What should I do if someone tells me they are thinking about suicide?

When someone is considering suicide, even though you may wish you could talk them out of it, that is not the best way to help. Avoid saying things like, “You have so much to live for,” or “Think about how this will hurt your family.” Instead, show concern and compassion by saying, “Things must really be awful for you to be feeling that way.” Let them know you are there to listen. Encourage them to share what they are feeling. Let them know that people sometimes feel like there is no answer, but that treatment can help them to feel better. Tell them you will support them to find help. Ask if they have a specific suicide plan. If they do, do not leave them alone, and take away any firearms, drugs, or objects they could use to hurt themselves. Take them to a doctor, mental health professional, or hospital emergency room, or call 911 or or Here 24/7 at 1-844-437-3247 for help.

If somebody really wants to end their life, is there anything I can do to stop them?

Most of the time, when someone thinks or talks about suicide they actually have mixed feelings about dying. Most often, suicidal feelings come from having a mental illness, and these illnesses can be treated with professional help. Medication, talk therapy, or a combination of the two has been shown to save lives. The best way to help is to encourage and assist the suicidal person to get the help they need.

What should I do if I encourage a suicidal person to get help but they refuse?

To someone feeling suicidal, depressed, or anxious, the idea of talking to a doctor or mental health professional can seem overwhelming. Sometimes suicide seems like the only way to control their pain. Continue to tell them that you are concerned about them, and to suggest that a professional who understands what they are feeling can help them to feel better. Let them know you are there to listen, and offer help finding or getting to a doctor, mental health professional, or hospital emergency room. You can also help by staying with them and calling the Here 24/7 at 1-844-437-3247. If you are concerned that the person will hurt themselves call 911.

If a friend confides in me that they are thinking of suicide and makes me promise not to tell, shouldn’t I respect their right to privacy?

Privacy is very important, but your friend’s life is even more important. Depression and other mental disorders may be distorting their judgment and leading them to want to hurt themselves. Even if you lose your friendship, saving a life is the most important priority. Tell someone you trust about your friend and ask for their assistance getting them to a professional.

My friend purposely cuts herself when she is upset. Is this the same as making a suicide attempt?

Some people cut or otherwise hurt themselves when they feel overwhelmed by difficult or stressful feelings, or to relieve their inner tension. Many people who cut themselves never attempt to kill themselves. However, in some cases, self-harm is the first indication that someone may be at risk for suicidal behavior. Whether or not they feel an impulse to take their own lives, someone who is cutting or otherwise hurting themselves needs help. Health and mental health professionals are trained to determine whether a person is at risk for suicide, and to suggest a treatment plan to help them with their self-harm behavior and underlying feelings.

Is it true that a person who talks about suicide isn’t really planning to do it?

No, that is not true. In fact, most people who die by suicide tell someone they plan to hurt themselves before they take their lives. When someone tells you they are thinking of suicide, they are giving you a precious opportunity to help before it’s too late. All mentions of suicide should be taken seriously.

Why do I feel so uncomfortable at the thought of talking to someone who is thinking of killing themselves?

Many of us grow up with the belief that people who take their own lives are crazy, selfish, or have some kind of a moral defect. As they understand that suicidal thinking and behavior is the result of a treatable medical condition, people become less fearful and more able to listen to a person in distress with empathy and without judgment. Even if it makes you feel anxious, remember that listening and encouraging treatment can help.

With the combined stresses of work or school, relationships, financial pressures, and family problems, isn’t it normal to feel depressed sometimes? Do we all need mental health treatment?

Most of us do have a lot to feel stressed about, and it’s normal to feel depressed sometimes. However, the following signs may mean that someone is seriously depressed and in need of help. Someone who is seriously depressed may have little interest or pleasure in doing things they used to enjoy. They may have trouble falling or staying asleep, or they may sleep more than usual. They may lose their appetite, or eat more than usual. They may feel tired or without energy, or like everything around them is moving slowly. Or they may feel agitated, fidgety, and restless. They may have trouble concentrating. They may feel like a failure, or that they’ve let themselves or someone else down. They may feel that they would be better off dead.

