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How To Bring Up Suicidal Ideation in A Conversation

How To Bring Up Suicidal Ideation in A Conversation

Suicide is a big problem in the United States, exacerbated by factors like mental and physical health, poor relationships, problems at work, financial worries, and many others. According to the U.S. Centers for Disease Control and Prevention, suicide – taking one’s own life – accounted for almost 46,000 deaths in 2020. If you know the warning signs and identify them in someone else, you may be able to talk to that person and help them get better.

What Is Suicidal Ideation?

Suicidal ideations (SI), “often called suicidal thoughts or ideas,” is widely used to define a range of ideas, wishes, and obsessions with death and suicide. Part of the problem is there’s no unanimously accepted definition of SI, causing difficulties for educators, healthcare professionals, and others to identify the warning signs and provide treatment for someone in need.

There are two kinds of suicidal ideation:

  • Passive suicidal ideation means someone is thinking about or wishes for it without planning to make it happen. 
  • Active suicidal ideation is when someone thinks about precise ways to end their life. It’s about thinking of suicide which has a plan to harm oneself, whereas passive suicidal ideation lacks a formal plan for carrying out suicide.

Know The Warning Signs

If you’re close to someone or otherwise know that person well, you can often identify when something appears wrong. There’s a sudden change in behavior or routine, or obsession with certain things. All of these can point to the risk of suicide. Warning signs may be expressed by the way someone talks, behaves, and how their moods affect daily life. 

You should be concerned if a person talks about:

  • Killing or harming themselves
  • Feelings of hopelessness
  • No desire to live
  • Being a weight on someone
  • Feeling stuck
  • Agonizing pain

Behavioral changes are also worrisome and may include.

  • Heavier alcohol or drug use
  • Looking for a means to end their life, like online research for specific methods
  • Avoiding certain activities
  • Self-isolation
  • Problems sleeping
  • Making the rounds to say goodbye
  • Giving away personal possessions
  • Aggressive behavior
  • Fatigue

Finally, warning signs of suicide can manifest themselves in someone in the form of depression, anxiety, loss of interest in things they used to enjoy, irritability, humiliation or shame, agitation and anger, and the sudden appearance of feelings of relief or improvement in moods.

Talking About Suicide Is Never Easy

How to bring up suicidal ideation in a conversation is never easy, but studies show that talking about suicide can help, rather than harm, their situation. If you know of someone who’s contemplating suicide, there are ways you can talk about it. Here’s what you can try.

Ask pertinent questions:

  • How are you feeling?
  • How are you getting along?
  • Are you thinking of hurting yourself?
  • Do you ever think about harming yourself?
  • Have you ever tried to harm or kill yourself before?
  • Do you have a specific plan on how to take your life?
  • What makes you feel this way?
  • Is there something positive in your life holding you back?

Employ active listening techniques:

  • When talking to someone who may be suicidal, don’t be judgmental and always have an accepting attitude.
  • Make sure the person knows you’re paying attention. You can do this by restating or summarizing what the other person said.
  • Allow the conversation to flow naturally, respectfully, and at a pace the other person is comfortable with. Time may allow the other person to be honest.
  • Pay attention to how the other person behaves and what their body language says about their situation.
  • Remain calm in your demeanor and speech. If the conversation is upsetting, suggest taking a short break.

How to bring up suicidal ideation in a conversation often depends on trust and mutual respect. If the other person feels comfortable, that’s a good time to find out what’s specifically wrong, how it’s affected them, and what can be done to improve things.

The conversation may lead into how you can help the other person, and how that person can help themselves. It’s important the other person knows you’re there as a friend and will support them on their terms, even if it’s difficult. Showing your commitment to the other person can go a long way in cementing trust and eventually lead to discussing treatment options, like therapy or medicine. If you know someone who’s suicidal, encourage them to seek help from a healthcare professional and to ask about care options like ketamine infusion therapy.


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