Jay Shetty & Matthew Nock ON How to Spot Suicidal Thoughts
In this On Purpose episode, Jay Shetty welcomes Matthew Nock, a Professor of Psychology at Harvard University and director of the Laboratory for Clinical and Developmental Research. Nock has dedicated his life's work to understanding why people engage in self-harm, specifically focusing on suicide, utilizing large-scale surveys, lab experiments, and clinical studies to predict and, most crucially, prevent these behaviors.
We often train for emergencies that are statistically rare, like earthquakes or fires, but how equipped are we to handle the mental health crisis that affects one in seven people globally?
In this On Purpose episode, Jay Shetty welcomes Matthew Nock, a Professor of Psychology at Harvard University and director of the Laboratory for Clinical and Developmental Research. Nock has dedicated his life's work to understanding why people engage in self-harm, specifically focusing on suicide, utilizing large-scale surveys, lab experiments, and clinical studies to predict and, most crucially, prevent these behaviors.
Escaping the Burning Room
Nock told Jay Shetty that the leading reason why people resort to suicide is their desire to escape their current realities. He explained that 9/10 times, people don't want to be dead per se, but rather they want to escape what they perceive as intolerable pain.1 Nock explained that this core pain is often related to depression, one of the strongest predictors of having suicidal thoughts.2
However, there is no common cause for all cases; it affects people from all income levels and socioeconomic factors. Therefore, it's crucial to recognize that it can always look different in different people and understand that person's unique experience of pain, what they are going through, and what they are trying to escape is crucial.
While it's often believed that people committing suicide genuinely want to die, Nock explained to Jay Shetty that, in fact, the opposite may be true. They are mainly trying to avoid a problem, not achieve death. However, most people attempting to take their own lives don't die from that attempt.3
Tracing the Stages of the Suicidal Pathway
Nock clarified to Jay Shetty that researchers and clinicians identify four steps in the pathway to suicide:
- Suicide Ideation: Having ideas or serious thoughts about suicide. Approximately 15% of people in the US report having had suicidal thoughts at some point in their lives.4
- Suicide Planning: Actively formulating an intentional plan, including a time, place, and method for killing themselves. About one-third of people who experience ideation will move on to make a plan.5
- Suicide Attempt: Engaging in the physical steps to intentionally end one's life. Only about 5% of people who have suicidal thoughts will ever make an attempt.5
- Dying by Suicide: The lethal outcome.
Nock asserted that while suicide attempts are carefully planned in advance, many acts remain impulsive.6, 7 Even if suicidal thoughts have persisted for years, the decision to act is often made only in the few hours preceding the event, Nock told Jay Shetty. Yet it's rare for someone to decide to end their life on a whim, but rather after a slow buildup of depression, anxiety, or distress.
The Staggering Statistics and High-Risk Periods
Matthew Nock shared with Jay Shetty several sobering statistics underscoring the severity of the crisis:
- Suicide is one of the leading causes of death globally; the World Health Organization asserts that it takes more lives than illnesses such as HIV and malaria, and more than all wars and homicides.8
- As of 2023, in the United States, an individual is statistically more likely to die by their own hand than by someone else's.9
- Suicide is the second leading cause of death among people ages 10-34, trailing only accidents.9
The highest risk time for a suicide attempt is usually the first year after the onset of suicidal thoughts.10 If an unsuccessful attempt has been made, then the next delicate period is the following year, with about 20% of survivors trying again.11
Nock highlighted that, contrary to popular belief, another high-risk period is right after discharge from psychiatric hospitalization. He explained to Jay Shetty the reason behind it: effective treatments like antidepressants take between two and four weeks to show effects, while hospital visits are usually only one week long. Therefore, it's essential to remain vigilant if a loved one is recovering from an attempt because they are highly vulnerable and at risk of trying again in the near future.
From Thoughts to Action
Depression is the key driver for suicidal thoughts, Nock told Jay Shetty, yet other factors influence this decision. Depression by itself doesn't strongly predict action, he added.5 Instead, if combined with one of the following factors, the risk increases12:
- Anxiety
- Aggressiveness
- Poor behavioral control
- Drug use
- Alcohol use
Nock also shared with Jay Shetty that certain familial traits can play a role in someone's decision to take their own life, such as a parent's history of depression. This increases the risk and persistence of suicidal thoughts in their child; however, it is not a predictor of their actions. On the other hand, if one parent suffers from antisocial behavior or panic disorder, the child is more likely to act on their intent to end their life.
