How to Help a Suicidal Autistic Person

Written by Luna Rose

Last Updated: December 11, 2022 References

Autistic people are especially vulnerable to mental illnesses, and suicidal thoughts present a significant problem in around 14% of them.^{[1]
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Research source} If you love an autistic person, how can you help?

Part 1

Part 1 of 4:

Identifying Risk

When you figure out that they are suicidal, the first thing you need to do is figure out how immediate the danger is.

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Find out how immediate the risk of suicide is. Any suicidal thoughts present a serious risk, but some are even more urgent than others. These questions will help you figure out how likely they are to harm themselves soon. These are the first questions that many medical professionals ask.
- How long have you felt like this?
- Do you have a plan for how to do it?
- Have you been gathering any supplies (pills, sharp objects, gun)?
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Get immediate help if their life is at risk. If the person is actively suicidal, then they need to get immediate medical help. This is a matter of safety, so in this case you should get help even if they don't give you permission. A doctor or nurse can help them calm down and come up with a safety plan and treatment plan.
- Do not leave them alone.
- In some areas, calling the police can be helpful to get to a person you can't reach (e.g. a person who has locked themselves in a room). Some police are trained for this. Suicide is illegal in many areas, specifically so that police can enter and help on suspicion that a crime will occur. However, in the United States, there have been cases of police officers traumatizing, injuring, or killing suicidal people (including suicidal autistic people), so calling the police may not be safe in the U.S.^{[2]
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- If they are not in immediate danger, get the soonest available doctor's appointment, and help them come up with a safety plan in case they become immediately suicidal.
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Get help right away if they suddenly seem to be at peace. Once people make the decision to kill themselves, they present a calmer demeanor, and may seem to be making a miraculous recovery. This means they could die any time. Here are some signs:
- Saying things like "It won't hurt anymore soon" or "Don't worry, I won't be a burden for much longer"
- Insisting they don't need treatment (because they'll be dead soon anyway)
- Getting their affairs in order (cleaning, writing or updating their will, giving possessions away)
- Saying sudden appreciative thoughts (saying goodbye): "You've been such a good friend to me" "Thanks a lot for all you've done"
- Seeming serene or almost at peace

Part 2

Part 2 of 4:

Listening Well

When they tell you what's going on, it's important to respond gently and let them talk.

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Listen compassionately without passing judgment. Right now, your autistic loved one needs to be heard. Do your best to stay calm, no matter how horrifying their words are.^{[5]
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- Telling them that it's selfish or sinful will only alienate them even more and make it harder to help them.
- Don't guilt them by saying "This would destroy your family" or "You have so much to live for."
- Save your feelings for now. You can let them out later, perhaps with another loved one.
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Validate their feelings.^{[6]
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Research source} Validating their feelings helps them feel understood and process what is going on. Here are examples of validating things you could say:
- "That must feel awful."
- "You must be feeling a lot of pain right now."
- "That sounds rough."
- "Yeah."
- "I see."
- "It sounds like _____ was really difficult for you."
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Show gentle support as you listen to them. Use little signs to let them know that you care about them. This encourages them to tell you everything, and lets them know you love them and want them to stay alive and in your life.
- Holding hands, hugging, rubbing their back (if they like touch)
- Verbal support: "I'm so sorry to hear that," "That's too bad," "I can tell you're hurting"
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Encourage them to take their time if they're struggling to speak. They need to feel that they can take as much time as they need, and that there's no pressure from you. Ironically, not pressuring them to talk makes them even more open to talking more. Here are some phrases that can help:
- "Take as long as you need. I'm listening."
- "You don't have to talk about it now if you don't want to."
- "You seem upset. If you need to pause and take some deep breaths, I can wait."
- "I understand you're having a hard time talking. That's okay. This is hard to talk about."
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Recognize that they may not understand how serious this is. Due to alexithymia, autistic people can struggle with understanding their own emotions, and they may be surprised to see you so upset. Show them that you take this very seriously, to help them recognize that their feelings matter and they shouldn't brush it off as weakness or "just a bad mood."
- Even non-autistic depressed people may not realize that they are depressed.^{[9]
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Be kind, but firm in dispelling any irrational thoughts. Anxiety can cause people to perseverate, or repeat, on false ideas: "I'm a horrible sister!" "I didn't thank him and now he thinks I hate him!" Giving a firm "That's not true" or "I don't believe that" can help break the cycle, as it reminds them to evaluate whether their fears are based in reality.
- Talk to them about disturbing patterns. For example, they keep saying "I'm costing you and Mommy too much money," and you keep saying "No you're not," then clearly that isn't enough to break the cycle. Try saying "You say this often. I can keep telling you it's not true, and still you keep saying it. What is making you say this so often?"
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Ask what you can do. An open-ended "How can I help?" may confuse them, so it's best to ask specific questions—they are more likely to be able to think of an answer. Here are some examples that are designed to get answers.
- "Is there anything or anyone in your life that is particularly upsetting?"
- "Would you like to set aside some time this week to make a list of how we could make ______ less stressful for you?"
- "Would it help if we hung out more?"
- "How about we set aside some time each Saturday morning to bead bracelets together?"
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Check up on them. Ask how they're doing, and inquire about things that have been going on in their lives. ("How'd the physics test go?")
- If they pause for a bit, they are genuinely thinking. They may not know the answer, may not know how to phrase it in a way they think you'll like, or may be evaluating whether you'd believe them if they said "I'm fine."

