What I Wish More People Understood About Suicidal Thoughts: The Power of Connection
Author, Sanford Clinical Director Tessa Sterling, LMSW, LCSW, with Douglas on a beautiful day.
When people are feeling pain and suffering, the thought of suicide makes complete sense. When someone feels hopeless, like there’s nowhere else to go and no end in sight, suicidal thoughts can create a sense of comfort and a way out. Often, the conversation that I have with suicidal clients is about hope and a path forward. Even when they don’t feel it is possible, I know we can help them get there. So it’s about creating a space where shame and judgment aren’t the focus. It’s understanding that these thoughts can be a part of depression and can even be adaptive, actually helping people get through challenging times and catalyzing them to seek help.
Of course, we want people to know that there’s hope possible here on Earth. However, we must be able to tolerate our own discomfort when we are making space for people to talk about their pain. What I wish people understood about suicidal thoughts and suicide prevention is that it is important to let their loved ones know that it makes sense they are feeling this way. Shame and fear of judgment, combined with hopelessness, prevent many people from reaching out. We cannot minimize others’ emotional experience because it feels scary on the receiving end. A huge part of prevention is normalizing and accepting what someone is expressing, and offering comfort, love, support, and hope.
Suicide rarely stems from a single event. More often, multiple factors come together, including underlying vulnerabilities, stressors, access to lethal means, and the support and coping resources a person has available.
What I Wish More People Understood About Suicidal Thoughts
No one deserves to feel ashamed of the thoughts or emotions that arise when they are suffering. At Sanford Behavioral Health, we may not be able to take away someone’s pain immediately. Still, we can meet them with compassion and curiosity and ensure they don’t have to carry it alone. In doing so, we alleviate the shame that keeps people silent and create a safer path toward connection, support, and healing.
We lose too many people to suicide each year. According to the CDC, about 49,000 individuals died by suicide in the US in the latest reporting year CDC Suicide Data and Statistics, 2024). If we can keep someone feeling understood and heard, that’s a significant start to suicide prevention. If someone is willing to share how they’re feeling, it can change the level of risk. Many of our patients have suicidality, but everyone is different. We want to understand where the thoughts are coming from, why they are occurring, what the contributing factors are, and then create an individualized treatment plan that best addresses their needs.
The Power of Connection
Asking directly, “Are you having thoughts about suicide?” and listening without judgment can reduce shame, strengthen connection, and create an opportunity to help someone find safety and support. It also reduces isolation. In fact, connection has a biological component. When we experience distress of any kind, we often lose access to higher-level thinking in parts of our brain. So when someone is in that space, sharing can help them regulate and regain access to cognitive processes and more logical thought patterns, like making better-informed decisions.
Warning signs of possible escalating or imminent risk
- Talking or writing about wanting to die, suicide, or having no reason to live
- Expressing hopelessness, feeling trapped, or believing nothing will improve
- Saying they are a burden or that others would be better off without them
- Describing unbearable emotional or physical pain
- Intense guilt, shame, humiliation, or self-hatred
- Making a suicide plan or researching methods
- Seeking or obtaining access to firearms, medications, or other lethal means
- Giving away meaningful belongings
- Saying unusual or final goodbyes
- Making a will or abruptly putting personal and financial affairs in order
- Withdrawing or isolating from family, friends, treatment, work, or usual activities
- A significant change in affect or mood, including:
- Sudden worsening of depression
- Extreme mood swings
- Increased anxiety, agitation, irritability, anger, or rage
- An unexpected shift from severe distress to appearing unusually calm, happy, or relieved
- Increased alcohol or drug use
- Reckless, impulsive, or unusually dangerous behavior
- Sleeping or eating significantly more or less
- Decline in self-care or daily functioning
NIMH specifically identifies a sudden change from appearing very sad to very calm or happy as a serious warning sign
Risk factors and circumstances that may precipitate a crisis
- Previous suicide attempt
- Current or past depression, other mental health conditions, or substance-use disorder
- Hopelessness, impulsivity, or aggressive tendencies
- Trauma, abuse, bullying, harassment, discrimination, or interpersonal violence
- Chronic pain, serious illness, or a significant change in health
- Relationship conflict, separation, divorce, or loss of an important relationship
- Death of a loved one
- Job loss, financial problems, legal consequences, or disciplinary action
- Housing instability or other major disruption
- Social isolation or feeling disconnected from others
- Recent psychiatric hospitalization or discharge, transition in level of care, or medication change
- Family history of suicide
- Exposure to a suicide or suicide cluster
- Easy access to lethal means
- Stigma, shame, or limited access to behavioral-health care
If you or a loved one is living with a mental health condition, substance use disorder, or eating disorder, we’re here to help. Click the link below to connect with an admissions specialist anytime. With Sanford’s 24/7 EZ Admissions, you’ll speak with a real person, receive a free assessment, and begin treatment right away. Walk-ins are welcome.