The combination of these elements heightens the risk of action. Nock also noted that certain pieces of the pathway to suicide might be passed down differently through families. A parent's history of depression increases the risk and persistence of suicidal thoughts in their child, but it does not predict the child acting on those thoughts. Conversely, a parent's history of antisocial behavior or panic disorder (linked to hyper-arousal and impulsivity) predicts acting on suicidal thoughts.13
Gender, Age, and the Socioeconomic Picture
Matthew Nock brought up that the gender differences in suicide risk are significant and consistent worldwide. He explained to Jay Shetty that women and men display different patterns14:
- Women are much more likely to have suicidal thoughts and engage in non-lethal suicidal behavior, linked to higher rates of anxiety and depression. They tend to use less lethal means, such as cutting themselves or overdosing.
- Men are much more likely to die by suicide, by a ratio of about four to one, which is linked to higher rates of impulsive and aggressive behaviors, and alcohol/drug use disorders. Men also tend to use more lethal means, such as firearms.
In the Western world, we have experienced a significant increase in suicide rates among adolescents.15 Nock explained to Jay Shetty that a leading scientific theory points to an imbalance in adolescent brain development, in which the limbic system (the impulsive part of the brain) is maturing, while the prefrontal cortex (the rational part) is not fully developed until early adulthood.16 This discrepancy plays a crucial role in the increased risk-taking and aggressive behavior, as well as the onset of many mental illnesses.
Rates stabilize in young adulthood, only to increase again later in life, especially amongst men.17 One hypothesis is that men have fewer social connections, and loneliness increases, especially during retirement. Nock emphasized that suicide is a phenomenon that affects many people, regardless of their income, education, or socioeconomic factors.
We Need More Education Around Suicide Prevention
Jay Shetty believes that since suicide is a very relevant topic to our times, so we should learn how to prevent it, the same way we hold drills for physical disasters. Nock agreed that, while schools train for rare events such as school shootings, students are far more likely to encounter someone suicidal.
Moreover, Nock dispelled the misconception that talking to someone about suicide makes them want to do it. He asserts that it's only a myth stemming from stigma and fear. So, he advocates for more education on this topic and for introducing modules in schools to teach adolescents about suicidal thoughts, effective interventions, and safety plans. This knowledge can one day save someone's life.
Generative AI, Cyberbullying, and the Digital Crisis
Jay Shetty and Matthew Nock discussed the unfortunate death of Adam Rain, who used artificial intelligence (AI) as a suicide coach, and ended his life. It was a tragic instance, Nock observed, and a likely reason is that AI failed to identify the opportunity to intervene, and, in some cases, validates suicide as a logical solution, lacking human empathy. He warns that generative AI is a very powerful tool that can be used for both good and bad, exactly like a sharp knife. It's up to the user to discern right from wrong; at the same time, these tools must undergo rigorous testing and collaboration with scientific researchers, especially in domains such as mental health.
Online anonymity also increased the risk of cyberbullying – statistics show that it can make someone up to three times more likely to contemplate suicide than traditional in-person bullying.18 Nock told Jay Shetty that cyberbullying allows the abuse to manifest around the clock and feel more intense, making the victim feel like there's no escape. It's essential as a parent to be aware of the platforms your children use and the risks they may be exposed to.
The AIR Model: How to Help Someone at Risk
If you or someone you know find yourseves in a situation of risk, you can call the Suicide & Crisis Lifeline at 988 (USA) or access the website for support: https://988lifeline.org/. If you’re outside the US, you can find local, trusted helplines in your country at findahelpline.com, which connects you to suicide prevention and crisis support services worldwide.
Nock introduced Jay Shetty to the AIR model, meant to help identify and prevent suicidal behaviors:
A – Ask the Question: Initiate the conversation calmly and directly. Clinicians are taught to ease into the discussion by asking about depression or thoughts of death, then asking, "Are things so bad that you've thought about suicide?"
I – Initiate Support: Do not pull back. People often feel uncomfortable and withdraw, but Nock urges loved ones to lean in and be there for the person.
R – Refer: Do not try to solve the crisis alone; refer the person to professional care, such as the 988 crisis line in the US, which operates 24/7, or take them to the hospital if they are thinking about killing themselves that day.
Nock strongly advised against promising secrecy if someone shares suicidal intentions. Instead, reassure them of the love and care you feel for them and that their life is more valuable than keeping their secret. Ensure they understand that you will seek help for them. Nock warned that most suicidal people put out a wealth of indications before attempting to take their life, and it's crucial that you take these signals seriously.
Regret, Mental Health, and the Burden of Loss
Matthew Nock opened up to Jay Shetty about his personal experience of losing a good friend to suicide. He shared the gut-wrenching struggle of seeking clues and wishing he could have done more. For those who have lost someone, he suggests giving yourself grace. If trained experts can't always predict who is at risk, most likely neither could you. Join survivor support groups, such as those offered by the American Foundation for Suicide Prevention (afsp.org).
