On the Outside Looking In: How You Can Help Someone Experiencing Suicidal Thoughts

September is an important month: it’s National Suicide Prevention Awareness Month. This month is a great time to highlight this issue, and make sure we’re all aware of how big the problem of suicide is in our country – among people of all ages. We want to help to be part of the solution, so this month especially, we want to talk about suicide prevention, while still recognizing that there are people out there who need help year round – and we’re not just talking about people who are experiencing suicidal thoughts. We’re also talking about their family, friends, and other loved ones, who might be scared and unsure what they can do to help the people who are struggling in their lives. We will say that there is no one right thing to do, but it’s never the answer to ignore the problem. So what can you do if someone in your life is experiencing suicidal thoughts? 

How Big Is the Problem?

If you know someone who is experiencing suicidal thoughts, we can guarantee you’re not alone – and you should take the person in question very seriously. Because when we’re talking about suicide, we’re not talking about a rare occurrence: suicide is one of the leading causes of death in this country, and things seem to be getting worse not better. In fact, according to the CDC, suicide rates increased 30% between 2000 and 2018. 

The rates leveled off in 2019 and 2020 (we have yet to see the full picture of what the pandemic has done to the numbers), but only for some: the decline occurred among white people, but suicide deaths for the year increased among Indigenous, African American, and Latino people. Suicide rates for adults ages 35-74 declined, but rates for youth and young adults increased. 

hand on the floor with pills all around it

Other Americans with higher than average rates of suicide are veterans, people who live in rural areas, and workers in certain industries and occupations like mining and construction. Young people who identify as LGBTQ have higher rates of suicidal thoughts and behavior compared to youth who identify as heterosexual. In addition, men die by suicide 3.88x more often than women do.

All of the above means that suicide is now among the top 9 leading causes of death for adults in the United States, and the second leading cause of death for people ages 10-14 and ages 24-34. To put that in starker perspective, consider this: someone dies by suicide in this country every 11 minutes. 

The tiniest sliver of a silver lining is that not everyone who attempts suicide dies – but the other side of that coin is that the numbers of people who consider or attempt suicide is terrifying. Again according to the CDC, in 2020, an estimated 12.2 million American adults seriously thought about suicide, 3.2 million planned a suicide attempt, and 1.2 million attempted suicide.

When you look at these numbers, it’s not hard to believe that so many of us know someone who has thought about or is thinking about suicide – but it is beyond distressing. So let’s look at some ways to help if you are worried about someone you know.

What You Can Do

If you’re completely unsure what to do in this situation, you’re also not alone. Many of us are so afraid to do the “wrong” thing that we become paralyzed and don’t do anything, but you don’t have to be a trained mental health professional to help! You absolutely can make a difference. 

According to  Doreen Marshall, a psychologist and vice president of programs at the American Foundation for Suicide Prevention, “Everyone has a role to play in suicide prevention, but most people hold back. We often say, ‘Trust your gut. If you’re worried about someone, take that step.’”

And that first step? Reaching out. Yes, it’s as simple as that, since according to experts, people who feel connected are less likely to attempt suicide. So, contrary to what some people might think, your intervention will not make things worse, and talking about suicidal feelings will not make them more likely to act on those feelings. So what can you do?

1. Recognize the warning signs

While we did say that reaching out was the first step, before you can do that, you have to be tuned in and recognize the warning signs of suicide risk. The most important things to look out for are changes in mood and behavior. For example, they might:

agitated woman

  • Stop attending groups or activities they once participated in, or withdraw from other social contact
  • Get more angry, frustrated, or irritable than they used to
  • Seem depressed and/or anxious
  • Have trouble sleeping
  • Feel easily humiliated or rejected
  • Lose interest in things 
  • Become preoccupied with death, dying, or violence
  • Feel trapped or hopeless
  • Start engaging in more risky or self-destructive behavior, such as using drugs, drinking more, or driving recklessly
  • Search online for ways to die, look to buy a gun, or stockpile pills
  • Say goodbye to people, give away prized possessions, or “get their affairs in order”
  • Talk about wanting to end their lives, seeing no purpose, or wanting to go to sleep and never wake up

These are not all of the warning signs, since they will look different for everyone, but it is a good bet that if someone you know is exhibiting a combination of these behaviors, they need help.

2. Reach Out

If you’re worried about your loved one, the next step is to reach out to them, and have that difficult talk – but you can start with a question as simple as “Are you OK?” The most important thing you can do is check in and show that you care, so simply asking them how they are is a more powerful thing than you might think. And, unfortunately, they are very unlikely to reach out to you first, because of the nature of the feelings that they’re dealing with, and because the low state they’re in might make them feel like they’re being a “burden.”

According to DeQuincy Lezine, a psychologist and a member of the board of directors of the American Association of Suicidology, as well as a survivor of suicide attempts, “People who are having thoughts of suicide often feel trapped and alone. When someone reaches out and offers support, it reduces a person’s sense of isolation. Even if you can’t find the exact words [to say], the aspect that somebody cares makes a big difference.”

