Despite having lived with depression myself for decades and losing loved ones to suicide, when someone very close to me showed signs of suicidal thoughts, I had absolutely no idea what to do or say. It’s such a helpless feeling.
Luckily I am in ongoing therapy and felt comfortable asking my therapist for his advice. We talked through possible approaches I could take based on the limited information I had and his professional knowledge of what helps and what does not.
My doctor’s advice was incredibly helpful in deciding how to handle such a high stakes, scary, emotional situation. But what in the world do you do if you don’t have this kind of connection or you don’t feel comfortable asking for advice about how to help someone else?
GET HELP: - Call the National Suicide Prevention Lifeline: 1-800-273-8255. - Text TALK to 741741 to text with a trained crisis counselor from the Crisis Text Line for free, 24/7.
September is Suicide Prevention Month, and I’ve been seeing awareness efforts all over social media. Some of my favorites are Instagram posts by Self-Care is for Everyone featuring two helpful conversation guides created in collaboration with the American Foundation for Suicide Prevention (AFSP). One is about how to have a deeper conversation with someone you suspect may be suicidal about how they’re really feeling. The other is about how to respond if someone tells you they are suicidal.
Conversation Guide Links:
Although I knew I wanted and needed to talk with my loved one, I had lots of concerns. You probably do, too, because as it turns out, my worries are extremely common.
Common worries that came up when I thought about talking to my loved one about mental health and suicide:
- I was invading their privacy.
- I wasn’t the person who should be talking to them about this. Someone else was a more appropriate option.
- I would inadvertently say something to make things worse.
- I would embarrass them.
- Bringing up my concerns would put even more pressure on them.
These fears are common for a reason. We’re getting better all the time at openly talking about mental health in our culture, but so much of it is still taboo. Particularly among people from certain backgrounds. Even in the best circumstances, it’s intimidating to have such a high stakes conversation. However, we can work through our fears to initiate a conversation about this difficult topic that’s informed by recommendations from experts.
Some tips for conversations about suicide and/or mental health that I’ve found helpful:
- It’s okay to be direct.
- There’s no perfect way to bring it up.
- Assume you are the only person who will initiate a conversation like this with them. Don’t wait for someone else to do it.
- There’s no perfect time to have the conversation.
- You will not introduce the idea of contemplating or attempting suicide just by asking about it.
- Look at this as the start of a series on ongoing conversations.
As someone living with debilitating chronic migraine and advocating for people living with headache disorders, I feel compelled to mention the increased risk of suicide among patients with chronic headache disorders. Headache disorders, including both migraine and cluster headache, are the second most disabling condition in the world. A 10 year retrospective study of veterans with chronic headache disorders published this year found they were at increased risk of suicide compared to veterans with chronic pain. This is an important reminder of why our headache disorders advocacy work is so vitally important. If we can give people even slightly better control over their headache disorders their lives are more tolerable.
AFSP offers other helpful information, including conversation openers, that I highly encourage you to check out. Their suggestions can help you ease into this kind of inherently awkward talk with greater confidence in your approach.
I was nervous as hell when I started the conversation with my loved one. I still had doubts swimming through my head that I was doing something ill advised despite also knowing I was following the advice of mental health professionals. It took a bit of back and forth in our discussion for those nerves to settle on my end. But they did, and when we were finished I was relieved and proud of myself for doing something that felt incredibly hard. More importantly, the conversation went well. My loved one appreciated my concern and that initial conversation has led to an ongoing discussion.
You can do this, too.
- AFSP #RealConvo tools & resources. https://afsp.org/realconvo. Accessed September 9, 2021.
- Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 17 October 2020. https://doi.org/10.1016/S0140-6736(20)30925-9. Accessed September 9, 2021.
- Global Disease Burden 2019. GBD Compare. https://vizhub.healthdata.org/gbd-compare/#. Accessed September 9, 2021.
- Suicide Attempts in US Veterans with Chronic Headache Disorders: A 10-Year Retrospective Cohort Study. Journal of Pain Research. 24 August 2021. https://doi.org/10.2147/JPR.S322432. Accessed September 10, 2021.