As September begins, marking the start of Suicide Prevention Month, it is a crucial time to focus on mental health and how profoundly it can impact people’s lives. If you’re currently struggling with suicidal thoughts, you may be feeling isolated and overwhelmed. One of the most challenging and daunting aspects of mental health can be talking about suicidal thoughts with loved ones or a therapist. This guide offers practical strategies to approach these important conversations.
Understanding Suicidal Thoughts
Suicidal thoughts can look different for every person. They may not always be articulated as, "I want to kill myself." They may be expressed more subtlety as “I don’t want to exist anymore” or “I wish I was never born,” known as passive suicidal ideation. These thoughts are often accompanied by feelings of hopelessness, unbearable pain, uselessness, desperation, or numbness. Sometimes, focusing on the emotions associated with these thoughts can be more manageable than confronting the thoughts themselves.
Prepare yourself for the conversation
Talking about suicidal thoughts can be daunting. Because depression is frequently accompanied by feelings of isolation and worthlessness, it can be hard to recognize the individuals who care about you in your life. Before you engage in this conversation, make sure to prepare yourself for any reaction the other person might have. While you hope for empathy and understanding, not everyone may grasp the depth of what you're experiencing. Regardless, seeking help is such a brave and crucial step in your mental health journey, and reaching out to close others is something to be proud of!
In preparation for this conversation, you may want to read or watch videos about mental health and suicide to help you better understand your feelings and know what support might be helpful.
Additionally, you might have some fears about the conversation that are important to explore and acknowledge:
● Fear of Judgment: You might be worried that your loved one will judge you for having such “dark thoughts.” This is understandable given the stigma that still exists surrounding suicide. Stigma is almost always the result of ignorance or false beliefs that originate from history or modern media. You may fear being perceived as weak or as a failure as you contemplate sharing your suicidal thoughts with others. However, that is simply not true! It takes significant strength and courage to speak out about this topic with others, and suicidality is something that anyone can experience.
● Fear of Burdening Others: Another common fear is that you might be burdening others by talking about your suicidality. You might fear that you are “bringing the mood down” or causing other people to be overly concerned about you. While your loved ones may be concerned, they also will want you to support you, and sharing your suicidality might be the catalyst for you getting the help you need. You are cared for, and it’s important to share your thoughts and feelings honestly and openly with others to provide them the opportunity to help you.
● Fear of Lack of Support: You might be concerned that, once you share your experience with suicidality, your loved ones might minimize or even ignore your experience. While this might happen, especially if you share your concerns with someone who is unfamiliar with mental health, it is a reaction that is essential to prepare for before the conversation takes place. Regardless of how others react, it can be affirming to speak your experience aloud and recognize the seriousness of your thoughts and feelings.
Overall, it can be helpful to reflect on your emotional experience and prepare what you want to say ahead of time so that you can convey your message clearly.
Approaching the Topic
So you’ve chosen a person to share your thoughts and feelings with, but how should you actually broach the topic? First, it is essential to be honest and direct. Hopefully, in the previous step, you already prepared the message that you want to share. It is an incredibly difficult conversation to have, but it can be helpful to be as direct as possible when sharing your message. Select a comfortable and private setting to have this conversation, and share your thoughts and feelings as openly as possible.
A helpful tool is using “I” statements (e.g., “I have been feeling…”) to express personal feelings. A potential reaction that your loved one might have is to feel guilty or blamed for what you are going through, and they may try to project these feelings onto you. To minimize the probability of this happening, it can be helpful to express your feelings by using mostly “I” statements, which can make the conversation more constructive.
If the conversation becomes overwhelming or unproductive, it is okay to set a boundary for yourself. Don’t feel pressured or coerced to continue the conversation when you don’t feel like you have the capacity to do so. It can be helpful to take a pause and return to the topic when you feel more comfortable, or even find someone who might be more sensitive to your experience and supportive.
Practical Steps to Take Afterward
After your conversation, it is crucial that the care does not end there! If you can, it is helpful to seek professional help to deal with your suicidality. Professional help can take many forms, including finding an individual therapist to talk to. If this causes too much financial strain, there are also many support groups that center on suicidality and free crisis lines that you can call or
text at any time (National Suicide Hotline: 988). Support groups are commonly found at community centers or mental health practices at a much cheaper cost than individual therapy. It can also be helpful to meet others who are experiencing similar struggles to you. They can be online or in-person, so you can find an option that works best for your capacity.
It may also be helpful to make a safety plan with your loved one after this conversation. This can involve removing potential means of self-harm, especially if you have thought about a specific way you want to commit suicide. Then, make an arrangement of what steps you might take when you are feeling suicidal. This might look like reaching out to a therapist, a crisis line, or a close loved one and sharing your thoughts and feelings with them. It may also involve writing down activities you can do to distract yourself from these thoughts. Your safety is what is most important, and it is important to create a concrete plan of how you aim to cope with suicidality with it arises.
How Therapists Might Navigate Conversations Around Suicide
It can be incredibly scary to bring up the topic of suicidality with your therapist. Here are some ways your therapist might respond:
● Create a safe space: Your therapist will do their best to create a non-judgmental, safe space in which you can share and reflect on your feelings. They will use validation, or statements to affirm how you feel and think.
● Use open-ended questions: Once you share about your suicidal thoughts, it is likely your therapist will use open-ended questions to explore your feelings and thoughts related to suicide more deeply.
● Assess and evaluate risk: Assessing risk is something that every therapist is mandated to do, since it is their job to maintain safety as a priority for every client. Each therapy practice has a different protocol regarding this. If your therapist determines that you
pose an imminent danger to yourself, be aware that confidentiality may be broken, and they will have to contact an emergency contact and/or a local hospital to prevent any harm that might occur. If you are not in imminent danger, they may have you create a safety plan with them to identify specific triggers for your suicidal thoughts, list strategies you can use to cope with or distract from these thoughts, and provide resources you can use in times of crisis. These resources will likely be an expansion on the ones I have listed above, including numbers to crisis hotlines or referrals to local support groups. A trained professional should know the difference between these two situations, and just because you have suicidal thoughts does not mean you will be committed to a hospital.
● Ongoing Dialogue: After the initial conversation about your suicidality, your therapist will continue to check in on these thoughts periodically to monitor changes and provide necessary support.
In conclusion, it is critical to prepare yourself and engage in conversations about suicidal thoughts. By planning out what you want to convey and anticipating possible reactions your loved one might have, you can foster meaningful dialogues with loves ones and your therapist. If you are struggling with suicidality, reach out to trusted individuals and mental health professionals about what you are experiencing. You are important and deserve support and care!