When it comes to suicide, we often operate from crisis mode. A lion’s share of the education around suicide prevention assumes that someone is actively harming themselves or on the verge of making a deadly decision.
The reality is that suicidality exists on a spectrum. There’s an under-discussed gray area where people are struggling with their mental health to the point where they just don’t want to deal with it anymore; they don’t have a plan in place, but they don’t feel very invested in living, either. And more people live in that gray area than you might think.
This is called passive suicidal ideation. According to the US Centers for Disease Control and Prevention, the number of people who experienced suicidal ideation in a given month during the pandemic more than doubled since 2018. However ― given that many people don’t openly own up to these thoughts or don’t believe their detachment from being alive falls into the “suicidal” category ― it’s likely the number of people with suicidal ideations could be higher.
“It is not a good thing when someone is having suicidal thoughts, but it does not have to mean that there will be a bad outcome because of it,” said Dan Reidenberg, executive director of the Suicide Awareness Voices of Education. “With the proper care and support from many people, someone who has these thoughts can get through them and move on to living a healthy and productive life.”
Demonstrating that care and support lies in what you say. If someone you know just opened up about not wanting to be alive – whether to you personally or on social media – there’s a right and wrong way to handle it. Some comments that come from a good place can still perpetuate stigma and shame.
Below, experts share some of the phrases to avoid and what to say instead:
“Just ignore the thoughts, they’ll go away.”
As uncomfortable as it may be, it’s important for your loved one to feel their feelings, says Sherry Davis Molock, an associate professor of clinical psychology at George Washington University. Ignoring them only buries them deeper – it doesn’t address the problem.
“Don’t talk the person out of how they’re feeling, because how they’re feeling is legitimate,” Molock says.
“You’re not thinking about suicide, are you?”
Tone matters more when it comes to this phrase. If you ask with genuine concern to assess your loved one’s state, that’s fine. But if you’re asking incredulously, it can be harmful.
“It doesn’t sound like saying this would be dismissive, but it is,” Molock says. Saying this subtly sends the message, “I’m not ready to have this conversation with you, so I want you to confirm for me that’s not what you’re thinking,” she explained.
Telling someone that they’re overreacting or being dramatic is dismissive and minimizing.
“You are, even if you don’t mean to, telling them, their experience and their feelings don’t matter or are wrong in some way,” sys Jessica Gold, an assistant professor in the department of psychiatry at Washington University in St. Louis.
“For someone that is struggling – and may have really struggled to even tell anyone how they feel – this can really make them retreat and not want to talk to anyone,” she continued. “It can also make them judge themselves even more for how they are feeling and the fact that they can’t seem to get better.”
“Suicide is wrong/bad/a sin.”
“Whatever beliefs you may have about suicide, they are just that ― your beliefs,” Gold says. “This is about your loved one and where the conversation takes them. Your job is to listen and be there for them. Your job is to help them. You should not be putting your beliefs, especially ones that could add further judgment and pain, onto them.”
“You’re feeling this way again?”
It doesn’t matter if someone has experienced these types of thoughts before. Suicidal ideations can happen one time or a thousand times – and each one is serious and likely debilitating for your loved one.
“No matter how many times this has happened for the person, each time is different, so it is always real to them and should be for you, too,” Reidenberg says.
“But your life is so good.”
“Suicide is much more complicated than any one thing, and even people who have all of the on the surface ‘great’ things in life can still feel like their life isn’t worth living – see someone like Robin Williams or Anthony Bourdain,” Gold says.
“Reminding them of an arbitrary list of reasons is not going to make them all of the sudden feel better and more likely will feel minimising of their actual experience and they might feel worse … listen, empathise and validate their experience instead,” she adds.
How to support someone who doesn’t want to live
Make no mistake: thoughts of suicide ― even if someone isn’t in crisis ― shouldn’t be ignored.
“When someone tells you that they have suicidal thoughts, it is important to take them seriously, but it is also important to understand the nature of their thoughts in context,” Gold says. “There is a difference in how imminent their risk of harm to themselves is based on the thoughts ― just having thoughts is not an imminent risk.”
The first step you should take is to try to determine where they’re at in their thinking. Gold said to ask them if they have a plan to hurt themselves and if they’ve taken any steps toward that plan. Also, ask how frequently they have these thoughts and if they’re getting worse.
If someone isn’t happy being alive or struggling with thoughts like “why am I even here?” ― but isn’t in immediate crisis ― “you need to be present, calm and supportive,” Reidenberg says. “This is not a time to tell someone you’ll call them later and see how they are feeling or if they are over it.”
Next, affirm their feelings and listen to them. Listening ― without judgment ― is one of the best ways to support someone who is feeling this way, Gold says. Then, help them recognise they could benefit from professional help.
“Sometimes – because of stigma or even not realising it could be helpful for them – people don’t consider mental health help for what they are experiencing,” Gold says.
“You can help by suggesting it, but also going the step further and helping them get there. It is a heavy lift – emotionally and physically – to connect to care, and for someone who is struggling, it can be hard to follow through. You could ask if it would be helpful to call places for appointments with them, or take them to their appointment. You could also connect them to the suicide prevention hotline or crisis text line as well.”
Finally, know that having these conversations may be difficult, but it’s better than pushing them aside. Talking about suicide isn’t going to encourage someone to act – it’s going to help them get the support they need.
“It’s not going to make the person make an intent if you talk about it. It’s really a release to have someone to talk about it with. It’s a release to get these feelings off your chest,” Molock says.
“While you may not be able to provide an immediate solution, offering support and letting that person know they matter to you and they make a difference in your life is really important for them,” Molock adds. “It is worth staying around. It is worth solving this problem together.”
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI – this number is FREE to call and will not appear on your phone bill).
- CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email [email protected]
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.