When you think it would be better if you weren't here: on suicidal thoughts

“It’s not that I’d actually do anything. It’s just that sometimes I think everyone would be better off without me.”

People often say this sentence quietly, in passing, sometimes with a smile to soften it. Often they are saying it for the first time in their lives, after months or years of carrying it alone. And they almost always say it with the same fear: that they will now be labelled, that the people close to them will be frightened of them, or that someone will tell them they are exaggerating.

If you have ever had this thought about yourself, this post is for you. If someone you love has said it and you now do not know what to do, this post is for you too. I will write it slowly and carefully, because the subject deserves that.

Thoughts are not a decision

First, something that is important to hear: the thought that it would be better if you were not here is not yet a plan, and it is not a decision. It is a sign that the pain you are carrying is, right now, greater than the strength you have available to carry it. That is a state, not the truth about you or about your life.

In professional language we speak of suicidal thoughts. They take different forms. For some people they are quiet and passive — a wish to fall asleep and not wake up, or simply to disappear. For others they are louder and intrusive, returning when a person is tired, alone or awake at night. All of these forms are serious and all of them deserve a conversation. None of them means that a person is “mad”, weak or beyond help.

People who have lived through such thoughts often say the same thing afterwards: at the time it looked as though nothing would ever change. Your view narrows, as if you were looking through a tube — you see only the pain and no way out. That narrowing is part of the state, not an accurate description of the world. So it is worth not believing it completely, however convincing it feels.

More common than you think

One of the biggest obstacles to seeking help is the belief that you are the only one with such thoughts. Research shows otherwise. In a large international study in which Matthew Nock and colleagues (2008) analysed data from seventeen countries, roughly one adult in eleven — around 9 per cent — said they had seriously considered suicide at least once in their lives.

That means that in every larger classroom, on every office floor and at every bigger family table there is someone who knows what I am talking about. Most of them have never told anyone. And most of them got through that period and today describe it as something that passed.

Such thoughts often appear alongside depression, but not always. They can appear after a great loss, a break-up, shame, exhaustion, long-lasting pain, or with the feeling of being trapped in a situation with no way out. What matters is not whether the reason is “big enough”. What matters is that the pain is real and that there are ways of making it smaller.

Does asking “are you thinking about suicide?” put the idea in someone’s head?

This is the fear I hear most often from people close to someone who is struggling: “I don’t dare ask, in case I put the thought into their head.” I understand it. It seems logical that it is better to stay silent about dangerous things.

But the research here is fairly consistent. In 2014 Tanya Dazzi and colleagues reviewed the studies that examined exactly this question and concluded that asking directly about suicide does not increase the risk. For some people who were struggling, distress even decreased somewhat after such a conversation. When someone asks plainly, the person hears: this can be talked about, I am not too much, I am not alone.

That is why it matters to ask in words that leave no doubt. Not “you’re not going to do anything stupid, are you?”, because that question already contains the expected answer. But calmly and directly: “Are you thinking about taking your own life?” It is hard to say. Your voice may shake. That is all right. Having asked matters more than finding perfect words.

What such a conversation looks like

Below is a short example of a conversation between a sister and her brother (composite, not a real person). Above all, I want to show how little it takes for the conversation to open.

“You’ve been very quiet lately. I’m worried about you. Can I ask you something directly?”
“What?”
“Do you ever think about hurting yourself? About not being alive any more?”
“… Sometimes. Mostly at night. I didn’t want to burden you.”
“Thank you for telling me. You’re not a burden. I’m not going anywhere. Can we look together at who else we could call — today?”
“I don’t know if that would even help.”
“I don’t know exactly what will help. But I do know we’re not going to carry this alone.”

Notice what is missing from this conversation. The sister does not explain to her brother how good his life is. She does not call him selfish. She does not demand a promise or start frantically looking for solutions. She stays, listens, thanks him and suggests one small next step. I have written more about why well-meant advice often does not help in “Just snap out of it”: why advice from loved ones does not help.

The thoughts pass — and help works

I want to be very clear here, because this is the most important part of the post: suicidal thoughts are a state that passes. For most people they are strongest in relatively short periods, which alternate with calmer ones. Even when they keep returning over a longer time, their strength usually lessens with the right help.

Help exists on several levels, and the levels complement one another. A psychiatrist assesses whether medication makes sense and whether more intensive care is needed — I have written about when a psychiatrist is the first step in When you need a psychiatrist first. Psychotherapy helps you understand where the pain comes from and gradually build ways out of it. Crisis lines are there for the moments when things are bad at night or when you have no one beside you.

Research shows that relatively simple things work too. One of them is the safety plan, developed by psychologists Barbara Stanley and Gregory Brown. In a study from 2018, people who drew up a safety plan after a visit to an emergency department, and who then received a few follow-up phone calls, showed almost half as much suicidal behaviour in the following months as those who received usual care. It is not a magic wand, but it is a concrete tool you can make today.

