Talking about suicide is never easy – but it is incredibly necessary. The impact felt from suicide goes far beyond one individual – friends, family, coworkers, and entire communities are affected with heavy grief, trauma, and sometimes shame or guilt.
According to the National Institute of Mental Health, or NIMH, suicide was the eleventh leading cause of death in the United States in 2022, and the second leading cause of death for individuals between the ages of 10-14 and 25-34 years old.
People avoid talking about suicide because it creates uncomfortable conversation, but having an awkward conversation is worth the price for saving a life.
If you or a loved one is struggling with suicidal thoughts, please text or call the suicide hotline at 988 to receive immediate support. Together, we can break the stigma and end suicide.
What are the warning signs of suicide?
After someone passes away by suicide, people often say phrases like, “I had no idea they were struggling,” or “I never saw this coming.” Some warning signs of suicide are more subtle and easy to miss than others. It’s no doubt that suicide is always shocking and devastating, but learning the warning signs can help us prevent it from happening before it is too late.
According to the NIMH, unusual changes in behaviors, talking about wanting to die or being a burden, and showing certain emotional signs, indicate there may be risk of suicide or suicidal ideation.
One or two of these symptoms occurring may not bring cause for concern, but if someone is exhibiting multiple signs you should take them seriously.
Concerning changes in behavior include making and researching a plan, self-isolating away from loved ones, engaging in risky behavior such as substance use, displaying extreme mood swings, eating and sleeping more or less than usual, and giving away important possessions. A person experiencing suicidal thoughts may experience feelings of emptiness, hopelessness, being trapped, extreme sadness, increased agitation, anxiety, or rage, and unbearable physical or emotional pain.
Stigma: Why we need to have conversations about suicide
Despite it being one of the leading causes of death in the United States, suicide remains a taboo subject. Fighting thoughts of suicide is often a silent battle that goes unseen by others due to self-stigma and stigma from others. Stigma comes from a place of misunderstanding and fear due to a lack of information and exposure.
With open minds and hearts, we can fight stigma with education and conversation. Talking about stigmatized topics, like suicide, can save the lives of people we care about most. It makes the vulnerable individuals feel less alone and more understood and helps loved ones to be more aware.
Suicide is 100% preventable if we continue to raise our voices, share valuable resources, and show support for those who are struggling.
Therefore, the more we have conversations about taboo topics the less intimidating they are to discuss.
Who is at risk?
To better understand suicide, it is important to know common factors that can cause someone to develop suicidal ideation. According to the Cleveland Clinic, there are several reasons someone may start having suicidal thoughts. Underlying mental illness is a large component of developing thoughts of suicide. Data collected by the National Alliance on Mental Illness reports that 46% of individuals who died by suicide had a known mental illness.
Other common causes include stress, genetics, interpersonal relationships, negative or traumatic life events, substance use disorder, or experiences with disparity or prejudice based on gender, race, sexual orientation, ethnicity, or religion.
For example, according to the NIMH, American Indian/Non-Hispanic Alaskan Men experience the highest rate of suicide in the United States, at 39.5 per 100,000. Statistics recorded by The Trevor Project show that young people who are part of the LGBTQ+ community are more than four times as likely to attempt suicide. Personal traits such as gender identity, ethnicity and lived experiences greatly impact your risk level.
How can I talk to someone about suicide?
Bringing up suicide with someone you care for can be intimidating, but it’s important to remember that you are doing it out of a place of love and concern. As suggested by Cigna Health and the Marine Corps Community Services, here are a few measures you can take when starting the conversation:
- Time and Space: Be intentional. This is a serious and sensitive conversation you are about to start. Be sure you can talk for as long as needed, and that you have access to a quiet and private space where you won’t be interrupted or distracted.
- Be thoughtful: Use honest and non-judgmental language to express your concerns to this individual. Be patient, kind, and open.
- Express your support: Tell the individual why you are concerned, while making it clear that you are there to listen and help them if needed.
- Be Direct: Ask them if they are experiencing thoughts of suicide. Hold space for them to talk and be a good listener.
- Don’t act like their counselor: Remember it is not your job to fix the situation – solely listen and show support. You are not here to compare their problems to yours. Don’t minimize their battles or make it about you – just be there for them.
- Assist them in connecting with professional help: Even if they resist, a person who has reached a point where suicide is an option often believes they are beyond the point of help. But this is not true – they are at extreme risk, but it is still possible to receive help.