When someone notices changes in some or all of these areas that continue, day in and day out for at least two weeks, they may be seriously depressed. Someone who feels this way for two weeks or more should talk to their doctor or a mental health professional about their feelings. Even though we all sometimes feel stressed and depressed, this type of persistent depression is not normal and it can be treated. There is help and there is hope.

What should I do if experience the signs of depression?

If you have lost interest in doing things you usually enjoy, have had changes in your sleeping or eating habits, feel listless or agitated, have trouble concentrating, and feel blue every day for two weeks or more, you may be seriously depressed. Talk to someone you trust about your feelings. Make an appointment with your family doctor, or ask someone for help making an appointment. Do not keep your feelings to yourself. Talking to someone may seem hard, but most people find it makes them feel better after they let someone know they need help. Your close friends and family may already have noticed that you seem sad or tired. Letting them know what’s going on will help them to understand and support you.

Is there a questionnaire I can fill out to find out if I’m depressed?

You may find user-friendly depression screening questionnaires online, such as the PHQ-9. These questionnaires can help you to learn the symptoms of depression, and to decide whether to seek out a mental health professional, or encourage someone to do so. However, questionnaires cannot take the place of a doctor or mental health professional who can help you to figure out why you are feeling the way you do. A trained professional can work with you to find out if you have a treatable illness or mental illness and get you started on the path to healing. You may wish to start by taking an online test, but the best way to get help is by meeting in person with your doctor or a mental health professional.

Can antidepressant medications change you, or make you suicidal?

Research shows that depression is caused, at least in part, by changes in brain chemistry. Antidepressant medications work to reset the brain, helping you go back to feeling like yourself. When they are working effectively, antidepressants will help you to sleep better and feel more able to cope with things that used to upset you. You may feel more energetic, more talkative, and more interested in the world around you.

Some people experience side effects from antidepressant medications. While taking antidepressants or other medications, it is important to stay in close touch with your doctor, and to talk with her or him about all of the changes you feel and notice. Your doctor can change your medication or adjust your dosage to help you get the most benefit with the fewest side effects.

Studies show that early treatment with antidepressant medication can stop symptoms of depression from becoming more severe and long-lasting. They can also reduce the risk of the depression coming back, and reduce the risk of suicide resulting from depression. In a very small percentage of adolescents and young adults, antidepressants may contribute to increased suicidal thoughts or behaviors. However, no studies have found antidepressant use in any age group to be associated with completed suicide. In general, the benefits of antidepressant medication outweigh any risks.

Is someone who has had suicidal ideation or a recent attempt and is now feeling better still at risk for suicide?

Successful treatment for serious depression or suicidal behavior significantly reduces the long-term risk for suicide. However, it can be difficult to know where a suicidal person is in their recovery. Someone who has felt suicidal may work hard to hide his or her feelings, and may appear to be functioning well socially, professionally, or academically. In some cases, a person who has made the decision to die may seem calmer and at peace. Each year, suicide claims the lives of people who seemed happy, well-liked, and successful to his or her friends, families, and others around them. Staying in treatment after the suicidal thoughts and symptoms seem to be getting better is the best way to ensure a successful recovery. The decision to stop treatment should be made together by the mental health professional and patient.

Does psychotherapy (talk therapy) help to heal depression?

Psychotherapy includes a broad range of treatments that may or may not help a particular person or mental health condition. Most forms of open-ended psychotherapy have not been systematically tested or proven to be effective in treating depression. Short-term (16 weeks or less) intensive, structured therapies—like cognitive behavioral therapy and dialectical behavioural therapy—have been shown to be effective for depression, anxiety, borderline personality disorder, and suicide attempts.

Can lay people be trained to help prevent suicide?

Recognizing the risk factors and warning signs of suicide can help to save lives. Equipped with information, even untrained people can intervene to get help for suicidal or at-risk family members, friends, or acquaintances. Some people seem to be more inclined and better equipped to observe and reach out to others in this way. These people are called “natural gatekeepers.” Research suggests that brief gatekeeper trainings may increase knowledge but may not be effective in actually helping at-risk individuals.

Why? Why Did This Happen?

