Helping Your Suicidal Loved Ones

September is National Suicide Prevention Month, so let’s take some time to talk about suicide. I have recently seen many valuable conversations surrounding the idea that National Suicide Prevention Month should not be limited to “check in with your friends,” and I strongly agree with that. There are many systemic issues that lead to suicide and in order to truly “prevent” suicide, they need to be addressed. These issues include but are not limited to:

• Oppressed populations experiencing higher rates of suicide than other groups (example: Indigenous Americans and the LGBTQ+ population)
• Poor access to mental health services
• Ableism (discrimination and social prejudice against people with disabilities or who are perceived to have disabilities) making it difficult for people who need help to reach out

This blog post is about how to help someone who is suicidal, but this conversation cannot be had without acknowledging the larger issues that lead to suicide. I could (and may), write a completely different post about these issues, but please keep them in mind as you think about helping those you care about.

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​When I talk about my job with people outside of the field, I notice that they tend to get uncomfortable when I mention that I work with people who are suicidal. There’s something about that word or idea that people tend to shy away from, or see as “taboo,” but suicidal thoughts are not something to be ashamed of. Suicidal thoughts are more common than you’d think and are a symptom of great inner pain. 

Our brains are very efficient problem solvers. When presented with a problem, for example, high amounts of stress, our brains work to come up with the quickest and easiest solution to stop that stress. Often, that solution is distracting ourselves with our phones or ignoring the stress, even if that’s not the healthiest response and the stress comes back to bite us later. For someone in deep physical, mental, and/or emotional pain, a solution to stop that pain would be to not exist anymore. Suicidal thoughts can be someone’s way of trying to solve the problem of pain, even if it’s not the solution we would want them to take. There are other options to solve the problem of pain, they can just require more work and do not always have immediate effects. These thoughts are not a sign of weakness or selfishness, but are simply one’s way of trying to manage their hurt. 

​Suicidal thoughts also exist on a spectrum. On one end of the spectrum, someone might be having thoughts like, “I wish I could just sleep forever so I didn’t have to feel this way anymore.” If we keep moving down the spectrum, another thought might be “I want to kill myself so I won’t be experiencing this pain.” On the other end, you might have a thought like, “I am going to kill myself on Saturday night by using those pills I saw in mom’s medicine cabinet.” 
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These thoughts are not a sign of weakness or selfishness, but are simply one’s way of trying to manage their hurt. 

​Now that you’ve read about some of the basics, here are some ways to help or get involved. If you are worried that someone you know might be experiencing suicidal thoughts, there are some things you can look out for. The following list, taken from Suicide Awareness Voices of Education, can be warning signs of suicide: 

• Talking about wanting to die or to kill oneself;
• Looking for a way to kill oneself;
• Talking about feeling hopeless or having no purpose;
• Talking about feeling trapped or being in unbearable pain;
• Talking about being a burden to others;
• Increasing the use of alcohol or drugs;
• Acting anxious, agitated, or reckless;
• Sleeping too little or too much;
• Withdrawing or feeling isolated;
• Showing rage or talking about seeking revenge; and
• Displaying extreme mood swings.

If you notice someone you love showing some of those warning signs, you might become worried and wonder what to do. The Suicide Prevention Lifeline has some suggestions to help. Let’s talk about these:

• Ask: Start by asking if they are experiencing any suicidal thoughts or desires. There is a common misconception that if we talk about suicide, that will put the idea in someone’s head and then they will be more likely to hurt themselves. Research tells us that this is not the case! When you are able to acknowledge directly that someone is in pain, there is often a sense of relief in that person that someone cares enough to ask. 
  
  Yes, this is a challenging topic, and when we are uncomfortable, we tend to shy away from words like ““suicide,” “killing yourself,” and “self-harm.” When we are visibly uncomfortable with those things, it sends a signal to the person that is experiencing suicidality that those aren’t okay topics to discuss, which leads them to close off and fear reaching out for help.
  
  When asking someone about their suicidal thoughts, it is best to be as direct as possible and to seek specific answers. Asking questions such as “Have you been experiencing thoughts of suicide recently? To what extent? Do you have a plan?” etc. can be much more helpful than a generic “How have you been doing?” which can easily be brushed off with a “fine” or “okay.” The direct questions signal to someone that you are a safe person to talk to about these things, you won’t freak out if they mention those words, and are more difficult to avoid answering directly.
  
  
  
• Be there: Once you ask someone if they are experiencing suicidal thoughts, and they say yes, this is the time for you to step up. 
  
  There are many ways to “be there” for someone. It can be helpful to ask, “Is there anything I can do for you?”, but sometimes, a suicidal individual does not have the mental or emotional energy to figure out what might be helpful. Instead, provide suggestions and see if any of them stick. For example, you might say something like: “Thank you for sharing that with me, I know it’s not easy to talk about. I would like to do something to support you while you’re dealing with this. Would you like it if I sat with you for a little bit, or spent the night so you aren’t alone? Or maybe I can make a point to call you every night this week just to check in. I can also pick up some dinner for you on the way home from work tomorrow and we can eat together or I can just drop it off so you can have some alone time. Do any of those sound like they would be helpful?”
  
