During Suicide Prevention Month, mental-health professionals unpack the uncomfortable gap between recognising distress and knowing what to say when someone is genuinely struggling.
We have become much better at talking about mental health. We talk about burnout at work, anxiety on Instagram, therapy over coffee and boundaries in group chats. There is considerably less shame around saying, “I’m struggling.” But when the conversation moves from mental health to suicide, something changes. People become uncomfortable. They don’t know what to say, what to ask or whether asking the question directly could somehow make things worse.
The reality is that suicidal distress doesn’t always look like what we imagine it should. It doesn’t necessarily look like someone crying constantly, withdrawing from everyone or being unable to get out of bed. Sometimes, it looks completely ordinary. Someone can go to work, meet friends, attend a party, answer messages, make plans and even laugh with you while privately dealing with suicidal thoughts.
“Everyone’s definition of functional is different,” says Devina Kaur, Mental Health Educator, Certified NLP Coach, Meditation & Yoga Teacher and Author. According to her, a person experiencing suicidal thoughts may continue with their daily responsibilities without showing obvious signs of what is happening internally. “Some people master the art of hiding their emotions,” she explains.
And that is perhaps one of the most difficult parts of suicide prevention: there isn’t always a visible crisis to respond to. Sometimes there are only subtle changes. Someone might start talking more frequently about feeling helpless or worthless, lose interest in things they previously enjoyed, withdraw socially or experience changes in their sleep and eating patterns. These signs don’t automatically mean someone is suicidal, but they can be reasons to check in.
The conversation we’re still avoiding
Why are we still so uncomfortable saying the word suicide out loud?
Sakshi Rai, Senior Psychologist at Veda, Rehabilitation and Wellness, believes much of that discomfort comes from fear, uncertainty and helplessness. There is also a persistent stigma around suicide, with suicidal thoughts sometimes being dismissed as weakness, attention-seeking or something a person should simply “snap out of.”
There is also the long-standing fear that asking someone directly about suicide might put the idea into their head. But avoiding the subject altogether doesn’t necessarily protect someone. A calm, direct and non-judgemental conversation can instead give a person an opportunity to talk honestly about what they are experiencing.
“Talking about suicide does not mean encouraging it,” says Rai. It means creating a space where someone can communicate their distress and where their level of risk can be understood and appropriate support can be offered.
That doesn’t mean every worrying statement should immediately be treated as proof of suicidal intent. There is a difference between someone saying, “I can’t do this anymore,” and someone expressing thoughts about death or ending their life. But both deserve to be taken seriously.
As Rai explains, “I can’t do this anymore” may be an expression of emotional exhaustion, helplessness or feeling overwhelmed. It doesn’t automatically mean that someone is suicidal. The important thing is not to make assumptions either way. Listen. Ask what they mean. Understand what is happening rather than rushing to either dismiss or catastrophise the statement.
What do you say when someone says they don’t want help?
This is where things can get especially complicated.
You may know someone is struggling. You may suggest therapy. They say no. You suggest it again. They get defensive. Eventually, they stop telling you anything at all.
Ms. Ritika Aggarwal, Consultant Psychologist at Jaslok Hospital & Research Centre, believes refusal of professional help needs to be approached with respect rather than force. Repeatedly telling someone that they need therapy can sometimes leave them feeling judged, controlled or misunderstood.
Instead, she recommends trying to understand what is behind the refusal. Are they afraid of being judged or labelled? Have they had a difficult experience with therapy before? Do they simply not feel ready? Or do they not recognise their distress as something that requires professional help?
Understanding the reason can change the way you approach the conversation.
Keeping the channels of communication open is equally important. Letting someone know that they don’t have to make an immediate decision, but that you’re there when they want to talk, can make it easier for them to eventually reach out.
But there is an important distinction between respecting someone’s autonomy and ignoring their safety.
“If you notice concerns such as persistent inability to function, self-harm, suicidal thoughts, or other risky behaviours, then professional help should be sought urgently,” says Aggarwal. “In such situations, safety takes precedence.”
When does being a friend stop being enough?
We often expect friends and family to know what to do when someone is struggling. But being supportive doesn’t mean becoming someone’s therapist.
Aggarwal points out that there is a difference between supporting someone through a difficult period and treating an ongoing mental-health issue. Professional intervention becomes particularly important when distress is persistent or intensifying and begins affecting everyday life like sleep, appetite, self-care, work, relationships or the ability to enjoy things that previously brought happiness or meaning.
Significant behavioural changes, substance use as a way of coping and increasing social withdrawal can also indicate that someone needs more support than their immediate circle can provide.
And importantly, you don’t have to wait for a full-blown crisis before seeking professional help.
Therapy isn’t only for people with severe mental-health conditions. It can also help people understand their thought, behavioural and communication patterns, develop coping strategies, navigate major life transitions and prevent difficulties from becoming more deeply entrenched.
As Aggarwal puts it, the role of a loved one isn’t to diagnose or “fix” someone. It is to be there for them, ask what they need rather than assuming what they need, notice changes, listen without judgement and help them access appropriate support when the situation goes beyond what informal support can provide.
You don’t have to have the perfect thing to say
Perhaps this is where we need to change our understanding of support.
When someone tells us they are struggling, our instinct is often to immediately make the problem smaller. “Don’t think like that.” “You’ll be fine.” “Things could be worse.” “Think about everything you have to be grateful for.”
They may be well-intentioned statements, but they can sometimes make a person feel as though their pain needs to be defended rather than heard.
You don’t need to solve someone’s life in one conversation. You don’t need the perfect advice. And you don’t need to turn into their therapist.
Sometimes, the most useful thing you can do is stay.
Listen without judgement. Ask what they need. Take what they’re saying seriously. If you’re concerned about their immediate safety, involve someone who can help and seek professional or emergency support rather than trying to handle the situation alone.
Suicide prevention has to happen before the crisis
Suicide prevention isn’t only about what happens when someone is at their lowest point. It is also about creating a culture where people can admit they aren’t okay before they reach that point.
It happens when asking for therapy isn’t treated as weakness. It happens when friends notice that someone has changed and check in without waiting for a dramatic warning sign. It happens when workplaces take mental health seriously beyond an awareness-day post. And it happens when we stop assuming that someone who is functioning, smiling or showing up to work must automatically be fine.
Because the person who needs someone to ask, “How are you really doing?” may be the same person who just told you, “I’m fine.”
This Suicide Prevention Month, perhaps the conversation doesn’t need to be more complicated than that.
Ask. Listen. Don’t judge. And if someone is at risk, get them professional help.
If you or someone you know may be at immediate risk of suicide or self-harm, seek urgent professional or emergency support and do not leave the person alone. In India, Tele-MANAS provides 24/7 mental-health support at 14416 or 1-800-891-4416.
