by Ashley Smith, PhD

As a clinical psychologist, I probably think about suicide more often and in different ways than most. I’ve read the research. I’ve been trained to ask the hard questions. I am all too familiar with the frustrating gaps in our knowledge base: what causes it, who is at risk, how do we prevent it? I understand the stigma and misconceptions surrounding it, and I know, firsthand, the collateral damage that stems from it.

May 27, 2011 was the worst day of my life. I lost one of my favorite people on this planet to suicide. This week, sadly, my world was yet again touched by this tragedy, and I feel compelled to write these letters.

To the Grievers,

I feel your pain. I, too, have lost a loved one. I know the initial shock as your mind strives to process the news that seems so unfathomable, so impossible. We know that it happens, but we just didn’t see it coming.

I know the heartbreak that sets in as the shock wears off and you realize that your person is gone. This is not a bad dream. You’re awake, and it sucks. I know the deeper layer of heartbreak that comes with the realization of just how much pain your person must have been in. The weight is crushing.

You’ll want to go down the If Only path, but don’t. That will only result in endless loops of anguish and no real clarity. Know that it is not your fault.

You may be struggling with wanting to understand WHY this happened. Know that you may never fully understand your person’s state of mind or the factors that led to their death. You may never have a satisfactory explanation.

Know that it’s ok if you feel angry, but understand what happened. In the mind of someone who dies by suicide, they are a burden to others and do not belong. You and I know that’s not true, but in their mind, riddled with the insidious lies of Depression, they did not. They believed, TRULY believed that that their existence caused pain and that the world would be better off without them. From their perspective, their last act was a selfless one or one of mercy to end suffering. That’s the tragedy of suicide.

You feel lost and stuck as the rest of the world continues on like nothing has changed…but things will never be the same. The waves of grief that crash over you now, buckling your knees and taking your breath away, will gradually slow down. They will begin to come less often and with less intensity.You’ll find yourself feeling (almost) normal for increasing periods. You’ll stop feeling like you’re drowning, but it will never completely stop hurting.

Know that you WILL be ok. It’s going to hurt…a lot and for a long time. There’s no way around it and no way to avoid it. But know that you CAN get through this loss.

Be in Peace,


To the Contemplators,

I feel your pain…at least I want to. I want to listen, to wrap my arms around you, to tell you that you are NOT alone, that people care, that this will pass, that life CAN get better, that there IS hope, that NOTHING is unforgiveable or irreversible.

Know that brains lie, and yours is no exception! Question it. Challenge it. Fight back! You DO have worth! Things CAN get better! It will not always feel like this. These thoughts and feelings will pass if you can hang on. You are strong. The fact that you’re still here is a testament to that. Even the strongest need a hand sometime, though, so share your burden (and know that YOU as a person are NOT a burden). It will be easier to carry, possible to endure, with help.

There is always someone there. If not a family member or friend, call the confidential National Suicide Prevention Lifeline anytime, 24/7, at 1-800-273-TALK (8255).

Please find some tiny ray of hope and cling to it like the life raft that is. Things can get so much better!

Be in Peace,


To the Rest of the World

I feel your pain…even though you do not…yet. You may feel a mixture of judgment or disbelief when you think about suicide. “That’s only for the mentally ill/attention seekers/weak of heart. It will never happen to me.” Or “My loved one would never do that.” Or you don’t think about suicide at all. You’ve been lucky. It hasn’t touched your world yet, but it will.

Someone dies by suicide every 12 minutes in the US—every 40 seconds worldwide—and for every completed suicide, 20+ more attempt. Suicide is the 17thleading cause of death worldwide, 10thin the US, and 2ndfor teens and young adults. Rates are on the rise, with a startling 24% increase over the past 15 years, and 1 in 5 teens seriously considers suicide. That’s 20% of our youth!