Nock confirmed a huge connection between mental health disorders and suicide: 90% to 95% of people who die by suicide had a diagnosable mental disorder before their death, including depression, anxiety, bipolar disorder, and psychotic illnesses.19 Additionally, data shows that most attempt survivors regret their action.20 The majority of survivors report feeling guilt, shame, and disappointment; moreover, they admit they wished they had spoken to someone prior to attempting to take their lives. Matthew Nock emphasized to Jay Shetty that the feeling of being a burden to others is real and a key component in the thinking that leads to suicidal ideation.
Hope and the Future of Prediction
While other leading causes of death, like heart disease or infectious illnesses, have sharply dropped, suicide rates have remained relatively stagnant over the last century.21 Matthew Nock explained to Jay Shetty that stagnation is a sign that this topic isn't given as much attention because of stigma and underfunding. He believes that research on suicide needs to increase threefold to match the magnitude of the issue.
However, Nock remains optimistic that suicide prevention will become a more debated topic in the future. Around 50% of people who died by suicide had seen a clinician in the month prior to their death22; with modern technology, it would be possible to identify high-risk patients and allow targeted interventions. New tools, such as smartphone apps, collect data and can help clinicians predict when a patient is likely to attempt in the next few days. To Matthew Nock, combining the digital lore with scientific discipline can customize assistance and significantly reduce suicide rates in the near future.
More From Jay Shetty
Listen to the entire On Purpose with Jay Shetty podcast episode “Harvard Psychologist Matthew Nock: 20% of People Experience Suicidal Thoughts! (Spot the Signs and Ask THESE Questions That Could Save a Life)” now in the iTunes store or on Spotify. For more inspirational stories and messages like this, check out Jay’s website at jayshetty.me.
Useful Support Hotlines
If you’re in the United States, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988, or by chatting via 988lifeline.org. Support is free, confidential, and available 24/7.
If you’re outside the US, you can find local, trusted helplines in your country at findahelpline.com, which connects you to suicide prevention and crisis support services worldwide.
If you feel in immediate danger, please contact your local emergency number.
1Levi-Belz Y, Gvion Y, Apter A. Editorial: The Psychology of Suicide: From Research Understandings to Intervention and Treatment. Front Psychiatry. 2019 Apr 4;10:214. doi: 10.3389/fpsyt.2019.00214. PMID: 31019475; PMCID: PMC6458543.
2Mubasyiroh, Rofingatul & Pradono, Julianty & Nurchotimah, Enung & Nunik, Kusumawardani & Idaiani, Sri. (2018). Depression As a Strong Prediction of Suicide Risk. Global Journal of Health Science. 10. 52-52. 10.5539/gjhs.v10n12p52.
3Bostwick JM, Pabbati C, Geske JR, McKean AJ. Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew. Am J Psychiatry. 2016 Nov 1;173(11):1094-1100. doi: 10.1176/appi.ajp.2016.15070854. Epub 2016 Aug 13. PMID: 27523496; PMCID: PMC5510596.
4Harmer B, Lee S, Rizvi A, et al. Suicidal Ideation. [Updated 2024 Apr 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK565877/
5Klonsky ED, Dixon-Luinenburg T, May AM. The critical distinction between suicidal ideation and suicide attempts. World Psychiatry. 2021 Oct;20(3):439-441. doi: 10.1002/wps.20909. PMID: 34505359; PMCID: PMC8429339.
6Simon OR, Swann AC, Powell KE, Potter LB, Kresnow MJ, O'Carroll PW. Characteristics of impulsive suicide attempts and attempters. Suicide Life Threat Behav. 2001;32(1 Suppl):49-59. doi: 10.1521/suli.32.1.5.49.24212. PMID: 11924695.
7Smith AR, Witte TK, Teale NE, King SL, Bender TW, Joiner TE. Revisiting impulsivity in suicide: implications for civil liability of third parties. Behav Sci Law. 2008;26(6):779-97. doi: 10.1002/bsl.848. PMID: 19039790; PMCID: PMC2597102.
8World Health Organization. 2021. One in 100 deaths is by suicide. News release, June 17, 2021. https://www.who.int/news/item/17-06-2021-one-in-100-deaths-is-by-suicide
9National Institute of Mental Health. 2025. “Suicide.” NIMH. https://www.nimh.nih.gov/health/statistics/suicide
10Probert-Lindström S, Berge J, Westrin Å, Öjehagen A, Skogman Pavulans K. Long-term risk factors for suicide in suicide attempters examined at a medical emergency in patient unit: results from a 32-year follow-up study. BMJ Open. 2020 Oct 31;10(10):e038794. doi: 10.1136/bmjopen-2020-038794. PMID: 33130567; PMCID: PMC7783608.
