*Please note: If you or someone you know has the intention, the means, or a plan to commit suicide, call 911 immediately or take yourself/them to the nearest emergency room.

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I have a mental health private practice in Blue Springs, Missouri (right outside of Kansas City), where I primarily work with women who struggle with depression and anxiety.

A significant piece of criteria for clinical depression is recurrent thoughts of death and/or recurrent suicidal ideation with or without a specific plan, so I see this quite a lot in my practice.

There is buzz around the phrase “suicidal thoughts” for a plethora of reasons. It’s scary—rightfully so—for everyone involved. People feel “crazy” for having thoughts about death. Many people don’t know how to help someone who is having suicidal thoughts. The topic often sends people into a tizzy, an overreaction, or the assumption something immediately awful is going to happen. This can sometimes keep our loved ones from telling us they’re having these thoughts, because they don’t want to cause an uproar and feel like a burden to those around them.

I want to give you some insight as a therapist on what else “having suicidal thoughts” can mean, as opposed to the automatic assumption that someone is about to actually kill themselves. My hope is that whoever reads this can have a more grounded reaction to this topic when it arises, and as a result provide a more calming, proactive, and supportive environment for their loved one who discloses to them that they’re struggling in this way.

1. Just because someone is having suicidal thoughts does not mean they are planning to actually go through with killing themselves. See it first and foremost as a sign that your loved one needs help and support.
2. Suicidal thoughts are not based on actually wanting to die; they’re based on the need to escape from emotional pain. Suicidal thoughts are a symptom of that pain. When we focus on the emotional or psychological wounds at play, that’s when we find true improvement and true healing.
3. Having suicidal thoughts does not mean that the person having those thoughts is going to remind you of Eeyore—a down-in-the-dumps and gloomy individual. Anyone can have suicidal thoughts. If you know someone who is going through a hard time, don’t take their smiling face as confirmation that everything is alright. Have relaxed conversations about how your loved ones are doing in the face of difficult times, whether they seem outwardly depressed or cheerful.

Bring this insight with you to your relationships and your conversations revolving around mental health. The stigma is lessening in our society, but it still needs continued work, and normalizing the hardest parts of mental health like this is what’s most impactful.