In Slovenia, the suicide rate has fallen markedly over recent decades. Behind this lie prevention programmes, crisis lines, better access to help and more open conversation. This is not just a statistic. It is proof that things which seem inevitable can be changed.

Exercise: your safety plan

A safety plan is a short note you write in a calmer moment so that you have it to hand when the wave comes. In the knowledge base you will find it under the name crisis plan. It is best made together with a therapist, a doctor or a person you trust, but you can also start on your own. Write it on a sheet of paper or in your phone.

1. My warning signs. What do I notice when things start getting worse? Thoughts, feelings, situations — for example “I’m not sleeping”, “I don’t answer anyone”, “everything feels hopeless”.
2. What I can do on my own to get through the next hour. Two or three things that have helped at least a little before: a shower, a walk, music, writing, breathing, switching on the light.
3. People and places where I am not alone. Who can take my mind off things, where can I go to be among people — even if I do not talk about how I am.
4. Who can help me when it is bad. The names and phone numbers of two or three people I can tell the truth to. Next to them, write down professional help: your doctor or therapist and, in Slovenia, Klic v duševni stiski 01 520 99 00, Samarijan 116 123 and 112.
5. How I will make my surroundings safer. Agree with someone you trust that, for a while, they will store or remove things that would make you feel less safe in the hardest moment. At the end, write down one thing that makes it worth staying — even if it is small.

Keep the plan where you will find it. If you ever use it, that is not a defeat. It is exactly what it was made for.

What you can do if you are worried about someone

The people close to someone are often the first to notice that something is wrong: the person withdraws, talks about being a burden, gives things away, says unusual goodbyes, or is suddenly surprisingly calm after a long period of distress. None of these signs on its own means danger, but all of them are a good reason for a conversation.

• Ask directly and listen, without rushing to find solutions.
• Do not promise secrecy. If the person is in danger, help matters more than keeping a secret. You can say: “I love you too much to leave you alone with this.”
• Help with the first step. Call a crisis line or a doctor together, and offer to go with them.
• In immediate danger, do not stay alone with it — call 112 and stay with the person until help arrives.
• Look after yourself too. You can also call Samarijan or Klic v duševni stiski and talk about what you are carrying.

I have written more about how to stay beside someone over a longer time without burning out yourself in How to support someone with depression without burning yourself out.

It is also important that you know this: if, despite everything, the worst happens, it is not your fault. Those close to someone can do a great deal, but they cannot carry full responsibility for another person’s life. That is not a task anyone could carry out alone.

What happens in therapy

People are sometimes afraid that if they tell a therapist about suicidal thoughts, they will immediately be sent to hospital or the therapist will “panic”. In reality, talking about these thoughts is an ordinary part of therapeutic work. The therapist will ask how often the thoughts come, how strong they are, what triggers them and what helps them pass. That does not mean something is terribly wrong with you — it means you are being taken seriously.

In relational family therapy, in which I am training, we are also interested in what happens to pain within relationships. Who in the family is allowed to be sad? Who always has to be strong? Where did a person learn that their distress is a burden to others? As these layers are slowly uncovered, the feeling of complete loneliness that feeds suicidal thoughts so strongly often eases too.

As a therapist in training under supervision, I am not alone with demanding situations, and suicidal thoughts are among them — I consult more experienced therapists. When needed, I also work together with a doctor or psychiatrist. Therapy is not a substitute for emergency help; it is one of the pillars that, together with others, holds a person up until their own strength returns.

Where this post is not enough

I want to say honestly what a single blog post cannot do.

It cannot assess risk. From reading alone you cannot know how serious your situation is — and I cannot know that from a distance either. If the thoughts are frequent, strong, or you feel you cannot manage them, the first step is a conversation with a doctor, a psychiatrist or a crisis line, not more reading.

A safety plan is not a substitute for treatment. It is a tool for the hardest moments. If the waves keep returning for weeks or months, you also need longer-term help that addresses where they come from.

It is not always the way I describe it. For some people the thoughts are long-lasting and quiet rather than wave-like. For them the strength does not lessen within hours but more slowly, over years of treatment. That too is a path people walk — more slowly, but still.

And you do not owe anyone proof. You do not have to show that things are “bad enough” to deserve help. Crisis lines are also for people who are not sure whether to call.

What to remember

• Suicidal thoughts are more common than you think — roughly one adult in eleven has had them at some point — and they are not a sign of weakness.
• Thoughts are not a decision. They are a state that comes in waves and passes.
• Asking directly, “Are you thinking about suicide?”, does not increase risk; it often brings relief.
• A safety plan is a simple, tested tool you can make today.
• Help works — do not carry this alone. Call, tell someone, find a doctor or a therapist.