Helping Someone Hold On: How to Support a Loved One Struggling With Suicidal Thoughts
- Becky Johnston, LCSW
- 3 days ago
- 6 min read
Suicidal ideation—the experience of thinking about, considering, or planning one’s death—is a heavy burden that many people silently carry. In the United States, more than 12.8 million adults reported seriously thinking about suicide, with outcomes equaling one fatality every 11 minutes [1]. In Montana, the situation is especially urgent: For the past 30 years, Montana has consistently held one of the top five suicide rates in the United States, and earned the heartbreaking distinction of ranking the highest rate in the nation between 2019 and 2022 [2]. Alarmingly, Montana’s youth suicide rate is three times higher than the national average [2].
If you know someone who is struggling with suicidal thoughts, you may feel frustrated, helpless, or panic-stricken over what to say. But your support—genuine, compassionate, and consistent—can be life-saving. Whether you’re in Montana or elsewhere, knowing how to support someone experiencing suicidal thoughts can make a real difference. Here’s how to offer compassionate, informed support to a loved one who may be struggling.
1. Recognize the Warning Signs
Verbal Cues: Talking about feeling hopeless, being a burden to others, having no reason to live/wanting to die.
Unusual behaviors: Withdrawal from activities previously enjoyed, isolation from friends and family, changes in sleep patterns, loss of appetite/dramatic increase in eating, increased use of drugs or alcohol.
Mood Swings: Depression, anxiety, loss of interest, irritability, humiliation, or sudden calmness/heighted energy after a period of depression.
IS PATH WARM: An easy-to-remember mnemonic for the warning signs of suicide: Ideation - Substance Abuse - Purposelessness - Anxiety - Trapped - Hopelessness - Withdrawal - Anger Rage - Recklessness - Mood Change For additional details, visit: DPHHS Warning Signs
2. Start the Conversation
Choose a private, quiet moment to talk. Avoid public discussions that may increase shame and discourage open communication.
Use open-ended, empathetic questions like: “I’ve noticed you’ve seemed really down lately. Do you want to talk about it?” or “Is there something I can do to help support you right now?”
Be Direct - It’s a myth that talking about suicide will “plant the idea.” In fact, asking directly can reduce the risk and encourage the person to open up. Try questions like: “Are you thinking about hurting yourself?” or “Have you been feeling like life isn’t worth living?” According to the National Institute of Mental Health (NIMH), research indicates that asking these questions shows that you care and creates a space where your loved one feels safe to be honest [3].
3. Listen Without Judgment
Your loved one may be overwhelmed by feelings of hopelessness or isolation. Often, they aren’t looking for you to solve their problems, in fact advice may be the last thing they want to hear—they just need someone to genuinely listen.
Offer your full undivided attention and try to allow them the space to express their feelings and thoughts without interruption or judgement.·
Avoid Minimizing or “Fixing” - Statements like “Things will get better” or “You have so much to live for” or comparing their pain to the pain of others can invalidate their experience and deepen their distress. Instead, try: “That sounds really hard, which is why I’m staying right here with you.”
Lean into curiosity - questions about what the experience is like for them or how they are impacted by their struggles communicates genuine caring and efforts to understand. A willingness to meet them where they are at is a powerful demonstration that they don’t have to go through this alone.
Most of all, remember they are communicating their perspective. Avoid expressing disagreement with their perspective, even if you feel that it may be wrong or distorted.
Active listening can help them feel seen and validated, which is a powerful step toward healing.
4. Offer Support and Reassurance
Stay Calm: Keep your composure to avoid escalating their stress.
Show Empathy: Acknowledge their pain and let them know they are not alone. “I’m here for you, and I care about you.”
Reassure Them: Let them know that their feelings are valid and may ease if given time. Ask them to consider the last time they felt this way and try to remember if they felt a bit better a day or so later - do they remember if they did anything specific that helped?
Remind them: Help is available whenever they are willing to take that important step.
5. Assess the Risk
Ensure Safety - If your loved one suffers from depression, consider safely limiting access to lethal means right away—this could include medications, firearms, or sharp objects. Restricting access to these items early rather than waiting until a crisis can be life-saving.
