Dear Gritty Therapist,

How can I help my friend who is feeling suicidal?

Feeling difference. As we grapple with complex issues of anxiety, depression, and suicide globally, it’s imperative to recognize the nuanced difference between feeling suicidal and being suicidal. While some may consider these terms synonymous, those with extensive experience in the field understand that they represent distinct states of mind. With September being National Suicide Awareness Month in the United States and considering the profound impact of the COVID-19 pandemic on mental health worldwide, it is crucial to understand our part in this crisis. The World Health Organization-WHO reports that one person dies every 40 seconds by suicide, and suicide is preventable. WHO expects that all countries implement suicide strategies in national health and education.

Feeling suicidal

Feeling suicidal is often the initial stage preceding being suicidal, and it manifests as a profound emotional state. It’s important to understand that this feeling can vary significantly among individuals. For some, it lingers as a persistent, underlying sense of despair, while for others, it may be a transient and fleeting experience. This emotional state can manifest as a reluctance to engage with life, a sense of hopelessness, or even indifference to personal safety, such as neglecting to react to potential risks, like environmental hazards. Importantly, feeling suicidal does not inherently involve a defined plan or a concrete intention to commit suicide.

In the context of global statistics, the prevalence of individuals experiencing suicidal feelings has risen alarmingly in recent years. The Centers for Disease Control (CDC) reports that the number of suicides continues to increase. In response to this concerning trend, there is a growing consensus that we need to shift our perspective from one focused on disease and crisis intervention to one centered on prevention and holistic mental health promotion.

Being suicidal

Being suicidal, on the other hand, represents a more advanced and dangerous stage in the trajectory of suicidal thoughts and feelings. It involves the operationalization of those initial feelings into a more defined and structured process. Someone who is suicidal not only continues to grapple with the overwhelming emotional pain but also has developed a plan, the opportunity, and the means to carry out their intentions. This progression from feeling to being suicidal is a critical juncture where immediate intervention is paramount.

It is crucial to acknowledge that this transition is not uniform, and individuals may spend varying amounts of time in the feeling suicidal stage before progressing to being suicidal. The urgency and severity of the situation depend on factors like the individual’s access to means, the feasibility of their plan, and their immediate support network.

With suicide rates reaching unprecedented levels globally, it’s incumbent upon all of us, regardless of our professional backgrounds, to become change agents in this crisis. Two key elements that can serve as powerful preventive measures and interventions on these paths to recovery are connection and hope.

Connection: Bridging the gap

  1. Reach Out: One of the most effective ways to combat anxiety, depression, and suicidal feelings is to reach out to those in need. Contact a friend or family member who may be experiencing distress and ensure they understand they are not alone in their struggle.
  2. Immediate Engagement: Set up immediate engagements that provide comfort and support. Extend an invitation to have lunch or dinner today, or better yet, offer to bring lunch to their home. The immediacy of your offer can make a world of difference.
  3. Demonstrate Authentic Concern: Approach the conversation with empathy, authenticity, and love.
  4. Physical Connection: Physical touch can be immensely reassuring. Whenever possible, connect on a deeper level by maintaining eye contact, offering a reassuring hand on their back, or simply sharing a comforting hug.
  5. Holding Space: Sometimes, the best support you can provide is to hold space for someone. Acknowledge that you may not have all the answers to their problems, but your presence and empathy may alleviate their sense of disconnection.
  6. Limit Phone Activity: Avoid distractions like phone use when engaging one-on-one, in person, with someone in crisis. Your undivided attention reinforces the sense of connection and support.

Provide hope: Illuminating the path

  1. Plan Exciting Engagements: Foster hope by planning exciting engagements or celebrating personal victories with your friends and family. Whether a day out with friends or a weekend trip, these experiences can infuse life with hope for the future.
  2. Embrace Adventure: Encourage adventurous activities and enthusiastically speak about them. Infuse your voice with excitement, and transform routine outings into exhilarating adventures. An upcoming concert, a standing get-together with friends, a monthly planned trip.
  3. Outdoor Activities: Activities involving movement and the outdoors can profoundly impact mental well-being. Explore nature through park trails or engage in indoor sports like tennis or swimming.
  4. Creative Pursuits: For those who may not be as physically active, creative activities like painting or games can provide a therapeutic outlet and offer hope and enjoyment when enjoyed by friends. Painting with a twist, watching a play or movie, and visiting local museums.

Professional help

It’s crucial to recognize that you may not possess the expertise to single-handedly navigate someone through the depths of their despair. At any point, it is entirely appropriate and sometimes necessary to recommend seeking professional help. Your role then becomes one of unwavering support, whether accompanying the person to a healthcare facility or staying by their side as they make the call to a treatment program. Your commitment to their well-being, even when seeking professional help, is a powerful source of reassurance.

Imagine the impact; You can make a difference

If each of us took the initiative to call, connect, and provide hope to just one person in need, we could ignite a seismic shift in the global fight against suicide. What will your strategy be to save a life?

  • Who will you reach out to today to offer connection and hope?

  • How will you structure your strategy for ongoing support to ensure your family and friends understand you are there for them?

  • Will it be a daily, weekly, bi-weekly, or monthly commitment?


Consider the small but impactful ways you can demonstrate compassion such as sending an unexpected card in the mail, paying for a stranger’s coffee, or holding a door open for someone with full hands. These seemingly minor acts of kindness can serve as glimmers of connection and hope during critical moments.

In a world where suicide rates continue to rise, we can make a difference. By recognizing the crucial difference between feeling suicidal and being suicidal and actively fostering connection and hope, we can work together to save lives and build more compassionate and supportive support systems and communities.