Discussing suicide: How to support someone you’re worried about

Suicide rarely happens without a warning.  It is definitely not comfortable or pleasant when someone who you know and love talks about ending their lives.   You may feel uncomfortable and ask yourself, how and what can I talk to them about it?  The trick is simple:  Always allow the person the time and the space to talk.   It can make the person feel supported and understood.  It may eventually help them put things into perspective.

Watch

Look for the warning signs:  “This hurt will never go away unless I do something about it” could be a red flag.  In children and in youth, artistic expressions on themes of death, hopelessness, pain, and suffering; drawings where the body sizes of figures shrink over time may reflect the suicidal person’s sense of worthlessness. 

Although you cannot always predict suicide, here are a few other warning signs:

  • Verbal statements like, “I wish I were never born” or “I wish I could sleep and never wake up”, “It doesn’t matter anymore; I am not going to here much longer anyway” could be warning signs.
  • Social withdrawal; repeatedly asking to be left alone, refusing activities that the person once enjoyed doing.
  • Increased use of alcohol, drugs or other substances.
  • Getting personal affairs in order, making a will, giving away belongings and valuables, especially when there is no logical explanation to it.
  • Obtaining means for suicide, chemicals, weapons, medicines
  • Self-destructive behaviors, reckless driving, other harmful behaviors
  • Talking about low self-esteem, hopelessness and worthlessness
  • Saying goodbye to people as if they won’t be seen again or writing letters
  • Sudden and/or extreme changes in sleeping and/or eating patterns
  • Changes in work/school performances
  • Changes in life situations:
  • Major loss – in business/finances,  a loved one, home, pet, status, relationship
  • Chronic illness
  •  Natural calamities

Ask

Photo by Liza Summer from Pexels
  • Choose a time and place where you can talk openly and easily, without getting interrupted.  Be prepared for a long conversation, make sure you do not have pressing commitments or appointments.   Choose a place that feels safe.   Choose a time or activity that you can do together if that feels more comfortable.  Sometimes it is easier to talk when you are out on a walk or a long drive or simply while watching TV together at home.
  • Start the conversation.

Some of the simple conversation starters could be:

“I just had a terrible day at work; how was yours’s?”  Or “I noticed you have not been yourself lately, what’s wrong/ can I help? / Want to talk about it?”

  • Be specific:  “Is everything okay at school/at work/at home?
  • Be direct: “Have you been thinking about suicide?”  “Do you feel like life is not worth living anymore?”  And don’t worry.  Bringing it up doesn’t increase their chances on actually acting on it.

Listen

Image by Gerd Altmann from Pixabay
  • Listen to the person’s struggles and feelings with empathy and let them know that you care about them.  Do not judge.  Be prepared to listen if it makes you uncomfortable or upset. Statements like, “I appreciate you telling me this, and how you’re feeling. Thank you for sharing this with me” helps develop trust and understanding.   Open ended questions helps keep the conversation going.
  •   Let the person know that no matter what they have to say, it won’t affect your relationship.  You are there to help, to support them in what they are going through.  Let them know they are not alone in this. 
  • Respect their feelings even if you feel they are not being logical.

What to say?

  • “What’s causing you to feel so bad?” or “What has helped you in the past” or a simple “How can I help?” can go a long way.
  • Offer reassurance
  • Find out if they’ve already made a plan and how do they plan to implement it.   “Have you been thinking about how to kill yourself, or when?”  “Have you taken any steps yet?”  Asking this is extremely important.
  • “Shall I call your therapist?”  Or “Do you want me to drive you to the doctor?”   A suicidal  person may not have the energy or motive to find help. You may not always be in a direct position to help.  Encourage them to seek a professional.  Offer help in setting an appointment.   Connecting them to a support group, crisis center, faith community, teacher or other trusted person may be extremely beneficial.
  • Use terminology that is not stigmatizing.  If you are talking to the family member or a loved one of the person who died by suicide, make sure you use terms that emphasize respect and not stigma.  Sentences like “died by suicide” or ‘took his life”  or “attempted to take his life” are less stigmatizing than “committed suicide” or ’failed suicide attempt”.

What not to say

  •  This is not a time to remind them of ‘what they’ve got going for them’ or “how selfish they are not to think of the impact of their actions on their family”
  • “Don’t be over dramatic” “why are you trying to seek attention this way” “Grow up; don’t act immature” can do more damage than good.   Take them seriously and acknowledge the reasons they want to die.  They are not attention seeking.  They are seeking help.
  •  “I am shocked.  How can you even think of this? “Is not going to help them when they are in a state of ‘impending doom’.
  • “Be grateful for the things you have. ““Things could be worse” or “You have everything to live for”, definitely does not help either.
  • Last but not the least, don’t make promises to keep their ‘suicidal intent’ confidential.   You cannot and should not keep it confidential but confide it to people who are in a position to help.

