Just about every list of “suicide myths” mentions this one: “If a person is serious about killing themselves then there is nothing you can do.” But is it always a myth?
In important ways, yes, it is a myth. There are many things that loved ones of a suicidal individual can do to help – things like asking directly about suicidal thoughts, fully listening to the person, providing nonjudgmental emotional support, removing firearms and other lethal means from the home, giving a list of resources for help and support, and helping them to get professional help.
At the same time, especially when suicidal thoughts and behaviors persist for many months or years, loved ones may come to a point where they have to recognize their limitations. In some important ways, their hands are tied.
Recognizing My Own Limitations with a Suicidal Person
I came to the realization many years ago that I could not fully protect a close friend from suicide. She went through an extremely suicidal time for over a year. One night, she came to my house at midnight with her wrist bleeding. She had attempted suicide. She refused to let me call an ambulance, and it even took much persuading before she would let me take her to the ER. They gave her stitches and discharged her to my house (she refused hospitalization and did not meet criteria for involuntary commitment). The doctors advised me to remove all sharp implements and pills from her reach.
My friend stayed with me a couple days. When she went back home, I was left with this feeling of abject helplessness, this recognition that she might kill herself, and also this sudden acceptance that ultimately I could not control if she died by suicide.
Even when she was at my house, even with all my sharp implements and pills hidden in the locked trunk of my car, I could not have prevented her suicide. I had to use the bathroom sometimes. I had to sleep. She could have walked out the door at any time and found other sharp implements, pills or means to die by suicide.
Recognizing Your Limitations with a Suicidal Person
No matter how desperately you may wish otherwise, there is only so much you can do to stop another person from dying by suicide. You cannot monitor a family member or friend every second of the day. You cannot remove all means for suicide entirely from their world. Although you can talk with them about their suicidal thoughts, you cannot read their mind if they choose not to share them.
Even professionals are not fully able to prevent suicides. One study found that almost 1 in 5 people who died by suicide had seen a mental health professional within 30 days of their death. That means that in the United States, with almost 43,000 people dying by suicide in 2014, more than 8,000 of them had recently seen a mental health professional. A study in Finland found that almost 10% of suicides occurred within 24 hours, at most, of an appointment with a health professional.
Even inside locked psychiatric hospital units, even when patients are under constant supervision, some patients die by suicide. That is staggering. It is also illuminating. If mental health professionals and psychiatric hospitals cannot prevent all suicides, then how can friends and family be expected to do so?
Coping with Your Limitations when Someone You Know is Suicidal
When I realized my inherent limitations with my friend, I came up with a saying (I’m sure I’m not the first):
Do everything you can, but know you can’t do everything.
It is hard, terribly hard, to sit with the fundamental helplessness you may feel about your loved one who is in danger of suicide. At these times, it can be helpful to really recognize that many, maybe most people, who die by suicide have depression, post-traumatic stress or another mental illness, a genuine and sometimes severe illness, just like cancer or heart disease. Although the illness is treatable in most cases, and although most suicidal people go on to live many years without ever dying by suicide, the illness occasionally proves to be fatal.
Michael J. Gitlin, M.D., is a psychiatrist who lost a patient to suicide shortly after finishing his psychiatric residency. He wrote about his experience in a poignant journal article. As somebody who specialized in treating people with severe depression, he articulated the high probability of suicide among some of his patients. He came to accept that his work was like that of a doctor working with cancer patients: Not everyone could be saved.
What You Can Do to Help a Suicidal Person
I am not saying that loved ones and therapists should not do what they can to prevent a person’s suicide. Of course they should! There are many things you can do to help someone who’s in danger of ending their life:
First, listen. Really listen. Don’t immediately give advice, try to talk the person out of suicide, or try to make the person feel better. Instead, try to understand. Be curious, not judgmental. (For more info, see my post: How Would You Listen to a Person on the Roof?)
Talk directly about suicide. Ask questions about suicidal thoughts. (I talk about this more in my posts Uncovering Suicidal Thoughts and Let’s Really Talk about Suicide.)
After you’ve truly listened, heard, and tried to understand the person, help the person to problem-solve, identify other options besides suicide, etc. Also help them create a safety plan.
If you’re unsure what to say or do, call 988 to reach the Suicide & Crisis Lifeline. A counselor there can give you advice. (You can also find other free places to get help by phone, text, or chat on this site’s Resources page.)
I’ve also written a book about what you can – and can’t – do to help someone with suicidal thoughts, and how to take care of yourself, too, during such an ordeal.
Limitations and Hope when Helping a Suicidal Person
Many lives have been saved by the actions of concerned others who did their best to help. In fact, my own friend, the one whose possible suicide I’d come to feel hopeless about, recovered.
Not everyone is so fortunate. And when a life is lost to suicide, that does not necessarily mean that anyone failed, that anyone made a grave mistake, or that anyone is to blame.
You do everything you can, with the understanding that “everything you can” cannot be everything.
EDITED: Feb. 5, 2015; Aug. 12, 2021, Sept. 2, 2022
*Copyright 2013 Stacey Freedenthal, PhD, LCSW, All rights Reserved. Written For: Speaking of Suicide. Photos purchased from Fotolia.
