Talking About Suicide

Saying “I want to kill myself” has become part of daily conversations. So much so that when chatting over text, there’s an acronym for it: KMS. The problem is that we often turn away from the person who says it, assuming it to be a joke or not that serious. Maybe there’s some worry that if we respond, the person will be angry or judge us, saying we’re making a big deal out of nothing. But what if the person who said it actually is in distress and needs us to reach out?

Most people who die of suicide told someone at some point that they were contemplating it. Suicide is a growing health problem in the United States and the second leading cause of death for young people. Whether a friend, classmate, or family member talks about killing themselves, we need to take it seriously and start treating mental health as part of overall health. Just as we wouldn’t ignore someone who broke an arm or was experiencing a seizure, we need to intervene when it comes to mental health crises. We need to remember that what feels like a crisis to someone is a crisis to that person. Minimizing others’ feelings or judging whether they should be in pain because of a test, a breakup, or whatever the crisis may be doesn’t help. If someone expresses distress, however subtly and for whatever reason, be there for them!

Geaux Girl!’s Teen Advisory Council provided the following poignant and thoughtful questions about mental health and suicide prevention. Thank you for asking what many teens wonder about but might be too afraid to say!

“We must become comfortable with asking the question:
Are you okay?”

Is thinking about death the same as being suicidal?

Not necessarily. As we’re growing up, it’s quite common to think about life and death and what that means. Some people can’t stop thinking about death, fearing it will happen to themselves or a loved one. It can become a preoccupation that disrupts their day-to-day activities, like going to school. Other times, it progresses into wanting to die. Those who find themselves thinking excessively about death should ask themselves: Am I worried about dying? Am I thinking about not being alive anymore? Do I not want to be alive anymore? If people start thinking and speaking about death a lot, it’s vital to have an open conversation to see what kind of thoughts they’re having. Pull in someone you trust; it can be a teacher, school counselor, or a parent.

How to handle people who joke about depression and suicide?

People joke about depression and suicide because the topic makes them uncomfortable. Society hasn’t taught us to take a minute to check on people when they make statements like “OMG, I just want to die” or “I’m just going to KMS.” Sometimes we are afraid to do so because we don’t want them to judge us or think we’re overreacting, but we must become comfortable with asking the question: Are you okay? If it turns out that they were just joking, at least it’ll remind people that they should be careful about how they choose their words. The point isn’t to be judgmental but instead to indicate “People are struggling, and maybe you are too. Let’s talk. I’m your friend and want to make sure you’re alright.”

It’s possible that you don’t get taken seriously if you reach out to someone or that people who love you don’t want to believe that you’re experiencing suicidal thoughts. There’s a lot of stigma and fear around mental health. A crisis line is an ideal safe space. There are people available 24 hours a day who have conversations like this multiple times a day. They can help you talk through exactly what it is that you’re feeling and provide resources. If it’s a friend you’re worried about, they will guide you on how to help your friend.

How can I tell if someone is serious about being depressed or suicidal? How do I respond?

We have to take it seriously every time we hear people talking about being depressed or suicidal. Even if people are joking or friends say it a lot, take their comments seriously and ask if they are okay. Knowing how to intervene and making others comfortable to share when they’re in distress can save lives.

What language should I use when talking to someone who might be struggling? How do I avoid triggers?

Talking about suicide doesn’t cause suicide. Ask people directly: Do you think about suicide? Are you thinking of ending your life? Inviting people to talk about their pain takes the stigma away and shows them that we care. That said, how we present the question matters. The tone isn’t “You’re not thinking of suicide, are you?” To the listener, this translates to “Please tell me you’re not thinking of suicide because I don’t know what to do if you tell me you are.” They may not feel safe to tell you the truth and continue to think that what they’re going through is abnormal, even shameful. Instead, we need to communicate to people who are experiencing these thoughts that they aren’t alone. Talking openly is one of the best ways to prevent suicide.

RED FLAGS

• Sadness and hopelessness
• Anxiety and fearfulness
• Trouble concentrating
• Anger, irritability, and agitation
• Withdrawn from friends and family
• Withdrawn from activities
• Extreme sensitivity to rejection and failure
• Loss of energy, increased fatigue
• Change in weight (up or down)
• Physical complaints such as headaches or stomachaches
• Symptoms interfere with the person’s ability to function (personal hygiene, school attendance, participation, grades, and relationships)
• Talks about wanting to die, expresses thoughts of suicide

“Talking openly is one of the best ways to prevent suicide.”

Stephanie Hepburn, J.D., is the editor in chief of #CrisisTalk, a publication that serves as a platform for ongoing, diverse conversation on mental health crises, including missed opportunities, gaps, innovations, and best practices. She is also the chief content officer for RI International, a global nonprofit organization that offers more than 50 programs throughout the United States and abroad, characterized by recovery and a focus on what’s strong, not what’s wrong. For this article, Hepburn consulted with expert Wendy Martinez Farmer, MS, LPC, President & CEO of Behavioral Health Link, an organization that operates the Georgia Crisis and Access Line.