Yet, there is so much stigma, so many misconceptions and unhelpful attitudes around suicide.  What if we likened it to cancer? Like cancer, suicide does not discriminate on the basis of gender, race, or socioeconomic status. There is no stereotypical face of it and no one single path that leads to it. For some, it is a sudden, intense phenomenon that takes life rapidly and with little warning. For others, it is a war waged internally for years. And, like with cancer, what if we did not blame the sufferers, even if their actions seemingly contributed in part to the outcome, and instead understood that they, tragically, lost their battle?

Suicide is not a selfish or cowardly act. It is not due to a lack of discipline or religion or to a weakness of character. It is caused by a number of factors, a perfect storm of biological vulnerabilities and environmental elements that results in circumstances that are beyond someone’s ability to cope. In that final moment, there is no alternative, no way out. Like when a heart no longer has the capacity to keep beating during a heart attack, they die of a brain attack.

“Suicide is just a cry for attention or a cry for help,” you may say. Maybe it is sometimes. That brave soul is fighting for their life! LISTEN TO THAT CRY! Help if you can.

I urge you to be kind to others. You can not tell by looking at someone if they are struggling with suicidal thoughts or who they’ve lost to suicide. Arm yourself with education and compassion. Suicide is a public health issue and affects us all.

Know that it’s ok to ask someone about suicide. There’s a common misconception that asking someone if they have suicidal thoughts will implant the idea. That’s a myth. If someone is not suicidal, asking about it will NOT cause them to be. And, if they are, asking about it may just save their life. By asking and listening without judgment and without anger, you’ll let them know that the door is open to talk about it, that you are a safe place for them, and that you will help them take the first steps toward preventing it.

Be in Peace,


To Z and the Others Who Lost Their Battles,

I can’t feel your pain…it’s too overwhelming and unbearable. My heart breaks that you suffered alone. Seven years later it’s still hard to imagine—and live in—a world in which you don’t exist. Know that I love you and that my life is better because you were in it. Be in peace.


About the Author:

Ashley Smith, PhD, began studying and treating anxiety disorders in graduate school. She earned her PhD in clinical psychology from the University of Nebraska-Lincoln in 2007. As part of that training process, she completed an APA-approved predoctoral internship at Children’s Mercy Hospital and Clinics before joining the staff at Omaha Children’s Hospital to help develop their dedicated anxiety services. In 2009, she relocated to Kansas City to serve as a senior staff psychologist at the Kansas City Center for Anxiety Treatment before starting a private practice in 2017.

In addition to direct clinical work, Dr. Smith is actively involved in other scholarly activities. She has been an adjunct assistant professor in the Department of Psychology at the University of Missouri-Kansas City and has provided supervision, trainings, and consultation for students and other professionals. She has several publications (see below) and maintains active involvement in professional organizations like the Anxiety and Depression Association of America. She regularly presents workshops and trainings on a local and national level and has been involved in planning and producing local and national conferences.

Dr. Smith strives to provide top-notch care in a collaborative and supportive manner. You will find her to be direct and knowledgeable, open and honest, and enthusiastic about guiding you through your journey.

Visit Dr. Smith's website here. 

My mind can't cope with how people are valued and I can't seem to get past my perception of lacking in it. I keep trying but to no solution past these dark thoughts. I hope others are having better luck/results past these unreasonable mental blocks.

I agree. Her words are great but my mind isn't able to move forward from these mental blocks and even though I know what I'm thinking isnt how it actually is I can't seem to fully accept that.

Really good article, great in fact, but I agree with Kyle. There are things in life that are simply unforgiveable and irreversible. An example that immediately came to mind, a drunk driving accident that caused the demise of someone (or severe unrecoverable injuries). Aside from that, excellent piece.

