If You or Someone You Know is Struggling with Thoughts of Suicide: Where to Begin
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2020 4.9% of adults had serious thoughts of suicide, while 1.3% made a suicide plan and 0.5% attempted suicide in the past year.
- Among adults of mixed ethnicity, 11% had serious thoughts of suicide, 3.3% made a suicide plan and 1.2% attempted suicide in the past year.
- Among Whites, 5.3% had serious thoughts of suicide, 1.4% made a suicide plan and 0.5% attempted suicide in the past year.
- Among Hispanics and Latinos, 4.2% had serious thoughts of suicide, 1.2% made a suicide plan and 0.6% attempted suicide in the past year.
In teens, a 2020 study found that the lifetime prevalence of passive suicidal ideation in patients aged 13 to 17 years was 22.2%. Passive ideation refers to thinking about death, dying, or not being alive without an intention to act to end your life.
The same study found the lifetime prevalence of serious suicidal ideation in this same age group was 9.8%. Serious, or active, ideation refers to having a concrete plan (stepping into traffic, overdose), although individuals may feel differently at different times about their intention to act on their plan.
The lifetime prevalence of a suicide attempt in patients aged 13 to 20 years was 6.7%.
While your age and ethnicity may play a role in your level of vulnerability, a number of other internal and external factors may increase your risk of attempting or dying by suicide.
Internal Risk Factors
- Previous attempts
- Family history of suicide deaths
- Mental health conditions
- Trauma
- Past Abuse
- Neglect
- “Black and White” thinking
- Severe physical health constraints
- Traumatic brain injury
- Perfectionism
External Risk Factors
- Access to guns, drugs, etc.
- Losing a loved one to suicide
- Suicide in the media
- Relationship Issues
- Harassment & bullying
- Concerns about money
- Rejection
- General stress
I am struggling with thoughts of suicide
You may be struggling with thoughts of suicide if you’ve caught yourself thinking:
‘The world would be a better place without me;’
‘My family would be better without me;’ or
‘No one would care if I’m not here.’
These thoughts are common, but it is important to know that they are heavily influenced by your emotional state right now. In other words – that’s the depression talking. You may have experienced events in your life in the past that seemed overwhelming and impossible to improve – and then, something shifts or changes and you think, “Wow, I couldn’t see a way forward, but now things aren’t as bad as I thought.”
If you have personally considered dying by suicide, there are some things you should know.
You are not alone. It may feel like you are alone, but there are so many resources available for support in even the darkest time. It is precisely the belief that you are alone in this struggle that may cause you to isolate yourself from the support of others – so reach out.
Talk to someone. The most important first step that you can take is talking with someone you trust about your experience. If you have a friend, family member, or even a teacher with whom you feel safe, simply letting them know the weight you are carrying can provide enormous relief. They can help you find resources for ongoing support as well. If you don’t have someone in your life that you feel safe sharing with, know that the folks on the other end of a crisis hotline have chosen to dedicate their time and energy to supporting people just like you who feel they have nowhere to turn. Contact the Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.
Focus on today. If you have struggled with wanting to die for a while, or if this is uncharted territory, don’t act on your thoughts today. Instead try to focus your thoughts on taking small steps to get through the day. Think, “I am going to put on my shoes, get my keys, and drive to work.” And once you arrive at work, try to focus your mind on the next small steps toward the end of the day (“I’m going to send this email and go to lunch”).
Avoid drugs and alcohol. In addition to alcohol lowering your mood, it impacts the parts of your brain that control judgment, focus and behavior. Drinking may make you more likely to act on suicidal thoughts impulsively. Similarly, cocaine and other amphetamines increase impulsivity and may make you more likely to take risks. Other drugs can cause hallucinations, confusion and paranoia, thereby increasing your risk of acting on your thoughts of ending your life.
Be around other people. Decreasing your isolation can help keep you safe, even if you don’t feel comfortable letting someone know how you’re feeling. Try spending more time in populated places – go out to lunch, grocery shopping, to a coffee shop, or to a busy park. This may even help to decrease your sense of feeling alone and help you find the courage to talk to someone you trust about how you are feeling.