Part 3

Part 3 of 4:

Getting Medical Help

Suicidal thoughts are a sign that something is seriously wrong. Mental illnesses—chemical imbalances in the brain that affect mood and daily functioning—are likely at play.

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Help them call a hotline. Lifelines, such as the Suicide and Crisis Hotline at 988, are open. Numbers for specialty hotlines, such as transgender hotlines, boys' hotlines, LGBT hotlines, et cetera, can be found online. If they are not comfortable with calling on a phone, they can go to CrisisChat.org to talk via a text chat.
- Avoid chat-based crisis hotlines that are not done by medical professionals or allow people to volunteer, such as BlahTherapy. These kind of chat-lines are not done by professionals, so the "listener's" bias may come into play with something like, "I'm sorry, I don't think I can help you. You're autistic and I don't think anyone can help you", which will just make the autistic person feel worse.
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Tell a trusted adult what's going on, if you're not an adult. Do so even if you were asked to keep this a secret. This is a matter of safety, so letting responsible adults know is very important. It may upset your autistic loved one, but it may also save their life. In the long run, they will be grateful you got help.
- Don't talk to an adult who may be abusive towards the autistic person. Abusive people may abuse this information.
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Offer to go to the doctor with them. A doctor can help figure out what is wrong, and prescribe medication and/or therapy for any illnesses. You can help by staying with them, holding their hand, and offering moral support (if wanted).
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Be in it for the long run. The first medication may not work. It often takes several tries to find pills that solve the problem, and it may take months to find the right prescription. Assure them that this is normal, and you are proud of them for sticking to it.
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Help them find a good doctor. While most doctors are very helpful, there is a slight chance that you will meet a bad one. If so, recognize that they are wrong and the problem is real. Another doctor will treat this situation with the gravity it deserves.
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Remind them that this isn't their fault, and they are not dragging you down. Suicidal people may feel like they are only being a burden to their friends and family. Having repeated love and reassurance can't fix everything, but it can help a lot.

Part 4

Part 4 of 4:

Building a Positive Lifestyle

You can indirectly fight the autistic person's suicidal thoughts by supporting them and making their world a happier place.

