Talk Saves Lives™: If You Do Anything this World Suicide Prevention Day, Learn the Suicide Warning Signs and How to Have a Conversation with Someone You’re Worried About
Note: This blog relies heavily on information from the American Foundation for Suicide Prevention.
I AM A SURVIVOR OF SUICIDE LOSS
One month before I flew cross country to enter residential treatment for an eating disorder in May 2013, my friend and college varsity tennis teammate Paige died by suicide. In hindsight, I realize there were warning signs that preceded her death. But none of us knew them at the time. I, at least, thought suicide only happened in movies and to “crazy people” – a harmful stereotype. Paige started mentally declining a month before her death. She had stopped sleeping; began hyper-focusing on a problem she was experiencing in one class, and then stopped caring about all of her classes (notable for an honors student who had just been accepted into nine law schools); her eyes appeared glazed over as if she wasn’t really there with you; her speech slowed and seemed to take great effort, as if it was hard for her to pull words out of her brain to form sentences; her weight drastically changed; she distanced herself from her partner, friends, and family; and more. She had one month left of college, so we were all just trying to get her to graduation. Then, we figured, she’d be able to take time off before law school to prioritize her mental health. She didn’t make it to graduation.
This suicide loss, and my eating disorder healing journey, fundamentally changed my values and who I was as a person. In 2016, I secured my first full-time marketing job, at the American Foundation for Suicide Prevention. By working at AFSP, I felt I was able to honor Paige and apologize for not realizing how bad things in her brain had been, though I know that her death was not my fault. In the four years I worked for AFSP, I learned so much about suicide and mental health. I also became comfortable speaking about my eating disorder to people in my personal life, and then publicly through NAMI’s In Our Own Voice and Ending the Silence programs. While I no longer work at AFSP National, I am now a proud member of the AFSP Oregon Chapter Board of Directors.
Throughout my (almost) eight years of involvement with the organization, many friends, aquaintances and even strangers have reached out for guidance if there was someone in their life they were concerned about. I’ve also had several conversations with friends I personally was worried about. As far as ties to the eating disorder space, nearly 1/4 to 1/3 of those who have an eating disorder have also attempted suicide. Suicide effects so many more people than we realize, but no one gives this leading cause of death the attention it needs until they, or somebody they know, is personally effected.
I now strongly believe that everyone should learn the suicide warning signs and how to have a safe and supportive conversation with someone they’re worried about. If working and then volunteering for AFSP has taught me anything, it’s that Talk Saves Lives™.
SUICIDE WARNING SIGNS
I want to start by clarifying that suicide is complicated. There is no single cause. Suicide most often occurs when stressors and health issues converge to create an experience of hopelessness and despair that exceed a person’s ability to cope. Most people who take their lives exhibit one or more warning signs, either through what they say or what they do. Something specific to look out for is a change in behavior or the presence of entirely new behaviors. This is particularly concerning if the new or changed behavior is related to a painful event, loss, or life change.
Talk
If a person talks about:
Killing themselves
Feeling hopeless
Having no reason to live
Being a burden to others
Feeling trapped
Unbearable pain
Behavior
Behaviors that may signal risk, especially if related to a painful event, loss or change:
Increased use of alcohol or drugs
Looking for a way to end their lives, such as searching online for methods
Withdrawing from activities
Isolating from family and friends
Sleeping too much or too little
Visiting or calling people to say goodbye
Giving away prized possessions (even computer or phone passwords)
Aggression
Fatigue
Recklessness
Mood
People who are considering suicide often display one or more of the following moods:
Depression
Anxiety
Loss of interest
Irritability
Humiliation/Shame
Agitation/Anger
Sudden relief or improvement (this may indicate that they have made the decision to end their life and have a plan to do so)
HOW TO HAVE A CONVERSATION WITH SOMEONE YOU’RE WORRIED ABOUT
Suicide is a topic that hides in the shadows. All too often it goes unaddressed, even when we may sense someone is struggling. If you think someone might be thinking about suicide, assume you are the only one who will reach out. You don’t need special training to have an open, authentic conversation about mental health – and often, just talking about it can be the first important step in understanding how someone is doing, and helping them get support or treatment if needed.
How to Start (and Continue!) a Conversation About Mental Health
Let people know you’re willing to talk about mental health by speaking about your own.
Talk to them in private, and start with an expression of care, followed by an observation.
Listen to their story and validate them. Let them know you get it, and that it’s okay – and normal – to struggle in response to life’s challenges.
