You may be reading this because you have a close friend who is struggling with their mental health. It is normal to feel scared, worried, or confused. Mental health, and specifically suicide, are not easy topics to talk about. Suicidal ideation, having thoughts or plans about suicide, is not uncommon, and it is especially prevalent among young adults ages 18-25. Opening up a dialogue with your loved one is incredibly important and can initiate the process of getting them the mental health treatment they need. Starting with resources like this one can help guide you in supporting both yourself and your loved one.
Recognize the Signs
It can be helpful to know the signs that someone might be struggling. Keep in mind that everybody is different, so these will depend on your friend’s unique situation.
Withdrawal: Your friend begins to withdraw from their work, family, or social life. They no longer engage in activities they once found pleasurable.
Hopelessness: Your friend expresses feelings of hopelessness or worthlessness. Their mood is low and depressed.
Habit changes: Your friend is sleeping excessively or having trouble falling asleep. They have changes in their appearance or hygiene, and/or you notice changes in their appetite or eating patterns.
Unsafe behaviors: Your friend engages in dangerous behaviors. They use alcohol or drugs excessively. They are acting impulsively.
This list of signs is not exhaustive, and it is always a good idea to check in with your friend if you are feeling worried about them. It is best to have this check-in occur in person (rather than via text) and in a private space where both parties feel comfortable speaking openly. You can break the ice by saying: “Hey, I’ve noticed you haven’t been yourself lately. How can I be there for you right now?” It is a great way to create space for your friend and show that you care.
How to Talk About Suicidal Ideation
Your friend may express worrisome thoughts to you and make statements such as “The world would be better without me” or “Things will never get better.” It can be hard to hear statements like these from someone you really care about. It is also likely difficult for your friend to open up about how they are feeling. Thank them for opening up to you and sharing their experience. You can offer them support by actively listening to what they are saying, through your verbal responses and body language. It is a time to show compassion and empathy.
Try responses that validate their experience, reaffirm your support, and show that you believe them. Avoid invalidating phrases such as “You have so much to live for,” “You just want attention,” or “Your problems aren’t that bad.” These phrases are unhelpful, as your friend might think you are judging them, undermining their feelings, or not taking their pain seriously.
An individual’s statements that loosely or directly refer to suicide, with other signs that they are struggling with their mental health, may lead you to believe they are thinking about suicide. There is a common misconception that asking an individual if they are suicidal increases their risk of suicide or suicidal thoughts. In fact, the opposite is true. It is important to ask your friend explicitly: “Have you been having thoughts of suicide or killing yourself?” It is a time to check for immediate safety and get a clear answer. Ask follow-up questions about whether your friend has tried to hurt themselves already, if they have a plan or timeline to hurt themselves, and if they have access to anything dangerous.
If your friend is at immediate risk of self-harm or suicide, call 911, 988, or have them go to their nearest emergency room. If you are not physically with your friend, stay on the phone with them until emergency services arrive.
If your friend is experiencing suicidal ideation without the intention of harming themselves or carrying out a plan, ask how you can be there for them. Encourage them to seek help from a licensed mental health professional, such as a therapist or psychiatrist. Your friend may ask you to keep their thoughts or struggles a secret. For their safety and well-being, do not promise to keep this a secret and reinforce the need for a larger support system. Remind them that they are not alone, and still, you are not a professional with the capacity to support them in the way they need right now. After this initial conversation with your loved one, you can check back in and let them know that you are thinking about them. You can also send them 24/7 crisis resources, including the 988 Suicide and Crisis Lifeline.
Self-Care Matters
You may have heard the phrase: “You can’t pour from an empty cup.” When helping loved ones, you must also take care of yourself. Even experienced mental health professionals are not immune to feeling burnout and compassion fatigue from helping others through traumatic events. It emphasizes the importance of self-care, which can be anything from meditation to exercise to journaling. Practice self-compassion and set healthy boundaries with your loved ones. If it feels like your friend is relying heavily on you, directly communicate your limits and encourage them to seek additional support from professionals with formal training in crisis intervention. Practicing self-care and setting realistic expectations for how much you can give will ultimately protect you, your friend, and your friendship in the long term.