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Watch them. Since they may have trouble understanding how they are doing, you can help by keeping an eye on them. If you notice a relapse or dip in mood, you can check up on them and figure out what's going on.
- It may be worth keeping a journal to show doctors how they're doing.
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Cut away bad influences from their lives, including anti-autism ones. Some people and groups feel that autistic people are tragic burdens that need to be normalized at any cost. When autistic people feel like they are burdens, or when their bodies are constantly controlled by others, they are more likely to feel depressed.
- Some therapies, like ABA, may worsen mental health risks.^{[10]
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- Stay away from forums and other sites on the internet, even the YouTube comment section, that may have a negative effect on your autistic identity. Some internet users feel so insecure about their lives that they come up with the most irrational, toxic nonsense that they could think of to bring others down. Don't feed the trolls. You're an important person with friends and family who love you for who you are.
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Help them feel useful. If they feel like they're making a meaningful contribution, they are less likely to feel like a burden. Here are some ways they can be helpful:
- Ask them to babysit (or co-babysit)
- Go volunteering together
- Encourage them to engage in their special interests, such as writing articles for wikiHow about their passion.
- Ask them to take their younger sibling(s) out for a walk
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Gently encourage them to do something about a problem. If they get moving, it will help keep their anxiety at bay. If they can do something about their problem (even something small), suggest that they do it, and try offering to be there with them while they do it. Otherwise, take a walk with them. This will help convince their brain that something has been done and it can stop worrying.
- Suggest that they do a small part of a task they're worried about, such as writing a paragraph for their upcoming essay.
- Brainstorm and write down a plan for the family to handle the disaster they're afraid of. Assure them that now you all know how to handle it, so no more worrying is necessary.
- Sit down with them while they email the professor in the difficult class, and then go do something fun together.
- Take a walk around the block and talk about an issue that's on their mind.
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Help them stay engaged. If they are depressed, they will probably feel very tired and may self-isolate. Moderate amounts of interaction and attention will keep them from being stuck alone with their bad thoughts from too long. Even if they decline sometimes, keep inviting them to do things, and encouraging them to get out of the house (or at least their bedroom). There's nothing wrong with saying "I love you and miss spending time with you, and it would make me happy if we could _____ together." Here are some ideas:
- Go for walks, or sit outside together, so they can soak up some sunshine
- Take them out to eat
- Do quiet activities together, like drawing or reading to them
- Sing along to their favorite songs
- Find good movies to watch together
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Engage with their special interests. Talking about their passions can help autistic people feel more energized and happy. Paint with them, visit a space museum, listen to a monologue, or watch their favorite movies together.
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Carefully introduce them to the autistic community. Autistic culture in general is very supporting, positive, and welcoming. It may help them get rid of some of their self-hatred about autism.
- Sometimes, the autistic community talks about serious issues, like abuse and human rights violations. This is not good reading material for a person fighting depression. Encourage them to be careful about the links they click, and heed trigger warnings.
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Be accepting of who they are—autism and all. Loving actions show that they are not a burden, and you are okay with them the way they are. Autistic people who hide their autistic traits are at higher risk for suicidality so start encouraging them to be themselves.^{[11]
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Research source} Here are some ways that you can show that you accept them:
- Let them stim as much as they want. Forcing an autistic person to stop stimming may make things worse, especially if they’re suicidal or have difficulty with accepting who they are as an autistic person.
- Honor all forms of communication (echolalia, AAC, behavior, etc.) and do your best to understand.
- Be patient with their struggles.
- Support their special interests
- Respond compassionately to meltdowns. Don’t tell them things such as "You’re being silly!" or "You're ruining our day!" Help them learn how to avoid meltdowns, but respond supportively when they happen.
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Take time for yourself too. You can't help a drowning person if you're barely afloat yourself. Take care of your own needs first, and remember that while you can be helpful, you are not responsible for the autistic person's well-being. Your physical and mental health matter too.
- Enlist other friends/family members/caregivers to build a support network for the autistic person. This way, you won't be their only helper.
- Take at least half an hour for "me time" every day. Take a bath, read a book, knit, or do whatever relaxes you.
- Take time to talk or vent about your feelings to another person. It's okay to feel stressed about your loved one being suicidal. It's a scary situation.
- Be upfront if you can't help them through a certain crisis. It's okay to say "While I care about you, I'm not able to help you this time, because I have something of my own I need to deal with. Try your sister/best friend/boyfriend/etc. We can talk another time."
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Be there for them. Offer hugs, hold their hands, draw them pictures, hang out, say "I love you," and let them know they matter to you in whichever ways feel best.

Warnings

You cannot singlehandedly prevent a suicide. If something bad happens, it is not your fault. But don't take this as advice to not do anything!

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If they become so tired and isolated that they cannot even pursue basic activities (fun, special interests, self-care acts that they can usually do), this is a sign of serious illness and they need to see a doctor.

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