Helping Those Who Feel Helpless: Responding To Family And Friends With Suicidal Thoughts

Suicidal thinking is more common than most people realize.  Four percent of the population in the U.S. will contemplate suicide at some point during the next year.

Of course, most people who consider suicide do not act on these thoughts, but even so 48,000 people in the US take their own life each year.  

Research shows that 17% of adolescents will consider taking their life during the next twelve months if recent trends remain unchanged. 

Moreover, suicide is the second leading cause of death among teens.

For children ages 5 to 11 years, suicide is less common but still ranks as the 8th leading cause of death.  

A 2022 study shows that over the past 20 years (with some fluctuations) child and adolescent suicide rates have increased, with the largest increases occurring in the 10 to 12-year-old age group.

These statistics provide a sober reminder of the widespread nature of suicidal thoughts and behavior. They also point to a need for people to be aware of the signs that someone is at risk for self-harm and understand how to respond in these situations.

To help you gain this type of understanding we will, in the following passages, briefly look at what commonly drives someone to consider suicide, and the steps one can take to help prevent them from acting on these thoughts.

Why Does Someone Get To The Point Of Wanting To Take Their Own Life?

There are two major theories of what drives suicidal behavior. The Interpersonal Psychological Theory (IPT) suggests that deeply rooted feelings of not belonging, coupled with the sense of being a burden and having access to lethal means of ending one's life, are the major factors driving suicidal thoughts and behaviors. 

Another major theory of what leads to suicide is referred to as the Integrated Motivational-Volitional Model (IMV).

In this theory, there are two major considerations. The first is when a person feels defeated, trapped, and has little social support. This emotionally painful experience is thought to give rise to thoughts of self-harm and suicide (provides the motivation for suicide, but not the intention to act).

The other aspect of this model focuses on what pushes a person from considering suicide to landing on the decision to end his or her life. This includes hearing of others who have committed suicide, joined with a growing lack of fear about death, and a heightened degree of impulsivity.

In both of these theories, emotional distress is all-consuming influence. So intense that it leads a person to feel as though there is no solution that will bring relief. This leads the tormented individual to conclude that their life is bound to be one of perpetual pain, with death offering the only escape.

Although theories can be helpful in better understanding suicidal thoughts and behavior, by necessity they paint in broad brush strokes. If you are worried that someone you love may be at risk for suicide you want specifics. You want to know what to look for and specific steps to take in order to be of help.

Common Characteristics Found In Suicidal Individuals

About two-thirds of people who complete suicide are depressed at the time of their deaths.  

The lifetime risk of suicide among those with untreated depression is approximately 20%. When thinking of the theories just mentioned, it’s worth noting that depression is well known for heightening a sense of being helpless to change one’s life circumstances. It also is common for depressed individuals to feel worthless and believe themselves to be a burden.

Social withdrawal and a sense of no longer belonging are two more frequent experiences of those who struggle with major depression.

People who commit or attempt suicide often report feeling hopeless. (This is more common among those who have suicidal plans versus those who impulsively attempt suicide) 

The suicidal person most often simply wants to escape the pain that presses in on them unceasingly. 

When considering this insight it becomes clear why telling a suicidal individual that there are no guarantees they will go to heaven is unpersuasive. They are not looking to obtain heaven, only to escape the hell of their current experience.

It is not unusual for the suicidal individual to have been through a traumatic experience, be the victim of harsh and unrelenting bullying, or have just ended an important relationship.

It’s important to note that what is missing from the preceding description of a suicidal person’s presentation is their unequivocally declaring “I’m thinking of ending my life.”

Most of those who attempt suicide do not make announcements of their intent. Some will make passing references to the difficulty they have in waking up to another day of facing the same old troubles. Others may express that they envy the peace of someone who recently died.

But a clear declaration of an intent to take their own life is rare. This is why it is important to ask someone directly about their intentions. It is the first step in the multi-step strategy that follows describing how to intervene when you are worried someone is suicidal.

