# Suicide Prevention > If you are thinking about ending your life, the first thing to know is that you can get through tonight with help that exists right now: call or text 988. The second is that suicidal thinking is a symptom, and symptoms can be treated. **Source:** https://www.uniquembhs.com/suicide-prevention **Practice:** Unique Minds Behavioral Health Services, LLC. Baltimore, MD: 6810 Park Heights Ave, Suite C6, Baltimore, MD 21215 · Washington, DC: 1402 North Capitol St NW, #1, Washington, DC 20002 · Delaware, OH: 1 W Winter St, Suite 211, Delaware, OH 43015 **Phone:** (443) 538-8400 **Clinically reviewed by:** Dr. Victorine (Vicky) Ngang, DNP, APRN, PMHNP-BC, MSN, RN **Last reviewed:** 2026-08-11 ## Quick answer If you or someone you love is having thoughts of suicide, free confidential help is available right now: call or text 988, the Suicide & Crisis Lifeline, or call 911 in immediate danger. Unique Minds provides follow-up psychiatric care across Maryland, Washington, D.C. and Ohio: treating the depression, trauma or pain underneath the thoughts. ## If this is an emergency **Call or text [988](tel:+1988)**. The [988 Suicide & Crisis Lifeline](https://988lifeline.org/) is free, confidential and open 24/7, everywhere in Maryland, Washington, D.C. and Ohio. In immediate danger, **call 911** or go to the nearest emergency department. Everything else on this page can wait until you are safe. ## Warning signs worth acting on According to the [National Institute of Mental Health](https://www.nimh.nih.gov/health/topics/suicide-prevention), warning signs include talking about wanting to die or being a burden, withdrawing, giving away possessions, increased substance use, and dramatic mood shifts, including a sudden calm after despair. The list above covers more. None of them proves what is coming; all of them justify a direct question and a call. Two actions are consistently protective: **asking directly** (it does not plant the idea. It relieves the secrecy), and **reducing access to means** during a dark period, from medications to firearms. Neither requires training. Both have saved lives. ## What raises risk Suicidal thinking is a symptom, and it has recognised contributors. Knowing them is useful for one reason: nearly all of them are treatable or addressable. - **Mental health conditions**: [depression](/depression-treatment) above all, and also [bipolar disorder](/bipolar-disorders-treatment), [PTSD](/trauma-ptsd-treatment), [psychotic illness](/psychotic-disorders-treatment) and [anxiety](/anxiety-disorders-treatments), particularly when untreated. - **Alcohol and drug use**, which raise risk in two ways: they deepen despair over time, and they remove the pause between an impulse and an action. - **A previous attempt**, which is the single strongest predictor there is, and precisely why follow-up care after one matters so much. - **Recent loss or upheaval**: bereavement, a relationship ending, job loss, financial crisis, legal trouble, or public humiliation. - **Chronic pain or a serious physical illness.** - **Isolation**, and a sense of being a burden to the people you love. - **Family history** of suicide, and exposure to another person's. - **Access to lethal means**, which converts a survivable moment into an unsurvivable one. And what protects: connection to other people, being in treatment and staying in it, a written safety plan, reduced access to means, and reasons for living that have been named out loud rather than assumed. ## The moments that need extra care Risk is not constant. Certain windows are known to be higher, and they are the ones where booking the next appointment matters most: - **The days and weeks after leaving an emergency department or a hospital stay.** This handover is one of the highest-risk periods in all of psychiatry, and one of the most preventable. - **Early in treatment for depression**, when energy and initiative can return before mood does. Being told about this in advance is part of good care, not a reason to avoid treatment. Say so immediately if it happens. - **A sudden calm after a long darkness.** It can be relief, and it can be the peace of a decision made. It always deserves a direct question. - **Anniversaries, court dates, discharge dates** and other things that were being waited for. ## If you are worried about someone You do not need training or the right words. You need four things, in order. - **Ask, using the word.** "Are you thinking about suicide?" Not "you're not thinking of doing anything silly, are you?". That phrasing asks for reassurance rather than the truth. - **Listen without fixing.** Do not argue them out of it, list their blessings, or react with panic or anger. Being heard without alarm is the intervention. - **Reduce access to means, now.** Lock up or remove medications, firearms and anything else specific to their plan. This is the single most effective practical action a family member can take, and it does not require their agreement to be worth raising. - **Connect them to help, and stay while it happens.