Living with a family member who constantly threatens suicide. He has a toddler daughter. He sleeps all day and plays video games all night. He eats terribly and is sedentary and is becoming ill because of it. He’s bitter and mean and refuses help. It’s going on two years now. He refuses to work and just keeps taking. If questioned he says just wait and see I’ll kill myself. Ten years ago he was committed for a year after trying to kill himself. What the fuck am I supposed to do. He’s hurting our family and his child. Of course we want to help but what are we supposed to do. We can’t just keep having talks.
Kara, I know what you are feeling. I live with a family member who makes lots of suicide attempts. I feel like I have PTSD seven times over. When I get angry, I try to think about the fact that although suicidal people can appear to be very manipulative, they have an illness which robs them of the power to make sensible choices and sometimes – very hurtfully- robs them of the ability to appreciate the pain of other people. Try to hang to the fact that he does love you and he doesn’t consciously want to hurt you. Im in the process of trying to figure out what to do in my situation. I’m not sure what the next move is, but it will involve taking a step back to protect my own sanity. I hope that you can find a little bit of comfort in knowing that you aren’t alone.
I also live with a relative who frequently says he is going to kill himself. He has said this for years, but fortunately never acts on it. He seems to use it as a way to vent him feelings but doesn’t seem to really mean it. I think at first he liked freaking us out about him and making us worry about him, but it seems like he just likes saying rather extreme things. I think the word for it is hyperbole. When he gets upset, he always says the most extreme things, but doesn’t seem to mean it. He used to take out his frustrations on inanimate objects like doors and walls, punching his fist in them and making holes, but that got too expensive for him, so now he just resorts to words which don’t cost him anything to vent and blow off steam. The sad thing is that now no one takes him seriously, so if ever does mean it someday, we wouldn’t know in time to do anything about it.
Some of the phrasing in the article suggests that mental illness is not a real illness. Compared to “genuine illness…like cancer or heart disease”
Thanks for trying, but that is quite a flub.
Sorry for my very late response, but I just saw this and was confused by what you wrote, because I would never say that mental illness is not a genuine illness.
Indeed, the sentence you quoted is not quoted accurately; what I wrote above is, “At these times, it can be helpful to really recognize that most people who end up dying by suicide have depression, post-traumatic stress or another mental illness, a genuine and sometimes severe illness, just like cancer or heart disease.”
In other words, mental illness is a genuine illness, just like cancer or heart disease.
I can understand your concerns if I’d said otherwise. Too many people deny the reality and seriousness of mental illness. I hope you will continue to challenge people when you perceive that they deny this reality.
And in the future, I will have to be careful to be more clear!
Just want to be loved unconditionally. Just once.but who cares? nobody.
i want the same thing but no one wants me. nomater what i do i always feel unwanted
I care…Most of all…GOD CARES… KNOW YOU ARE WORTH SO MUCH MORE AND THE ACTIONS OF OTHERS DOES NOT DETERMINE YOUR OR MY WORTH!!
PRAYERS FOR YOU, ME, AND BE ALL WHO ARE DEMEANED, ABUSED VERBALLY, PHYSICALLY ..OR MADE TO FEEL UNLOVED OR UNCARED FOR!!
I care 🙂
I do too…
I care
I don’t even know you but I care. And it sucks that I have to read that here and respond here. Allow a new vision of yourself. Make changes in your life. Move away if you can. Everything has its triggers. Nobody has to be unhappy. We get stuck in ways and when we do we have to push ourselves to make change. No one is weak. It’s a choice to fight or flight. And if overwhelmed one does not owe anybody anything that causes hurt for them self. It’s not failure. It’s something you weren’t designed to do. You should notice it after many attempts. Thats when you change what your evolved with. Like move away. It’s a free country. There is always a place where someone will fit in. No matter what or how they think or how they act or react. Sounds to me your not in a city or a residence that suits your needs and if true. Be brave and move on to better. Do research. Visit places. Close or far from current place. There is a residents in this earth for you. Be adventurous and find that place. Use the feelings to push you to find your reality and do not give up until you do. We all have reasons and choices. We make our choices by relationships and social influences. Social media can be traumatizing if for you. Avoid it. Delete it. Rid of those things making you unhappy. You have the right to be happy. It’s called civil rights.
You need to learn to love yourself! Try sprituality and yoga (not the sport)
For some of us suicide is our only option
When you loose who you are, you’ve lost everything!!
Fighting to find myself again, but feeling like a wound up clock and the spring is going to break!
Verbal abuse is worse than physical abuse..I know..I’ve had both!
But when you are demeaned and nothing you do is ever right and you fight daily to just get up, I wonder if I will ever get my self with back.
I’m lost! But I’m fighting to recover! Ty
I hate it not being within my control, and with my boyfriend’s mom NEVER getting back to me when I call and text her frantically because he’s threatening suicide I feel absolutely hopeless. He texted until 11:19 last night, said he was going to try to sleep. I have not heard from him since, normally he’s up by ten. I have no idea what to do, his mom ignores me, I don’t know his dad’s number, he has no other relatives I know that I can contact. I’m terrified that later today I’ll find out he’s dead, and I feel absolutely helpless. He lives 7 hours away, I don’t know what the hell to do.