So if you’re not sure how to begin the conversation, don’t worry so much about it: simply start. Even asking them how they are – really – and asking if there’s anything they need can interrupt the downward spiral they’re in and give you time to help them get help before they reach a true crisis point.

3. Empathize with Them

4 hands holding each other around the wrists
Show support and emphasize with someone who has suicidal thoughts.

You’ve opened up the lines of communication, and that’s an excellent first step. While you’re doing this, though, be aware that you can’t know exactly how they feel – but you can still empathize with them. You can say something like, “I can’t even imagine how painful this is for you, but I would like to try to understand.” Once you’ve done this, you might feel more comfortable with moving on with the conversation, and asking more questions, and they might feel more comfortable answering.

4. Be Direct and Ask Questions

As we’ve already pointed out, you talking to your loved one about suicide is not going to “put ideas into their head.” On the contrary: you’ll be giving them a chance to open up and get the help they need. As long as you’re being sensitive, it’s OK for your questions to be as direct as “Do you ever think about suicide?” Some other questions you might consider include:

  • What do you think of people who kill themselves?
  • Are you thinking about dying?
  • How are you coping with what’s been happening in your life?
  • Do you ever feel like just giving up?
  • Have you thought about how or when you’d do it?
  • Do you have access to weapons or things that can be used as weapons to harm yourself?
  • Can you tell me about your reasons for living and dying? 
  • Have you felt like this before? How did your feelings change last time? 

Listen carefully, and allow them to collect their thoughts and finish their answers. In addition, try to repeat back their words to them, so they know you’re really taking everything in and are understanding what they say as best you can.

And remember, trying to “solve” their problems will not help, and neither will telling them to “cheer up,” comparing their situation to those of others, downplaying the seriousness of their feelings, judging their situation, or telling them you know exactly how they feel. This is not a time to offer advice or distract them – it’s a time to listen.

5. Don’t Panic, but Know the Risk

If you’ve determined that your loved one is having suicidal thoughts, your first reaction might be to panic, and wonder whether you need to rush them to the hospital. In most cases, you don’t have to do that, according to experts, but if you think they are in immediate crisis you should call 911. 

One psychologist suggests asking direct questions like: “Are you thinking of killing yourself in the next day or so?” and “How strong are those urges?” They also suggest that you determine if the person has a suicide plan, since someone who has a plan is at a high risk of acting on it, according to the Suicide Prevention Resource Center: their research shows that 38% of people who have made a plan go on to make an attempt. 

If you think they are in crisis, try your best to stay with them. Be gentle and validate their feelings, but ask them to hold off on their plans. Buying them 24 or 48 hours could allow time for the most intense and impulsive feelings to subside. If you can, remain with them during this time, and if you can’t, or don’t feel equipped, find them immediate medical help or another form of social support. You can also call the National Suicide Prevention Hotline if you don’t feel confident to get them through those crucial hours. 

6. Know When to Step Back and Seek Professional Help

You being there will make a world of difference, but you might not be equipped to head off a crisis, as noted above. If you believe they might attempt suicide, don’t leave them, but don’t try to handle the situation alone:

  • Get help from a trained professional as quickly as possible
  • Encourage the person to call a suicide hotline number. In the U.S., call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor

If you believe they have already attempted suicide, again, don’t leave them alone, and:911

  • Call 911 or your local emergency number right away. Or, if you think you can do so safely, take them to the nearest hospital emergency room yourself.
  • Try to find out if they are under the influence of alcohol or drugs or may have taken an overdose
  • Tell a family member or friend right away what’s going on

And finally, to prevent a future crisis, offer to help your loved one connect with a mental health professional to find out what might help them, and how they can learn ways to manage their mood and suicidal thinking.

7. Take Care of Yourself

Finally, being there for someone is one of the most amazing things you can do, but it can also take a toll on your mental health. Don’t be afraid to reach out if you find yourself struggling. 

Resources

The following resources can help you and your loved one to navigate out of this crisis, so please use these if you know someone who is struggling:

  • The American Foundation for Suicide Prevention has a template for creating a safety plan, since research has shown that having a safety plan can help. It includes making a list of the person’s triggers and warning signs of a coming crisis, people they feel comfortable reaching out to for help, and activities they can do to distract themselves during those times.
  • There are smartphone apps available, like Virtual Hope Box, which is modeled on cognitive behavioral therapy techniques, and websites, like Now Matters Now, which offers videos with personal stories of suicide survivors talking about their own struggles and how they have overcome their suicidal thoughts, both of which can help people feel more connected. 
  • If you or someone you know is in crisis and needs immediate help, call the Suicide Prevention Lifeline at 1-800-273-8255 or go here for online chat.
  • Check out the six questions to ask to help assess the severity of someone’s suicide risk, from the Columbia Lighthouse Project.
  • Find 5 Action Steps for helping someone who may be suicidal, from the National Suicide Prevention Lifeline.

No one should ever feel like they’re alone in this world – and they don’t have to. You can reach out and be a friend and a ready ear for someone in crisis. But if you find that things have gotten out of control, don’t panic, simply refer to the resources above, all of which are there to help. This month, and every month, let’s all work to take care of ourselves and those around us. Together, we might just save a life.

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