Psychologist Dr. Jessica Stern on Suicide Awareness and Prevention

For National Suicide Prevention Month, we sat down with psychologist Dr. Jessica Stern to discuss suicide awareness and prevention. Dr. Stern is a licensed clinical psychologist, consultant, trainer, public speaker, media contributor, and clinical assistant professor in the Department of Psychiatry at NYU Langone Health.

Read along for our interview with Dr. Stern and learn more about suicidal ideation, suicide prevention, and other ways you can get support or support a loved one!

What are some of the differences between passive suicidal ideation and active suicide?

“What we know about suicidal passive ideation is it essentially is a wish to not be alive, thoughts of being better off dead, or thoughts about not wanting to have been born. Active suicidal ideation is thoughts about wanting to actively end your life. Some examples of both of those:

Passive suicidal ideation might be something like “I wish I wasn’t born”, “I wish I wouldn’t wake up in the morning”, or “I wish that I would just get hit by a car”. You don’t necessarily have the intention to act on ending your life, but you wish that you weren’t here.

Active suicidal ideation might be something like “I want to take some sort of action to actively end my life because I no longer wish to be alive”.”

What are the warning signs of suicide?

“Some of the key things that we tend to look out for are noticing that you’re drastically changing your lifestyle in ways where you’re reducing taking care of yourself. Maybe it’s hygiene, not taking medication that you need, not going to doctor appointments, etc. Another example is noticing that you are really disconnected from things that you enjoy or really disconnected from the people that you love. That disconnection can also come up with depression, so it’s not unique to suicidal ideation, but it is something we try to keep our eyes on if we’re a little bit concerned about that.

Other things that we might see or you might notice in yourself, is if you are starting to take some sort of preparatory action to actually end your life. Some examples would be giving away valuables to loved ones, writing a will, stopping medications that are really important for your health and safety, etc. One of the more obvious ones is preparing something for your loved ones such as a suicide note, which is an indication that someone should definitely get some help”

What treatment options and therapies are available?

“The good news is there are a lot of treatment options! What can be really helpful is investigating what your suicidal ideation is related to (if anything). For some people, it’s depression and for others, it is bipolar disorder, personality disorders, or more on its own where it’s not so clear where it’s coming from.

Step one is to identify where it’s potentially coming from because then you can treat the underlying cause. In terms of treatment for that, there’s psychotherapy, talk therapy, or pharmacotherapy. I say CBT and DBT are two of the best forms of therapy for ideation, and then from a therapeutic pharmacology perspective, we’ve got a couple of different medication options. We can help people through SSRIs, antidepressants, and mood stabilizers, among many other options.”

Does asking someone about suicide put the idea in their head?

“One of the biggest misconceptions is that you can inspire someone to be suicidal. What I mean by that is people frequently worry that if they ask someone if they’re suicidal, and that person wasn’t already suicidal, they will then become suicidal. Thankfully, that is not likely. If someone is already suicidal, asking them about it is not going to put that in their head. If they’re not suicidal, asking them is likely not going to make them suicidal. If they are suicidal, you are more likely to help them because they will feel a little bit less alone and feel like they have an outlet to talk about it.” 

What can you say or do for a loved one who might be suicidal or have suicidal ideation?

“The number one thing to say or do (and this might seem really obvious), is to remind them that you love them and that you care about them. Saying things like “I am here for you” or “I support you”, and even if you don’t know exactly what to do, you can tell them “I’m not exactly sure how to help you, but I will figure it out with you or I will point you in the right direction. I am not going to abandon you or shame you”.

Again, it may sound obvious, but it goes a long way in helping someone because suicide and suicidal ideation are largely associated with loneliness and feeling isolated. Reminding someone that they’re not alone can be so instrumental in helping them feel connected, loved, and protected. The next thing would be to figure out what types of resources they might need to fill in the gaps that they have.”

What should you do if you are having suicidal thoughts?

“I would say step one is to find someone you can talk to. Obviously, it is ideal to talk to a professional and that’s definitely something that you should pursue. If you are feeling suicidal, you can also find someone in your personal life that you feel safe talking to, because feeling like you’re not alone on this journey can be really helpful and meaningful. You can figure out what feels right to you in terms of how much you want to share and sometimes you might work your way up to sharing a little bit more at a time, but starting with finding someone that you can talk to can be really helpful.

Another thing you can do is create a safety plan. We actually created a safety plan at Wondermind and it’s available here. A safety plan is a strategy of coping mechanisms that you fill out before you get to the place where you’re suicidal. You have it available for you in your back pocket if you’re ever in a state of overwhelming crisis. It has information about who you want to contact, agencies you want to call, and different distraction techniques that you can use to help.” 

What are some of your resource recommendations for someone who is struggling with suicidal thoughts?

“There are a few different numbers you can call or reach out to. ‘988’ is a great option and can help you figure out what you should do, such as how much acute care or support you should seek out. They are trained professionals who answer phone calls and texts and guide you through whatever you’re feeling. Other resources you can utilize are organizations for the specific type of identity that you identify as or needs that you have. One example is the Trevor Project.

You can also always visit your local emergency room if you’re feeling like you need help ASAP.”

Dr. Jessica Stern is a wealth of knowledge and support. We hope that this informative interview can assist you in finding ways to support yourself or other loved ones in your life!

Be sure to follow Dr. Stern on Instagram @drjessicabstern and visit her website at drjessicabstern.com.

This interview has been edited and condensed for length and clarity.