Wednesday 17 June 2020

How to Take Care of Yourself When Your Friend is Suicidal

This article is excerpted and updated from chapter 7, “The ‘S’ Word: Being There When Your Friend Is Suicidal,” of our book High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder. Photo by Alex Blăjan on Unsplash.

Taking Care of Myself

Being in a relationship with someone who talks about wanting to die can be stressful and draining, so remember to pay as close attention to your well-being as to your friend’s. My self-care needs are threefold. First, I need to believe I can handle myself and Fran safely. The more I learn about her illnesses and situation, the more confident I am in my ability to support her and help keep her safe. Second, I need to know what to look out for, and who to contact should I ever find myself out of my depth. I keep a copy of her wellness plan, which includes contact details for friends and key medical professionals, with me at all times. Third, I need my own support team. It is vital to have someone — a friend, colleague, family member, or perhaps someone in a more formal support or counselling role — you trust and feel able to approach if necessary. I am fortunate to have a close circle of family and friends to call on if I need to unburden myself.

Awareness and Education

Before I met Fran, I knew little about bipolar disorder, chronic fatigue syndrome, fibromyalgia, or suicidal thinking. At first, I imagined I could discover all I needed to know by talking with Fran and spending time with her. I learned a great deal, but after a while I realised I needed additional sources of information. No book, website, or training course can tell me how illness affects Fran personally, but she does not know everything about mental illness and cannot provide a broader, impartial perspective. I seek to educate myself by talking to people with lived experience, by reading books and online material, by taking relevant courses and training, and by participating in the wider mental health community.

It’s Good to Talk

When Fran is actively suicidal my focus is on her, not on educating myself. At other times we discuss what happens when such thoughts arise, how she feels, and how best we can keep her safe. Fran is the expert on how her illnesses affect her personally, but I have read more widely about bipolar disorder, suicide, and suicidal thinking. Sharing allows us to learn from each other. If and when crisis comes, we are as prepared as we can be to face it together.

Fran is not the only person I talk to, however. It is a sad fact that many people have personal experience of suicide, attempted suicide, and suicidal thinking. One friend told me:

There is kind of shame involved, in having considered such a thing. But the silence that is born out of that shame leaves others feeling they are the only ones to have such feelings, and that isolation adds to their thinking. . . . In the moment, there is such despair that suicide seems to be the only option. It can feel a logical choice; the only answer. Looking back, for me, is still scary and painful. I find it hard to believe that I could feel so overwhelmed by life and yet I know that such feelings still lie under the surface of my thinking.

I am indebted to her, and to all who have shared their experiences and insights. In the course of writing our book we approached many people for permission to quote from their messages, e-mails, and social media posts. All were happy to do so. As one contributor said, “Absolutely! It’s so important. Nothing is more so.”

Books and Reading

The appendix to our book High Tide, Low Tide contains a selection of books we have found useful including some relating to suicide and suicidality. Night Falls Fast: Understanding Suicide, by Kay Redfield Jamison, approaches the subject of suicide and suicidal thinking with authority and compassion. Edwin Shneidman’s The Suicidal Mind is also useful. Edited by Sarah Fader, the Stigma Fighters Anthology shares personal stories written by people living with a range of conditions.

Courses and Training

The Internet is a rich source of educational and training material. In a recent post we published a listing of seventeen online suicide awareness courses and podcasts, many of which are free. I have found the following especially helpful:

ZSA Suicide Awareness Training (20 minutes) — Free
This course “aims to give you the skills and confidence to help someone who may be considering suicide. It focuses on breaking stigma and encouraging open conversations.”

Real Talk Film (15 minutes) — Free
This interactive film offers an “introduction to conversations supporting someone with suicidal thoughts. Viewer interaction influences the conversation and safely explores how to support someone in crisis.”

We Need To Talk About Suicide (90 minutes) — Free
E-Learning module from Health Education England covering who is at risk of suicide, warning signs those people might display and what you can say in response. The module also provides links to national support resources.”

LivingWorks (1 hour) — £12
This course offers “Foundational skills to help someone who is thinking about suicide connect to life-saving help. Opportunities to practice skills in a variety of conversation scenarios.”

Dealing with Distress: Working with Suicide and Self-Harm — £35
This in-depth course “explores how to support people in distress and at risk of suicide or self-harm. Aimed at counsellors and psychotherapists, it is, however, relevant to a wide range of helping professionals as well as survivors themselves. Lifetime access with 6 hours’ CPD certificate upon completion.”

Classroom training includes the excellent Mental Health First Aid (MHFA) programme. Originally developed in Australia in 2001, MHFA is available in many countries including Canada, China, Denmark, Finland, Hong Kong, Japan, New Zealand, Portugal, Saudi Arabia, Scotland, South Africa, Sweden, the United Kingdom, and the United States.

I have also completed the internationally recognised Applied Suicide Intervention Skills Training (ASIST) workshop. Widely available, ASIST is aimed at caregivers wanting to feel comfortable, confident, and competent in helping prevent the immediate risk of suicide.

The Mental Health Community

Fran and I support a number of mental health organisations and campaigns, including the National Alliance on Mental Illness (NAMI), Mind, Bring Change 2 Mind, and Time to Change.

We also follow the blogs and social media accounts of groups and individuals working in this arena. As well as providing information and countering stigma and discrimination, the mental health community offers people the opportunity to share their experiences and extend support and encouragement to one another. Some peer support forums are run by official organisations; others are informal or run by individuals.

Social media is sometimes criticised on the grounds that a lack of professional governance may jeopardise the safety of vulnerable people through well-meaning but misguided advice. Vigilance is advisable, but in our experience, most support offered in online communities is genuine, caring, and balanced.

It may not be for everyone, but we encourage you and your friend to engage in the wider mental health community to the extent you feel comfortable. It has provided us with information, guidance, and support, and helped us feel part of something larger than our own situation. We have also found many new friends along the way. On a personal level, it has made me more aware of what it means to live with mental illness, and contributed to my ability to support Fran effectively.

If You Need Help

Our resources page includes links to suicide crisis lines / support organisations, training resources, and books. UK mental health charity Mind offers a range of help and information if you need support or are concerned for someone else.


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