Steps To Take If You Believe Someone Is At Risk For Suicide

Talk with the person in a kind tone. Express your concern without judgment. Explicitly ask if he/she is thinking of harming themselves.

No, such direct questions do not increase the risk of suicide. Many people worry that by bringing the topic it will cause a distressed individual to begin to contemplate suicide when they had not done so previously.

This is nearly always false. More often it makes the person feel better understood. Instead, you are likely to find that the individual feels grateful that someone finally recognizes the depth of their pain.

Remove lethal items from their possession as much as possible. This includes lethal drugs, firearms, knives, etc. Sometimes this is not possible. Do what you can.

If they express a desire to kill themselves but tell you they have no plan or intention, encourage them to seek counseling immediately. Give them the number for the suicide hotline (have them dial 988).

Stay with them while they talk to the person on the crisis line. When that conversation ends bring up the topic of having them voluntarily enter a psychiatric hospital.

If they volunteer to enter a program, and explicitly state that it is because they are having suicidal thoughts but are not intending to hurt themselves, in nearly all cases they can also discharge themselves whenever they like.

If they express a desire and intention to harm themselves, encourage voluntarily psychiatric hospitalization. If they are agreeable to this idea, accompany them to the hospital. Don’t count on the person to make you a promise and then follow through at a later time.

If they refuse hospitalization, then try to persuade them to call the suicide hotline (just dial 988).

If they agree and end up calling the suicide hotline, you may wish to call the police. In most locales, a police officer will be dispatched to your location and speak with the suicidal person. If the officer believes them to be an immediate danger to themselves, he or she has the authority to take them to the hospital.

You may question the wisdom of calling law enforcement. Won’t this forever damage your relationship with the person? Truthfully, it may, but much less so than were they to end their life. You must consider the bigger picture, and your willingness to take this risk to save that person’s life is a reflection of your concern.

If all of the above steps fail, it may be best to spend the night with the suicidal individual. The next morning, have another conversation about their clearly stated desire to end their life. Ask what you can do to help. If what they request (most times the person makes no request at all) is reasonable, try your best to follow through and fulfill what they have asked.

This does not include providing a large loan, agreeing to marry the individual, etc. But it could involve keeping them company for several nights, helping them find a counselor, or developing a plan for improving the problems that currently weigh them down.

After this make an attempt to be in frequent contact. Not just to check on their suicidal ideation, but to participate in everyday life events. The idea is to breach the gap that makes this person feel alone, burdensome, and hopeless. You do that by showing that you enjoy them, even though they are distressed and depressed.

This same advice holds true if your family member or friend attempted suicide: find ways to remain, or become, meaningfully involved in his or her life. Your concern can be crucial to them working through this dark chapter, and moving on to the point where no more attempts to take their own life are entertained.

The majority of those who survive a suicide attempt never try to take their life again. This should provide a measure of hope. Getting through the distress that accompanies an unsuccessful suicide attempt is most often the first step to a brighter future.

Conclusion

Although the above guidance works well in many cases, it should not be seen as a prescription for what you should do when attempting to help a friend or loved one who is suicidal. Every situation is different.

Nevertheless, it is intended to provide you with a sense of the main issues that arise when someone is thinking of taking their life, and how you might be able to effectively respond.

It is worth noting that research shows clinicians are not good at predicting who will attempt suicide. If clinicians who spend their professional lives attempting to understand the human psyche have a difficult time making these predictions, then certainly the non-professional cannot be expected to have expertise in this area.

This is to say, there is a limit on what you can be expected to know. If your loved one or friend assures you that he/she is not going to harm themself and ends up doing so, don’t conclude that you are at fault.

Each of us is responsible for our actions, even those who decide to take their own life. This is heartbreaking and tragic. They likely did not see another solution. But it ultimately is a choice.

Removing the pressure to consider yourself prophetic in these matters will help you more readily engage a friend or loved one who is at risk, and possibly guide them to a point where they see hope and make the choice for life.