11De la Torre-Luque, Alejandro, Andres Pemau, Wala Ayad-Ahmed, Guilherme Borges, Jessica Fernandez-Sevillano, Nathalia Garrido-Torres, Lucia Garrido-Sanchez et al. "Risk of Suicide Attempt Repetition after an Index Attempt: A Systematic Review and Meta-analysis." General Hospital Psychiatry 81, (2023): 51-56. Accessed November 27, 2025. https://doi.org/10.1016/j.genhosppsych.2023.01.007.
12Fawcett, Jan. 2012. “Diagnosis, Traits, States, and Comorbidity in Suicide.” In The Neurobiological Basis of Suicide. Edited by Yogesh Dwivedi. Boca Raton (FL): CRC Press/Taylor & Francis. Chapter 1. https://www.ncbi.nlm.nih.gov/books/NBK107213/
13Diaconu G, Turecki G. Family history of suicidal behavior predicts impulsive-aggressive behavior levels in psychiatric outpatients. J Affect Disord. 2009 Feb;113(1-2):172-8. doi: 10.1016/j.jad.2008.03.028. Epub 2008 May 27. PMID: 18504057.
14Berardelli I, Rogante E, Sarubbi S, Erbuto D, Cifrodelli M, Concolato C, Pasquini M, Lester D, Innamorati M, Pompili M. Is Lethality Different between Males and Females? Clinical and Gender Differences in Inpatient Suicide Attempters. Int J Environ Res Public Health. 2022 Oct 15;19(20):13309. doi: 10.3390/ijerph192013309. PMID: 36293891; PMCID: PMC9602518.
15Curtin SC, Garnett MF. Suicide and homicide death rates among youth and young adults aged 10–24: United States, 2001–2021. NCHS Data Brief, no 471. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: https://dx.doi.org/10.15620/cdc:128423
16Institute of Medicine (US) and National Research Council (US) Committee on the Science of Adolescence. The Science of Adolescent Risk-Taking: Workshop Report. Washington (DC): National Academies Press (US); 2011. 3, Biobehavioral Processes. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53414/
17Shoib S, Amanda TW, Saeed F, Ransing R, Bhandari SS, Armiya'u AY, Gürcan A, Chandradasa M. Association Between Loneliness and Suicidal Behaviour: A Scoping Review. Turk Psikiyatri Derg. 2023 Summer;34(2):125-132. doi: 10.5080/u27080. PMID: 37357899; PMCID: PMC10468686.
18Nixon CL. Current perspectives: the impact of cyberbullying on adolescent health. Adolesc Health Med Ther. 2014 Aug 1;5:143-58. doi: 10.2147/AHMT.S36456. PMID: 25177157; PMCID: PMC4126576.
19Nock MK, Hwang I, Sampson NA, Kessler RC. Mental disorders, comorbidity and suicidal behavior: results from the National Comorbidity Survey Replication. Mol Psychiatry. 2010 Aug;15(8):868-76. doi: 10.1038/mp.2009.29. Epub 2009 Mar 31. PMID: 19337207; PMCID: PMC2889009.
20Dombrovski AY, Hallquist MN. The decision neuroscience perspective on suicidal behavior: evidence and hypotheses. Curr Opin Psychiatry. 2017 Jan;30(1):7-14. doi: 10.1097/YCO.0000000000000297. PMID: 27875379; PMCID: PMC5291285.
21Mineo, Liz. 2016. “Against Suicide, a Century of Little Progress.” Harvard Gazette, June 21, 2016. https://news.harvard.edu/gazette/story/2016/06/against-suicide-a-century-of-little-progress/
22Raue PJ, Ghesquiere AR, Bruce ML. Suicide risk in primary care: identification and management in older adults. Curr Psychiatry Rep. 2014 Sep;16(9):466. doi: 10.1007/s11920-014-0466-8. PMID: 25030971; PMCID: PMC4137406.
Sign up for the only email that puts purpose at the center of your day.
Looking for greater meaning? This quiz shows you how to live with purpose every day.
Take the Quiz
Dreaming of becoming a life coach? This quiz tells you if a coaching career is right for you.
Take the QuizDreaming of becoming a life coach? This quiz tells you if a coaching career is right for you.
Take the Quiz
Everyone communicates differently. Discover your own personal fight style now.
Take the Quiz
Understanding your role in a relationship is the first step to making things work.
Take the Quiz