  Often, people who are experiencing suicidal thoughts believe that they are a burden to everyone in their lives and that their loved ones would be better off without them. When you are expressing your desire to support them, make sure you emphasize that you don’t think they are a burden, that they are important to you, and that you actually want to help them, not that you feel you have to.
  
  
  
• Keep them safe: When you ask someone if they are experiencing suicidal thoughts and they say yes, there are some important follow up questions you can ask. One, you can ask them if they have a plan. If they say yes, ask what it is. Then, you can determine whether they have access to that plan. For example, if your friend tells you that they have a plan and they are going to take their roommate’s pain pills, you can now work with the roommate to find a safe hiding place for their pills so that your friend no longer has access to those pills. As expressed on the Suicide Prevention Lifeline Website, “A number of studies have indicated that when lethal means are made less available or less deadly, suicide rates by that method decline, and frequently suicide rates overall decline.”

If someone expresses that they are actively suicidal (meaning that they tell you they have a plan, they have access to the means to carry out that plan, and they have the intent to carry out that plan), it might be time to seek professional help. Offer to sit with them while calling the National Suicide Prevention Hotline at 1-800-273-8255 or in the state of Georgia, you can call the Georgia Crisis and Access Line at 1-800-715-4225. If more immediate assistance is needed, call Emergency Medical Services and stay with the individual until help arrives. 

See the end of this post for a more detailed list of suicide crisis lines.

• Help them connect: As mentioned earlier, one of the warning signs of suicidality is withdrawing and self-isolation. This can be an effect of not having enough social energy or because one feels their friends don’t actually want to spend time with them. By coming to them, you can ease the amount of energy the individual has to expend, but you also are letting them know you want to spend time with them. Help connect the individual to their support system, and if they don’t have one, assist them in building it. Bring them out with you, help them get involved in local religious organizations, connect with co-workers, or even offer to take them to a therapist.
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• Follow up: Don’t let your care end when the crisis ends. Continue to reach out to the individual who shared their suicidal thoughts with you. Your continued effort and connection can make a huge difference for someone who can easily get trapped within their depression. By setting up a habit of checking in, you are continuing to show your love for that person and can help them get support again if they need it, before they reach the same level of crisis as before. 

As you are working to care for someone in such deep pain, make sure that you are also being taken care of. Crises are challenging for both those experiencing the crisis as well as those supporting the individual experiencing the crisis. By taking care of yourself, you are able to have the time and energy to devote to your loved ones to show them you care and want them around.

Below is a more comprehensive list of national suicide crisis lines (taken from this Wikipedia page):

• 911 is the national emergency number in the United States.
• The National Suicide Prevention Lifeline         (http://suicidepreventionlifeline.org/) is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress.[42][43] It provides Spanish-speaking counselors, as well as options for deaf and hard of hearing individuals. It is only available in the United States.[44] A 24-hour an Online Chat in partnership with Contact USA[45] is also available.
  • The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and in 2019, the use of 988 was approved.[46][47]
  • The National Suicide Prevention Lifeline (ESP) can be reached at 1-888-628-9454
  • The National Suicide Prevention Lifeline (Deaf & Hard of Hearing Options) can be reached at 1-800-799-4889
• The Veterans Crisis Line (https://www.veteranscrisisline.net/) is a 24-hour, toll-free hotline that provides phone, webchat, and text options available to military veterans and their families. It provides options for deaf and hard of hearing individuals.
  • The Veterans Crisis Line can be reached at 1-800-273-8255, followed by Pressing 1.
• IMAlive Crisis Chatine (www.imalive.org) is a non-profit, worldwide 24/7, anonymous chatline to help anyone in crisis via instant messaging.
• The Crisis Text Line (crisistextline.org) is the only 24/7, nationwide crisis-intervention text-message hotline.[48]
  • The Crisis Text Line can be reached by texting HOME to 741-741.
• Samaritans USA (http://www.samaritansusa.org/) is a registered charity aimed at providing emotional support to anyone in distress or at risk of suicide throughout the United States.[9]
• The Trevor Project (http://www.thetrevorproject.org/) is a nationwide organization that provides a 24-hour phone hotline, as well as limited-hour webchat and text options, for lesbian, gay, bisexual, transgender and questioning youth.[49]
  • The TrevorLifeline can be reached at 1-866-488-7386.
  • TrevorChat can be found at https://www.thetrevorproject.org/get-help-now/ (available 7 days a week from 3PM to 10PM ET).
  • TrevorText can be reached by texting TREVOR to 1-202-304-1200 (available M-F from 3PM to 10PM ET).
• The Trans Lifeline (https://www.translifeline.org/) is a nonprofit organization that is created by and for the transgender community, providing crisis intervention hotlines, staffed by transgender individuals, available in the United States and Canada.
  • The Trans Lifeline can be reached at 1-877-565-8860.[21]