When I talk with people who have lived through suicidal despair, I’m struck again and again by something that doesn’t fit neatly into a clinical checklist. Yes, there are sometimes symptoms of depression, anxiety, trauma, or addiction — but beneath all of that, there’s often something deeper. Something profoundly human.
More than just so-called broken brains and diagnoses, there is an unbearable weight of being alive and wondering if one’s life matters.
The philosopher Albert Camus wrote that the only serious philosophical question is whether life is worth living. That question — ancient, raw, and deeply personal — lies at the heart of suicidology. And yet, our systems too often treat suicide as if it were purely a medical malfunction rather than a crisis of meaning (Camus, 1942).
The Two Stories We Tell About Suicide
In modern society, we tend to hear two competing stories about suicide.
The first story is the clinical one: suicide is a symptom of mental illness — a preventable outcome of depression, trauma, or distress that overwhelms coping skills. The treatment approach is focused on stabilization: risk assessments, safety plans, and symptom management.
The second story is the existential one: suicide as a response to the unbearable weight of human freedom and meaninglessness — what philosophers like Camus and Viktor Frankl called out so long ago. Here, the crisis isn’t only about pain; it’s about the loss of the reason to endure it.
The truth, of course, is both. Suicide often emerges at the intersection where emotional suffering meets existential void (Frankl, 1959).
What It Means to Feel Like a Burden and Alone
One of the most influential clinical models of suicide, psychologist Thomas Joiner’s Interpersonal Theory of Suicide, offers a bridge between these worlds. Joiner (2005) proposed that suicidal desire grows when two painful experiences converge:
Perceived Burdensomeness — the belief that one’s existence causes more harm than good, and
Thwarted Belongingness — the feeling of profound disconnection or alienation from others.
These aren’t simply diagnostic symptoms; they’re existential questions in disguise:
“Am I lovable?”
“Does my life matter?”
When these two beliefs harden into hopelessness — the sense that nothing will ever change — life can begin to feel unbearable.
Psychiatrist Irvin Yalom identified four “ultimate concerns” that shape the human condition — death, freedom, isolation, and meaninglessness — each capable of provoking deep existential anxiety when confronted directly. In many ways, Thomas Joiner’s clinical constructs mirror these existential themes. His idea of “thwarted belongingness” echoes Yalom’s concept of isolation — that unbearable sense of being cut off from others and unseen in our suffering. Similarly, “perceived burdensomeness” parallels meaninglessness — the painful belief that one’s life lacks purpose or value, and that one’s very existence may be a liability to others rather than a gift.
As Clemente and Goodman (2024) note, despair is often “the hopeless feeling of not wanting to be yourself,” a crisis not of mood alone but of identity and purpose. When people lose the sense that their being has meaning — when they can no longer see themselves as worthy participants in life — suffering becomes profoundly philosophical.
Beyond Safety Plans: Healing Through Connection and Contribution
Don’t get me wrong — clinical tools like crisis response plans and lethal means safety might save lives. But they rarely help people find a passion for living again.
What heals is connection and contribution.
People recover when they rediscover belonging — through peer support, faith communities, mentorship, or shared purpose. And they thrive when they find ways to make a meaningful impact — when they can see that their presence is a gift rather than a burden.
Frankl (1959), a Holocaust survivor and psychiatrist, called this the will to meaning. He found that people could endure unimaginable suffering if they found a purpose to serve — something or someone beyond themselves. When life loses meaning, despair floods in. But when meaning is rekindled — even in small ways — people rediscover the strength to endure suffering.
In other words, the antidote to suicide goes beyond just keeping people safe. People need to find reasons to live.
Agency and the Momentum of Life
When we help people reconnect with purpose, we help restore something sacred: agency.
So many who struggle with suicidal thoughts describe feeling trapped — stuck between pain and meaninglessness. Existential therapy reframes that paralysis as a crisis of freedom. Humans are “condemned to be free,” Sartre wrote — meaning we must continually choose who we become, even when we feel powerless.
Empowerment and agency can begin with the smallest actions: helping someone else, creating something, showing up for a cause. These choices generate forward motion — momentum — and remind us that while we may not control our circumstances, we always have some control over our response to them.
Building a Unified Vision of Suicide Prevention
What if we approached suicide prevention as both a medical and a meaning-making endeavor?
Clinical care restores cognitive clarity and emotional regulation; existential care restores purpose, belonging, and dignity.
The future of suicide prevention could look like this:
Immediate care that treats the acute pain and restores safety, and
Long-term healing that helps people build lives of connection, purpose, and contribution.
Because surviving is not the same as living.
And our goal should always be to help people do more than stay alive — to help them feel alive, connected, and meaningful again.
References
Camus, A. (1942). The Myth of Sisyphus. Vintage International.
Clemente, M., & Goodman, D. (2024, May 3). Despair and the crisis of meaning: What is the hopeless feeling of not wanting to be yourself? Psychology Today. https://www.psychologytoday.com/us/blog/our-human-condition/202405/despair-and-the-crisis-of-meaning
Frankl, V. E. (1959). Man’s Search for Meaning. Beacon Press.
Joiner, T. (2005). Why People Die by Suicide. Harvard University Press.
Yalom, I. D. (1980). Existential Psychotherapy. Basic Books.