Helping a Friend Overcome Suicidal Thoughts

Discussions on suicide are fraught with mystery.  For most of us, suicide is not an option that is ever seriously considered - we experience emotional setbacks, but there is never the desire to end everything.  Jobs are lost, families break apart, and loved ones pass away, but we mourn these losses and continue.

Yet when we imagine suicide - the ultimate sacrifice, a kind of permanent surrender to conflicts that cannot be overcome - we often believe that such external stresses are to blame. 

Unfortunately, someone who has reached the "end of the rope" will often be unable to see how much you care.  This isn't because of something you say or fail to say - it's because someone trapped in the downward spiral of suicide has turned most of his or her thoughts inward.  Instead of thinking "oh, I'm loved," a suicidal friend might think "oh, someone else is here to feel sorry for me."  Your friend might not be receptive to your presence - you might hear something like "I don't want to take up more of your time," or "I'm fine.  Really, it's okay."

Unfortunately, this makes it very challenging to help your friend.  A suicidal individual who reassures you that "everything is okay" might be impossible to read.  Are things okay?  Or is your friend telling you things are okay just to prevent you from worrying?

In deciding what to do, first find out what's wrong.  Pay attention for the warning signs of suicide.  Certain jokes, comments, and actions can indicate that your friend doesn't plan to be alive in the near future.  A star football player who starts saying "If I'm around for the championship" or an overworked student who says "pretty soon I won't need to worry about any homework" might be showing signs of suicidal ideation.  A friend who begins giving away cherished possessions - a favorite necklace, for example, or that brand new computer - might be "preparing" for death.

If you see these signs, it's important to find out what they really mean.  If you're worried, it's best to go talk with your friend.  Ask how things going.  In particular, asking about future plans.  Does your friend look away when you ask about the summer road trip you've been planning?  Or do you see eyes that light up with "OMG!  Once classes are over, that trip's going to be great!"  Future planning is a good sign - someone who's ready to die will usually avoid long-term commitments.

If initial conversation doesn't clear things up, dig deeper.  We usually restrain the urge to ask pointed, personal questions.  When dealing with a friend who might be considering self-harm, it pays to ask these questions.  "Are you thinking about hurting yourself?" is a good place to start.  A friend who is emotionally healthy will be taken by surprise by a question like this.  Your friend might say something like "Um...no.  Why?  Do I look psycho?"  On the other hand, someone suicidal may hesitate before answering.  Follow your gut here - if you think your friend is at risk, keep asking questions.  Asking "Are you thinking about killing yourself?" will not cause a non-suicidal person to suddenly consider suicide.  But if your friend is thinking about taking his or her own life, this question can open the conversation.  It can reassure your friend that it's okay to talk.

Let's say your friend is honestly suicidal.  On one level, you are very important to your friend's well-being.  You are in a position to offer help and reassurance.  Unfortunately, this isn't enough.  Even if you have been trained in counseling or other forms of therapy, it will be impossible for you to consider your friend from an objective perspective.  Feelings of attachment will make you want to help your friend so much that you won't set aside enough time for yourself.  Torn between work, life, and your friend, you won't be able to provide the attention to make sure your friend is safe.  Worse still, you'll put your own health (both mental and physical) at risk.

The first thing you must do is encourage your friend to seek help.  If you're students, then your school will either have guidance counselors or therapists available to provide guidance and resources.  Otherwise, have your friend call the Suicide Prevention Hotline at 1-800-273-TALK (8255).  Additionally, many areas have local hotlines, and these local hotlines can put your friend directly in touch with therapists who can provide ongoing mental health treatment.

Professional help is important because suicide is more than just a feeling of loneliness.  It is a self-degrading pattern of thoughts which eats away at the mind from the inside.  The only real escape from suicide comes through reevaluation of one's life and purpose.  Someone suicidal must learn to see the world in a new light, to see the events of life as more than just signs of personal failure.  And you probably won't be able to provide the guidance to make that happen.  Besides not having the time, you won't know what questions to ask.

Plus, everything you say will be suspect.  Your friend will use your words to judge how close the two of you are as friends and to decide whether or not the difficult discussions are "burdening" you.  A friend in need may begin to depend on you too much, and possibly expect more from the friendship than you can possibly provide.  It's not uncommon for someone suicidal to "fall in love" with the guy or gal who's providing all the free counseling - and you might not be looking for that kind of relationship.  Conversely, a friend who sees you struggling to help might cut you off.  In your friend's mind, the need to preserve your personal time might seem more important that protecting his or her own life.

You can't force counseling on someone.  But you can encourage it.  And once your friend begins that road to recovery, both of you will feel better about life in general.

In the meantime, though, continue treating your friend as a friend.  Avoid "shielding" your friend from life, or scheduling "special times" to "discuss the illness."  Instead, focus on maintaining a strong friendship.  Do normal friend activities.  Watch movies, play sports, break out the checker board.  Talk about ordinary things.  Tests, dating, shopping - these are all valid conversation topics, and they will keep your friend focused on staying alive for the here-and-now.

Very importantly, be sure to make plans.  Choose a weekend to go camping, or make appointments for coffee.  Invite other friends to come with.  They don't necessarily need to know what your friend is going through, but they'll still help provide a sold social network to help your friend through difficult times.