Can we talk about suicide? I know this is a difficult topic and that for some people even the mention of suicide brings back painful memories of family members or friends who have died by suicide, and the fear about the impact of suicide. But it’s so important that as a community we know what to do when someone we love tells us they have suicidal thoughts, or if you yourself have suicidal thoughts. So, it’s important to push past the discomfort and talk openly about suicide.
When life feels overwhelming it can be within the normal responses to have thoughts like “I wish I didn’t have to keep going” or “It would be better if I wasn’t here.” It’s normal to have times when you feel like giving up. Most people do at one point or another. These thoughts become scary when they start to feel like a real option and it becomes more than just a passing thought. Let’s talk through what to do if someone tells you they have suicidal thoughts.
If you have a child, or someone else close to you, who tells you they have thoughts of killing themselves, first, take a deep breath and realize that coming to you and telling you this is most likely very difficult for them. Second, the fact that they are talking about those feelings is a good sign and it opens the conversation in a way that gives them options to get help. So after they tell you about their thoughts, take some time with them to acknowledge the strength it takes to talk about it. It’s okay to feel sad and to have other emotional reactions to what they are telling you, but keep in mind that they are reaching out for help and this is a good sign. With all of the emotion swirling around in you, take a moment to express gratitude to the person for being willing to reach out. This is a big step for them.
As a therapist, when someone tells me they have suicidal thoughts, I have a list of questions that I have been trained to ask. Even though the conversation can be difficult, it’s important to understand what the person is experiencing. I will ask how long they have had these thoughts, this gives me an idea of if this is a new experience for them or something they have been dealing with for months or years. I will ask what the thoughts specifically are, and when it’s difficult for them to share I will remind them that I’m here to help and not judge. I will ask if they have a plan to kill themselves and what that plan is. Again, I know asking these questions is difficult but it usually does not come across as a shock to the person since its something they’ve been thinking about.
I ask these questions to understand what level of help they need, and together we can create a plan to help keep them safe. For example, if the person says they are passive thoughts like “it would be better if I was dead” without a specific plan and with no intent to kill themselves, then therapy is a great place for them to be so they can talk openly about it and work on how to stay safe. If the person does have a plan to kill themselves and they don’t feel confident that they can keep themselves safe, then it’s important to get them the immediate help they need. This most often means going to the hospital and working with the emergency care team to get supervised help.
Sometimes I hear people talk about suicide in a judgmental way, for example I have heard people say that suicide is a selfish act. Suicide is not selfish, it’s desperate, and lonely, and it’s often very painful and confusing. It can also feel that way for the family and friends who are left behind.
I recently had a friend die by suicide. When I first heard about it, I felt overwhelmed by sadness. My body ached for him and how alone and hopeless he must have felt. I felt confused and mad at myself that as a therapist I didn’t see it coming and that I couldn’t stop it. My mind went over and over our most recent conversations trying to find what I had missed. In the last few months I have felt waves of different emotions, mostly grief for the loss of my friend. There are times I feel angry at him for making the choice to end his life. It’s been important for me to acknowledge these emotions and to also remember that he must have been in so much pain. It has been helpful for me to talk to people about him and about how I feel. I miss him. As I honor my feelings of grief and loss, I feel like it also honors him and the impact he had on me.
As a community we have to be willing to talk about suicide. It’s difficult but the alternative of losing friends and family members to suicide is much worse. Don’t hesitate to get help if you or someone you care about is having suicidal thoughts. You are not alone.
National Suicide Prevention Lifeline – 800-273-8255
Utah County Crisis Line – 801-691-5433
APA Suicide Prevention Webpage