Suicide is a leading cause of death in the United States, and responding when a loved one is at risk can be scary but necessary.

During times of stress or crisis, some people might have feelings or thoughts of self-harm or suicide.

If the person lives with a mental health condition, these thoughts or feelings might happen often.

According to the National Institute of Mental Health (NIMH), suicide was one of the leading causes of death among people ages 10 to 44 in the United States in 2019.

If someone you know is having thoughts of suicide, there are ways you can help.

Suicidal ideation describes a preoccupation with death, suicide, or self-harm. This desire can be passive or active.

Passive suicidal ideation can include a desire to “no longer exist” but doesn’t necessarily include the intent to harm or create a plan.

Active suicidality includes an active desire to commit the action and potentially having a plan to carry it out.

People of varying backgrounds can have suicidal thoughts or feelings.

According to the Centers for Disease Control and Prevention (CDC), some people have a higher chance of experiencing factors that may lead to suicide, including:

  • veterans
  • adults ages 35 to 64
  • people who live in rural areas
  • folks in the LGBTQIA+ community
  • American Indians or Alaskan Natives
  • people with disabilities

Not everyone who experiences suicidal ideation has a mental health condition, but it can be a contributing factor to consider if your friend or loved one raises concern.

Some other contributing factors to consider include:

  • a history of suicidal ideation or attempts
  • a family history of clinical depression or suicide
  • having weapons or firearms in the home
  • living with depression or another mental health condition
  • recent incarceration
  • a history of abuse

An important distinction to make is whether your friend is actively or passively suicidal. Both should be taken seriously, but an active desire requires an urgent response.

Common symptoms you can look out for include:

  • significantly altered sleep habits (sleeping through classes or not sleeping at night)
  • talking about feeling empty, hopeless, or trapped
  • behavior that could result in harmful consequences or serious injury
  • saying goodbye to loved ones
  • giving items away
  • expressing concern over being burdensome
  • withdrawing from friends and family

It’s important to remember that people can show symptoms differently. Some may decide to keep their thoughts and feelings to themselves. This makes it crucial to know the symptoms and keep an eye on a friend’s behavior.

Learning that a friend or loved one has thoughts or ideas of suicide can be scary. But if you’re concerned, there are ways you can help.

Here are some strategies you can try.

Ask questions

It’s OK to ask questions. Bringing up suicide doesn’t put the thought in someone’s head.

In fact, a 2012 study shows that being honest in your discussions does not pose an increased threat to anyone’s safety.

You can be direct and ask questions such as:

  • “Are you thinking of hurting yourself?”
  • “Are you having thoughts of suicide?”

Follow-up questions can help identify whether this is an active or passive concern. For example, you can ask, “Do you have a plan that you intend to carry out?”

Don’t try to fix it

Our inclination is often to try and rectify a situation, especially when it comes to people we care about. It’s important to remember that your support is crucial.

Try to reassure them that you’re there for them whenever they need you.

Centering their feelings

Try not to minimize the person’s feelings or convince them that “things aren’t that bad.” This can undermine their experience.

Instead, try to listen and validate the way they’re feeling.

Offering support

If the discussion leads to possible solutions, you can offer support in those ways.

If the person is overwhelmed with daily chores and responsibilities, consider offering to take the kids to school or help with dinner.

Suicidal ideation often evolves from a combination of things, not just one isolated incident. So, reaching out to check in and offer a hand where you’re able can make a big difference.

Safety planning

A suicide safety plan is a written set of instructions for when a person begins to experience thoughts of suicide. This plan can include information such as:

  • symptoms to look out for
  • coping strategies, such as meditation or deep breathing
  • a trusted person you can ask for help
  • people or activities that can work as distractions
  • professional resources
  • ways to create a safe environment

If a safety plan is already in place, you can spend some time discussing and going through the steps with your friend or loved one to make sure each step has been properly filled out.

Know when to ask for help

There may be a time when you feel that your friend or loved one’s desires are urgent and need to be addressed.

You can reach out to a healthcare or mental health professional to set up an emergency session. A visit to the emergency room (ER) might be required if this isn’t an option.

Continue to stay in touch

A 2017 study shows that people are less likely to die by suicide when they remain in contact with others who are aiming to give support.

Consider calling your friend or inviting them for coffee to check in and see how they’re doing. This can show them that your support isn’t only for emergencies.

Taking care of yourself is important, especially if you’re navigating depression and suicidal ideation yourself.

Discussions about these heavy topics can be triggering, so try to be aware of when you need to step away to recenter yourself.

Supporting a friend or loved one during a difficult time can be challenging. Consider creating circles of support for yourself and maintaining a self-care routine during this time.

Suicidal ideation affects many people, and it can be overwhelming to support someone through it. Try to be compassionate and supportive and practice active listening.

If you’re looking for resources, you can check out Psych Central’s page on suicide prevention. Calling the Suicide Prevention Lifeline at 800-273-8255 is a good first step.

If you need help right now or are actively worried about someone’s safety, you can visit the emergency room or call 911 for immediate assistance.