How to respond when a friend is suicidal

With the recent tragic suicide, people are passing out suicide helplines in hopes of giving people another option, and scientific articles and analysis to try to understand the mind of people suffering. But what often gets left out is guidance on how to handle that point of stark reality that occurs when you find out that someone you care about is suicidal. Maybe you saw the warning signs. Maybe the person trusted you enough to reveal their secret.

So what do you do?

1) Before you do anything else, you need to check your own baggage at the door.
One of the biggest mistakes people make when responding to a person in crisis is that they don’t realize when they are putting their needs ahead of those of the person in crisis. People don’t realize how easy it is to put their need to solve a problem ahead of the actual problem, or they don’t see when their need to be seen as the savior eclipses the needs of the person suffering. But when they lose sight of that, they risk trying to make the problem go away or risk shaming a person for not accepting help that is not helpful. If this happens, the person in need will silence him or herself to take care of you, and hide the problem and isolate more. When dealing with people in suicidal crisis, this push to shame them for their needs can dangerously inflate the sense of being a burden that is a risk factor for suicide.

2) Talk to your friend. More importantly, listen to your friend. Do not fight with your friend.
The last thing you want to do is shut this person down. If you try to minimize or dismiss their problems, you are focusing on your needs, not his/hers. In addition to feeling like a burden,  suicide risk is connected to a sense of of being disconnected from others. Your goal is to reconnect to them and remind them their needs are not a burden to you. Any attempt at argument distracts from this. They will tell you things that may be hard to hear, but the more you can get them to discuss their suicidal feelings and thoughts openly, the more they will feel connected to you. When they tell you the hard truths, thank them for being that vulnerable with you. Don’t try to find solutions for their problems, provide the empathy and connection to make the problems less painful.

3) Get them to professional help.
You can’t save them on your own; this is too big for you. Give them the numbers for suicide helplines (also here). Get them connected to a therapist. If you are at college, walk them to the college counseling center. This is the only point where you should stand firm if your friend disagrees. Argue if you must, but persuasion works better, and if you’ve done a good enough job listening to them, they should be willing to listen to you on this. They don’t actually want to die, they just don’t want to go on living in the state they are in, so selling them help as a way to change the situation can work. Something to also emphasize is that the risks of getting help are low compared to the risks of not getting help. A common myth is that seeking help automatically results in commitment to some dehumanizing mental hospital. The truth is that a mental health professional has a duty to balance safety with the duty to maintain the freedom of your friend, will assess the severity of the suicidal thoughts, and will only take extreme action when the risk is immediate. If you find your friend when the risk is immediate, call 911.

4) Keep them away from alcohol, drugs, and guns.
There are a lot of people who think that you are helping a person by getting them to take the edge off with drugs or alcohol. But think about all those great party stories involving you getting drunk or stoned and barely but spectacularly avoiding death due to some impulsive act. Now imagine how that story would change if you were looking to die. But even worse, if you are looking to have a person self medicate their problems away, if they see life as the problem, you are actually encouraging self euthanasia.
As for guns, having one in your home makes you statistically 5 times more likely to kill yourself. When a person is actively suicidal, you need to put politics and propaganda aside and protect your friend. You don’t actually want to have to pull a gun from your friend’s cold dead hand.

In the end, the best thing you can do is to take your friend seriously, connect him or her to yourself and other, and make sure they get real help. Don’t let fears, judgments, politics, or anything else get in the way. The only thing that matters is removing the sense that they are a burden, removing their sense that they are disconnected, and making sure they are under the care of the professionals who can do the deeper work.

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2 thoughts on “How to respond when a friend is suicidal

  1. Lydia

    So I have been struggling with whether to write here or not. My decision to do so came from fear. You see I realize if I feel afraid, then I must value my life in some way. But something, or rather this strange feeling of an inner someone seems to have it out for me. I find myself with this feeling of slices of selves or something. Like there is many more than just me here inhabiting this body, and they do not care all for it as much as I do. I am aware that there is a slice that continuously thinks about ways to kill my body just in case they need to. But like I said before I value myself so this really scares me. I don’t even know if what I’m saying makes sense with all these slices. I don’t want to die. And I don’t want to go to the hospital. But I know I need to be safe. How do you talk your inner slice off a ledge?

    • Lydia. I have met very few people who want to go into the hospital, but your safety needs to be the number one priority. If you are in crisis, if you are in a state of danger, the best thing is to call the crisis line or 911, even if that ultimately results in a short stay in the hospital. Your life is important enough to protect even if doing so means a hospital stay.
      If you are not in a crisis state, but just afraid, then in section 3 of this post, there are hyperlinks to suicide hotlines. Please use them to get the support you need to keep from going into crisis. The sooner you seek help when the bad times come, the less likely you will find yourself in the need for a hospital stay.
      As for the battle with yourself, this is a fight you should not be having on your own. You did not get put in this position by yourself, so you should not have to face it by yourself. Many people do have a self destructive part the fight with, but the key to finding peace is a journey too personal and individual for it to be stated in the comment section of a blog. So I once again need to urge you to find a good therapist (you can find one by calling your insurance company, and your state’s psychological society should have a referral system) in order to take you on this very personal journey,
      And remember, you are not in an impossible situation, just a very difficult and painful one. When you get the right help, you will eventually find the point when you can live the life you want. You just have to make sure you can get yourself to that point. Call a crisis helpline when you need help to keep from slipping into a crisis, and, if the choice is between going to the hospital and putting your life in danger, please call 911.

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