Dear Ashley,
I can tell you've never experienced the pain yourself. You don't 'get' it. Too many people out there with initials and titles before and after their names, such as yourself. You've studied and researched and probably written interesting papers on this subject. Plus, the loss of someone you knew gives you an interesting perspective....But, you don't get to the heart of the matter because you've never been there. I'm 68. Three months ago there was a murder/suicide in my family. There's a 7 month old orphan left behind. Until you really get down into it, you don't know how it feels to grieve the loss of a child. It never ends. You wish morning wouldn't come. You don't know what day it is, and you don't care. The depth of the pain is unfathomable. Friends and family think you should be over it already, they don't come around. Don't assume everyone has caring relatives and friends. You really need to learn more about this. Your knowledge is superficial and your writing is condescending and full of platitudes. I'm sorry to come across as being rude, but you need more than institutional learning. I was a help-line/crisis interventionist. Nothing prepared me for this level of pain....and for the very limited resources for real understanding.

My hope in writing these letters was that by sharing how I made sense out of and came to terms with the death of my person, I could help others do the same. I am so very sorry for your loss and for your pain, and I am sorry that my words could not offer any comfort.

You may not have helped them, but you helped me. Thank you for this. It helped me not feel alone. You are a wonderful person so thank you. I wrote down how my death would affect everyone around me and it helped me see some light. I don’t want to hurt anyone or make them feel pain as I do.

Your comments, you accuse Ashley of being rude? You are the one that rude. You are transferring your pain & suffering onto someone that is ONLY trying to help. Give her credit for that instead of bashing her. You don't know exactly how she or anyone else truly feels. You're not that powerful. No one is. She is showing compassion. You'd be better to do the same.

My son, my only child, I lost to suicide in Oct. 2017

There is much to say about suicide and depression. No one mental health professional can cover all perspectives. "Never been there", Sterling says. But Ashley has been there, and she admits it. "Never experienced the pain yourself", he says. Yes, she has, and she says so. "Your writing is condescending," he complains. I didn't feel I was being talked down to.

I lost my brother to suicide many years ago, so I recognize the pain you're in, and I empathize. But your criticisms are of Ashley are unduly harsh and unfair.

As a guy who is writing a play about a suicidal teenager, I have read dozens of books and online articles about depression and suicide among teens. One thing Ashley emphasizes that many others don't: the convictions of worthlessness that people who want to die feel and express are essentially lies, not just (as cognitive-behavioral psychologists would have it) "cognitive errors". When we feel that low, we say things to ourselves like, "the world would be better off without me," "I'll *never* recover from this rejection, " "No one will care if I take my life," "I *can't* ever feel any better than I do now," and so on. When we hear someone talking this way, we should know it's time to intervene and help in some way. Because truly, it's never hopeless until you're dead.

I know what it feels like to not care about anything. Lock yourself in a room and be in a position you can't even talk to someone. You can't even cry because the trauma makes you numb. You know there is someday tomorrow but you hope there isn't. Every day feels like you come up to the top of the sea and you drown yourself all over again. It hurts. Heart bleeds. Mind aches. Body stops functioning. You feel like to die. But it is okay. We are strong people. We can make it through the end. I hope you heal.

My brain runs constantly make it hard to focus and just be able to breathe. I have lived like this for as long as I can remember in and out of therapy ( currently in) I get stuck with the voice telling me that I am a burden know mater what I do or say if something goes wrong my brain tells me it’s my fault. I have tried 6 times to commit suicide and I can’t even do that right. Six times I’ve ended up in the hospital with doctors rushing around to save my life when all I wanted was the pain to stop and my brain to stop screaming at me all the time. I have been in and out of rehab and hospitals over 12 times. I’m 24 years old and should want to live life but I don’t. Out of those 12 times maybe more I have seen the pain I have caused my mother and grandmother everytime. The hope they have when I’d get out and the disappoint and pain on their face when I start to go back down hill. I know that they would live with the pain of losing me but my mind tells me that if I just do it then they will learn to move forward not saying they would be in less pain but they wouldn’t have to be afraid when their phone rings because they don’t know if I’m alive or dead. I cause them pain every single time I end up not being okay and it shows on there face I know it’s because they care and love me but if I would just end it it would be the last time they would ever have to worry. So in my mind I am the burden and even though I truly don’t mean to or want to I cause them pain constantly. I just want the pain inside of me to end.

