Tuesday, August 16, 2016

What To Do If A Friend Posts Suicidal Thoughts

We've all seen it. Those of us who battle a mental health condition on a daily basis cringe at it.  The post or tweet or whatever it is these days that goes something like this: "Oh my god, so and so showed up to this party and was wearing the same dress. It was SO embarrassing.  I just wanted to die." Personally, I want to smack this person. Not because of the old stigmatization "people with mental illness are violent", because we aren't, but because this poster, probably without even thinking, trivializes what it feels like to truly want to die. Usually, we get annoyed or scroll past or in some way don't give it much merit because my guess is that this person does not genuinely want to die.  But there are people who do want their lives to end. Not over a slightly embarrassing moment at a party but because they suffer from depression or a mood cycling disorder or numerous other mental health conditions. They actually feel that they, or those in their life, would be better off if they were no longer alive. So what do you do if a friend posts something that indicates severe depression or thoughts of suicide? Of course, everyone is different, and what helps one person may not be best for another. But here are some general guidelines:
  • First and foremost, and I can't stress this enough, take it seriously and reach out. I often find a direct, personal reach out is best  - PM, direct reply, text, call.  A "like" or "favorite" doesn't count (even the new sad emoji on Facebook).  All it shows is that you saw it, but didn't care enough to actually contact them. That's honestly worse than no reply/interaction at all. 
  • Don't just take their word for it once and figure you've done your duty. If someone truly is suicidal, truly wants to die, they may well not tell you. Because if they do, you'll (presumably, I hope) try to stop them in some way. And in that moment, they may not want you to. 
  • That does not mean you shouldn't help them. You should always help them. Their life matters more than they realize in that moment, so you need to realize it for them. This doesn't mean push them. It means don't give up on them as a lost cause. 
  • Never, ever assume "they're just saying that" or "they'll get over it" or "it'll pass". You know the saying about assuming. But in this case, assuming could be even worse - it could cost someone their life. 
  • Do not figure someone else will handle it. I don't care if you met them yesterday. I don't care if they're a twitter follower who you've never met and never interacted with. If you were having a heart attack, would you want everyone to assume someone else would help you or would call 911? Depression can be just as deadly as a heart attack. 
  • When you reach out, do not, under any circumstances, bully them or make them feel bad about how they feel. This is a no-brainer, right? Your friend is contemplating ending their life. Don't make them feel worse about themselves. You'd be surprised. Don't get me wrong, I think people do it with the best of intentions - saying or doing anything that they think will make their friend reconsider. But often, it has the reverse effect, or no effect at all. Some examples: 
    • Do not use religion against them. Telling them that they'll go to hell does nothing but hurt them. If by any chance it stops them, they feel horrible about themselves; if it doesn't, now they have lost their lives feeling like they're soul won't be saved. Or they may not be religious, or hold your same religious beliefs, so the only effect it may have is them distancing themselves from you. 
    • Do not make them feel bad for YOU. This includes things like how lonely you'll be if they leave you, or how upset you are to see them like this.  Let's get one thing straight. This is NOT about you. It is all about THEM. Yes, it will be awful for you. Yes, you may never be the same again. But they will never BE again. Period. They are so depressed that they do not want to live. It is them and only them that need to be focused on, not you. Don't make them feel like they're failing you because of their illness, like even in death they will fail you. 
    • Don't threaten them. It's possible they may need to go to the hospital, or to get an emergency appointment with their therapist (if they have one). But don't use it as a threat. They're not a bunch of rowdy teenagers throwing a loud party who may quiet down if you say you're going to call the police. They are a severely depressed person whose life is at risk. Threatening them will push them further away, and they won't trust you. 
  • Do not tell them you know how they feel unless you do. If you have never been horrendously depressed, or had such severe anxiety you feel you cannot function, or cycled between depression and mania to the point of feeling defeat, or gone through one of the numerous other mental health struggles with such intensity that you feel you and your loved ones would be better off if you were dead, you do not know how they feel. So don't pretend you do. This only minimizes what they're going through. Tell them instead the truth - that you cannot imagine what it's like for them, but that you are there for whatever they need. And mean it. Back it up with actions. 
  • Follow up. Not for a day or two. Continue to. One post that says they're feeling better doesn't mean they're 'fine'. It means in that moment, maybe only in that moment, they aren't quite as despaired. And it may mean the opposite. Survivors of suicide often say their loved one seemed to be improving just before the suicide. They may have appeared better, but in no way were.
  • Never, ever, think that someone is sharing their depression, their illness, their thoughts of suicide for attention. They are not. It is true, they may be asking for help. But they are not asking for attention. There is a world of difference. To use the heart attack analogy again, because I feel that people seem to understand these concepts better with "physical" illnesses, if your friend, or anyone, posted that they were having severe chest pains and having trouble breathing, would you think they were just looking for attention? It is the same with mental health. 
As I mentioned in the beginning, everyone is different. No two people are going to need exactly the same thing. What's most important is that you take your friend's mental health seriously. Understand that you may never understand exactly what it's like, and that it's ok to admit that. Be there for them, as often and as long as they need. The recovery from severe depression or a suicide attempt is a long road with many ups and downs along the way. Those who suffer, who have have experienced suicidal thoughts, who have attempted, are always at risk because there is no cure for depression or mood cycling. Be prepared to support them and be there for them in the long haul. Never give up on them. It's when they are giving up on themselves that they need you most. 

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