Have you ever been worried that a friend or family member might be considering suicide, but been too afraid to ask for fear of putting the idea in their head? Don’t be. If your loved one is suffering from the type of stressors or mental illness that put them at risk, your question won’t cause them to become suicidal. More likely, it could be the question that will save their life. Trust your instincts and reach out.

September is Mental Health Awareness Month, which is especially important in Mendocino County where we have almost twice as many suicide deaths as the state average.

Like many health-related issues, suicide affects people of all ages and ethnicities, rich and poor, young and old. Men are about three times more likely to die via suicide and firearms are the most common method. In 2017, the highest suicide rate was among adults between 45 and 54 years of age, and the second highest rate occurred in those 85 years or older.

Sadly, because of the stigma associated with suicide, we do a poor job of teaching the average person how to express suicidal feelings and also how to support someone in deep distress or despair. If someone you care about says they want to die, do not brush the comment aside by saying something like, “No you don’t.” or “You don’t mean that.” Instead, take a deep breath, steady yourself, and engage. Ask for more information. “Why? What’s going on?”

Signs and Symptoms

Although each individual is unique, people considering suicide often exhibit similar behaviors. They withdraw from their social circles; experience dramatic mood swings; increase their drug and alcohol use; say goodbye as though they won’t see people again, and/or exhibit impulsive, reckless or aggressive behaviors.

They may also exhibit behaviors that indicate a psychiatric emergency is imminent, like giving away prized possessions, suggesting that the world would be better off without them, and hoarding pills or buying a weapon.

How to Respond in an Emergency

If you feel like your loved one may be in immediate danger, speak in a calm, reassuring voice and ask simple, direct questions like, “Can I help you call your therapist?” or “Would you like a ride to the health center or hospital?” If possible, remove means such as guns, knives or stockpiled pills and avoid comments that put you at odds with your loved one—this isn’t the time to judge. You may also consider recommending that your loved one call the National Suicide Hotline at 1-800-273 TALK (8255) or if they prefer to text, to get in touch with a suicide hotline worker by texting “NAMI” to 741-741. They can also contact Redwood Community Services (visit redwoodcommunityservices.org/crisis for details) or even 911.

Helping Teens Through Despair

Suicide is heartbreaking at any age, but can be especially hard to accept when someone has so much life ahead of them—like a teenager. The human brain is not fully developed until our mid-twenties, which is why teens are so impulsive. They do not have access to the part of the brain used for long-term reasoning and delayed gratification. Instead, teens are completely engrossed in the current moment and often uninterested or unable to consider the consequences of their actions. Because of this, they also have trouble understanding how quickly their current crisis will pass. When they add drugs or alcohol to the mix, their thinking becomes more distorted and their actions more impulsive.

If you fear your teen may be suicidal, seek professional help. There’s a great article at healthychildren.org titled, “10 Things Parents Can Do To Prevent Suicide.” It notes that suicidal teens often have several risk factors, including major loss (i.e., break up or death), public humiliation, social/peer pressure, substance use, a chronic medical condition or chronic pain, access to weapons, and a family history of suicide. If your child is suffering from these, pay close attention.

Whether you’re concerned about a teen or an aging parent, a friend or a co-worker, if you think someone may be suicidal, ask the question. If the answer is no, you’ve simply shown you care enough to engage on a deep level. If the answer is yes, you may have just thrown a lifeline.

Sean Re is a marriage and family therapist at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental and behavioral healthcare to people in Lake and Mendocino Counties.