Understanding why anyone kills himself is always complex, but even mental-health experts were puzzled when the CDC released its latest suicide data in June: Eighty-four percent of men who die by suicide have no known mental-health conditions. “People in general—and men in particular—try to hide having a mental-health problem,” says David A. Jobes, Ph.D., director of the Catholic University of America’s Suicide Prevention Lab. That’s part of the problem. The suicide rate for men is about three and a half times that of women—probably because men are less likely to seek help or talk to one another when they’re in trouble, and because they’re more likely to own a gun than women and more likely to use one in a suicide attempt. (About 49 percent of suicide deaths in America are the result of using a firearm, and suicide risk is higher in homes where guns are not stored safely.)
“We need prevention strategies that focus not just on helping you not want to die by suicide but on whether or not you can die,” says Michael Anestis, Ph.D., associate professor of clinical psychology at the University of Southern Mississippi. “Locking a gun in a safe doesn’t make you less suicidal—but it makes you less likely to die.” And while an individual’s suicide can seem surprising, there are usually signs. “In my experience, upon honest reflection, most of us would recognize in hindsight that our friend who died by suicide was not doing well—that something was off,” says Jobes. We need to do a better job of looking out for each other. Use this guide (like, right now) if you’re worried about a friend.
Be blunt. If your buddy isn’t bouncing back from a layoff or a breakup or is posting concerning messages, ask how he’s doing. If he says he’s feeling awful, say—and this is tough—“That must be really stressful. How are you handling it? Are you really down? Are you thinking about killing yourself?” Asking if he’s thinking about suicide doesn’t increase his risk of killing himself, says Raymond P. Tucker, Ph.D., assistant professor of clinical psychology at Louisiana State University. It can actually help him feel supported and connected. “Even if they aren’t thinking about suicide or lie about having those thoughts, they know you’re willing to listen, and they’re more likely to come back to you later.”
• SUPPORT: Ask what’s going on and why he thinks he feels the way he does. Don’t project judgment. “Sometimes the reason why someone could say they’re suicidal can seem minuscule to you—but it is the biggest thing in the world to them,” says Tucker.
• HELP: Suggest calling the Samaritans of Singapore hotline (1800-221 4444) together. “Crisis-line workers are expertly trained. They’re used to talking to suicidal people, and they’re good at it,” says Jobes. Or help him make an appointment with his doctor or find a mental-health professional. If he needs immediate help, offer to drive him to the emergency room.
• FOLLOW UP: Text or call a couple times a day and see how he’s doing. Communicate just how awful it would be to lose him. “The conversation does not always need to be about suicide, but certainly let them know that you’re there to help,” says Tucker.
• TEACH HIM TO CONTROL HIS RESPONSE: Tell your friend that just like an ex he fell for, suicidal thoughts can still show up at the door from time to time, says suicide researcher Ursula Whiteside, Ph.D. The trick is how he responds. “Go out for a drink with that ex and you might end up in bed,” she says. “Don’t respond to the ex—instead, cook dinner or do a workout—and you’ll change your relationship to the thoughts. It’s not the thoughts themselves that are dangerous; it’s how you respond.”
While depression is a big risk factor for suicide, it’s not the only one, says Igor Galynker, M.D., Ph.D., director of the Galynker Suicide Research Laboratory at Mount Sinai’s Icahn School of Medicine. People who experience all of the below can be 15 times more likely to attempt suicide in the near future than those who don’t, he says.
Feeling trapped or hopeless
Losing control of thoughts (like he’s locked into a negative loop of thinking that he can’t escape)
Extreme anxiety or rapid mood swings Insomnia or agitation
Social withdrawal (avoiding social outings he’d normally take part in)
• TEC-TEC: This gamelike version of a psychological technique called evaluative conditioning tasks the user with pairing certain words and images together. Find it on the Apple App Store or Amazon.
• VIRTUAL HOPE BOX: Funded by the Military Suicide Research Consortium, it uses coping strategies such as relaxation, distraction, and positive thinking. Find it on the Apple App Store or Google Play.
• NOWMATTERSNOW.ORG: Ursula Whiteside’s tool-packed site includes survivor stories and a YouTube channel that teaches skills to help people get through hard moments.
• MAN THERAPY: This award-winning campaign cuts through the BS and stigma of depression, divorce, anxiety, and suicide in a humorous but helpful way.mantherapy.org
THE SUICIDE RATE FOR MEN IS ABOUT THREE AND A HALF TIMES THAT OF WOMEN—PROBABLY BECAUSE MEN ARE LESS LIKELY TO SEEK HELP OR TALK TO ONE ANOTHER WHEN THEY’RE IN TROUBLE.
Has your friend been bailing on your soccer-league games or cancelling your weekly poker night? When someone is depressed, they can lose motivation to do the things that make them happy, says Anestis. Behavior therapy says: Do ’em anyway—if your friend changes his behaviour, his emotions will follow. ■