When someone you know appears suicidal, you might not know what to do. Learn warning signs, what questions to ask and how to get help.
By Mayo Clinic Staff
When someone says he or she is thinking about suicide, or says things that sound as if the person is considering suicide, it can be very upsetting. You may not be sure what to do to help, whether you should take talk of suicide seriously, or if your intervention might make the situation worse. Taking action is always the best choice. Here's what to do.
The first step is to find out whether the person is in danger of acting on suicidal feelings. Be sensitive, but ask direct questions, such as:
- How are you coping with what's been happening in your life?
- Do you ever feel like just giving up?
- Are you thinking about dying?
- Are you thinking about hurting yourself?
- Are you thinking about suicide?
- Have you thought about how you would do it?
- Do you know when you would do it?
- Do you have the means to do it?
Asking about suicidal thoughts or feelings won't push someone into doing something self-destructive. In fact, offering an opportunity to talk about feelings may reduce the risk of acting on suicidal feelings.
You can't always tell when a loved one or friend is considering suicide. But here are some common signs:
- Talking about suicide — for example, making statements such as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born"
- Getting the means to commit suicide, such as buying a gun or stockpiling pills
- Withdrawing from social contact and wanting to be left alone
- Having mood swings, such as being emotionally high one day and deeply discouraged the next
- Being preoccupied with death, dying or violence
- Feeling trapped or hopeless about a situation
- Increasing use of alcohol or drugs
- Changing normal routine, including eating or sleeping patterns
- Doing risky or self-destructive things, such as using drugs or driving recklessly
- Giving away belongings or getting affairs in order when there is no other logical explanation for why this is being done
- Saying goodbye to people as if they won't be seen again
- Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
If you believe someone is in danger of committing suicide or has made a suicide attempt:
- Don't leave the person alone.
- Call 911 or your local emergency number right away. Or, if you think you can do so safely, take the person to the nearest hospital emergency room yourself.
- Try to find out if he or she is under the influence of alcohol or drugs or may have taken an overdose.
- Tell a family member or friend right away what's going on.
If a friend or family member talks or behaves in a way that makes you believe he or she might commit suicide, don't try to handle the situation without help — get help from a trained professional as quickly as possible. The person may need to be hospitalized until the suicidal crisis has passed.
If you're a teenager who's concerned that a friend or classmate may be considering suicide, take action.
- Ask the person directly about his or her feelings, even though it may be awkward. Listen to what the person has to say, and take it seriously. Just talking to someone who really cares can make a big difference.
- If you've talked to the person and you're still concerned, share your concerns with a teacher, guidance counselor, someone at church, someone at a local youth center or another responsible adult.
It may be hard to tell whether a friend or classmate is suicidal, and you may be afraid of taking action and being wrong. If someone's behavior or talk makes you think he or she might be suicidal, the person may be struggling with some major issues, even if not considering suicide at the moment. You can help the person get to the right resources — even though he or she may not want to ask for it.
If a friend or loved one is thinking about suicide, he or she needs professional help, even if suicide isn't an immediate danger. Here's what you can do.
- Encourage the person to seek treatment. Someone who is suicidal or has severe depression may not have the energy or motivation to find help. If your friend or loved one doesn't want to consult a doctor or mental health provider, suggest finding help from a support group, crisis center, faith community, teacher or other trusted person. You can help by offering support and advice — but remember that it's not your job to become a substitute for a mental health provider.
- Offer to help the person take steps to get assistance and support. For example, you can research treatment options, make phone calls and review insurance benefit information, or even offer to go with the person to an appointment.
- Encourage the person to communicate with you. Someone who's suicidal may be tempted to bottle up feelings because he or she feels ashamed, guilty or embarrassed. Be supportive and understanding, and express your opinions without placing blame. Listen attentively and avoid interrupting.
- Be respectful and acknowledge the person's feelings. Don't try to talk the person out of his or her feelings or express shock. Remember, even though someone who's suicidal isn't thinking logically, the emotions are real. Not respecting how the person feels can shut down communication.
- Don't be patronizing or judgmental. For example, don't tell someone, "things could be worse" or "you have everything to live for." Instead, ask questions such as, "What's causing you to feel so bad?" "What would make you feel better?" or "How can I help?"
- Never promise to keep someone's suicidal feelings a secret. Be understanding, but explain that you may not be able to keep such a promise if you think the person's life is in danger. At that point, you have to get help.
- Offer reassurance that things will get better. When someone is suicidal, it seems as if nothing will make things better. Reassure the person that these feelings are temporary, and that with appropriate treatment, he or she will feel better about life again.
- Encourage the person to avoid alcohol and drug use. Using drugs or alcohol may seem to ease the painful feelings, but ultimately it makes things worse — it can lead to reckless behavior or feeling more depressed. If the person can't quit on his or her own, offer to help find treatment.
- Remove potentially dangerous items from the person's home, if possible. If you can, make sure the person doesn't have items around that could be used to commit suicide — such as knives, razors, guns or drugs. If the person takes a medication that could be used for overdose, encourage him or her to have someone safeguard it and give it as prescribed.
If someone you know says he or she is thinking of suicide or is behaving in a way that makes you think the person may be suicidal, don't play it down or ignore the situation. Many people who commit suicide have expressed the intention at some point. You may worry that you're overreacting, but the safety of your friend or loved one is most important. Don't worry about straining your relationship when someone's life is at stake.
You're not responsible for preventing someone from taking his or her own life — but your intervention may help the person see that other options are available to stay safe and get treatment.
June 09, 2012
- Schreiber J, et al. Suicidal ideation and behavior in adults. http://www.uptodate.com/home/index. Accessed March 13, 2012.
- Kennebeck S, et al. Evaluation and management of suicidal behavior in children and adolescents. http://www.uptodate.com/home/index. Accessed March 13, 2012.
- Suicide prevention. Depression and Bipolar Support Alliance. http://www.dbsalliance.org/site/PageServer?pagename=home. Accessed March 29, 2012.
- Warning signs of suicide. American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?page_id=0519ec1a-d73a-8d90-7d2e9e2456182d66. Accessed April 30, 2012.
- McDowell AK, et al. Practical suicide-risk management for the busy primary care physician. Mayo Clinic Proceedings. 2011;8:792.
- Teens. Suicide Prevention Resource Center. http://www.sprc.org/featured_resources/customized/teens.asp. Accessed March 29, 2012.
- When you fear someone may take their life. American Foundation for Suicide Prevention. http://www.afsp.org/index.cfm?page_id=F2F25092-7E90-9BD4-C4658F1D2B5D19A0. Accessed March 22, 2012.
- Bostwick JM (expert opinion). Mayo Clinic, Rochester, Minn. May 2, 2012.