When Pain Becomes Too Much: Understanding Suicide and How to Help

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If you or someone you know is in immediate crisis, please reach out now. See the full list of crisis lines at the bottom of this post — for Greece, the Netherlands, Europe, and internationally.

Suicide is one of the most difficult topics we can discuss, yet it is one of the most important. If you are reading this because you are worried about someone you love, or because you are struggling yourself, please know: you are not alone, and there is help available.

This post aims to help us understand what leads people to consider ending their lives, what they experience in those dark moments, and most importantly, how we can support them through it.

Why Do People Reach This Point?

When someone contemplates suicide, they are not trying to end their life — they are trying to end unbearable pain. This distinction matters because it helps us understand what is really happening.

The Nature of Psychological Pain

Suicidal thoughts emerge from a state of profound psychological suffering that feels:

• Unbearable: The pain is so intense it eclipses everything else.
• Inescapable: They cannot see any way out of their circumstances.
• Permanent: They believe things will never improve.

This creates what researchers call "psychache" — a term coined by psychologist Edwin Shneidman to describe psychological pain so severe that death seems like the only relief. The person is not choosing death; they are desperately seeking an escape from agony.

Clinically, suicidal thoughts are referred to as suicidal ideation — thoughts about self-harm involving the deliberate consideration or planning of ending one's own life. These thoughts are a core symptom of several mental health conditions, most commonly major depressive episodes. They can range from a passive wish not to wake up, to the belief that others would be better off without them, all the way to the development of a specific plan.

Common Contributing Factors

While each person's experience is unique, certain factors frequently contribute to suicidal thoughts:

Mental health conditions

• Depression, which distorts thinking and eliminates hope
• Bipolar disorder, especially during depressive episodes — research estimates the lifetime risk of suicide in Bipolar I Disorder is at least 15 times higher than in the general population
• Post-traumatic stress disorder (PTSD)
• Anxiety disorders
• Borderline Personality Disorder, where completed suicide occurs in approximately 8–10% of individuals
• Schizophrenia — approximately 5–6% of individuals with schizophrenia die by suicide
• Substance use disorders, which both contribute to and result from pain

Life circumstances

• Major losses: relationship endings, the death of a loved one, job loss
• Chronic physical pain or serious illness
• Financial crises that feel insurmountable
• Social isolation and profound loneliness
• A history of trauma, especially childhood adversity

The burden belief One of the most painful aspects of suicidal thinking is the deep conviction that one has become a burden to family and friends. People believe, wrongly, that their loved ones would be better off without them. This belief is a symptom of distorted thinking, not reality.

The Tunnel Vision Effect

Here is something crucial to understand: suicidal thinking creates a kind of tunnel vision. When someone is in crisis, their perspective narrows dramatically, they cannot see alternatives or solutions, temporary problems feel permanent, and they lose the ability to imagine a future where things are different.

This tunnel vision is why the same person who feels completely hopeless on Tuesday might feel differently on Friday. The crisis state is often temporary, even when it does not feel that way to the person experiencing it.

What People Experience

The Emotional Landscape

When someone is experiencing suicidal thoughts, they are navigating a complex emotional terrain:

Hopelessness is the core feeling — a complete absence of hope that anything will ever improve. Research shows that hopelessness is often a stronger predictor of suicide risk than depression alone.

Worthlessness — a deep belief that they have no value, that they are fundamentally broken or defective, that they do not deserve to exist.

Disconnection — feeling profoundly alone, even when surrounded by people. They may feel no one truly understands their pain, or that they cannot burden others with it.

Exhaustion — mental and emotional fatigue from fighting the pain for so long. The thought of continuing to fight feels impossible.

Ambivalence — and here is something many people do not realize: most people experiencing suicidal thoughts feel ambivalent. Part of them wants to die, but part of them wants to live. They are looking for reasons to stay, even when they cannot see them.

A sudden sense of calm — sometimes people feel relief after deciding on a plan. This can be particularly dangerous because loved ones may think the person is feeling better, when in fact they have moved closer to action.

Warning Signs

While not everyone shows obvious signs, there are often indicators that someone is struggling:

Direct statements:

• Talking about wanting to die or to hurt themselves
• Expressing feelings of hopelessness or having no reason to live
• Saying they feel trapped or in unbearable pain
• Talking about being a burden to others

Behavioral changes:

• Withdrawing from friends, family, and activities they once enjoyed
• Giving away important possessions or saying goodbye
• Putting affairs in order
• Increasing use of alcohol or drugs
• Changes in sleep patterns
• Engaging in reckless or self-destructive behavior

Mood changes:

• A sudden shift from despair to calm
• Extreme mood swings
• Increased anxiety or agitation

Important note: the absence of these signs does not mean someone is not at risk. Some people hide their pain very effectively.

How to Help

If Someone Is in Immediate Danger

Take it seriously. Never dismiss statements about suicide as attention-seeking. Even if someone has made threats before, each instance needs to be taken seriously.

Ask directly. Say: "Are you thinking about suicide?" or "Are you thinking about hurting yourself?" Research shows that asking about suicide does NOT plant the idea — it actually opens the door to getting help.