In many communities, local and county law enforcement agencies are willing to store firearms temporarily, no questions asked, to ensure safety.
Determine Immediate Danger: If they have indicated they have suicidal thoughts, do not hesitate to ask if they have a specific plan and access to the means to carry it out.
Seek Professional Help: If the risk is high, do not leave them alone. Bring them to a local Emergency Room for evaluation, contact emergency services, or call/text 988 to reach the Suicide & Crisis Lifeline. All are available 24/7.
6. Encourage Professional Help
Encourage your loved one to talk with a mental health professional. You can offer to assist them in finding a therapist, counselor, or support group. If transportation or rural access is a barrier, remind them that many therapists offer telehealth appointments that can be accessed easily by phone or computer. Find a local therapist or counselor through directories like Psychology Today.
Request they add crisis resources to their phone or have them easily accessible:
National Crisis and Mental Health Lifeline - Call 9-8-8
If text support is preferred, the National Crisis Text Line - Text “MT” to 741-741
Local Emergency Services: Call 9-1-1
If your loved one has a current therapist, request your loved one provide you a copy of their safety plan.
Technology can offer additional support, especially between therapy sessions. Phone apps - such as the Virtual Hope Box (iPhone/Android), Calm Harm (iPhone/Android), and MoodTools (iPhone/Android) - are specifically designed to provide immediate support such as research-supported coping tools, mood tracking, videos, and distraction activities for people coping with suicidal thoughts and other emotional challenges.
LGTBQ+ specific support can be found at The Trevor Project
Technological support can be incorporated as a meaningful part of a daily self-care routine and a great recommendation for someone you’re supporting [4].
7. Stay Present and Follow Up
Suicidal ideation isn’t a one-time issue. Continue checking in through texts, calls, or visits, even after the immediate crisis seems to have passed. A short “Just thinking of you” message can go a long way. Your consistent presence helps break the isolation and reminds your loved one that they’re not alone.
8. Take Care of Yourself, Too
Supporting someone through suicidal ideation can be emotionally draining. Make sure to check in with your own mental health and seek support when you need it. It is unreasonable to assume you are solely responsible for your loved one’s safety or mental health. You're not a replacement for professional care, and your wellbeing matters too.
Talk to a therapist, join a support group, or set boundaries when you need to rest and recharge.
Seek Support: Talk to a therapist or counselor , or consider joining an in-person/online support group for your own emotional support.
Set Boundaries: While it’s important to be supportive, ensure you are not overwhelmed and maintain your own well-being. Set healthy emotional boundaries (it's okay to say "I'm not okay right now") and stick to scheduled downtime. Being a support system for someone in crisis is an act of deep love, but you don’t have to do it at the cost of your own mental health.
Additional Support Resources:
National Alliance on Mental Illness (NAMI) – Free peer-led support groups for family members and friends of individuals living with mental illness.
Mental Health America – Caregiver Support, Tools and articles on caregiver burnout, self-care strategies, and boundaries.
American Foundation for Suicide Prevention (AFSP) - Education, local events, and online support communities for those affected by suicide and suicidal ideation.
TheTrevorProject.org offers specialized, LGBTQ+ affirming support. In addition to crisis services for youth, they provide educational resources and guidance for parents, caregivers, and friends on how to best support LGBTQ+ individuals through mental health challenges. Their trained counselors are available 24/7 via phone, chat, or text.
Final Thoughts
Montana’s high suicide rate is a sobering reminder of how much work we still have to do to support mental health—especially in our rural communities. Support starts with one person showing up for another. If someone you care about is struggling, your compassion, your presence, and your willingness to listen can be a powerful lifeline.
Remember that professional help is crucial, they don’t have to handle this alone...and neither do you.
Sources
Centers for Disease Control and Prevention (CDC). Suicide Data and Statistics
Montana Department of Public Health and Human Services (DPHHS). Montana Suicide Rates
National Institute of Mental Health (NIMH). Talking About Suicide
American Psychological Association. Mobile Apps for Suicide Prevention
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