Hugs, Help, and Hope: Assisting A Loved One Through Suicidal Thoughts

Monday, May 04, 2015 by Meg   •   Filed under Depression

Why do people commit suicide?

Contrary to popular belief, most people don’t commit suicide because they hate themselves or because they are cowards. They truly believe that their families will be better without them. For most, suicide is seen as a way out. This does not bode well for all who must suffer their loss.

But as the Dalai Lama notes in The Art of Happiness, those who want to kill themselves want to end their suffering, showing that they have at least some self compassion and self love left. I tend to take this approach and see suicidal thoughts as a last ditch effort to make themselves feel better, because somewhere inside they know they don’t deserve to be unhappy. 

You want to die? You love yourself enough to try again.  

But how to drive this point home? How can we help someone who is struggling with suicidal thoughts?

First, let’s do a little background. Understanding matters.

Things that make someone more likely to commit suicide:

  • History of mental health issues such as depression and personality disorders
  • History or current substance abuse issues
  • History of abuse or trauma
  • Family or friend history of suicide, or exposure to suicide in their community or through the news
  • Easy access to lethal stuff (like guns or pills)
  • Major physical illness such as cancer, ALS or fibromyalgia
  • Lack of support or isolation
  • Stigma within their community about asking for help
  • Religious or cultural beliefs that suicide is noble or will be rewarded in the afterlife 

But you won’t necessarily know what type of history someone has unless they told you. So what can you look for in a loved one? 

Suicide Warning Signs

In the early stages, folks may be having suicidal thoughts, but they tend to say that they will not harm themselves. They may possibly have a vague or not very lethal plan. At this point, look for: 

In later stages, individuals progress from a few fleeting thoughts to seriously considering suicide as an option. In this stage, watch for: 

  • Collecting lethal objects, usually guns or drugs
  • Making plans such as writing wills
  • Saying goodbye
  • Giving away pets
  • Changes in mood: Most people look for changes from happy to depressed, from outgoing to withdrawn, signs more typical of sliding into depression. While these are good signs to look for, I also get concerned when I see sudden calm or even happiness after a period of severe depression. This seems counterintuitive, but most people who actually kill themselves feel relieved once they have made the decision to do so. The end is in sight, and they enjoy the relief and the peace knowing it will be over soon. Plus, they are often kinder than usual to those around them as they work towards saying goodbye.  

Okay, so you have some idea of what to look for. Now what? 

How to Help A Suicidal Loved One

  • DO speak up. If someone admits that they are depressed and hopeless, ask if they are having suicidal thoughts. You won’t put the thought in their head; talking about it openly is one of the best things someone in this situation can do. Assure them that the thoughts happen to many people and that they are temporary. Offer hope about the future, tell them that you love them and let them know that you will do what you can to help.
  • DON’T act shocked or freak out, at least not if you want them to come back to you for assistance. Don’t yell, “Oh my god! How can you even say that? We need to get you to a hospital RIGHT NOW!” Stay calm, take a deep breath, sit down and talk with them to assess the situation and determine your next move. 
  • DO assess what they need. MANY people have suicidal thoughts, but the ones in immediate danger tend to have a specific plan and an intention to go through with it. A vague, “I kinda want to die,” without a plan might be a cry for help, a way to express that they want to get out of this suffering and may not require a trip to the emergency room. Even so…
  • DO get help. Even professionals with suicidal friends need assistance. Someone else needs to be made aware of the situation and provide another set of options. Don’t go it alone when dealing with a suicidal loved one. On a related note… 
  • DON’T let them swear you to secrecy. Tell your loved one that while you respect their privacy, this is an issue that needs to be dealt with. You can use it as a way to make sure they get help, as in, “Either you go see this therapist I set you up with, or I will tell mom.” Blackmail is not an ideal situation, but hey, neither is suicide. 
  • DO ask them what they need. Do they need you to stay with them for the night or the weekend? Do they need you to make an appointment with a doctor and drive them? Do they need you to be on call so they have someone to talk to if a scary thought pops up? Can you go jogging with them in the evenings to help them get out of the house and release some feel good endorphins? Give them control of their bodies and offer to provide what they think they need at that moment. Autonomy matters, particularly when one feels their life is spinning out of control. Give them power where you can, but.…
  • DO make a safety plan. If they are having thoughts but don’t have a plan, ask them to agree to call you or an ambulance if they feel like they will harm themselves. Program the police numbers into their cell or home phone. Put the number for the National Suicide Prevention Hotline in there too (1-800-273-8255). Add a link to National Suicide Prevention online to their computer. If they own a gun or have a stockpile of tranquilizers from oral surgery last year, take them with you, second amendment be damned. Even if they are not ready to commit suicide that day, there is not reason to make it easy should they change their mind. And if they have a plan and intent, don’t leave them alone. 
  • DON’T argue with them about their feelings. “You have so much to live for!” will fall on deaf ears and probably shut them down. Listen to them and respect their feelings even if they scare you or you disagree. 
  • DO visit often and follow up on their progress with treatment. If your loved one is dealing with thoughts but not a plan, make it a point to call or visit often (If someone is actively suicidal with a plan, again, don’t leave them alone). During those calls or visits, see how they are feeling and offer an ear or a hug. Ask about therapy. While they might not tell you all about their progress with their shrink, it’s enough for you to know they are going. Just be sure to be proactive and don’t wait for them to call you; as one of the main thoughts often revolves around being a burden, the odds of them stopping by your place are slim. 
  • ALWAYS TAKE THREATS OF SUICIDE SERIOUSLY, whether they threaten once, twice or a hundred times. If someone says they are having suicidal thoughts but they don’t have a plan, stay with them and make them an appointment with a professional. If someone tells you they want to kill themselves and they have a plan to do so, drive them to the hospital. NOW. If you’re on the phone and too far away to pick them up, call an ambulance or the police. Even if you suspect that the person is trying to use it as a control tactic (e.g. they tell you they will kill themselves every time you try to leave them, as in narcissistic relationships) take it seriously and call the police so they can go and pick him up. Worst case scenario, he’ll be pissed because he isn’t suicidal. Best case, you saved his life. Err on the side of everyone living. 
  • DON’T blame yourself. We love to think that we are omnipotent, but I can’t even get my kids to brush their teeth let alone exert power over all other creatures in the world. You cannot cure someone else’s depression. You cannot take away their suicidal thoughts no matter how much you love them. All you can do is be there to support them while they work through these issues. And if someone you love did commit suicide, avoiding self blame will be the biggest gift you can offer yourself. Give yourself the same compassion you would have given them. 
  • DO offer additional resources. Leave a copy of Suicide: The Forever Decision or Out of the Nightmare: Recovery from Depression and Suicidal Pain on their bedside table. 

For more on healing after a suicide, read Robin Williams and the Evolution of Survivor’s Guilt, PTSD and Surviving Suicide and Trauma Treatment Alternatives. And pick up a copy of Night Falls Fast: Understanding Suicide along with Healing After the Suicide of a Loved One for more on coping with tragedy. 

There is always hope and there is always help, whether you are the one contemplating suicide or the one left behind. 

You are not alone.

Related Posts: 


Topic-Relevant Resources

Night Falls Fast: Understanding Suicide
Great insight into the whats and whys of suicide, along with helpful tips on identifying these issues and coping after loss.

Healing After the Suicide of a Loved One
Coping tools and insightful, compassionate explanations of the process of grieving after loss to suicide.

Against Depression
Detailed explanations of the systems involved in depression along with personal stories of success from psychiatrist Peter Kramer.