If yoire going to kill yourself, and not try and keep riding the merry go round, try leaving. There's no reason to not radically change whatever you can. If you can afford a ticket than do it, who cares about rent or hotels or plans. Just go.

That is not an alternative that is a death sentence. People who suffer from depression and anxiety don't need to be further alienated from human contact they need to be helped. I have a daughter and a granddaughter who suffer from this and it is agonizing to watch them suffer. I have been there and will continue to be there for them and to help in whatever way I can. I am sixty five and my daughter is 30 and granddaughter is 20. Neither on them deserve this, but they fight ever single day and I am there to fight with them and nothing will ever make me stop fighting for them or with them. I have stopped there numerous attempts at suicide and will continue to do so and will continue to tell them they are loved, they are not worthless, they are not a burden and I will always be there for them. It is an on going struggle that they will go through for the rest of their lives and have there good days and bad days and thank god more good days than bad days now. All people want in this situation is the pain to stop and for someone to know their in pain, care that their in pain and that they are worth something and the world is not better without them. My prayers are with all of you that are suffering with these feelings and the pain of it all. One thing that is a big help is to surround yourself with positive people that give you positive feedback not negative people at all and if your are around negative people had as hard as it may be being family or not get away from them or send them away because they will only make the pain worse and the thoughts of suicide worse.

After 30 years of clinical depression and suicidal thinking, all I get is no one cares and it doesn't get better. Every time I've tried to seek help, I become a liability and people get away from me as fast as possible. Therapists, teachers, counselors that say they will help. Until the fear of a potential lawsuit after I kill myself. Just like 13 reasons why. All talk, but not real.

Hey i know what your saying believe me. I am that lliability, that problem for people that claim that they are family. I have done all the yes/no conversations in my head. Couple of trust. I care and I mean that with all my heart. I understand where your coming from. Sorry for your pain. Please try and stay, one step at a time.......

I’m not going to go into detail but I’ve battled this illness for a very long time and this past year has been the loneliness that I have ever had in my life I lost my best friend of 30 years suddenly ,my husband doesn’t communicate with me and doesn’t try to understand or engage in any type of intimacy from holding hands & so forth I have no friends anymore/ my only child is 20 and she’s pretty much erased me from her life & response to me as her Narcissis father does she shows traits of following in his footsteps she will not go to therapy
..all of my family know that i’m lonely and what I battle with but for 11 months now -not one person has came knocking at my door or calling my phone I have escaped death 6 times- I see a psychiatrist but it’s really what’s the point & I hv seen a therapist really what’s the point . The three loved ones that truly knew me & showed interest in spending time w/me & thought I was funny have all passed away in the last four years / my husband doesn’t even sleep with me.. re-married eight years the only thing I’ve ever asked from him is his time ... and I’ve been waiting for that for four years the darkness is getting stronger and stronger I don’t know what to do

Hello Roxkiki, I just want to let you know that I completely understood everything that you wrote about. The way that you described your husbands actions, your daughters actions and your former friends. Everything I read was exactly what I have been dealing with. Only difference is I’m no longer with my significant other. We weren’t married but she didn’t respond, or care, in any way to help me through my rough times. Now I’m alone, no friends, not one. Haven’t communicated with any family member in over 30 years. I go months without anyone speaking to me. I feel we have much in common and would love to communicate with you, if possible. Not in this open forum. I’m sure I’m older than you, but that shouldn’t matter. Especially under these issues that we are dealing with. If, on the outside chance that you read this reply, and can offer a way that we can better communicate with each other, then please respond on here again. I will check this site regularly with hopes that you respond. Hang in there!