This is one of the first questions almost everyone asks after a suicide is: Why? Why would someone you love end their own life? How could I not have seen this coming? Suicide is very complicated, and it is almost always leaves many questions unanswered. Often, we never learn exactly why our loved one took their life. At least 90 percent of all people who died by suicide were suffering from a mental illness at the time, most often depression. The decision generally comes from a place of helplessness, hopelessness, and deep despair. People who are impulsive, or who use alcohol and drugs, are at higher risk. The choice to die by suicide may seem to have been made in a few impulsive moments of deep turmoil…or it may have been a decision that had been contemplated for some time due to unrecognized, untreated mental illness.

I know someone who died by suicide and he didn’t seem depressed.

Sometimes, even close friends or family members don’t know that their loved one is depressed. People who are depressed don’t always act the way we expect they would. They may not seem sad, tearful, or withdrawn. Men who are depressed may seem angry or irritable rather than sad. As well, some people hide their intent so carefully that their families are not aware of what they are considering.

Is the risk for suicide inherited?

Suicide risk factors such as depression and bipolar illness tend to run in families. However, having a family member who is depressed or who died by suicide does not automatically mean that you will become depressed or die by suicide. Because family members may be at greater risk, however, people who have a family history of suicide or mental illness should be particularly alert to psychiatric symptoms in themselves and get an evaluation as early as possible. Another consideration is that when a suicide has already occurred within a family, this may appear to open the door for others to consider it as an acceptable way to end one’s life eg. well, Dad did it…so I will too!

Does asking someone if they are considering suicide plant the idea in their mind?

Studies show that people do not start thinking about suicide just because someone asks them about it. If you suspect a friend or loved one is suicidal, tell them that you are worried and want to help them. Don’t be afraid to ask whether they are considering suicide, and if they have a specific plan in mind. Having a plan may indicate that they are farther along and need help right away. Sometimes people who are thinking about suicide won’t tell you so because they don’t want you to stop them. Your direct, non-judgmental questions can encourage them to share their thoughts and feelings. Regardless of their response, if you suspect that the person may be suicidal, get help immediately.

How do I cope with all of these feelings after the death of my loved one by suicide?

A loved one’s suicide can be emotionally devastating and can trigger intense and overwhelming emotions. Some of these may be:

a)      Shock. Disbelief and emotional numbness might set in. You might think that your loved one’s suicide couldn’t possibly be real.

b)      Anger. You might be angry with your loved one for abandoning you or leaving you with a legacy of grief – or angry with yourself or others for missing clues about suicidal intentions.

c)      Guilt. You might replay “what if” and “if only” scenarios over and over in your mind, blaming yourself for your loved one’s death.

d)     Despair. You might be gripped by sadness, loneliness or helplessness. You might have a physical collapse or even consider suicide yourself.

Intense reactions may continue during the weeks and months after your loved one’s suicide — including nightmares, flashbacks, difficulty concentrating, social withdrawal and loss of interest in usual activities – especially if you witnessed or discovered the suicide. Seeking support will help you to begin the journey through your grief. Consider a grief counselor especially during the early days.  Finding a support group for families affected by suicide will also help. Sharing your story with others who are experiencing the same type of grief can help you to find good ways of coping and give you comfort and strength.

What is the best language to use when talking about suicide?

Language used when talking about suicide can have a negative impact on survivors and can prolong the stigma associated with suicide. Although we may hear that someone has “committed suicide,” most people find “died by suicide” to be more objective and less judgmental. The terms “committed suicide”, “completed suicide”, ‘incomplete’, ‘unsuccessful’ or ‘failed suicide attempts’ should not be used.

  • The word ‘commit’ presents a particular problem since it is also used for criminal offences. It evokes a time when suicide was a criminal act.  Suicide has not been a criminal act since 1972 in Canada.
  • The word ‘committed’ can also have a negative religious inference as in committing a sin. This refers back to a time when someone who died by suicide was not allowed to be buried in Catholic cemeteries. In 1983, a papal decree reversed this prohibition.
  • To describe a suicide attempt that does not result in death as a “failure” is misleading. To say it was a ‘failed’ attempt infers that the person was a failure for living.
  • To say an action was an ‘unsuccessful’ attempt infers that to have died was to be successful. Obviously, the term “successful” does not match the meaning of the word with the action.

The preferred terms to use are died by suicide or died by their own hand – thesemore accurately describe the reality of suicide without judgement and respect the needs of those left behind.

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