** Call or text 988 together. Go with them to the emergency department if the danger is immediate. Then follow up tomorrow, and next week, the crisis passing is the beginning of the treatment, not the end of the risk. Do not promise to keep it secret. It is the one promise you cannot safely keep, and saying so honestly at the start protects both of you. ## What we do, and when to come to us We are follow-up care, not a crisis line: the treatment that addresses what the thoughts grow from. After an evaluation, that usually means treating the underlying condition: [depression](/depression-treatment), [trauma](/trauma-ptsd-treatment), substance use, with [therapy](/therapy-services/individual-therapy) and [medication](/psychiatry-practices/medication-management) as fits, plus a written safety plan: your warning signs, your reasons, your people, your numbers, made before the next dark night rather than during it. [DBT skills](/therapy-services/dialectical-behavior-therapy) help many people ride out surges of pain without acting on them. If you have recently left an emergency department or a hospital stay, that handover window matters enormously: book the follow-up now, while the discharge papers are still on the counter. ## For the people alongside Loving someone through this is frightening and exhausting, and you are allowed support too, 988 takes calls from worried families, and so do we. You do not have to be the whole safety net. You just have to help them reach the rest of it. ## What it can look like - Talking about wanting to die, feeling trapped, or being a burden to others. - Withdrawing from people, giving away possessions, or saying goodbyes. - Searching for means, or rehearsing plans. - A mood that suddenly turns calm after a long darkness. Decisions can look like peace. - Increased drinking or drug use, recklessness, or rage. - Sleeping far too little or far too much. - Saying "everyone would be better off", in any phrasing, at any volume. - Putting affairs in order, or settling things that did not need settling yet. - Talk of unbearable pain, with no end to it that they can picture. ## How we treat it - [Psychiatric Evaluation](https://www.uniquembhs.com/psychiatry-practices/psychiatric-evaluation) - [Medication Management](https://www.uniquembhs.com/psychiatry-practices/medication-management) - [Individual Therapy](https://www.uniquembhs.com/therapy-services/individual-therapy) - [Dialectical Behavior Therapy](https://www.uniquembhs.com/therapy-services/dialectical-behavior-therapy) ## Frequently asked questions ### I'm having suicidal thoughts right now. What do I do? Call or text 988 now: the Suicide & Crisis Lifeline is free, confidential and answered 24/7 by trained counselors. If you are in immediate danger or have taken steps to harm yourself, call 911 or go to the nearest emergency department. Do not wait for an appointment, and do not wait to feel 'bad enough'. You already qualify for help. ### I'm worried about someone. Should I ask them about suicide directly? Yes. Plainly and without euphemism: 'Are you thinking about suicide?' Research is clear that asking does not plant the idea; it opens the door. If they say yes, stay with them, help them call or text 988, and help remove access to means where you can. You do not need perfect words. Presence is the intervention. ### What happens after the crisis passes? That is where we come in. A psychiatric evaluation looks at what has been feeding the thoughts (depression, trauma, substance use, unbearable circumstances) and builds treatment for it, including a safety plan you help write. Suicidal thinking is a symptom with causes, and causes can be treated. Follow-up care is what turns one survived night into a changed trajectory. ### Is what I tell you confidential? Yes, within the limits the law sets for every clinician: if we believe you or someone else is in imminent danger, we act to keep you safe, and we tell you what we are doing and why. Honesty about dark thoughts does not trigger automatic hospitalisation. It triggers a plan. ### What is a safety plan, and what goes in it? A short written plan made while you are well, for use when you are not. It names your personal warning signs, the coping steps that have actually helped you before, the people and places that distract or steady you, who you can tell, the professional and crisis numbers to call including 988, and, importantly, what will be done to make means less available during a dark stretch. You write it with your provider, and you keep it somewhere you will find it. ### Does asking someone about suicide make it more likely? No. This is one of the most persistent and most harmful myths about suicide, and research does not support it. Asking directly does not plant the idea. It relieves the isolation of carrying it alone and opens a conversation that can lead to help. Use the plain word rather than a euphemism, listen without arguing or panicking, and stay with them while they call or text 988. ## Sources - 988 Suicide & Crisis Lifeline. 988 Suicide & Crisis Lifeline. https://988lifeline.org/ - Suicide Prevention. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/suicide-prevention ## Related pages - [Depression](https://www.uniquembhs.com/depression-treatment) - [Trauma & PTSD](https://www.uniquembhs.com/trauma-ptsd-treatment) - [Substance Use & Dependence](https://www.uniquembhs.com/treatment-for-substance-abuse-and-dependence) --- This page is general health information, not medical advice. In a crisis, call or text 988 (988 Suicide & Crisis Lifeline) any hour, or call 911 in an emergency.