My best friends husband committed suicide two summers ago and now I see why. It was sudden and nobody was prepared.... I was confused, sad, and mad all at the same time. But the more I'm here I understand why! I walk around every day and I try to smile, I pray, I even listen to gospel 80 percent of the time.... The only reason why I'm here is Because I have one child and I know that if I leave he would be miserable. I've set in bathrooms for hours trying to talk myself into ending this life because you dont know how it is to be alone until you really realize your actually alone. I use to think that people that do that are selfish but now that I'm in the same boat I understand it a little more. Selfish is waking up every morning going to work and barely having a check left after you've paid all the Bill's, and not being able to do anything differently because you dont have help! People always make it seem like it wasnt that bad for someone to take there life.. but you dont know what they were dealing with. I have quote on quote friends who are always to wrapped up in there own lives to even talk to me. I text and they may respond 2 days later. Sometimes the signs be right in your face but most people dont open there eyes to see. I do believe in God I just believe the devil is riding my back and apparently has installed a seat! I'm working two jobs in school trying to better myself but it's just to much at times. Most of my problems have came from helping others and letting my guard down for people who didnt care about me just used me. So now I'm here ...... what's ironic is I wasnt going to keep my don but my faith wouldn't let me go through with it..... hes my knight in armour and he doesn't even know it. He saves me every week!

yea same , I’ve been through heartbreak and it’s ruining me I don’t know what to do .. I’ve spoke to everyone about it like by everyone I mean mum, it’s just hard to cope as I have anxiety bad thought ocd and suicide thoughts and I’m becoming 13 and a boy is telling everyone to kill there selves on snap x

I’m not depressed but I also don’t want to be here anymore. Why is that so wrong. My husband and I love each other deeply but I’m a burden on him. He needs some on his own time and I respect that. Family...sister 1000 km away I make an appointment to see her. She suddenly is busy this happens or that and she can spare an hour. I don’t want to be a burden. Friends... I have tried lots of lovely people in my life as long as I organise a meet up, listen to all their problems. I’m retired I have tried hundreds of hobbies but nothing is s passion. So at sixty I reckon out is a relief why is that depression it just makes sense.

I am so stressed because my partner is so arrogant and dominant character, my stress level has reached to extreme level. I don’t have any choice to except to suicide my self but I am worried about my elderly father and my little children. Please god help me to solve and separate from my partner, it’s so hard for me to live with her.

It's great that people try to be this supportive. But how do you make life seem worth living to those of us who can hardly find a reason to leave bed? I've been fighting every day for the vast majority of my life, and the thing that gets me most is the exhaustion. People like to say, "keep fighting," but that's all I ever do. At some point it's just too tiring to think about. When do I get to stop fighting my own brain for my right to just exist? Haven't I fought enough? It's kind of amusing that the earlier form of my depression saw my use of, "I'm just tired," as a dodge, and nowadays it's the genuine truth. I am just tired. I'm so tired I can hardly justify spending energy on myself. There is no cure for being this way. At this point I don't even want to fight anymore. I'm still here, still trying, but god damn sometimes I really don't want to be.

One thing I’d like to say is that when someone is contemplating suicide, it isn’t always because they think that the world is better off without them. Sometimes that isn’t a thought that crosses their minds. It’s more of a desperate act of trying to get their own personal pain to stop, and they may not actually be thinking of the ones that are close to them. Although, believing you’re a burden to those around you is a common symptom of depression.
Losing someone is extremely tough, because you’re just left thinking what you could have done, which is good you say, “that will only result in endless loops of anguish and no real clarity,” because it’s true. We often feel like there was something we could have done and beat ourselves up for something that we truly didn’t have control over. Still, trying to get over that is still hard because there is always going to be some sort of guilt over the whole situation.
I like your comparison for suicide being like cancer, and how it doesn’t care what race, or gender you are. I think depression/ suicidal thoughts can affect anyone, at any time. I used to think things like depression would only affect people who have had it rough their whole life, but the older I get the more I realize people who live a pretty good life, with a good home situation, a good job and financial security, and people who adore them, can still have depression and can still contemplate suicide. Depression definitely isn’t picky when it comes to choosing a target, and I’m glad more people, as well as myself, are starting to realize that a bit more.

