Suspecting that someone you care about might be experiencing suicidal thoughts can be terrifying and disorienting.

You desperately want to protect their safety and wellbeing but may feel helpless. Misunderstanding the issue and the stigma associated with suicidal feelings is also common, despite how frequently the problem occurs.

Rates of suicide climbed in recent years, with more than 48,000 Americans dying by suicide in 2018, according to the Centers for Disease Control and Prevention (CDC). As depression and anxiety soared during the COVID-19 pandemic, a CDC report found 11% of adults—and one in four young adults—faced thoughts of suicide in the previous 30 days.

Teen Line, a nonprofit hotline for teenagers headquartered at Cedars-Sinai, saw a 35% increase in youth contacts about suicide in the first three months of 2021, compared with the same period in 2020, according to Executive Director Michelle Carlson. There was also a roughly 10% jump in teens talking about having a method or plan for taking their own life.

"Suicide is the worst psychiatric outcome that someone can have," says Dr. Itai Danovitch, chair of Psychiatry and Behavioral Neurosciences at Cedars-Sinai.

Mental health struggles don't have to lead there, even if someone becomes actively suicidal. Support can make a crucial, lifesaving difference. Experts recommend tackling the problem as you would a serious physical illness: Don't blame the sufferer. Instead, throw your support behind them.

Allow time for self-reflection, but don't let fear of intruding on someone's privacy or of saying the wrong thing keep you silent. Honest and open communication is critical.

"When we ask somebody how they feel, we're intrinsically conveying we care how they feel," Dr. Danovitch says.

If you're a parent worried your teen might be depressed and contemplating suicide, Michelle suggests asking them directly about it—but not in an accusatory way. Sharing your concerns will create a safe space to start a dialogue and develop a plan together to get help.

"Asking that question and just listening is really a gift, because if your child is feeling overwhelmed, hopeless and suicidal, it alleviates a burden for them to be able to talk about their secret," she says. "You're basically saying to them, 'There's no shame in feeling this way and we can have a conversation about it.'"

Guilt or embarrassment might make your loved one hesitant to admit they're struggling.

Dr. Danovitch recommends approaching them with a nonjudgmental attitude and validating difficult emotions. That's more helpful than rushing to immediately try to fix things.

The majority of those who consider suicide show symptoms. It's important to be aware of what they are to provide an opportunity to intervene and offer help.

Giving away beloved possessions or arranging where they might go can be one indicator. People contemplating suicide might also: 

• Start to talk or draw about death
• Express hopelessness or a belief that others would be better off without them
• Lose interest in normal activities
• Engage in risky behaviors
• Noticeably change sleeping, eating and grooming habits
• Withdraw from family and friends
• Experience drops in school performance

If you notice any of these signs—take them seriously.

Risk factors for suicide include having a serious mental illness (including depression, bipolar disorder, personality disorders and substance use disorder), a history of suicide attempts, family history of suicide or mental illness, access to guns or other deadly methods, and social isolation—which has been prevalent during the pandemic.

Substance use may also leave someone more vulnerable to suicide, because alcohol and drugs lower inhibition and can lead to decisions someone wouldn't have made otherwise.

Suicide prevention always begins with addressing root causes, Dr. Danovitch stresses. That includes treating mental illnesses and other risk factors, as well as helping people find outlets to express their emotions.

With physical distancing and school closures during COVID-19, many people lost their usual forms of support—right at a time when anxiety, stress and loss were skyrocketing.

If your child is having trouble coping or finding themselves overwhelmed and looking for ways to escape, it's time to bring in a therapist, Michelle says. They can talk about and identify healthy ways to cope with "overwhelming emotions before it gets to that point where it becomes too much."

"It's not the responsibility of a parent to try to take on the role of a mental health professional," she says.

If you notice potential signs of suicidal ideation or your child expresses thoughts of suicide specifically, always consult your child's healthcare provider right away.

With potentially suicidal adults, it's their responsibility to seek care, not yours. Family members and friends, though, can help with phone calls, share resources and urge them to contact a doctor if they're feeling too defeated to reach out for help, Dr. Danovitch points out. Do your research and empower yourself with enough facts and tools to support their treatment plan. 

Suicidal ideation encompasses both general thoughts of wanting to die and an active desire to take your own life.

If someone says they are considering suicide—especially if they have a plan—it becomes a mental health crisis and requires a higher level of care.

Ask them to contact emergency services immediately, either a suicide hotline including the National Suicide Prevention Lifeline at 1-800-273-TALK (800-273-8255) and Teen Line at 800-TLC-TEEN (800-852-8336) or 911. They can also reach out to their doctor if they're not in immediate danger but getting worse. If they choose not to take action, it's imperative for you to make the call instead, Dr. Danovitch urges.

Depression is isolating. Anything you can do to make "people feel like they're part of a community, connected and important" is valuable, Dr. Danovitch says.

And never underestimate the power of a kind word.

"There is hope—and these feelings are not forever," Michelle says.