More than Stigma: Say the Word. Suicide.

By Hope Chookazian, MSW, LCSWA

Trigger Warnings: Suicide, Suicidal ideation, and Suicidal thoughts.

• 988 Suicide & Crisis Lifeline: Call or text 988
• Crisis Text Line: Text HOME to 741741
• LGBTQ support call The Trevor Project: 866-488-7386
• The Trans Lifeline: 877-565-8860

Content note: This article discusses suicide, suicidal thoughts, and stigma surrounding suicide. If this content brings up difficult feelings, you don’t have to navigate them alone. Consider reaching out to someone you trust or one of the supports listed above. If you or someone else is in immediate danger, call 911.

Suicide. A word that society has learned to whisper, to avoid, or treat almost as a contagion. Yet silence does not make it disappear. If anything, it can deepen the isolation someone experiencing suicidal ideation may be feeling. Having open conversations about suicide or suicidal ideation is important as

The idea that suicide itself is something that should not be discussed or that simply talking about it risks spreading it, can become a form of stigma. Avoidance can reinforce the negative beliefs and social disapproval that already surrounds those experiencing suicidal thoughts.

Stigma is defined as “the negative social attitude attached to a characteristic of an individual that may be regarded as a mental, physical, or social deficiency,” according to the American Psychological Association. Despite the prevalent societal stigma, suicide remains a major concern worldwide.

More than 720,000 people die by suicide worldwide each year. In 2021, it was the third leading cause of death among people ages 15-29. In the United States, suicide remains the second leading cause of death for youth and young adults aged 15-34, according to the U.S. Centers for Disease Control and Prevention (CDC).

How Are Eating Disorders and Suicide Connected?

People with eating disorders face a higher risk of suicide than the general population. In a nationally representative study of U.S. adults, about 1 in 4 people with a lifetime history of anorexia nervosa or binge eating disorder, and nearly 1 in 3 people with bulimia nervosa, reported a past suicide attempt. Among people with anorexia, suicide accounts for about 1 in 5 deaths, according to a recent meta-analysis.

The risk is not limited to anorexia. Scott Crow, MD, a psychiatrist and the former Director of Psychiatric Services at The Emily Program, whose research included suicide in eating disorders, has written that suicidal thinking is common across eating disorders, that the risk in bulimia nervosa may be as high as or higher than in anorexia, and that it is elevated in binge eating disorder as well. He also notes that suicidal thoughts occur in people with an eating disorder even when no other condition, such as depression, is present.

Stigma often shows up twice in these moments. Eating disorders carry misconceptions of their own: that they are a choice, a phase, or about appearance. Many people hide their symptoms out of shame, and someone living with both an eating disorder and suicidal thoughts may feel there are two things they cannot say out loud. Eating disorders also affect people of every body size, so someone can be seriously struggling without looking the way others expect.

The same shifts in language that reduce suicide stigma help here, too: listening without judgment, and treating what someone shares as real whether or not it matches what we expected to see. Eating disorders and suicidal thoughts are both treatable, and care that addresses them together can make reaching out feel less like explaining yourself twice.

Fostering a more supportive environment begins with making conversations about mental health or treatment easier to have openly. But changing the conversation isn’t only about encouraging people to speak; it also requires considering how we respond when they do. Even words offered with positive intentions of support can carry assumptions that reinforce stigma, shame, or isolation. Sometimes the language meant to comfort can inadvertently do the opposite.

What Should You Avoid Saying About Suicide?

• “Committed” suicide: “committed” is historically linked to crime, which could be internalized and interpreted as a moral failure.
• “Successful” or “Unsuccessful” suicide: success suggests death is a “good” outcome, while unsuccessful ties suicide to a “goal” the person did not complete.
• “There are people that have it much worse” reinforces the belief that what they are feeling is not valid unless it hits a certain threshold.
• “You are too strong for this” reinforces failure of strength and frames the person struggling as “weak.”
• “Suicide is selfish” turns suffering into moral judgement. 
• “You don’t look like you have an eating disorder” ties the seriousness of someone’s struggle to their appearance. Eating disorders, like suicidal thoughts, are often invisible from the outside.

What Can You Say Instead?

• “Died by suicide”: describes the outcome without assigning moral judgement or linking the action to a crime.
• “Suicide attempt” or “suicide attempt that did not result in death” this phrasing eliminates the link of death being a goal and tying it to failure. 
• “I may not understand what you are going through, but I know what you’re feeling is real, and I’m here to listen.” Validates what the person is experiencing without setting a threshold or limiting it, and allows them the space to express their emotions without judgement. You can still show up and support without full understanding of what someone may be experiencing. This messaging reinforces they have support when they may not believe they do.
• “You don’t have to go through this alone. It is okay to ask for help or support when things feel bad or overwhelming” acknowledges that asking for help is not a burden or weak, as they may hold that belief, and takes away any shame associated with seeking help when needed.
• “You are not selfish for feeling this way. You’re hurting and you deserve support.” reduces moral judgement with compassion and shame reduction.
• “Thank you for telling me. I believe you.” responds to a disclosure about an eating disorder or suicidal thoughts without questioning whether it is serious enough to deserve support.

Changing language around suicide does not eliminate or erase the complexity surrounding suicidal distress, but it can change the conversation. Sometimes, words can create more distance, reinforce shame, or make someone feel as though they are a burden. When someone feels they are a burden or isolated in their experience, it can reduce the chance of them reaching out. Research shows suicide-related stigmas were most commonly associated with increased suicide risk and reduced help-seeking.

Reducing barriers to care and shame created by stigma begins, in part, with recognizing one does not need to understand the feelings or have the right answers. Sometimes it begins by choosing words and phrasing that leave room for someone to speak honestly, without judgement, about what they are experiencing and reminding them that they are not alone;

Frequently Asked Questions

Why shouldn’t you say “committed suicide”?

“Committed” comes from a time when suicide was treated as a crime, and it can suggest moral failure. “Died by suicide” describes what happened without judgment.

Does talking about suicide make someone more likely to act on it?

No. A review of the research found that asking people about suicidal thoughts did not increase them, and that acknowledging and talking about suicide may reduce suicidal thoughts.

What should I say if someone tells me they are thinking about suicide?

Listen, take them seriously, and let them know that what they are feeling is real and that they do not have to go through it alone. Encourage them to call or text 988. If they are in immediate danger, call 911 and stay with them.

Are people with eating disorders at higher risk of suicide?

Yes. Suicide attempts are more common among people with anorexia, bulimia, and binge eating disorder than in the general population, and suicide accounts for about 1 in 5 deaths among people with anorexia. Eating disorders and suicidal thoughts are both treatable, and eating disorder treatment can address co-occurring depression, anxiety, and trauma at the same time.

Finding Support

If you or someone you love is struggling with an eating disorder, you do not need to wait until things feel serious enough to ask for help. The Emily Program offers eating disorder treatment in person and virtually, including care for co-occurring conditions such as depression, anxiety, and trauma.

Call 888-364-5977 or get started online to talk with our team about next steps. If you are thinking about suicide or are in crisis, call or text 988, or call 911 if you are in immediate danger.

About Hope Choozakian, MSW, LCSWA

Hope Chookazian (she/her) is a licensed clinical social worker associate and writer whose work centers on mental health, stigma, and the language we use to make sense of difficult times. With background in journalism and psychology, she is interested in creating more thoughtful, educational, and compassionate conversations around mental health.