How to Help Someone Who May Be Suicidal

When the Signs Feel Subtle but Serious

Warning signs can sometimes be loud and obvious. Other times, they are silent.

A loved one may withdraw rather than openly declare, "I want to die." They may also sleep more. They start giving away possessions. Or even saying things like, "You would be better off without me in the picture." Hearing statements like these may cause significant confusion for families and leave them unsure of how serious the situation really is. Is this merely stress? Depression? Or does this call for something more grave?

Suicide remains a serious public health issue. According to the CDC (2023), over 49,000 suicide fatalities were reported in the United States in 2022, making it one of the top causes of death. Families in Southern Utah need to be especially vigilant because Utah's suicide rate is continuously above the national average (Utah Department of Health and Human Services, n.d.).

We frequently remind families at High Desert Counseling that asking loved ones directly, even if we are wrong, is preferable to remaining silent and missing the chance to help.

Recognizing the signs early and seeking intervention saves lives.

Understanding Suicide Risk: What Families Should Know

Suicidal thoughts, or clinically called suicidal ideation, rarely come "out of nowhere." They usually arise from depression, untreated trauma, substance use (Jones et al., 2023), or even extreme or chronic stress (Harmer et al., 2024). Substance abuse and emotional distress frequently reinforce one another, increasing the risk of suicide during active use, relapse, or early recovery.

Take EJ, for example. He has been downplaying his drinking issue for years. EJ's alcohol intake increased, and he became lonelier after losing his job. His family believed he lacked motivation. However, deep inside, EJ needed structured addiction treatment and a sense of safety in his environment.

Here are some warning signs families should be aware of:

• Speaking about feelings of being a burden or hopeless in life
• Increased substance use
• Significant changes in appetite or sleep
• Putting distance between family and loved ones
• Sudden calmness following severe stress

It is important to understand and keep in mind that asking someone straight out and with compassion, "Are you considering harming yourself?" does not raise suicide risk. Research suggests that asking compassionate, straightforward questions can reduce distress (Dazzi et al., 2014).

Being silent does not keep you safe. Communication does.

What High Desert Counseling Offers in a Crisis

Support from a professional is important when a loved one starts showing signs of suicidal thoughts.

High Desert Counseling is an outpatient provider. Call 911 or visit the closest emergency room if someone is in imminent danger or has made attempts to hurt themselves. We work with hospitals and crisis services to ensure safety when a higher level of care is required.

At High Desert Counseling, our outpatient addiction treatment programs use evidence-based approaches such as:

• Cognitive Behavioral Therapy (CBT) to challenge pessimistic or hopeless thought patterns
• Dialectical Behavior Therapy (DBT) to improve emotional control and build distress tolerance
• Seeking Safety for people with histories of substance abuse and trauma

In fact, Dialectical Behavior Therapy (DBT) provides substantial and expanding research that improves emotional stability and reduces suicidal tendencies (Brown, 2016), particularly when it comes to substance use disorders (Linehan et al., 1999).

To reduce immediate danger, improve communication, and develop safety plans, High Desert Counseling works closely with families and their loved ones in Southern Utah. When more advanced care is necessary, we also coordinate with community resources and other healthcare providers.

Justin, one of our clients, was admitted to PHP following a relapse in which he expressed suicidal thoughts. He later developed useful DBT skills from daily therapy and structured support in learning to manage emotional waves without acting on them. His family characterized the shift as steady rather than abrupt.

Quick fixes are not the goal of crisis stabilization – it is about developing the necessary skills, establishing safety, and restoring hope.

Practical Steps Families in Southern Utah Can Take Today

These simple acts can make a significant difference if you are concerned about someone:

• Ask direct but gentle questions. Frame questions such as, "Are you considering hurting yourself?"
• Stay present in the moment. Refrain from arguing or downplaying their emotions.
• Remove any immediate dangers. Keep medications, drugs, firearms, and other hazardous materials away and safe.
• Help them get care. Offer to accompany them to their appointments.
• Make use of local resources. The Suicide and Crisis Lifeline can be reached by texting or calling 988.

Research reports that a significant majority of people who died by suicide--approximately 83%--have interacted with healthcare professionals in the year before their death and roughly 50% in the month before (Ahmedani et al., 2014). These encounters present important but frequently missed chances for intervention. This demonstrates how crucial it is to seek counseling services early on.

Professional addiction and mental health services and support are available in St. George, Cedar City, and the surrounding municipalities in Utah. Families should not have to deal with this alone.

Hope Is Built Through Action

It can be terrifying and lonely when a loved one appears to be overcome with hopelessness. Suicidal thoughts, however, can be treated with the right support and care. The likelihood of hopelessness may rise when substance abuse and depression coexist. Suicide risk can be decreased with integrated addiction treatment that targets both substance abuse and emotional regulation.

We at High Desert Counseling believe that skill development, emotional safety, and compassionate care are all important factors of recovery. Trust your gut if your loved one shows signs of despair, withdrawal, or changes that concern you. Get the conversation going. Seek help. Safety is not an indicator of weakness but a show of strength.

Hope often begins with a single bold question rather than a dramatic breakthrough. Moreover, sometimes, that very question has the power to change everything.

If you are concerned about a loved one struggling with substance use and suicidal thoughts, contact High Desert Counseling to schedule a confidential assessment.

Disclaimer: Composite stories are created from common patterns observed in our practice. Any resemblance to specific individuals is coincidental.

References:

Ahmedani, B. K., Simon, G. E., Stewart, C., et al. (2014). Health care contacts in the year before suicide death. Journal of General Internal Medicine, 29, 870–877. https://doi.org/10.1007/s11606-014-2767-3

Brown, J. F. (2016). The emotion regulation skills system for cognitively challenged clients. Guilford Publications.

Centers for Disease Control and Prevention. (2024). Suicide data and statistics. https://www.cdc.gov/suicide/facts/data.html

Dazzi, T., Gribble, R., Wessely, S., & Fear, N. T. (2014). Does asking about suicide and related behaviours induce suicide ideation? What is the evidence? Psychological Medicine, 44(16), 1–3. https://doi.org/10.1017/S0033291714001299

Harmer, B., Lee, S., & Saadabadi, A. (2024). Suicidal ideation. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK565877/

Jones, A. A., Hard, G., Gray, J., Apsley, H. B., & Santos-Lozada, A. R. (2023). The role of substance use disorders on suicidal ideation, planning, and attempts: A nationally representative study of adolescents and adults in the United States, 2020. Substance Abuse: Research and Treatment, 17, Article 11782218231216233. https://doi.org/10.1177/11782218231216233

Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addictions, 8(4), 279-292.

Utah Department of Health and Human Services. (n.d.). Suicide deaths — Utah Indicator-Based Information System for Public Health (IBIS-PH). https://ibis.utah.gov/ibisph-view/indicator/complete_profile/SuicDth.html