Go someplace safe. When the thoughts are strongest and you are finding it most difficult to cope, go someplace that feels safe to you. This may be a friend’s house, a church, mosque, temple or spiritual center, a crisis center, a library or even your own bedroom. This may serve as a distraction and even lift your mood and sense of hopelessness.
Move your body. Doing something physical for at least 20 minutes will increase your levels of dopamine and serotonin, the “feel good” hormones in your brain. Try to go for a walk outside for as long as you’re able. At least 20 minutes of walking each day can have a big impact on your mood over the course of a week. If it’s raining, maybe reach for your VR and go rock climbing , walk around the mall, or clean your house (bonus – the house is cleaner!).
Be outside. Being in nature – or simply in fresh air near a tree or two – has been shown to reduce levels of cortisol, the stress hormone. It’s also associated with better sleep and decreased muscle tension and heart rate. Try catching up on school or work assignments at the park, going for a walk through your neighborhood – or another neighborhood that looks nice, walking your dog, or building a fire outside.
Someone I care about may be contemplating suicide
It can be difficult to know how to approach this conversation with someone who seems to be struggling. Finding the right words – or just saying the word “suicide” – can feel intimidating. Here are some ways to approach this tender subject.
Have a direct conversation. People often worry that asking someone if they are considering suicide may plant a seed or offend. However, research has shown that this is not the case. Further, asking someone directly if they are thinking about suicide both destigmatizes a historically taboo conversation, and lets that person know that you care enough to have an uncomfortable conversation (Harkavy-Friedman).
Avoid stigmatizing language. If you are concerned about choosing your words with care, try avoiding stigmatizing phrases such as, “commit suicide” or “successful suicide” as these may feel negative or insensitive to the individual. Instead, try “die by suicide” as this avoids judgement. Similarly, rather than saying, “failed suicide attempt” or “unsuccessful suicide,” try “attempted suicide” or “suicide attempt.”
Even outside of intentional conversations around suicide, we often use language that supports the stigma around this issue and may create isolation or shame around those silently suffering with suicidal thoughts. The Suicide is Different model suggests avoiding common phrases like, “I would rather kill myself,” or “just shoot me now,” and try saying something like, “I would rather do anything else.”
Listen actively. When the person is talking, try to listen actively and attentively. This means giving them your undivided attention – put your phone down, make eye contact, avoid multitasking – and trying to understand their perspective. Avoid interrupting or offering solutions, and instead focus on expressing support and empathy. Phrases like, “That does sound overwhelming,” “I hate that you’re dealing with this,” or, “I think I would feel the same way in that situation,” can communicate validation and willingness to sit with discomfort without trying to fix the situation. Thank the person for talking to you, and share that you are glad they did.
Encourage professional help. If the person is struggling with thoughts of suicide, it is important that they seek professional help. Encourage them to talk to a mental health professional, such as a therapist or counselor, who can provide them with the support and treatment they need. You might offer to help them navigate PsychologyToday.com and brainstorm the type of therapist they would feel comfortable with (gender, age range, spiritual beliefs, queer affirming, etc.)
Offer practical support. In addition to offering emotional support, you can also offer practical assistance to the person if it is within your capacity. This may include helping them make an appointment with a therapist, accompanying them to therapy sessions, or providing them with information about mental health resources in their community.
Take care of yourself. Supporting someone who is struggling with suicidal thoughts is emotionally taxing. Make sure to take care of yourself and seek support if you need it. This can include talking to a therapist or counselor yourself, reaching out to friends and family, or participating in self-care activities.
If you or someone you know is experiencing a mental health, suicide or substance use crisis or emotional distress, reach out 24/7 to the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at suicidepreventionlifeline.org to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.
References:
https://www.nami.org/Blogs/NAMI-Blog/September-2017/Learning-More-About-Suicidal-Ideation
https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health
https://www.suicideisdifferent.org/language-around-suicide
https://www.fs.usda.gov/features/wellness-benefits-great-outdoors
Author: Nicole Boudreaux, LCSW
Nicole is a Licensed Clinical Social Worker in the state of North Carolina. She earned her Master’s Degrees in Social Work from Western Carolina University where she focused on Integrated Healthcare and was recognized for Excellence in Leadership. She is passionate about working with adolescents and teens (12-18) and young adults who may be experiencing challenges with difficulty adjusting to new situations, anxiety, relationship issues, and trauma.
