Hello and welcome back to The Therapist Diaries,
Every September, we pause to recognize Suicide Prevention Month, a reminder that conversations about mental health can save lives. This year, I’ve committed to write an eight part blog series on topics around suicide that I (as a trauma therapist) think we need to talk about more. Suicide does not happen in isolation; it often follows a period of deep emotional struggle, where signs may be present. Learning to recognize these signs (in ourselves and others), and knowing when and where to reach out for help is a vital part of prevention. So let’s get talking.
Recognizing the Signs in Ourselves
If you’ve ever been on a plane, you’ve heard the phrase “fit your own mask before helping other.” Well sometimes the hardest person to check in on is ourselves. We often downplay our own situations and dismiss our struggles as “just stress” or “a rough patch,” but there are important red flags to be mindful of:
Persistent sadness or hopelessness – Feeling like life has lost its meaning or that nothing will get better.
Withdrawal – Avoiding friends, family, or activities we once enjoyed.
Changes in sleep or appetite – Sleeping too much or too little, eating far less or more than usual.
Loss of energy – Daily life feels overwhelming, and even small tasks take immense effort.
Thoughts of death or dying– Suicidal ideation doesn’t have to be thinking about wanting to die and coming up with a plan to do it. It can be. But sometimes it can be quiet thoughts that become louder if we don’t pay attention to. Thinking about not being here, or feeling like others would be “better off” without you. Maybe even brief thoughts about wanting to fall asleep and not wake up.
If you notice these patterns in yourself, it’s important not to wait until they escalate. Help doesn’t have to be a last resort, it can be a step toward healing.
Recognizing the Signs in Others
You know how you feel but you don’t always know how someone else is feeling. Sometimes there’s no signs at all that others are struggling, but sometimes there is and when you know what to look for, you’ll find that spotting these symptoms becomes a lot easier. Suicidal thoughts often show up in subtle ways. Friends, coworkers, or family members may not directly say “I’m struggling,” but their behavior might tell us otherwise. Some common signs include:
Talking about death or describing themselves as a burden – Even if it’s framed as a joke.
Sudden withdrawal– Declining invitations, avoiding phone calls, or becoming difficult to reach.
Extreme mood changes – Shifts from deep sadness to a sudden calm or cheerfulness can sometimes signal a decision to act on suicidal thoughts.
Risk-taking behaviors – Increased use of alcohol or drugs, reckless driving, or other self-destructive choices.
Giving away belongings– Offering up possessions or tying up “loose ends” unexpectedly.this could also present as not showing up or “caring” about work as much.
Paying attention and showing concern can open a door. Contrary to popular belief, asking someone directly if they’re thinking about suicide does not put the idea in their head - it communicates care and can reduce feelings of isolation.
When to Ask for Help
For yourself: If thoughts of suicide cross your mind, even fleetingly, it’s a sign to reach out. Help is not just for moments of crisis; it’s for building resilience before a crisis develops.
For others: If you notice signs in someone else, trust your instincts. A compassionate check-in, even if you’re not sure, can be life-saving. Don’t be offended if your check in is met with an unpleasant response, remember this is something difficult to talk about and many feel embarrassed to share about it. Reassure the, that you’re a safe person to talk to if/when they’re ready. I’d rather have someone mad at me for the rest of their lives than feel guilty that I never so much as asked them if they were ok before it was too late.
Where to Ask for Help
Support is available in many forms, and knowing your options can make reaching out feel less overwhelming:
Crisis Lines – In the U.S., dial 988 for the Suicide & Crisis Lifeline to connect with trained counselors 24/7. This is for adults or children. In the U.K., you can call Samaritans at 116 123. (For blog readers outside these areas, check your local hotlines.)
Professional Support– Therapists, social workers, psychiatrists, and primary care doctors can all be entry points to help. Try googling in your local area, asking your GP for a referral or using sites like Psychology Today.
Trusted People – Friends, family, or mentors who will listen without judgment. Sometimes sharing the weight can be the first step to feeling lighter.
Online Resources– Many organizations provide chat services, educational tools, and safe spaces to talk.
Suicide prevention is not just about crisis, it’s about creating space for honest conversations, building supportive communities, and reminding one another that help is available. If you’re struggling, please know: you are not a burden, your life has value, and reaching out is a sign of strength, not weakness.
This Suicide Prevention Month, let’s commit to noticing the signs in ourselves and others, and to asking the difficult but necessary questions. Together, we can create a culture where no one feels like they have to face their darkest moments alone.
I’ll leave you with this Reflective Journal Prompt that I give to my clients who have struggled with suicidal ideation or self harming behaviors previously. It helps us formulate A Safety Plan, which is what I’ll be discussing on the blog next week.
Take some time to think about and answer the following :
What signs do I notice in myself when I’m under emotional strain?
How comfortable do I feel asking for help when I need it?
What barriers hold me back from reaching out, and how can I gently challenge them?
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