know someone or love someone who has. Hearing that someone you care for is contemplating hurting themselves or ending their life can feel alarming and even scary as it is difficult to know how to handle these important conversations. Knowing the warning signs, so you can broach the topic is important. Signs to look out for include:
- An increase in mental illness symptoms
- Substance abuse issues
- Increase in impulsive or dangerous behaviors
- Previous suicide attempts or family history of suicide
- Withdrawing from social events or groups
- Giving away important items or large sums of money
- Increased apathy about life goals
- Irritability or mood swings
- Self-harm (which is not always indicative of suicidal thoughts, but repeated self-harm attempts are more likely connected with future suicide attempts)
- Traumatic brain injury
The way in which warning signs present differs for each individual, which is why knowing ways to start these important conversations, as well as what to do if the person you care for is feeling suicidal, has the potential to save lives.
1. Ask the Question
There is a common misconception that bringing up suicide will evoke these thoughts in others, which is simply not true. In fact, the more we discuss the topic the less likely someone will be to act out these urges. Internalized shame around suicidal thoughts creates more isolation and has a detrimental impact on mental health, but by checking in with your loved one and asking how they are doing you are letting them know it is safe and okay to open up about their struggles.
If your loved one says anything sounding like these statements: “I don’t want to be here anyone”, “everyone would be better off without me” or more direct statements like “I wish I could just die” make sure not to overlook these as dramatic gestures and instead explore further. Be direct and ask the person if they are feeling suicidal or if they want to hurt themselves. While some people will be open, others may feel more guarded. In these circumstances use open ended questions such as “How have you been feeling?” and leave the door open to talk any time they are ready. For those who do not want to talk, remain persistent and present, but follow their lead.
2. Try to Remain Calm
Having someone you love express that they are, or have been suicidal, can naturally cause alarm. It is important to know that just because someone has had these thoughts, does not mean they are in immediate danger when they are speaking with you. In fact, because they are speaking to you, they are more likely to remain safe. When speaking with them, it can help to use grounding and mindfulness skills for yourself, especially in these moments, such as connecting with your breath and if possible, consciously relaxing your body. These practices make it easier to remain present, while also helping to reduce stress for the person you are speaking with as well.
3. Listen Without Judgment
When concerned for someone you love it can be tempting to try to fix the problem, or help the person look at their situation more positively. While these actions may be motivated by good intentions, it can leave the person feeling minimized or even judged. Practice “listening to hear not respond” which also allows you to learn as much as possible and not cut the person short from expressing themselves.
It is important not to minimize the feelings the other person is sharing with statements such as:
“Everything will be okay”
“You have so much to be thankful for”
“Things are not as bad as you think, it will get better”
“You will be fine”
Rather try practicing compassion which also helps the person feel that their feelings matter and they are not a burden for sharing them, but rather are brave and respected for doing so. Some compassionate statements include:
“I hear you”
“Tell me more”
“This seems really hard, thank you so much for sharing how you feel with me”
“What would you find most helpful right now?”
4. Find Other Supports
If your loved one does express an active plan or intent to hurt themselves or take their own life, it is not your responsibility, nor is it advised, to be solely responsible for their safety. If they currently have a therapist or medical professional they are working with, this is the time to call and make sure they know what is happening. You could offer to “body double” for your loved one and sit with them while they call these supports or offer to do so if they would prefer. Trying to get them in for an appointment as soon as possible is crucial.
In some cases, it may also be necessary to seek emergency help immediately. This can be a difficult decision to make, as research shows that hospitalization does not always improve symptoms related to suicidal thoughts — however if the person is in crisis, it is necessary. Looking up your local crisis hotline can be a good place to start, or you can call the 988 Suicide and Crisis lifeline. For veterans and military personal you may also wish to call the Veteran Suicide Hotline which has a local number designated for most areas and connects veterans with their local VA hospital.
Personal Support
It is important to remember that as someone supporting a person experiencing suicidal thoughts, you will need your own support. Whether it be a therapist, family member, friend, religious leader or support group, the impact on your own stress and wellbeing can be detrimental — made even more impactful if the person you are supporting is someone you love. Just as you want them to be open and seek out the help they need, you too deserve the same. By prioritizing your needs, you also make it more likely that when the time comes to support someone else who is struggling, you will have more emotional energy to provide and reduce the risk of compassion fatigue. Suicide impacts us all and by acknowledging its impact we all become part of the solution.
Dr. Amelia Kelley is co-author of Surviving Suicidal Ideation: From Therapy to Spirituality and the Lived Experience.
