World Suicide Prevention Month: Supporting a friend’s mental health

Friends often notice changes in each other before anyone else does. Signs of mental illness can often be first noticed by friends and family, long before professional help is sought. Often, they are the first support system a suicide-prone individual turns to.  In observance of World Suicide Prevention Month, we look into this and help people understand how to support a friend in need.

The first signs

Abdul Hamid is an eminent psychotherapist at the Monobikash Foundation, and he clarifies that one of the first indicators of a crisis is often a change in a person’s usual routine.

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Individuals may start to show indifference toward friends and activities they once profoundly enjoyed. They might even stop attending classes or going to work, and express feelings of “having no way out of despair" frequently.

Noticeable changes in sleep patterns and eating habits are also observed. Some may sleep excessively and eat much more, while others may sleep and eat drastically less.

While these changes do not necessarily indicate that someone is contemplating suicide, they can signify that something is wrong. And it is best to use these changes as a reason to check in and ask how they are doing, rather than making assumptions.

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Be their listening ear

When we see someone in adversity, our first impulse is to begin with “Everything is going to be all right” or “You have so much to live for” to uplift them. These may seem motivating, but they can also unintentionally make someone feel misunderstood and belittled.

Hamid explains that sometimes just being there and giving them enough space to express what they are experiencing, without rushing to find a solution, can help them cope with their emotions better.

For Inti, who is now a media professional, the memory goes back to 2006, when he was an A-level student. One of his best friends, with whom he had lost contact for almost a year, suddenly reached out and suggested they should catch up. They never got to meet. She took her life two days before they could.

Looking back nearly two decades later, Inti wonders whether that unexpected message was more than simply an attempt to reconnect. He had once been the person she could turn to when she needed to vent. Perhaps, he thinks, he could have been that person again — if only he had known.

Ask them directly

Novera is now in her mid-40s. While still a teenager, she stood by her friend during one of the most difficult periods of his life. She recalled, “I couldn't ask him if he was contemplating whether life was worth living, even though he sometimes expressed feelings of hopelessness and uncertainty about what he wanted from life.”

When asked if mentioning “suicide” in front of people who are showing signs of suicidal distress “plants the idea in their head”, Hamid explicitly mentions, “When you start seeing indicators, it is already too late to observe more or ignore the signs altogether. So, it is better to ask them directly in a one-on-one setting. It mostly allows them to open up about their thoughts.”           

If someone says yes, do not panic or criticise them. A calm response can make it easier for them to continue talking honestly. Instead of trying to solve the situation yourself, let them know that they do not have to deal with their overwhelming emotions alone, and connect them with a trusted person or a mental health professional if possible. 

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Do not promise secrecy

Hamid advises that even if someone close to you tells you to keep their suicidal thoughts a secret, it is important to involve trusted elders or professionals for their own well-being.

He particularly emphasises that seeking support from a psychologist may not always be the quickest option, and if a loved one reaches out to you just before attempting suicide, you must immediately contact someone close to them or try to reach them as soon as possible.

Differentiating between someone going through a rough patch versus someone in genuine crisis

One of the most misunderstood concepts is understanding when someone is facing just a transient difficult phase and when someone is truly experiencing suicidal ideation.

Hamid points out, “When someone is having a hard time, that is always due to a former incident. But when someone is at risk, they would feel gloomy and dejected without any significant reason.”

However, it is common for people to feel defeated after enduring long periods of mental anguish.

Inti recalls how his friend often spoke about her deep struggles with life, family, and so-called ‘beauty standards.’ Her distress was not an isolated incident; maybe it was a recurring source of sadness that weighed heavily on her.

Novera remembers that her friend, later diagnosed with bipolar disorder, was always exuberant. They had been friends since they were four years old, and he had clear expectations for life from an early age. They would talk frequently and share almost all the little details of their everyday lives. However, suddenly, he started mentioning that he did not feel well and was not as cheerful as he used to be. That was when she realised her friend needed professional help.

Do not take on more than you can handle

Whether or not a friend accepts, supporting someone who is having thoughts of ending their life is demanding and inherently complicated. Not to mention the lingering guilt that follows.

Novera paused for a moment when asked about the hardest part of supporting her friend throughout his struggles. “Although he is living his best life now, I have never admitted this to him, but every time he attempted to end his own life back then, I felt overwhelmingly guilty. It was devastating for me. I often thought that I was not able to help him enough, and I could not prevent him from going through with it.”

So, in the end, understanding your friend's problems through the challenging phase can be meaningful, but it is important to recognise the limits of your role. You can be there for them and involve a family member when necessary, but you should also protect your own well-being by setting healthy boundaries and taking breaks when needed. Because being there for someone does not mean you have to carry their struggles alone.

Disclaimer: Some names have been changed to protect individuals’ anonymity.