Updated July 14, 2014.

Question:  My friend says she's depressed but not suicidal?  Should I believe her?  Is it possible to be having thoughts of suicide, but not be in any danger of actually hurting oneself?

Answer:  While only your friend truly knows what is on her mind – and we want to take all talk about suicide very seriously – it is possible that she could be having fantasies of suicide without having any intent to carry through with any sort of plan to hurt herself.

What I often tell people is that when people are thinking about death and suicide it's not due to any real desire to die;  instead it's a desire to make the pain of depression end.  People commit suicide when they reach the end of their coping resources and come to believe that there are no other options left to make their pain end.  It is very possible that your friend is having fantasies about suicide which she has no intention of acting upon because she has not yet reached that point where she believes that it is her only option.

Whether she is sincere about not hurting herself isn't really the point, however.  While she may be safe today, this could change if she reaches the point where she feels like all hope has been lost.  It is very important no matter how likely we believe someone is to hurt themselves to take what they are saying very seriously.  If she is having these feelings then she is in a great deal of emotional pain and needs help.

Perhaps the most important thing that you can do to help your friend is to encourage her to seek professional help.

  Psychotherapy and antidepressant medications are very effective in alleviating depression and suicidal urges.

Some of the other things you can do to help your friend through this time include:

• Be a good listener.  Offer to let her talk about her feelings of sadness, anger, fear and loneliness.  By allowing her a safe place to unburden herself  you can lighten her emotional load and relieve some of stress that she is under.
• Don't judge.  By exhibiting a calm, accepting, non-judgmental demeanor you can help her become calmer and more self-accepting as well.
• Be there for her.  Show her that you care by holding her, spending time with her and talking with her.  Showing your care and concern is always the right move.
• Resist the urge to offer quick solutions or to tell her that her problems are insignificant.  It's not about how bad her problems are, but how big she perceives them to be.  When a person feels depressed she is not in a rational frame of mind so it does no good to make logical arguments about how easily she could solve her problems if she wanted to.  Instead, be empathetic to the fact that her perception of her problems is causing her a great deal of distress.
• Don't be afraid to ask about her thoughts of suicide.  It isn't possible to put an idea in her mind that isn't already there.  Ask specific questions about whether she has thought about how and when she would take her life.  If she has the means available to harm herself – for example, a gun or pills – take them to a safe place where she can't access them.  By keeping the lines of communication open you give her the opportunity to ask for the help that she needs.

Finally, if you believe that your friend is in any danger of hurting herself don't hesitate to ask for assistance by calling for an ambulance or other emergency services.  While you might be tempted to keep the secret out of loyalty, it is better to risk having her be temporarily angry with you than losing her to suicide.

<sub>Sources:

American Association of Suicidology.  "How to Be Helpful to Someone Who Is Threatening Suicide." National Suicide Prevention Lifeline.  SAMHSA.  Accessed:  June 27, 2014.</sub>