Depression & Suicidal Thoughts

Depression isn't sadness. It drains someone's ability to want things, including the ability to want help, which is why "just tell me what you need" so often gets nothing back. The most useful thing you can do is ask directly about suicide and keep showing up whether or not they respond well to it.

A licensed clinician is reviewing this guidance and it may change. It is general information, not advice about a particular person. If someone is in immediate danger call 911, and for trained help call or text 988.

If they have a plan, a method, or a time in mind

Don't leave them alone. Call or text 988, or call 911 if the danger is right now. Ask whether they can get to whatever they were thinking of using, and help put distance between them and it. Getting pills or a firearm out of the house is one of the few things a person nearby can do that clearly saves lives.^{1, 2}

What helps

Ask the question plainly — "Are you thinking about killing yourself?" You're not planting anything. Studies of this exact question find no increase in suicidal thinking, and being asked outright is usually a relief — it ends the effort of hiding it.^{3, 4}
Make it small and do it with them — "Let's walk to the corner and back" is doable. "You should exercise" is one more task on a pile they already can't lift.
Keep showing up on the ordinary days — Depression lasts far longer than the crisis, and most support disappears within two weeks. Being there in week six is worth more than being dramatic in week one.
Take it at face value — "You've got so much going for you" is heard as "you have no right to feel this." Depression isn't a mistake in their thinking and can't be argued away. "That sounds like a lot to carry" keeps you in the conversation.
With anxiety, be warm without answering the same question forever — Answering "are you sure it's fine?" for the twentieth time feels kind and quietly makes the anxiety stronger, because the relief is what keeps the loop going. Stay warm but step out of it: "I know that feels urgent. I'm not going anywhere."

What tends to backfire

None of these are stupid. Most of them are what caring looks like when it is frightened, which is why they are so common.

"Have you tried...?" — They've tried it, or they can't, and either way it sounds like you think they haven't been trying. Ask what has helped before instead.
Pointing out that others have it worse — It never produces perspective. It produces silence, and a reason not to tell you next time.
Taking the silence personally — Canceled plans and unanswered messages are symptoms, not a verdict on the friendship. Keep inviting without needing an answer: "no need to reply, just so you know it's on."
Relentless positivity — Constant brightness is tiring to be around and tells them which parts of themselves you'd rather not see. You can be steady without being cheerful.

What you could suggest

Understanding the situation does not tell you what to actually do. These are things you can offer.

Offer to sit with them while they call — 988 takes calls and texts any hour. Dialing is the hard part, and doing it with someone in the room is much easier than doing it alone.
Help them get one appointment booked — Their regular doctor is a normal, low-drama place to start. Offer to make the call or drive them.
Ask about locking things away for now — "Can I hold onto those for a while?" It's a temporary favor, not a punishment, and it's the single most protective thing you can offer.
Agree a time to check in — "I'll text you Thursday" gives them something dated to expect, and gives you a reason to follow up that isn't an emergency.

Questions that are easier to ask than to invent

Are you thinking about killing yourself?
How long has it been like this?
What does a bad day actually look like for you?
Has anything helped even a little?
Who else knows?
Do you want help with this, or do you want me to listen?
Can I sit with you while you make the call?
What would make tomorrow slightly easier?

Words you will hear

Means safety

Putting distance between someone and the method they've thought about. One of the few things a person nearby can do with strong evidence behind it.

Anhedonia

Losing the ability to enjoy things that used to work. From outside it often looks like not trying.

Panic attack

A rush of physical alarm — racing heart, can't breathe, a sense that something terrible is about to happen. Peaks within minutes. Frightening, and not dangerous in itself.

Help Now is not a crisis line, a counseling service, or a substitute for emergency care. This is general guidance for people supporting someone they care about, not clinical advice about a particular person.