Conversations We Need to Be Having about Suicide

By Janna Comrie, MA, Registered Psychotherapist

Talking about death can seem morbid at the best of times. People often shy away from these conversations for fear that they will upset someone or that talking about it will cause death to happen, or they simply do not want to think about it because the idea of loss is painful. But what about death by suicide? What do you do when you’re thinking about suicide, or you suspect someone that you love may be feeling suicidal?

People who contemplate, attempt, or die by suicide typically feel stuck and overwhelmed in a situation or feeling that leaves them hopeless. They feel like there is no “out”. Clients will sometimes come into my office with severe anxiety, depression, or trauma-related symptoms. They will say things like, “I wish I were dead”, “nothing matters”, or “I just want to die”. As we start to process their feelings, they will often realize that they don’t actually want to be dead, but they feel that they can’t go on in the emotional state that they are in. They feel that death may be the only relief from their current level of emotional pain and are unable to imagine how to change their experience because of how terrible they are feeling. These clients are not exaggerating or being dramatic. They legitimately experience life, the way that they are currently living it, as unbearable, and they would rather be dead than continue feeling as they are. This is why it is so important to talk about suicide if you are feeling suicidal or if you suspect someone is suicidal. For someone who is struggling with suicidal thoughts, opening up and talking about those thoughts can lower anxiety, giving them a moment to think differently which, in turn, lowers impulsivity. Talking about suicide is helpful – it does not cause suicide.

How Do You Recognize Potential Signs of Suicide?

It is not always obvious that someone is struggling with suicidal thoughts or ideation. There are many warning signs, but the three most important signs are:

• thinking, writing, or talking about suicide or death
• having a plan to kill one’s self
• having the means to carry out that plan

These need to be taken seriously and help from a physician or mental health professional should be sought out immediately if these signs are present. Other common signs involve:

• collecting items to put the plan in place (e.g., weapons, medications)
• withdrawing from friends and family
• increased substance use
• hopelessness
• feeling trapped or feeling like “it [the negative feelings/situation] will never end”
• change in mood (e.g., increased anger, crying, irritability, grief)
• giving away personal or important items
• an increase in risky behaviours (e.g., driving fast, jumping/diving off higher and higher rocks, inappropriately crossing streets)

The greater the number of signs, and the more severe the individual signs are, the more serious the issue. That said, all signs are notable and worth talking about.

Suicide is more likely when people are experiencing additional life stressors. These include but aren’t limited to things like the death of a family member or friend, loss of a job or relationship, financial stresses, chronic pain, experiencing or witnessing traumatic events, and experiencing 
discrimination on the basis of sex, gender, gender identity, sexual orientation, age, race, religion, and other traits. 

How to Approach the Topic of Suicide with Someone You Fear Might be Contemplating Suicide

Talking about suicide is uncomfortable for just about everyone! That said, talking about it to someone who may be considering suicide can be lifesaving. When talking about suicide, it is so important that you approach the individual with care and compassion. Using judgement, biases, 
prejudices, shame or guilt, and minimizing their feelings is not helpful. Instead, be direct and approach the individual from a place of wanting to understand what they are feeling and thinking. Here, active listening skills are key. For example, don’t say things like:

• “People who commit suicide are so selfish.”
• “My friend’s daughter tried and failed.”
• “You wouldn’t do that, would you?”

In the first example, the word “commit” sounds judgemental – people commit sins and crimes. The rest of the statement is a judgement. In the second sentence, labelling suicide as a success or a failure makes it sound like a grade or a desirable achievement. Sensationalizing or inadvertently glamorizing suicide is not helpful. The final statement employs subtle shame and guilt which can make someone feel even worse if they are already feeling suicidal. Instead, do say things like:

• “Are you thinking about suicide?”
• “You must be hurting so deeply to feel like killing yourself.”
• “Have you thought about how you would do it? If so, how?”
• “Have you been collecting things to be able to put the plan into action?”
• “It sounds like it’s been really hard.”
• “What are the things stopping you from killing yourself?”

These statements are direct, kind, and curious. They make no assumptions but simply seek to elicit a non-judgemental conversation that may show you how you may help or may help you to guide the individual thinking about suicide to someone who can provide assistance with greater 
ease. They allow the individual who is struggling with suicidal thoughts to feel heard and understood.

Know that talking about suicide is NOT putting an idea in someone’s head or increasing the likelihood that they will attempt suicide. Instead, it opens the door to someone understanding and the individual being able to start a conversation to improve their situation. Validation of their 
feelings can be helpful. This does not mean agreeing that they have reason to want to kill themselves or that you agree with them killing themself, but it does mean trying to empathize with the pain, anxiety, depression, or other emotion that is overwhelming them. Recognizing them for the courage it takes to open up when feeling so low, can mean a lot! Be yourself and understand that you don’t need to be able to “fix” the suicidal thoughts for them. Instead, let them know that you appreciate them trusting you. If they have a plan and have collected the items required to complete the plan, do not leave the individual alone. Contact a professional. If they don’t have a plan but admit they are having thoughts, take them seriously. Check-in regularly and as quickly as possible, help them to get connected to a doctor, a mental health professional, or a religious figure who can provide additional, psychologically informed support.

What to Do if You Are Having Negative Thoughts and Are Contemplating Suicide

First and foremost, know that there are things you can do! Don’t isolate. Talk to someone that you trust about how you are feeling – a family member, friend, your doctor, a colleague, or mental health professional. Reach out immediately!

Sitting in suicidal thoughts by yourself only gets harder the longer that you do it. When you talk about your suicidal thoughts, be open and honest – especially if you feel hopeless and like nothing can be done. It doesn’t matter if you know exactly how to explain how or what you’re feeling. It just matters that you start talking.

Have a safety plan including someone you can call, a safe place to go, and something distracting to do should you feel suicidal. Keep crisis phone numbers handy and use them.

These people are trained to help you get through the toughest of moments. Know that what you are feeling is very real but just because you have not found a way out of those feelings yet, does not mean that there isn’t one!

Talking about what you’re going through is the first step to changing it. Chances are that you’ve been living through the pain alone and in your head. You can’t change things unless you’re willing to do something different, and the second you let your thoughts live outside your head and tell someone, you’ve just done something different. Again, that is the first step. Be open to help and be open to being uncomfortable. If you’re doing the same things over and over, they’ll seem much more comfortable than something different will. If you’re doing something different, it always feels uncomfortable at first! Suicide is a difficult topic.

But by opening the lines of communication, hope can be given, and lives can change. Talking is the first step to that change by promoting understanding, empathy, knowledge, and trust. All of these are key to helping an individual who is dealing with suicidal thoughts address the 
challenges in their life. So, it’s time to start talking!