Suicide is the second leading cause of death for people between the ages of 10 and 34, and there are one million annual deaths by suicide. Although it affects millions every year, knowing how to help a suicidal friend can be an overwhelming challenge – what to say, how to help, or where to lead them to get the support they need, all while also taking care of your own wellbeing. 

The pandemic has taken an emotional, mental, and physical toll on people worldwide and as a result, mental illness is as prevalent as ever. Additionally, typical coping strategies to improve mental health have been made less accessible since the beginning of the pandemic. Therapists and other mental health specialists have had to resort to virtual meetings. Group gatherings, which are a major source of connectedness for individuals, also decreased or discontinued altogether. At large, people’s routines have been disrupted and they’ve been challenged to learn new ways to understand and control their thoughts, feelings, and emotions. 

On the bright side, there are many ways to look out for and help others during tough times to prevent thoughts of suicide or other self-harming practices.

Causes for suicidal ideation:

The causes and risk factors for suicidal ideation are a combination of genetic, physical, and environmental risk factors. 


People born into families with a history of mental illness or suicidal thoughts are at higher risk for developing similar disorders. However, not everyone with a family history of mental illness and suicide will develop these ideations, nor do all those who have suicidal ideation have a family history of the disorder.


Abnormally low levels of dopamine and serotonin, in addition to changes to the structure and function of the brain, can increase the risk for mental illnesses, including those that cause suicidal thoughts and behaviors.


Those who experience repeated, negative life events and/or consistent high stress that impacts their ability to cope are also at higher risk for suicide. Individuals who are exposed to others who die by suicide are also at greater risk for developing suicidal ideation.

Risk factors:

Many risk factors contribute to thoughts of suicide or poor mental health like untreated mental disorders, a family history of suicide or mental disorders, domestic violence, having guns in the home, and incarceration. Males are also statistically at a higher risk for having suicidal tendencies.

Warning signs:

The following warning signs can help you determine if a friend or loved one is at risk for suicide, especially if their behavior is new or has escalated. These signs can be especially prevalent when related to a painful event, loss, or change. Here’s what to look out for:

  • Giving away prized possessions and/or getting affairs in order
  • Talking about death, dying, or contemplating suicide
  • Talking about feeling hopeless, trapped, in pain, being a burden to others, or having no reason to live
  • Using phrases such as “when I’m gone…” or “I’m going to kill myself”
  • Saying goodbye to loved ones
  • Obtaining items needed for a suicide attempt
  • Decreased social contact
  • Increasing drug and alcohol usage; behaving recklessly 
  • Withdrawing from once-pleasurable activities
  • Extreme mood swings

How to help a suicidal friend:

The first step to helping a friend is simply to reach out – connecting with others is majorly helpful to those contemplating suicide, as it decreases their feelings of isolation. When someone is struggling, they’re less likely to reach out at the risk of placing a burden on others. The National Suicide Prevention Lifeline outlines several steps you can take, as well as what to say to someone who is suicidal. 

Ask and listen

Ask your friend if they feel safe and/or if they’re feeling suicidal. Then, listen, listen, listen. These questions allow them to share how they’re feeling. If a person is considering suicide, they’re more likely to answer direct questions. Additionally, their response will clue you into their current mental state and you’ll be able to mirror the language they’re using.

Be there

Assess the risk of the situation – suicidal thoughts don’t automatically necessitate a hospital visit. While it’s essential to keep tabs on your friend and their health, many more people experience suicidal thoughts than act on them. However, if after assessing the risk of the situation and it is, in fact, a crisis – please take all precautions to ensure the safety of your friend. 

Keep them safe

Be gentle and validating, and stay with them until their intense emotions calm or subside (this usually happens within 24-48 hours). If you’re unable to stay with them during this stressful time, you should ensure they’re in a safe environment or have other immediate support and are not left alone.

Help them connect

Actionable next steps (once intense emotions have de-escalated) may be to ensure your friend is talking to their doctor or another mental health professional about the feelings and thoughts they’re experiencing. You can also create a safety plan that includes tools to help them recognize extreme feelings about suicide and what to do in these moments. The suicide hotline (800-273-8255) is also a helpful resource and calls often result in people feeling less overwhelmed and suicidal. The counselors on the hotline provide judge-free listening, a list of positive reasons to live, and a network of support.

The pandemic has created obstacles for those wanting to visit doctors and therapists in person, but virtual appointments have greatly improved the availability of mental health care across the world. Telehealth helps address the treatment gap and makes treatment services more accessible and convenient, thereby improving overall health outcomes.

Follow up

After connecting your friend with immediate resources, you should follow up to see how they’re doing. Let them know you’re there to listen and help when they need it. This ongoing connectedness is grounding for someone who is contemplating suicide and will reinforce how much you care for them.

Remember: Caring for someone doesn’t mean keeping secrets.

Listening, empathizing with, and validating the hard feelings your friend is experiencing is important, but if you’re unsure of how to help a suicidal friend or concerned they’re displaying signs of suicide, the best option is to seek help. Finding help will alleviate the responsibility you feel for your friend’s wellbeing while still ensuring they’re in safe hands and will be properly cared for.

Resources for friends of suicidal individuals:

Knowing how to talk to someone who is suicidal can be a tough situation to navigate, and helping them can also weigh heavily on your own mental health. It’s essential to know there are resources out there to help you, too. Take advantage of your own support system including friends, family, counselors, therapists, and doctors to maintain your own mental health long-term.

Suicide Prevention Awareness Month:

Suicide is the second leading cause of death among people aged 10–34 and the 10th leading cause of death overall in the United States. For this reason, we recognize September as Suicide Prevention Awareness Month. While suicide prevention is an important topic year-round, Suicide Prevention Awareness Month is a dedicated time that Americans gather with collective passion and strength around a topic that impacts thousands of people daily. Plus, everyone can all benefit from honest conversations around mental health and suicide.


The following warning signs can help you determine if a friend or loved one is at risk for suicide, especially if their behavior is new or has escalated. These signs can be especially prevalent when related to a painful event, loss, or change. Here’s what to look out for:

  • If you or someone you know is in an emergency, call 911.
  • The suicide helpline is 800-273-8255.
  • If you or someone you know is uncomfortable talking on the phone, you can text NAMI (which stands for National Alliance on Mental Illness) to 741-741 to be connected to a free, trained crisis counselor on the Crisis Text Line.
  • Virtual Hope Box is an app designed to help patients connect with their behavioral health providers as an accessory to treatment. 

For more information on how to help, visit the American Foundation for Suicide Prevention website or check out the protocol for helping someone who is suicidal here.


Common signs of extreme anxiety and depression in teens include: sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, and poor concentration. If you see a major change from your teen’s baseline behavior that doesn’t dissipate over a couple of weeks, you may wish to seek local professional help. Or consider Shelterwood, a residential treatment center that strives to create an environment where teens know they are loved, valued, and have a purpose. Contact us now: 800.584.5005.