Tips for Having 'the Talk' About Suicidal Ideation


Editor’s note: If you experience suicidal thoughts or have lost someone to suicide, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741-741

There is an increasingly open dialogue among people and their experiences with attempted suicide as well as issues with suicidal ideation. I find this to be impressive and heartwarming — regardless of the subject. I am happy people are willing to be open and share freely. I hope these discussions — now happening outside the closed doors of the therapist offices — will enable us to see for ourselves not only what the spectrum of struggle there is, but what degree of hope there may be.

My entry into adult life brought me crashing into depression and anxiety. As I struggled to control and understand it, so began my issues with self-harm and suicide. I’ve since pushed away the ritual of self-harm as I’ve matured. I’m not actively suicidal, but — as many can relate to — the feelings of worthlessness drives episodes of suicidal ideation.  

These attacks can be short or can last for days. In my own personal experience, it’s like someone is following me around with a gun to my head ready to pull the trigger at any moment. If I make one wrong move I’m done. I have to behave normally to get through the day, but on the inside I’m screaming to be set free from the terrorist that is my own mind.

Reaching out to others is difficult when this happens. At first I got some very negative reactions and I felt like I was doing something very wrong. Responses took the form of, “How could you do this to me?” “We need to get you to a mental hospital right away!” and “Where is the number to your psychiatrist?” At this point I went from looking for comfort into a full blown panic thinking, “Look what I’ve done now! I hurt/confused/angered them by just letting them know what I’m experiencing. If I share what I’m going through, it makes people angry.”

Or, there were the responses like, “But, look at how much you have?” and “Look at all you can do? So many people in this world have so much less.” I can’t disagree. It’s all true. And, I feel even worse because I have all these good things and I want to die. This makes me feel twice as horrible.  

These reactions made it clear to me I needed to keep my troubles inside the walls of my therapist’s and psychiatrist’s offices. For the most part, I do. But 20 years have passed, and it is pretty much impossible to not learn something and grow a little in the span of 20 years, even if your symptoms don’t change. I want to share it with you — especially for those of you starting this dialogue for the first time and for those of you who may be starting a relationship with someone who has these issues. Because, communication will be critical. So, read on to learn some of the tools that have been helpful to me.

It’s time to really examine the situation from both perspectives.

First, the receiver of the information. If the receiver is not prepared, he/she is at a disadvantage from the start. Reactions like the one described above are normal, given what they perceive as a scary situation with someone they love.

So, what to do? First, try not to overreact. The fact someone is sharing this deeply personal information at the risk of being judged is a sign they are in need of some comfort and acceptance. The experiences they’ve had include a repetitive dialogue that goes something like this:  “You don’t belong here, you are making everyone’s life worse, remove yourself so things can be better without you.” These thoughts are very real to them and while it’s OK to say you don’t feel the same way, do not to deny their feelings.

Please keep in mind the people struggling with these issues often have been through a lot before they open up to you about it. Repetitive negative thoughts like the ones described above stem from a multitude of issues you likely aren’t totally familiar with. Often, just listening without judgement, without trying to fix the problem, without overreacting and simply saying, “I’m always here for you. I love you and I’m glad you can share these thoughts with me,” goes a long way to building a support system they can feel safe with.

A key distinction to note is these feelings are often thoughts and not suicidal plans. There is a big difference. Will talk more about that in a couple paragraphs.

Next, therapists and psychiatrists are there to help. They are trained to handle these discussions with care. They know what questions to ask, signals to look for and instructions to give to both parties. Ask if you can go to the next appointment so you can learn how to best communicate in a therapeutic way. If your loved one says no and you still feel you need help, it may be worthwhile to find yourself a therapist to get some input.

Next, for the person in crisis. You are in a vulnerable state. You have a huge burden you are trying to lessen. Remember, the information you are communicating is familiar to you but very new to the person you are sharing with.

If you can, try to remember how scared you were the first time you had these thoughts. You likely overreacted, called everything in your life into question and made some bad decisions.  You cannot expect others to be as cool, calm and collected as your therapist and know what triggers to avoid. Remember, they truly want to help and they are going to do what comes naturally to them – which may make you feel worse.  If you can, guide them to help you. Tell them, “I have some upsetting news to share with you. I would like you to just listen to me and be here for me. I need someone to accept me for who I am right now. Please don’t try to fix the situation, just say that you love me.”

If your loved one doesn’t respond in the way you need, this does not mean all hope is lost and you will never have a support system. It means it takes education, communication and patience from both parties to develop a supportive relationship.  

The person in recovery wants to be understood, but it has to go the other way too. Talking about suicidal ideation is also hard on the people around the individual struggling and a practical perspective of this cannot be lost. For example, try not to overreact when people don’t comfort you in a way you need. If you’re too upset in the moment, remove yourself and come back when you’re calm and explain what you need and why their instinctual reactions do not work for you. This is your responsibility in developing your support system.

It is very easy for things to get very emotional for both parties and for a healing encounter to turn into a hating encounter. Try not to set yourself up for that additional stress.  

Being able to communicate with your partner or family and friends effectively is complementary to and does not replace professional help.

Last, some pointers for both parties. One thing both parties have to accept is you must do a real, honest, check-in about planning. Suicidal ideation and planning are two different things. It’s one thing to have a voice in your head telling you that you should be dead and you don’t deserve to be part of the world around you. It’s another thing entirely to start thinking about a plan and put a plan together. It doesn’t take a lot of stress to go from ideation to planning. Please, be honest with yourself and those around you and reach out if you need help.

Follow this journey on Pieces of My Mind

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255.

We want to hear your story. Become a Mighty contributor here.

Image via Thinkstock


Find this story helpful? Share it with someone you care about.