Suicidal Thoughts: What to Watch for and How to Support a Loved One

by Tiffany Todd, LCSW

When someone you care about is struggling with suicidal thoughts, it can feel overwhelming to know what to do. You may worry about saying the wrong thing or fear that bringing it up will make things worse. In truth, silence often leaves people alone with their pain while connection offers the possibility of relief. Even a small act of care such as a text, a quiet presence, or a simple question can open a door. This guide weaves together three perspectives: how to recognize the warning signs, how to begin a conversation, and what to avoid when offering support.

Recognizing the Warning Signs

Suicidal thoughts rarely appear without any clues. They often show themselves in shifts of mood, behavior, or health. A person may speak in ways that signal hopelessness, such as saying things will never improve or that others would be better off without them. Sometimes the signs are subtle, like a sudden loss of interest in future plans, a withdrawal from once-loved activities, or even a casual joke about suicide that lands heavier than expected. These moments deserve attention because they often reveal more than they conceal.

Changes in daily behavior can raise concern as well. A friend who suddenly cancels plans, ignores calls, or seems unusually distant may be carrying more than they can manage. Some people begin giving away treasured belongings or tying up loose ends in ways that suggest finality. At times a person who has been visibly distressed may suddenly appear calm, which can signal that they have made a decision to act. Risk-taking behaviors such as reckless driving, heavy substance use, or dangerous stunts may also reflect an underlying wish to escape pain.

Emotional suffering often makes its way into the body. Disturbed sleep, whether too much or too little, is common. Appetite can change, sometimes leading to significant weight loss or gain. Even personal hygiene may decline, not from lack of care but from a depletion of energy that makes daily tasks feel impossible.

You may not always see a clear sign. Sometimes all you feel is a quiet unease, a sense that something is off with someone you know well. That intuition matters. Trust it enough to reach out. Asking is always better than staying silent, even if it turns out that you are wrong. In the United States, if someone talks about wanting to die, shares a plan, or shows intent to act, it should be treated as urgent. Dialing or texting 988 connects directly to the Suicide and Crisis Lifeline, and calling emergency services is the best step when immediate safety is at risk.

Beginning the Conversation

Even when the signs are present, speaking them aloud can feel daunting. You may wonder how to begin, how to phrase your concern, or whether you will make things worse. Yet the very act of reaching out can relieve someone of the heavy burden of secrecy. The presence you bring often matters more than the words themselves.

Before you speak, pause to ground yourself. Notice your breath and your body. If you feel tense, take a slow inhale and exhale until you feel steadier. Entering the conversation with calm presence lets the other person know you are safe to talk to. If you still feel panicked, it is okay to wait until you can return with greater steadiness.

The environment you choose matters too. Quiet and private settings create more space for honesty. A walk through the neighborhood, a car ride without distractions, or a quiet corner at home can all allow difficult words to rise more gently. Try to avoid beginning the conversation during moments of chaos, exhaustion, or conflict.

Starting may feel like the hardest part. You do not need the perfect sentence. You can begin by saying, “I have noticed you seem weighed down lately,” or “I care about you and I want to know how you are really doing.” You might even ask directly, “Have you been thinking about suicide?” Though many people fear that asking will plant the idea, research shows the opposite. Being asked often comes as a relief, a signal that they no longer need to keep their pain hidden.

Once the door is open, the greatest gift you can offer is your attention. Resist the pull to fill every silence, to interrupt, or to rush toward solutions. Sometimes what someone needs most is not advice but the experience of being fully heard. Validation matters too. Letting them know their feelings are real and that you are not judging them creates safety in the conversation.

When it feels right, you can gently explore what support might look like. This could mean encouraging them to reach out to a professional, call a crisis line, or talk with another trusted friend. You might offer to sit with them while they make the call or go with them to an appointment, but the key is to avoid taking over. Your role is to walk alongside them, not to push.

Conversations about suicide are rarely finished in one sitting. What matters most is leaving the door open. A follow-up text the next day, a shared meal, or even a lighthearted moment of connection tells them that their life continues to matter. Over time, these small gestures weave a net of belonging strong enough to help someone hold on.

What Not to Do

When someone shares thoughts of suicide, your response matters. Some reactions, even when well intentioned, can deepen feelings of shame or push the person further into silence. Shaming, dismissing, or minimizing their pain can make it harder for them to reach out again. Lecturing or debating may increase their sense of being misunderstood. Making promises you cannot keep, such as guaranteeing secrecy no matter what, can place both of you in a difficult position if immediate safety becomes a concern.

What helps most is steady presence. Staying calm, listening closely, and showing care communicates more than perfect words ever could.

Reaching Out for Professional Support

Being present for someone in crisis is powerful, but you do not have to do it alone. Therapists at InnerVoice Psychotherapy & Consultation (IVPC) are here to walk alongside individuals and families who are struggling. Our team specializes in supporting people through moments of despair, helping them feel less alone while building skills and connection for healing.

If you or someone you love is carrying thoughts of suicide, reaching out to a trained therapist can be an important step. At IVPC we provide a safe and compassionate space to talk openly about what feels unbearable. Taking that step can bring relief, direction, and hope. To learn more or to connect with a therapist, we invite you to reach out through our website or by calling our office.

Holding On to Hope

Supporting someone with suicidal thoughts is not about fixing their pain but about standing with them in it. By learning to recognize the signs, beginning conversations with steadiness, avoiding responses that deepen isolation, and encouraging professional support, you create conditions where healing becomes possible. No single action erases suffering, but together they weave a lifeline. Connection that is steady, compassionate, and ongoing is often what makes it possible to hold on.

Resources

If you or someone you know is thinking about suicide, help is available. In the United States, dial or text 988 to connect with the Suicide and Crisis Lifeline, which is available 24 hours a day. If immediate safety is at risk, call 911. Outside the U.S., look for local hotlines and crisis services that can offer support.