What You Need to Know if You Think a Friend is Considering Suicide
Love it or hate it, 13 Reasons Why has inspired serious conversations about suicide. And after you finished binge-watching it (and bawling your eyes out), one of your first thoughts was probably something along the lines of: What if someone I know is a Hannah Baker and I don't even realize it?
That's a totally valid worry, tbh - suicide is the second leading cause of death among people between the ages of 10 and 34. So it's important to be able to spot the signs that a friend or classmate is thinking about taking their own life.
Here's what to watch for - and what to do next so they can get the help they need.
Look for signs of depression.
It's no secret depression plays a role in most suicides - as many as 90 percent, according to the Anxiety and Depression Association of America. That doesn't mean everyone who's depressed is suicidal - it just means if you think a friend is depressed, you need to talk to them and make sure they're getting treatment for it if needed.
"Depression is a major risk factor for suicide, so familiarizing yourself with the symptoms of depression can be helpful," says Ashwini Nadkarni, MD, a psychiatrist at Brigham & Women's Hospital and an instructor at Harvard Medical School. Look for sadness, sleep problems, or a lack of energy that lasts for at least two weeks.
And if you already know a friend is dealing with depression, pay extra-close attention to any warning signs for suicide, and definitely don't brush off any threats.
Know the basic warning signs of suicide.
As 13RW shows, it can be easy to miss the warning signs - especially since every suicide stems from a unique combo of triggers and risk factors. "Many times, there are multiple reasons, coming together like the perfect storm," says Phyllis Alongi, MS, LPC, ACS, clinical director for the Society for the Prevention of Teen Suicide.
That means there's also no single, foolproof way to predict whether someone might be considering suicide. But Alongi suggests using the acronym "F.A.C.T.S." to remember a few things you can be on the lookout for. If you notice one - or a few - of these signs, speak up:
FEELINGS of hopelessness about the future
ACTIONS that show overwhelming pain or distress
CHANGES in behavior, like withdrawing from friends or sleeping less
THREATS about suicide
SITUATIONS that are stressful, like being bullied or humiliated, or getting into trouble at home
Take these big red flags seriously.
Hannah dealt with bullying, betrayal, and rape - but it's also possible for someone to have a seemingly perfect life and still want to end it, because depression can affect anyone.
And it can be really hard for someone to admit they're thinking about killing themselves - even to their bestie - so keep an eye out for these not-so-obvious clues that someone you know is seriously considering suicide:
They're giving stuff away. If a friend randomly gives you her music collection or her favorite jacket, be wary. "If they're giving their stuff away and there's no clear reason, that's a big warning sign," says Jared Skillings, Ph.D., chief of psychology at Spectrum Health in Grand Rapids, Michigan. "Don't jump to conclusions, but ask: 'What's going on? This seems weird. Are you okay?'"
They seem dejected. "The biggest predictor of suicide is hopelessness," Dr. Skillings says. If a friend is going through a rough spot, listen for statements like, "I can't take this anymore" or "I just want to give up."
They have a clear plan. Any time a friend mentions suicide, it needs to be taken seriously. But the more specific their plan is, Dr. Skillings cautions, the more they've been thinking about it - and the more urgent the sitch is.
Don't be afraid to talk about suicide.
If you think a friend might be considering suicide, ask them: "I'm really worried about you because of X, Y, and Z. Sometimes those can be warning signs for suicide - are you having any thoughts like that?"
You might be worried that you'll plant ideas in their head, but Mayra Mendez, Ph.D., LMFT, a licensed psychotherapist at Providence Saint John's Child and Family Development Center in Santa Monica, CA, says it's a misconception that talking about suicide can make someone suicidal.
Talking about suicide is actually one of the most helpful things you can do, because it lets your friend know you see them struggling and want to help. "Talking confronts reality, reduces isolation, and allows for problem-solving," Dr. Mendez says. "It also promotes an opportunity to validate their feelings, and helps people feel heard."
If your friend confides that they are thinking about killing themselves, don't tell them they're crazy or that it's a dumb idea, and don't assume they're just being dramatic. Instead, say something like, "You're important to me and I don't want that to happen. Let's talk about how we can get someone to help you."
Talk to an adult - STAT.
Yes, there's a chance your friend will be mad that you spilled their secret. But this isn't the kind of thing you should try to fix on your own. "If you thought someone was having a heart attack in school, you would immediately run to get help," Dr. Skillings says. "This is the same idea. We're literally talking about life and death."
If you suspect a friend or classmate is thinking about suicide, talk to an adult ASAP. (If you get a Mr. Porter vibe from your guidance counselor, you can talk to a parent, a coach, a favorite teacher - anyone you trust not to blow off your concerns.) This isn't something you should try to fix yourself - the most helpful thing you can do is bring your friend's situation to light so they can get connected to a mental health professional.
If you don't have someone you feel comfortable talking to, call the Suicide Prevention Lifeline (1-800-273-TALK). The hotline also has an online chat option, or you can text the Crisis Text Line.
Remember you are NOT a "reason why."
"If somebody you know has killed themselves, it's never anybody's fault," Dr. Skillings says. "It's a failure of the whole system to not have better resources to help people. But nobody should say, 'I should have caught this.'" He points out that even mental health professionals occasionally have a patient kill themselves while in treatment - and if the experts can't always spot the warning signs of suicide with 100% accuracy, it makes sense that you might miss some red flags.
However, if you do notice any warning signs, absolutely speak up - don't assume someone else will deal with it, or that the person will seek help on their own if it gets serious enough. "That type of bystander thinking is not safe," Alongi says. "We have to take every threat seriously, and reach out to a trusted adult who can help."
If you or someone you know needs help, please call the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or visit their website.
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