What’s next?

You have spent time with your friend who feels suicidal.  You have asked, you have listened and offered reassurance.  You have validated their feelings and said all the right things.  It’s now time for you to take your next steps:

  • If you think you friend needs urgent help and has made his decision to end his life, call 911 or a local emergency number.   If the person is willing to accompany you, drive them to the hospital yourself.
  • Do not leave the person alone even for a short period of time.
  • Discourage them from drinking alcohol or using other elicit substances
  • Encourage them to eat healthy and balanced meals
  • Call a friend or family member for assistance if necessary
  • Remove all harmful objects away from their reach if possible.

If you feel the person is not in immediate danger, but still needs help, share your concerns with a person who can help.  It may be hard to tell whether a person is actually contemplating suicide if they have not been completely open with you, and you may be afraid of taking action and being wrong.  But if a person’s behavior or actions raise red flags, the person may be struggling with some major issues, even if not considering suicide at the moment. Getting the person to the right resources may be the best course of action to take.

Key takeaways

If you know someone around you is suicidal, don’t play it down or ignore the situation.  Although you may not be absolutely responsible for someone’s safety, your timely intervention and support may help the person see another perspective Many people who kill themselves have expressed the intention at some point. You may worry that you’re overreacting, but the safety of your friend or loved one is most important. Don’t worry about straining your relationship when someone’s life is at stake.  Maybe you have just been given this unique opportunity to save a life.  Make it count!

adsouzajy

I am Anitha Sara D'souza a mental health nurse and a blogger. If you are looking for help with your mental health issues or the issues pertaining to your loved ones' you are in the right place! You will find all the support you need, here You are a mental health professional or a nurse looking to delve into psych nursing, you will find all the help, support and have your questions answered here It is my mission and my vision to educate my fellow nurses and clinicians that mental health is a disease that needs attention and that there is nothing to be embarrassed about. I chose mental health with a purpose; so that I can help the most vulnerable sections of the society; I chose mental health so that I can help different people in all age groups, to work with people and the illnesses that people hesitate to talk about. Having traveled extensively all my adult life and having practiced nursing in three different countries, across the continents, if there is one thing that I have noticed, it is the stigma that is associated with mental illnesses. This blog is the voice of the voiceless; meant to educate not just those affected, but also the nurses and the professionals looking into venturing into this noble profession.

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17 Responses

  1. This is such an important and well written post. Thank you for sharing this. It’s so important that we pay attention to the one battling these thoughts and know how to communicate. Listening in non judgmental ways are important.

    Pastor Natalie
    Letstakeamoment.com

  2. adsouzajy says:

    Thank you for taking the time to read this. Awareness is definitely the key

  3. suicide is such an important topic and we should all learn how to recognize and help someone who may be feeling this way.

  4. quildon1 says:

    As someone who worked in mental for many years, I give this post 5 stars. It is comprehensive and well written. I hope it reaches many people who really need it.

  5. adsouzajy says:

    Thank you so much. It means a lot

  6. Mae Alexis says:

    Great article on how to effectively be there for someone going through a tough time. Reminds me of the Maya Angelou quote, be a rainbow in someone’s cloud.

  7. Powerful article. Suicide is such a deep and dark road that most are too afraid to even seek help.

    Talking, keeping the lines of communication open and letting these people who are suffering know they are not abandoned or left alone. This is so important for parents and relatives of those going through depression and such.

  8. adsouzajy says:

    Definitely ” be a ? in someone’s cloud”. Yes! We need more of that

  9. adsouzajy says:

    Thank you David. Yes, if are willing to be non judgmental and communicate, perhaps a life or two could be saved

  10. This is so well-detailed and has such good information. I know it’s helpful for me because I have a lot of young people who are going through challenging moments. I really liked when you said to respect their feelings even when I feel they’re being illogical. That will help a lot, not to unintentionally come across as judgemental, rude, uncaring and lacking empathy. Thank you for this!

  11. adsouzajy says:

    Thank you. I am glad you find it helpful

  12. Debbi says:

    I think this is important in all mental health situations but preventing suicide is so important. Suicide along with so many other things is such a taboo subject, its so important for everyone to have someone they can turn to

  13. adsouzajy says:

    Thank you for taking the time to read this. As you said awareness and communication is the key

  14. adsouzajy says:

    Yes, it sure is. Appreciate you taking the time to read

  15. Jean Nie says:

    I wish I read this before, reminds me of someone who was going through something that I am not aware of, I could have been there for her.

  16. adsouzajy says:

    It’s never too late. Someone somewhere always is in some need Thank you for taking the time to read

  17. Blaise says:

    This is a very useful and needed article. It can save lives especially the signs that someone is suicidal. Thank you!

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