Words Matter
Even with the best intentions, the words we choose matter. A single phrase can either build trust or shut someone down. Put yourself in the other person’s shoes and be mindful of the words you use. Be thoughtful and intentional.
When starting the dialogue between you and your loved one, show compassion but be honest. You want your message and concern to be clear to prevent unintentionally brushing it off as nothing of importance, but you also want to be sensitive. Finding a balance of showing empathy while being direct is key.
Conversation Starters
Now you know the steps you should take when starting the conversation about suicide. But what exactly should you say and ask? What words and phrases should you avoid?
Try these phrases to guide the conversation
First, communicate your care and support for this person. Say things like, “I really care about you,” “You matter to me,” “I’m here for you,” or “You don’t have to go through this alone” to demonstrate their importance to you.
Secondly, express your concern and interest in helping them by saying, “I want to respect your privacy, but I am worried about you. Can you talk to me about what’s going on?” or “Can you think of anything I could do to help you?” or “I may not know exactly how you feel, but I want to understand and help you,” and encourage them to reach out for help by asking, “Would you be open to reaching out to someone who can help us?”
The most difficult part will be asking the direct but critical question, “Are you thinking about suicide?” It may feel intrusive to ask this, but it’s better to ask than to ignore it. Skating around the question can cause more harm than addressing it.
Phrases you should avoid
During this conversation, do not use phrases that place blame, create shame, or minimize the person’s feelings and experience. You want to create a safe space for them to talk and do not want them to feel like they are in trouble or being shamed. Remember, they are already in a negative headspace – you do not want to make them feel worse. You are there to support them.
Phrases that minimize a person’s feelings include, “You’re being dramatic – everything is going to be fine,” “Your life is good, you have no reason to do this.”
Placing blame and making them feel ashamed may sound like, “Don’t be selfish – how could you do this to your family and friends?” to “Other people have it way worse than you,” and “Suicide is cowardly. Toughen up and things will get better.”
How Can I Handle Suicidal Thoughts?
Throughout this article, we have talked plenty about helping others who are thinking about suicide – but what if you start developing suicidal thoughts? What actions can you take to protect yourself? With help from the Cleveland Clinic, here are actions you can take if you are struggling with thoughts of suicide:
- Reach out for help: Call or text the 988 Suicide Hotline if you are in danger or thinking about acting on your suicidal thoughts.
- Reach out to someone you trust: Ask to meet them in person or talk with them. Suicide does not need to be the topic of discussion but being around others who care and listen is helpful.
- Participate in an activity you enjoy: The activity of your choice doesn’t have to be anything too strenuous. Partaking in activities you enjoy, such as going for a walk, can offer a positive distraction.
- Avoid drinking alcohol or using illicit substances: Using illicit substances or alcohol can enhance negative feelings and increase risky behavior. If you are struggling with substance use disorder, reach out to BrightView at 888-501-9865.
Breaking the silence could be the first step in saving a life – maybe even someone you love.
When we replace stigma with compassion, we create a world where no one has to feel alone. Every life matters. If we work together to end the stigma and build awareness, we can put a stop to suicide.
If you or a loved one is struggling, know you are not alone. Please call or text 988 to speak with a trained professional or call 911 in the case of an immediate emergency.
Sources
Facts about suicide among LGBTQ+ young people. The Trevor Project. (2024, January). https://www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/
Risk of Suicide. National Alliance on Mental Illness (NAMI). (2022, August). https://www.nami.org/about-mental-illness/common-with-mental-illness/risk-of-suicide/
Suicidal Ideation (Suicidal Thoughts). Cleveland Clinic. (2024, July 23). https://my.clevelandclinic.org/health/symptoms/suicidal-ideation
Suicide Warning Signs: What Do I Say?. Suicide Warning Signs: How to Start a Conversation | Cigna Healthcare. (n.d.). https://www.cigna.com/knowledge-center/suicide-warning-signs-what-to-say
Tough conversations: How to talk about suicide. MCCS: Marine Corps Community Services. (2021, July 13). https://hamptonroads.usmc-mccs.org/news/tough-conversations-how-to-talk-about-suicide
U.S. Department of Health and Human Services. (2025, March). Suicide. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/suicide
U.S. Department of Health and Human Services. (2025a). Warning signs of suicide. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/warning-signs-of-suicide