How to talk about suicide prevention with a partner, relative, or friend.
Content warning: This article focuses on suicide prevention. Coping skills, support, and treatment work for most people who have thought about ending their life. Here are resources if you or someone you care about needs support:
• Suicide and Crisis Lifeline —988, which refers callers/texters to a local crisis resource line.
• Veterans Crisis Line — 800-273-8255 ext. 1, or text 838255.
• Trans Lifeline — 877-565-8860 for transgender-specific help.
• Crisis Text Line — 741741; text HOME.
After months of increasingly intense depression, Magda* suspected that her friend was feeling suicidal. The friend had mentioned that she had a plan and had since been isolating herself. She would go long stretches without contact, instead revealing her thoughts on social media.
When one particular social media post worried Magda, she texted a mutual friend, and together they made a push to get their friend help. But it took facing the possibility that their friend might be so angry, she would never trust or speak to them again. The alternative possibility was worse, Magda says.
If you suspect a friend, relative, or your spouse is considering suicide, you likely want to do something — but what? When? Find time and space to talk about suicide with the person, even though this may feel daunting.
“One-on-one is best, and sooner rather than later,” says Garth LaHue, a marriage and family therapist with Chicago’s Empowered Connections Counseling. LaHue works with many clients who have thought about ending their life.
While treatment and support work for most people, suicides peak in spring and summer. Statistically, Americans most likely to succumb are men ages 85 and up. Not far behind are those 75 to 84, and those 25 to 34. Studies show that key times of vulnerability include after a divorce, a spouse’s death, or a heart procedure or stroke (both of which are linked to depression).
Among the oldest Americans, two major problems contribute to suicidal thoughts: having too few social connections and feeling a lack of purpose in life, LaHue says.
Disengagement became particularly acute during the pandemic when many social clubs and gathering places shut down. Additionally, in some cases, long-term substance use that has masked depression becomes worse when a spouse or buddy is no longer there to keep the person in check.
First step: Just talk
If someone you care about seems to be at risk, and you feel worried, LaHue says, “Grab some takeout, and hang out with them.”
A one-to-one chat shouldn’t feel alarming. And don’t hesitate: “You want to talk before someone’s thoughts have escalated to plans,” he says.
Start off by expressing concern. Note what you’ve seen and why you’re worried. Then push that aside, LaHue says, and let the other person say what they want and need to say — without judgment.
Keep your responses few; just try to understand. Maybe no one has listened to them in a while. “Being open to what they’re saying is important,” LaHue says. “We’ve all been in low places and can envision dark thoughts, so you can understand without necessarily agreeing.”
Phrases that work well:
- “I understand where those thoughts are coming from.”
- “I see….That makes sense.”
- “I would feel that way to some degree.”
Crying is normal. “Depression and despair are hard emotions to be with,” LaHue says.
Next steps: Connect with care
If you can, remove any weapons, pills, or other means that could be a danger to the person, LaHue says.
If the person has active suicidal thoughts or pervasive passive ones, ask if they’re talking to a mental health professional regularly. If not, and you have access to their insurance information, offer to help connect them with a provider.
Someone in this condition often won’t have the motivation to follow through with the details of seeking help, LaHue says. If they don’t have a specific provider, he suggests using the comprehensive nationwide Psychology Today directory, which is updated frequently.
If your spouse, relative, or friend has very active thoughts about ending their life and seems to be in danger, emergency departments offer psychiatric checks. In an ER setting for example, LaHue says, “It’s best to wait with the person, then leave them to get help on their own.”
The upsides of action
Such a chat, even if awkward or unresolved, can be a wake-up call to get help.
“A thoughtful conversation with a spouse, friend, or relative can be a catalyst to see your worth as a person through the eyes of another,” he says. “It’s hard to reconcile emotionally a spouse or friend’s reaching out to you out of caring and concern with negating some of your worth.”
Several steps — at any stage in life — can help maintain emotional balance:
• Maintaining a social network.
• Keeping up a sense of purpose in life.
• Eating and drinking in moderation.
As someone close, you can help with the first item. “Having plans with someone is really good preemptive care,” he says.
For a spouse, this is where “in sickness and in health” comes in. “A regular date night does knock down the depression quite a bit,” LaHue says. “It also helps to say out loud, ‘Can we be more open about our thoughts and emotions? Because I love and care for you, and I want to be here with you.’”
Magda and her friend found the best possible outcome. Magda went with her to an emergency department, and visited over the week her friend spent in an in-patient psychiatric unit.
The friends continue to check in with each other and talk openly about depression and suicide. And as LaHue does with his clients, they ask about and make plans for the future.
Resources:
• Suicide and Crisis Lifeline —988, which refers callers/texters to a local crisis resource line.
• Veterans Crisis Line — 800-273-8255 ext. 1, or text 838255.
• Trans Lifeline — 877-565-8860 for transgender-specific help.
• Crisis Text Line —- 741741; text HOME.
*Name changed for anonymity at source’s request.
