I’m Worried About My Friend’s Suicide Risk. How Can I Help?

I don’t know who she was.

It was the early 2000s, the height of the AIM craze, when middle schoolers rushed home at the end of the day to log on and start chatting. These were the early days, where we could hardly distinguish an LOL from a G2G and emojis had yet to replace emoticons (I know, (☉_☉)!).

One day, I was chatting with my friend when I started panicking: She had seen an apparent suicide note on someone else’s AIM profile, and didn’t know what to do. All of 13 years old, we called our respective parents to help save the day. Our parents called the police. But this was the early days of social media, when it was next to impossible to figure out where someone was or how to reach out to them.

To this day, I still wonder if that person is alright.

When It’s Closer to Home

What if the person we’re worried about isn’t a stranger on the internet, but a family member or friend? With the CDC estimating that 0.5% of Americans, or 1 in 200 people, have attempted to end their own life, suicide risk affects more people than we may realize. Given this number, it’s safe to assume it affects people in our own lives. With suicide the tenth leading cause of death in the United States, it’s important to know how to talk to someone you’re concerned about.

Worrying that someone close to us is suicidal can be a difficult and scary experience. It’s normal to have an intense emotional reaction, and to want to reach out. Reaching out can make all the difference. How can we be supportive and have these difficult, yet potentially life-saving conversations? Here’s what the experts advise.

Know the Signs of Suicide Risk

Maybe your friend or loved one has become withdrawn, or just seems down lately — or perhaps you’ve even heard them talking about suicide. Being able to recognize the warning signs is the first step in helping those going through a hard time.

Any loved one who seems depressed or withdrawn deserves support and concern. According to the National Suicide Lifeline, these are some signs to watch out for. If your loved one is doing any of the following, reach out for help:

• Talking about wanting to die
• Saying they feel out of control or unable to think clearly
• Talking about feeling hopeless or having no reason to live
• Saying they can’t bear the pain or feel that there’s no way out
• Looking for ways to kill themselves (like searching online or buying a gun)
• Extreme mood swings
• Inability to sleep, work, or eat
• Talking about being a burden to others
• Increased use of alcohol and drugs
• Giving away possessions or otherwise planning for death

If you notice any of the above signs, it’s time for a conversation. Everyone’s different, and you know when your loved one just isn’t right. If you’re ever in doubt, reach out.

Reach Out if You Feel Someone is in Distress

We all want to help our loved ones in distress, but actually reaching out can feel daunting, to say the least. We worry that we’ll say the wrong thing or even “give someone ideas” by openly talking about suicide. But research shows that asking about someone’s suicide risk and talking openly and supportively about your concern doesn’t “encourage” someone to harm themselves — far from it. In reality, frank, compassionate conversations about suicide can help save lives.

Asking is the first step. The National Suicide Prevention Lifeline recommends initiating a compassionate, and non-judgemental conversation. It’s okay to be direct, but not okay to be accusatory. You can open the conversation by expressing concern and asking how they’re feeling: “You seem down lately and I really care about you. Are you thinking about hurting yourself?” Then, listen — really listen — to what your friend says.

It’s normal for you to feel shocked, upset, confused, or even angry at your friend and their actions. However, it’s important that you express concern and give support without guilting, shaming, berating, or lecturing your friend. Being suicidal isn’t something that your loved one can “just walk off” or a sign that they’re being “irresponsible.” Instead, you should be grateful that your friend is willing to open up and accept your offer of support to keep them safe, without conditions or guilt.

Help Keep Your Loved One Safe in Immediate Suicide Risk

When you reach out to a friend who may be feeling suicidal, it’s important to assess their risk. You can ask whether they’ve tried to commit suicide before, whether they’ve made a plan to commit suicide, or whether they have access to guns, drugs, or other objects that they might use in an attempt.

If your loved one has a plan to harm themselves, they’re at immediate risk, and it’s important to take action. Make sure the person is safe, remove dangerous objects or weapons if you can, and don’t leave them alone. Can call the National Suicide Prevention Lifeline (1-800-273-8255), call 911, or drive them to the nearest hospital emergency room for immediate support.

Build Support if Risk is Occasional

If you feel that the risk isn’t immediate — that is, if your friend has had occasional thoughts of suicide but doesn’t have a plan to attempt it — t’s still important to offer support. Give them the National Suicide Prevention Lifeline number (1-800-273-8255), or you can call the lifeline yourself.

Make a plan with your loved one for how they can access social and mental health support, and help them reach out to a therapist or medical professional. Connectedness, or feeling close to other people, community, and medical care, is one of the greatest factors in preventing suicide, according to the CDC. When talking to your loved one, you can help discover other people in their life who can be present and supportive — friends and family members who will reach out or meet with them regularly, and community resources they can access.

Once you make a plan to support your friend, be sure to stick with it. It’s better to only make promises of support you can keep, than to promise a lot of support or time together that you won’t be able to give. Studies show that following up with people who are suicidal can reduce future attempts, so do your best to remain present and remind your friend that they are loved and valued.

Take Care of Yourself, Too

We all want to swoop in like a superhero and rescue our friends from their pain, but the truth is, no one can take on the entirety of someone else’s burden. It’s important not to commit to more than you can truly take on, for both your friend’s health (they shouldn’t feel abandoned if you can’t come through) and for your own. Caring for a loved one who is suicidal is exhausting and can be traumatic. If your loved one has attempted suicide, and especially if you’ve been a first responder to an event, you need care as well.

Instead of thinking you can do it all yourself, prioritize building support networks for both your friend and yourself. Talking to a trusted friend or online therapist about what you’re experiencing can help keep you healthy — ultimately the best thing you can do to support the people you love. We’ve all got to lean on each other, so nourish yourself to help stand tall on solid ground.

If you or a loved one are feeling suicidal, there is help. The following hotlines and organizations are there for you, whoever you are and whatever your story.

National Suicide Prevention Lifeline — 1-800-273-TALK (8255)

The Trevor Project for LGBTQ Youth — 1-866-488-7386

International Association for Suicide Prevention — for listings of suicide prevention hotlines and centers worldwide

National Suicide Prevention Lifeline — to report threats of self-harm on social media, read the the NSPL guidelines