"I have a relative who has struggled with depression for a number of years. When they feel any strong negative emotion, they start talking about suicide and friends and family rally around to show support. We wonder if this relative is stuck in this pattern, and defaults to these suicidal thoughts to gain reassurance or some other benefit?"

We all do it, if we're upset enough: "I could kill him"; "I'm just going to leave town"; "I just want to disappear". It's human nature to express feelings by verbalising what our emotions make us want to do. Angry enough, we want to lash out. Ashamed, we want to hide. Afraid, we want to run.

And if we feel desperate or trapped enough, we may feel like dying.

So if feeling strong emotions can make anyone express their emotions this way, what happens if you're prone to feeling most of your emotions this intensely?

Borderline Personality Disorder is a very scary sounding psychiatric diagnosis that is characterized by intense and frequent emotional swings, recurrent suicidal threats and attempts, self-harm, and turbulent relationships with others.

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It's strongly associated with childhood trauma or maltreatment, with around seventy-five per cent of people diagnosed having experienced sexual abuse in their childhood.

Whether or not your family member has this diagnosis, you are right to always take these threats seriously. One of the judgments that's thrown at people who struggle with intense, overwhelming emotions is that they're "attention seeking" or "manipulative".

Not only is this not true, it's not helpful. It's kind of like saying, "just calm down", which never helps when someone is upset. And besides, we all manipulate people all the time: we're all seeking to influence each others behavior in ways that are helpful to us.

So some people express strong feelings this way and while they may very well be at risk of hurting themselves, it's also true that over time it can wear people out.

What can you do? It's important to validate the emotion, not the behaviour or the threats. Focus on attending to the distress, and if necessary help them access appropriate support and treatment.

It can also be a good idea to "strike when the iron is cold", meaning talking to them about all of this when they're not distressed. You can encourage them to reach out for help earlier, and reassure them that just being upset is reason enough to ask for support: you don't have to be suicidal to ask for help.

As a support person you also don't have to fix it. While it can be overwhelming and frightening to have someone you care about express a wish to die, remember that just like anyone who is upset, feeling connected and supported by people who care about them helps. It's not magic; it's as simple as listening, validating and truly caring.

And that's the action of another strong emotion: compassion.

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u>Where to get help:

Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youth services: (06) 3555 906 (Palmerston North and Levin)
Youthline: 0800 376 633
Kidsline: 0800 543 754 (available 24/7)
Whatsup: 0800 942 8787 (1pm to 11pm)
Depression helpline: 0800 111 757 (available 24/7)
Samaritans: 0800 726 666 (available 24/7)
If it is an emergency and you feel like you or someone else is at risk, call 111.