Reader’s Question

I am a recent psychology graduate and a very close friend of mine is depressed, self-harming, and suicidal. I feel responsible for helping him but he keeps refusing, believing that nothing can help anymore. I used to think that it’s common for depressed people to refuse help so I should just try harder. We communicate on a daily basis but only via text. We never talk over the phone, we don’t meet often and sometimes even when we have made plans, he suddenly cancels, saying that he’s not in the mood. The bottom line is that, as the only person he confides in, keeping his trust is crucial. What should I do? Should I try to help him with another approach or should I just give him some space?

Psychologist’s Reply

Having someone close to you who is struggling with suicidal thoughts and depression can often make you feel helpless and powerless. However, you have already made the first step in helping and making a difference: you’ve noticed. Sometimes just noticing and showing concern can be very powerful and impactful. Many people know someone who struggles with depression and some even know a person close to them who has attempted or completed suicide. Over 30,000 Americans die by suicide each year and around 800,000 attempt suicide. It’s a very common problem, yet the stigma around it prevents us from doing what we really need to do to help — talk about it.

Talking about suicide is one preventative measure that I have seen help many of my suicidal clients. However, I hear many people ask: “If I talk about it, won’t it just encourage it? Won’t it just give them the idea?” The answer is no, not really. Talking about the emotional content around suicide, like depression and hopelessness, can actually help the suicidal person relieve stress and feel connected to supportive people like you. It’s rarely a comfortable conversation, but don’t let that stop you. If you suspect someone is thinking about it, it’s OK to be direct. Walking around the topic or beating around the bush can send the message that it’s not OK to talk about it. You can simply say something like “With the pain you’re in, I was wondering if you might have thought about hurting yourself?” If the answer is a “yes” you may want to see if they have thought about specific ways or plans on how they would do it. People who have seriously contemplated suicide might have gone ahead and made plans or taken action towards hurting themselves. Working with them to limit their access to their plans, like removing guns or stashes of pills is easier when you know that’s what they are planning to do. Ignoring it and just hoping it will go away isn’t the solution. Don’t let the comfortableness or the difficulty stop you from asking. Asking is good because it shows you’ve noticed.

Importantly, friends should never agree to secrecy about suicidal thoughts. Secrecy prevents people from talking about it. It’s alright to discuss with them about who to talk to and who not to talk to. Some people may not be very supportive and talking to them can actually make someone feel more alone and depressed. However, we need to keep them talking and keeping it a secret only prevents that.

You’d be surprised at how often people are willing to talk about it. Most suicidal individuals are looking for relief and escape from their pain, not for an end to their life. Talking about it can bring that relief. Once you can get them talking it may be easier than you think to keep the conversation going.

The next thing to help is really pretty easy: just be quiet and listen. Most of my suicidal clients report they often feel better for a bit when they feel like they have been heard. Don’t think you have to fix or solve their problems. A lot of people already know what they need to do to feel better. They just need support and encouragement to do it. Depression often inhibits their motivation to get to their solutions. Your support and hope can be enough to get them going toward recovery.

Where you can be more directive in helping is getting the suicidal person to the help they need. Assisting them in finding resources such as suicide crisis lines, therapy, psychiatrists and hospitals can be the next vital step.

One source is the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), which is free, confidential and available 24/7. There are even online crisis centers and crisis intervention through Skype or texting if talking to someone is too uncomfortable.

Please read my article on Myths About Suicide if you would like to learn more about suicide and those thinking about it.