When someone you know talks about taking their own life or says things that sound like a suicide plan, it can be very upsetting. You may not know whether to take the talk of suicide seriously. You also may wonder whether you could make the situation worse by getting involved. 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 feelings about suicide. 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 ever thought about suicide before or tried to harm yourself before?
• Have you thought about how or when you'd do it?
• Do you have access to weapons or things that can be used as weapons to harm yourself?

Asking about thoughts or feelings about suicide will not push a person into suicide. In fact, giving someone a chance to talk about feelings may reduce the person's risk of acting on those feelings.

When a loved one or friend is thinking about suicide, they may:

• Talk about suicide, such as "I'm going to kill myself," "I wish I were dead" or "I wish I hadn't been born."
• Get the means for suicide, such as buying a gun or gathering a supply of pills.
• Withdraw from social contact and want to be left alone.
• Have mood swings, such as being emotionally high one day and deeply sad the next.
• Talk or write about death, dying or violence.
• Feel trapped or hopeless about a situation.
• Increase the use of alcohol or drugs.
• Change routines, including eating or sleeping patterns.
• Do risky or self-destructive things, such as using drugs or driving in a way that could cause harm.
• Give away belongings or get affairs in order when there is no reason to do so.
• Say final goodbyes to people.
• Develop personality changes or be overly anxious or agitated, particularly along with other warning signs.

If someone has tried suicide:

• Do not 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 department.
• Try to find out if the person 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 loved one talks or behaves in a way that makes you believe the person might try suicide, do not try to handle the situation alone. Instead:

• Get help from a trained professional as quickly as possible. Your friend or loved one may need to stay in the hospital until the suicidal crisis passes.
• Urge the person to contact a suicide hotline.
  • In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
  • U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.
  • The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

If you're a teenager who's worried that a friend or classmate may be thinking about suicide, take action:

• Ask the person directly about their feelings, even though it may be awkward. You could start out with a general question, such as "How are you feeling?" 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 thinking about suicide. You may be afraid to take action and be wrong. If someone's behavior or talk makes you think the person is at risk of suicide, that person may be struggling with major issues. Even if your friend or classmate is not thinking about suicide, you can help the person get to the right resources.

If a friend or loved one is thinking about suicide, professional help is needed — even if suicide is not a danger right away. Here's what you can do:

• Urge the person to contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, or use the Lifeline Chat. Veterans or service members can call 988 and then press "1," or text 838355, or chat online. The Suicide & Crisis Lifeline has a Spanish-language phone line at 1-888-628-9454 (toll-free).
• Urge the person to seek treatment. Someone who is thinking about suicide or is very depressed may not have the energy or motivation to find help. If the person doesn't want to see a doctor or mental health professional, you can suggest other sources for help. Support groups, crisis centers, and faith communities are good options. A teacher or another trusted person also can help. You can offer support and advice too — but remember that it's not your job to take the place of a mental health professional.
• Offer to assist the person take steps to get help and support. You can research treatment options. Offer to make phone calls and review insurance benefit information. You also can offer to go with the person to an appointment.
• Urge the person to talk to you. Someone who is thinking about suicide may feel ashamed, guilty or embarrassed. Be supportive and understanding. Give your opinions without placing blame. Listen closely and do not interrupt.
• Be respectful and note the person's feelings. Do not try to change the person's feelings or express shock. Remember, even though someone with thoughts about suicide is not thinking clearly, the emotions are real. Not respecting how the person feels can cause the person to stop talking.
• Do not talk down to or be critical of the person. For example, do not 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 feelings about suicide 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, you must get help.
• Point out that things can get better. When someone has thoughts about suicide, it seems as if nothing will make things better. Reassure the person that treatment includes learning other ways to cope, which can make life feel better again.
• Urge the person to stay away from alcohol and drug use. Using drugs or alcohol may seem to ease painful feelings, but it makes things worse. It can lead to unsafe behaviors or feeling more depressed. If the person needs help quitting, offer to help find treatment.
• Remove dangerous items from the person's home, if possible. If you can, make sure the person does not have items around that could be used for suicide. Look for and remove items such as knives, razors, guns or drugs. If the person takes a medicine that could be used for overdose, urge the person to have someone keep it and give it as prescribed.

If someone talks about suicide plans or behaves in a way that suggests the person is thinking of suicide, do not play it down or ignore the situation. Many people who kill themselves 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. Do not worry about straining your relationship when someone's life is at stake.

You're not responsible for preventing a suicide. But you can take action to help the person see that other options are available to stay safe and get treatment.

Aug. 12, 2023

Original article: https://www.mayoclinic.org/diseases-conditions/suicide/in-depth/suicide/art-20044707