If they have a plan and access to means:

• Call emergency services immediately (see resources at the bottom of this post)
• Take them to the nearest emergency room
• Do not leave them alone
• Remove access to lethal means if it is safely possible to do so

Ongoing Support: What to Say and Do

Listen without judgment. Let them express their pain without trying to fix it. Avoid saying things like "you have so much to live for" or "think about your family" — these well-meaning statements can increase shame and guilt. Instead try: "I am here with you," "This sounds incredibly painful," "I want to help you through this."

Validate their pain. Acknowledge that their suffering is real. You can validate their pain while still maintaining hope: "I hear that you are in terrible pain right now. I believe things can get better, even though you cannot see it right now."

Stay connected. Check in regularly and consistently. Do not wait for them to reach out — people in crisis often cannot. Be specific with offers: "I am coming over Tuesday at 3pm to sit with you" rather than the vague "let me know if you need anything."

Help connect them to professional support. Encourage them to see a therapist or psychiatrist. Offer to help find providers or make appointments. If they are already in treatment, encourage them to tell their provider they are having suicidal thoughts. Professional help is not optional — it is essential.

What Actually Helps: Evidence-Based Approaches

Safety planning — working with a mental health professional to create a plan that includes warning signs, internal coping strategies, people they can call, professional contacts, and steps to make the environment safer.

Means reduction — reducing access to lethal means saves lives. This might mean temporarily removing firearms from the home or having someone else manage medications. Suicidal crises are often brief and impulsive. Even a small delay can save a life.

Consistent connection — regular, genuine human presence is protective. It does not mean grand gestures. It means showing up consistently and authentically.

Hope — helping someone see that their current state is temporary, even when it does not feel that way. Most people who survive suicide attempts report being glad they survived.

What Does Not Help

• Minimizing: "Everyone feels that way sometimes" or "You will get over it"
• Arguing them out of their feelings: "You have no reason to feel this way"
• Making it about you: "How could you do this to me?"
• Promising secrecy when someone is at serious risk — getting them help is more important than keeping a secret
• Leaving them alone with their crisis

Taking Care of Yourself as a Support Person

Supporting someone with suicidal thoughts is emotionally exhausting. You matter too.

Recognize your limits — you cannot save someone by yourself, and you are not responsible for keeping someone alive 24 hours a day. Professional help is essential; you are a support person, not a treatment provider.

Get support for yourself. Talk to someone about what you are experiencing. Consider therapy. Join a support group for people supporting loved ones in crisis.

Set boundaries. It is okay to say "I need to sleep now, but let us talk tomorrow morning." Taking care of yourself does not mean you care less.

If someone you love dies by suicide: it is not your fault. Suicide is complex, and no single person can prevent it through willpower or love alone. Please seek grief counseling and survivor support.

A Message of Hope

Suicidal thoughts are a symptom of treatable conditions. They are not a character flaw, a sign of weakness, or an inevitable outcome. They are a signal that someone is in profound pain and needs help.

The pain is real, but it is not permanent. What feels unbearable and unchangeable today can shift. Treatment works. Recovery happens. People do get through this.

Most people who survive suicide attempts are grateful they survived. Studies of people who survived jumping from the Golden Gate Bridge found that nearly all of them regretted their decision in that moment. They went on to live meaningful lives.

Help is available, and it works. Therapy, medication, support groups, crisis services — these interventions save lives every day. Reaching out is an act of courage, not weakness.

If you are reading this and struggling yourself: please reach out. Call a crisis line. Tell someone. Your life has value, even when you cannot feel it. The pain you are experiencing right now is not the totality of who you are or what your life can be.

We lose too many people to suicide every year. Each one is a tragedy. By understanding what leads people to this point and how to support them through it, we can be part of the solution.

You are not alone. Help is available. Recovery is possible.

Crisis Resources

Greece

• KLIMAKA Suicide Prevention Helpline: 1018 (free, 24/7)
• SOS Mental Health Line: 10306 (free, 24/7)
• General Emergency Services: 112 or 100 (Police)
• Psychiatric Emergency Unit (Athens): Accessible through general hospital emergency departments

Netherlands

• 113 Suicide Prevention: Call or text 113 (free, 24/7) | www.113.nl
• SOS Telefonische Hulpdienst: 0900 – 0767 (24/7)
• General Emergency Services: 112
• De Luisterlijn (emotional support): 0900 – 0767

Europe — International Lines

• European Emergency Number: 112 (all EU countries)
• Befrienders Worldwide: www.befrienders.org — directory of crisis centres in 32 countries
• International Association for Suicide Prevention (IASP): www.iasp.info/resources/Crisis_Centres/
• Find A Helpline (global directory): www.findahelpline.com

Selected European countries:

International

• US — 988 Suicide & Crisis Lifeline: Call or text 988
• Crisis Text Line (US, UK, Ireland, Canada): Text HOME to 741741
• UK — Samaritans: 116 123 (free, 24/7)
• Ireland — Samaritans: 116 123
• Australia — Lifeline: 13 11 14
• Canada — Crisis Services Canada: 1-833-456-4566
• The Trevor Project (LGBTQ+ youth, US): 1-866-488-7386 or text START to 678-678

This post is for educational purposes and is not a substitute for professional mental health care. If you or someone you know is in crisis, please seek immediate professional help.

With love, Elli