Each September, Suicide Prevention Month reminds us that many people struggle silently, and that with awareness, compassion, and action, lives can be saved. According to The National Alliance on Mental Illness, the goal of this month is to help people recognize warning signs, access support, and spark hope.
If you suspect someone you love may be considering suicide, it can feel overwhelming, scary, and confusing. Below are warning signs, risk factors, and techniques that can help, alongside insights into antidepressants, the role of self-care, and how you can prevent burnout as a supporter.
Warning Signs of Suicide: What to Look For
-
Talking about death or suicide (“I wish I weren’t here,” “You’d be better off without me”).
-
Hopelessness, helplessness, or feeling like a burden.
-
Withdrawal from loved ones and activities.
-
Mood swings or sudden calm after despair.
-
Risky behaviors, substance use, or searching for lethal means.
-
Giving away possessions or saying goodbyes.
Risk Factors That Elevate Danger
-
Mental health conditions (depression, bipolar disorder, PTSD).
-
Substance misuse.
-
Access to firearms or other lethal means.
-
History of trauma, abuse, or chronic illness.
-
Recent loss, financial stress, or major life transitions.
Why Antidepressants Sometimes Increase Suicide Risk
It can feel confusing to hear that antidepressants, meant to reduce depression, can sometimes increase suicide risk, particularly in young adults and teenagers. Here’s why:
-
Energy before mood improves: Antidepressants may boost energy and motivation before lifting deep hopelessness.
-
Activation of agitation or anxiety: Some medications can initially cause restlessness, agitation, or insomnia, which can intensify distress.
-
Age-related effects: Young people (under 25) may be more vulnerable. This is why the FDA includes a black box warning and stresses close monitoring in the first weeks of treatment.
💡 The takeaway: antidepressants save lives, but close observation, follow-up, and open communication are essential—especially early in treatment.
Suicide Prevention: What You Can Do Right Now
-
Acknowledge & Validate
Let them know you’re listening and you take what they say seriously. Say something like, “Thank you for telling me how bad things have been lately. I care about you and want to understand what you’re going through.” Reflect back what they say without trying fix it, but to show you hear them. -
Ask Direct, Compassionate Questions
It’s okay (and helpful) to ask clearly: “Are you thinking about harming yourself?” “How often do these thoughts come up?” “What scares you most about them?” These questions don’t cause or escalate suicidal thoughts. They open up space for honesty. -
Stay Present & Offer Support
Sit with them, follow their lead. Let them pause or stop the conversation if it gets overwhelming. Show empathy. “I’m right here with you.” “You’re not alone in this.” The emotional presence matters. -
Talk About Professional Help & Make It Easier
Encourage them to see a mental health professional. You might say, “Talking with someone like a therapist or psychiatrist might help get you relief.” Offer to help with next steps. Look up providers, call for appointments, even go with them if appropriate. -
Create A Safety Plan Together
If they share a plan, or the thoughts are intense, gently explore how to make them safer. Ask what makes them feel unsafe, whether they have access to means, and what steps might reduce risk. Together, think through what they need to stay safe right now. Employ a technique call “bridge burning”. Remove weapons, medications that can be used to self-harm, or any items that your loved one is thinking of using to hurt themselves. Keep the items in a safe place (the locked trunk of your car, a neighbor’s house, a safe), and distribute medication as needed. -
Connect to Crisis Resources
Make sure they know there are help lines and crisis services, even right now. “If this ever gets too much, you can call, text, or chat with the Suicide & Crisis Lifeline by dialing 988. I can sit with you while you call, if you want.” -
Continue The Connection
Don’t assume one conversation is enough. Check in regularly. Send a text, meet for coffee, ask how they’re doing. Remind them they matter—your continued presence is powerful.
What You Can Do in An Urgent Situation: “Explode the Fantasy”
When someone is thinking about suicide, they often imagine it as an escape, a peaceful ending, a relief from suffering. The “Explode the Fantasy” technique gently interrupts that illusion by asking direct questions that bring reality into the picture. This isn’t about shaming or scaring them. It’s about compassionately widening the lens so they can see the fuller impact.
⚠️ Note: This technique is most effective in the hands of trained professionals, but loved ones can use parts of it in urgent situations. The goal is to ground someone in reality while offering connection and alternatives.
Step 1: Stay Calm and Present
-
Approach with warmth, not judgment.
-
Use a calm tone and let them know you care: “I want to understand what you’re going through.”
Step 2: Ask Direct Questions About the Plan
Encourage them to describe what they’re imagining:
-
“How would you do it?”
-
“Who would find you?”
-
“What would it look like?”
Hearing themselves answer can break through the sense that suicide is simple or peaceful.
Step 3: Explore the Physical Consequences
Bring attention to the body’s reality:
-
“Would it be painful?”
-
“Is there a chance it wouldn’t work, and you’d survive with serious injuries?”
-
“What would those injuries mean for your day-to-day life?”
This disrupts the fantasy of a quick or painless escape.
Step 4: Bring in Loved Ones and Ripple Effects
Highlight the emotional impact on others:
-
“What would happen to your children/partner/family if they lost you this way?”
-
“Who would have to tell them? Who would carry the weight of your absence?”
-
“How might your children’s lives be shaped by growing up without you?”
This shift helps them see that suicide doesn’t end pain. It transfers pain to others.
Step 5: Redirect Toward Alternatives
Once the fantasy is “exploded,” guide the conversation toward hope:
-
“It sounds like what you really want is relief from the pain, not to die. Can we talk about other ways to find relief?”
-
“Would you be willing to reach out to a therapist, or call 988 together right now?”
-
“What’s one small thing that’s helped you cope before, even for a moment?”
Caretaker Burnout: Why Your Self-Care Matters
Supporting someone at risk of suicide is an act of deep love, but it can also be emotionally draining. Caretaker burnout often shows up as:
-
Feeling overwhelmed, anxious, or helpless.
-
Neglecting your own sleep, nutrition, or needs.
-
Irritability or resentment toward the person you’re supporting.
Self-care isn’t selfish. It’s survival. To sustain the energy your loved one needs, you must recharge yourself.
-
Set boundaries: You can’t be available 24/7. Build a support team.
-
Seek therapy for yourself: A counselor can help you process fear and exhaustion.
-
Keep healthy routines: Sleep, movement, mindfulness, prayer, journaling—small practices matter.
-
Find community: NAMI offers family programs and support groups so you don’t feel alone.
Remember: you can’t pour from an empty cup. Caring for yourself is a vital part of suicide prevention.
Takeaway
Suicide is preventable, but prevention requires awareness, courage, and compassion. By noticing warning signs, breaking through the dangerous fantasy of suicide, understanding the nuances of treatment, and caring for yourself along the way, you can be part of saving lives.
This Suicide Prevention Month, let’s commit not just to awareness, but to action, conversation, and community care. If you are experiencing caretaker burnout, Potomac Behavioral Health has appointments available.