Thank you Ashley and thank you to all who have commented.
I’m 61years old and on the other side of the World (down under) and I can tell you all of the thoughts/comments are familiar to me.
I found this article because I am not thinking or feeling well. I’ve been doing it most of my life. Without going in to why I just want to say that all of the people who have commented have left a mark, a positive, helpful, loving mark. Just writing something helps! It has helped me to read almond your comments, even though some of you are having a tough tough time. I hope it has helped you.

I felt it was well worth reading. I lost it a bit when the gen-pop were addressed.
"By asking and listening without judgment and without anger...".
Talking about what I consider my desired, imminent conclusion isnt something I can talk to anybody about freely. Even my strongest support systems are entirely exhausted by me and it isnt like I havent done everything and more to ration my sob story nonsense lately. After being left by my wife I genuinely overloaded and relied too heavily on friends and family to an extent that made me aware of how toxic my flaws and struggle were to them all. So I started "fixing" my behaviors. Now I feel like I'm in a wicked play and my character is destined to be flawed as well as fake... but my point is to pose a question.
I am so sick of being pandered to, patronized by friends and family. I didnt ask for what the marine corps gave me. I didnt ask to be desperate for death at 24. To have a brain with so many disadvantages. I want to talk about these things with people who have insight to share. Thoughts and progress I havent found or made. 24 is too young to die, I think. But being left alone without being able to debate and discover, or discuss it at least... being stuck in my own head just to remove the burden on my last handful of friends and family... where does someone like me find that. I dont want to be convinced I'm right or wrong. I dont want to be encouraged or dissuaded anymore. I just want to explore it in all of its glory so I can feel less scared of the unknown.

After reading this passage I can tell you, thank you. You have saved a life tonight. Anytime I have these thoughts, I will try to come back and read again. I'm not sure if it was God who brought me here. I was so close to giving in to these thoughts in my mind, and just ending it all.
I have been battling a life long of depression. Anxiety has completely taken over my body this past year, and I'm unsure where it comes from. I did not come here to talk about race, but I will say in the African American community, this type of thing is completely disregarded. I told my mother I wanted to die, I told her I am tired of living in pain. All while hiding under blankets in my bed (where I have been for two days). She called me weak, saying I have 3 kids who will have to wake up in the morning without me, so why wait. She brought me a bottle of pills, shaking them and telling me to just do it right now. In some strange way, I feel like she thinks she was trying to make it better, but in my sick reality it humiliated me to be THIS weak. I'm not sure what my life has become, and as I get closer to Christmas it's getting worse and worse. The pain is unbearable. The anxiety is sickening. The depression is embarrassing. I just want it all to end.
You said "our minds can lie to us", and that made me really think. Is this not reality. Is my mind playing some type of evil game with me. Is this normal? I just don't know where to go from here. What I do know is, I have 1 more night in me, and it's all thanks to this article.
Thank you so much Ashley, you are truly a blessing.

Thank you for taking the time to put a comment on this article. I can’t imagine the pain that you are going through. Am I right in saying that you must feel so misunderstood by your mother especially after finding the strength to tell her something that seems to be not very acceptable in your culture. I’m sorry that you are feeling this way. I too suffer from severe anxiety and depression. I am truly thankful that this article has helped you put it off for a night. I don’t know who you are or where you are from, but I am thinking of you in this really tough time. PS. You aren’t weak. You have gotten this far. That seems pretty courageous to me.


I have a question, I’m looking to submit my father’s suicide note he left to me to any type of research, to help anyone one for following thru with suicide. Just trying to help

I am going through depression and having thoughts in my head don’t know what to do it it’s killing me inside.. I cry everyday when my husband leave and I am sorry for what I did and cause... I just need help