As sensitive a topic it is, it’s not obvious to most of us, otherwise, we’d see the signs.
People are hurting. They want the pain to end. They’ve been dragged down by the weight of this invisible burden like a ball and chain on their soul. You may not see that or know much about their struggle.
There are three steps you can take when you’re talking with someone who’s struggling and thinking about suicide. They may or may not have a plan. Whether or not they are intentional about acting on the desire, you can still be keen on addressing this.
Having a healing conversation with someone is not natural, nor is it easy. There are tools you can learn to start talking to others, though.
Observe to Identify
The first step is to observe. It takes intentional effort to see if someone is suffering under an invisible, unbearable weight. Through spending time with them, take moments to dig deeper to understand how they’re really doing. Make an opportunity if you need to.
If someone is especially close to you, you may not see their struggle as well as you thought. This could be a spouse, family member, or close friend. No one else is inside your mind to know exactly how you feel, think, and believe. That’s a universal truth. It may be harder to confide in a family member or a best friend because you’re so important to them, and they might want to hurt you least.
Take time to observe their behaviors to see if they’re enduring psychological distress. Note any changes in energy changes — if they’re less responsive than usual, or more energetic than normal. Note facial coloring in skin tone (grayer than usual), and the light or lack thereof in their eyes. If anything is outside the normal range, dig a bit deeper.
This first step also involves discussing the possibility of them wanting to end their pain. As someone who has lived experience with suicidality, I find the “myth” of mentioning suicide won’t lead them to do it to be skewed. I look back on my life and know that as the pain worsened, suicide came into focus more so when a loved one questioned me about it. Whether I’d already thought of the idea of killing myself had been stirring around my head, or if suicide was a new revelation when the loved one mentioned it, I don’t know which came first. Regardless, the way you bring it up to them is something to do with care, wisdom, and gentleness.
Using a tender approach at the right time is one step in identifying where they are at mentally. In mental healthcare settings, we often ask a series of questions that can become rote and less poignant:
In the last 2 weeks, how often have you:
Had little interest or pleasure in doing things?
Felt down, depressed, or hopeless?
Had trouble falling or staying asleep, or sleeping too much?
Felt tired or had little energy?
Had poor appetite or overeating?
Felt bad about yourself — or that you are a failure or have let yourself or your family down?
Had trouble concentrating on things, such as reading the newspaper or watching television?
Been moving or speaking so slowly that other people could have noticed? Or so fidgety or restless that you have been moving a lot more than usual?
Had thoughts that you would be better off dead, or thoughts of hurting yourself in some way?
Please, don’t take this list to run through with your loved one. But do take note of these things. Especially the last question. In light of Suicide Prevention/Awareness month – September – we need to consciously educate ourselves and be reminded of the seriousness of this kind of conversation.
When you and your loved one have identified there are in fact feelings, thoughts, and/or plans toward suicide, the next thing to do is to ask them some clarifying questions.
Ask to Clarify
Listen to better understand their pain. And see if they are planning to end it all in some form or fashion (only once you’ve established they actually want their life to end). A plan involves a date and method.
Asking an open-ended question is key to starting the discussion. “Are you thinking you want your life to be over?” is one segway question. Take a pause, and wait for an answer. Silence can be uncomfortable, but necessary to get to the truth. When they’re done speaking, mirror what they said, repeating their answer back to them.
Leave plenty of room to let them be honest. This means steering clear of judgment. Be conscious of your inflection, too. If you sound condescending in your tone of voice, they may recoil. At this point, once the discussion is opened, you need to commit to being a safe person.
Let them confide in you and be that soft place to land. Try to listen well and paraphrase back to them what “it sounds like” they’re saying. If your paraphrase is correct, you don’t have to agree with them. But, at this point, do validate their feelings they’ve so bravely shared. Affirmations and validation can be instrumental in gaining rapport and their trust in you.
Obviously, this subject matter can get heavy quickly. After all, that’s how the burden usually feels — heavy. But this is a good place to be honest with them and be a safe person to turn to.
By being honest with each other, they may be able to see a little clearer through the fog of their depression. During my years as a clinician, working with others who have suicidal ideation overcame when they were engaged in professional counseling and therapies to recondition their suicidal thinking into appropriate thoughts.
But with patience, love, and tools like these, talking about their burden and hurt is an important first step to unlocking why they feel this way. The last step is crucial to follow as well.
Bring to Support
If they’re stuck in a rut with depression or anxiety, it’s always a good idea to bring them to support lines. You don’t want to keep going in circles rehashing what they feel, and why. That’s where a good therapist using Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, or another form of talk therapy is beneficial.
None of us want to feel down, depressed or hopeless. We wouldn’t feel that way if it were up to us. But we do. Our hearts get jaded and attitudes get turned around when we lose hope. On top of a clinical condition of depression, we can’t change our minds in our own strength.
With medication, therapy, and putting in the work, the depression and anxiety can be resolved. I recommend finding a Christian therapist. Therapists keep things confidential and are there to be trusted, to encourage us, and help us find thinking patterns that challenge our condition of hopelessness and cognitive loops.
When I was at my lowest points, my therapist was a rock to me. So was God, ultimately. But a well-trained therapist can pinpoint our mental and spiritual “pressure points,” if you will, and help us identify the erroneous thought patterns and replace them with truth and healthy thought patterns.
There are numerous supports out there that I can recommend, and I will list just a few here. For a more thorough, vetted list of resources, access your copy of my free e-book on my site here.
Fresh Hope for Mental Health, local and online support groups, hope coaches, training for loved ones to support those with a mental illness
Spiritual First Aid, curriculum for training church leaders and those serving others who are feeling suicidal
Church Mental Health Summit, online free event October 10th each year
Crisis Intervention Team, for training first responders
