MayoClinic, April 16, 2004
Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment — and renewed hope.
Hearing someone talk about suicide may make you uncomfortable. You may not be sure how to step in and help or even if you should take them seriously.
Not everyone who thinks or talks about suicide actually attempts it. But it's not true that people who talk about suicide won't really try it. That's why it is important to take them seriously, especially if they have depression or another mental disorder or are intoxicated or behaving impulsively.
Potential warning signs
You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signals:
Talking about suicide, including such statements as "I'm going to kill myself," "I wish I was dead" or "I wish I hadn't been born."
Withdrawing from social contact and increased desire to be left alone
Wide mood swings, such as being emotionally high one day but deeply discouraged the next
Preoccupation with death and dying or violence
Changes in routine, including eating or sleeping patterns
Personality changes, such as becoming very outgoing after being shy
Risky or self-destructive behavior, such as drug use or unsafe driving
Giving away belongings or getting affairs in order
Saying goodbye to people as if they won't be seen again
Some people don't reveal any suicidal feelings or actions. And many who consider or attempt suicide do so when you think they should be feeling better — during what may seem like a recovery from depression, for instance. That's because they may finally be able to muster emotional energy to take action on their feelings.
Questions to ask
The best way to find out if someone is considering suicide is to directly ask. Asking them won't give them the idea or push them into doing something self-destructive. To the contrary, your willingness to ask can decrease the risk of suicide by giving them an opportunity to talk about their feelings.
You may have to overcome your own discomfort to discuss the issue. Here are some questions you can ask someone you're concerned about:
Are you thinking about dying?
Are you thinking about hurting yourself?
Are you thinking about suicide?
Have you thought about how you would do it?
Do you know when you would do it?
Do you have the means to do it?
Remember, you're not trying to take on the role of doctor or mental health professional or to conduct psychotherapy sessions. But these questions can help you assess what sort of danger your friend or loved one might pose to themselves.
Don't swear your discussions to secrecy. Not only is that an unwanted burden for you, but if you do make such a promise, you risk having to betray that trust if you need to enlist professional help. Don't worry about losing a friendship to mistrust when it's a life that could be lost.
Do be supportive and empathetic, not judgmental. Listen to their concerns. Reassure them that help is available and that with appropriate treatment they can feel better. Don't patronize them by simply telling them that "everything will be OK," that "things could be worse" or that they have "everything to live for."
If possible, assess their home for potentially dangerous items. You may have to remove items that could become weapons of self-destruction, such as guns or knives. But don't put yourself in harm's way, either.
Getting help
If the person is at imminent risk of suicide, call the police or emergency personnel, or take them to a hospital emergency room if possible. Some people who are a danger to themselves may need to get help against their will, such as involuntary hospitalization. If possible, find out if they are under the influence of alcohol or drugs or may have taken an overdose.
If the danger isn't imminent, offer to work together to find appropriate help, and then follow through. Someone who is suicidal or has severe depression may not have the energy or motivation to find help. You may be able to make phone calls to set up medical appointments or go along with them, or help sort through health insurance policies for benefits information.
Many types of help and support are available. If your loved one doesn't want to consult a doctor or mental health professional, suggest finding help from a support group, faith community or other trusted contact.
Offering new options
There's no way to predict for sure who will attempt suicide. And although you're not responsible for preventing someone from taking their own life, your intervention may help them see that other options are available.
Direct questioning, supportive listening and gentle but persistent guidance can help you bring hope and appropriate treatment to someone who believes suicide will offer the only relief.
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