Avoid debating the value of life, minimizing their problems or giving advice.
If you think someone’s thinking about suicide, trust your gut and ask them directly. Research shows it will not put the idea in their head, or push them into action. Often, they’ll be relieved someone cares enough to hear about their experience with suicidal thoughts and that someone else said the scary word first.
Make sure not to sound like you’re passing judgment (DON’T say: “You’re not thinking of doing something stupid, are you?”) or guilt-trip them (DON’T say: “Think of what it would do to your parents.”)
Instead say: “Are you thinking about suicide?”, “Are you thinking about hurting yourself?”, or “Are you in danger of hurting yourself?”
Encourage them to seek help or to contact their doctor or therapist.
(Read AFSP’s complete #RealConvo Guide here.)
If Someone Tells You They’re Thinking About Suicide
Take the person seriously, but stay calm. Just because someone is having thoughts of suicide doesn’t necessarily mean they’re in immediate danger. Take the time to calmly listen to what they have to say, and ask some follow-up questions.
A follow up question I’ve asked is, “Do you have a plan [to end your life]?” You can find more examples of helpful follow up questions here.
Reassure them that help is available, and that these feelings are a sign that it’s time to talk to a mental health professional.
If they’re in immediate danger of attempting suicide:
Stay with them.
Help them remove lethal means (weapons, medication, etc.).
Call 988 to reach the National Suicide & Crisis Lifeline (free, available 24/7).
Text TALK to 741741 to text with a trained crisis counselor from the Crisis Text Line (free, available 24/7).
Encourage them to seek help or to contact their doctor or therapist. This might mean bringing them to the emergency room yourself, if needed.
(Read AFSP’s complete #RealConvo Guide here.)
DOING OUR BEST IN AN IMPERFECT WORLD
I want to acknowledge that our medical system is VERY imperfect. The United States does not have universal healthcare, and it can be hard to find a therapist. Trips to the emergency room can be incredibly expensive, and crisis responses, particularly if carried out by police offers, can sometimes cause further trauma and distress (particularly to marginalized communities). Thankfully, both the Crisis Text Line and 988 Suicide & Crisis Lifeline only contact emergency services as a last resort and at very low rates: less than 1% of Crisis Text Line conversations, and under 2% of 988 Lifeline calls. And within that 2% of 988 Lifeline calls, over half of the emergency dispatches occur with the caller’s consent.
Taking all of this into account, yes, it’s important to know the warning signs and have emergency resources programmed into your phone (see below). But it’s also important to help create a world where people will have to encounter fewer stressors whenever possible. Gun control is suicide prevention. Universal healthcare is suicide prevention. Wealth redistribution is suicide prevention. Access to gender affirming care and support is suicide prevention. Breaking down gender norms that tell men it’s “not manly” to have feelings and need support is suicide prevention. Fighting weight bias and diet culture is suicide prevention. The racial justice movement is suicide prevention. Eliminating antisemitism is suicide prevention. Affordable housing is suicide prevention. Bodily autonomy and abortion access is suicide prevention. Work/life balance is suicide prevention. Raising the minimum wage is suicide prevention. Normalizing the idea that we all have mental health just like we all have physical health is suicide prevention. Etc. As researcher Vikki Reynolds expertly said, “Nobody simply kills themselves. Events occur in context, and because we live in a society that has not delivered on the promises of social justice, which we are well qualified and able to deliver, we have to structure into our analysis of a person’s [suicide] death the context of social injustice in which they lived.”
ADDITIONAL RESOURCES
988 Suicide and Crisis Lifeline
Dial 988
(Press 1 for Veterans, 2 for Spanish)
Text 988 (English only)
Crisis Text Line
Text Talk to 741741 to speak with a trained crisis counselor for free, 24/7
Text AYUDA for Spanish
TrevorLifeline
1-866-488-7386
LGBTQ youth crisis intervention and suicide prevention phone service available 24/7/365
TrevorChat
Confidential online instant messaging for LGBTQ youth with a Trevor counselor, available 24/7
Access through a computer
TrevorText
Text START to 678-678
Confidential text messaging for LGBTQ youth with a Trevor counselor, available 24/7/365
Standard messaging rates may apply
SAGE LGBT Elder Hotline
Connects LGBT elders and caretakers with friendly responders.
1-877-360-LGBT (5428)
Confidential support and crisis response, available 24/7
Trans Lifeline
Staffed by transgender people for transgender people
1-877-565-8860 (United States)
1-877-330-6366 (Canada)
Confidential, 24/7 crisis support
