Almost every time a family loses someone to suicide, the same sentence follows in the days after. We had no idea. It is said with complete honesty, and it is almost never entirely true. When people look back, they sometimes find that the signs were difficult to see at that time. They were just quiet. A cancelled plan here, a joke about being tired of everything there, a slow fading from conversations that once mattered. Distress rarely announces itself. It whispers, and it whispers in a language most of us were never taught to hear.The scale of what we are missing should give all of us pause. As per the World Health Organization report Suicide Worldwide in 2021, released in June 2025, an estimated 727,000 people take their own lives every year, which means one in every 100 deaths globally is by suicide, and it remains the third leading cause of death among people aged 15 to 29. Closer home, the National Crime Records Bureau report Accidental Deaths and Suicides in India 2024, released in May this year, recorded 1,70,746 lives lost to suicide in a single year, with family problems a leading reported cause. Behind every one of these numbers is a period, sometimes weeks, sometimes years, when the pain was building and possibly visible to someone who loved them.What distress actually looks likeIn my work with therapists and psychologists, one thing comes up again and again. A crisis is rarely the first chapter of the story. It is often the point at which a much longer story of distress becomes impossible to ignore. The earlier chapters look surprisingly ordinary, which is exactly why we miss them.Withdrawal is often the first sign. The friend who always showed up begins finding reasons not to. The colleague who loved a good debate goes silent in meetings. We tend to read this as busyness or moodiness, when it is often a person quietly removing themselves from their own life.Then there is a change in rhythm. Sleep that becomes erratic, appetite that disappears or doubles, energy that drains out of routines the person once enjoyed. When these patterns change significantly and persistently, they can be important signals that someone may be struggling.Listen closely to language too. Sentences like I am so tired of everything, nothing is going to change, or you would all be better off without me are often delivered lightly, sometimes even as humour. We laugh along or offer a quick everything will be fine. Words like these deserve a pause, not a pep talk. Sometimes, people in pain express these thoughts indirectly, perhaps through a passing comment or humour, making them easy to dismiss.And perhaps the hardest sign to spot is the one that looks like recovery. A person who has been visibly struggling suddenly seems calm, settled, almost light. A sudden, unexplained shift to calm after a prolonged period of severe distress can sometimes warrant checking in, particularly when it is accompanied by other concerning changes. Which is why sudden, unexplained peace after a long period of turmoil should invite more attention.There is also a distinctly Indian dimension we must talk about, and that is how distress wears disguises. In many men, it shows up as irritability, anger rather than sadness, because sadness was never a permitted emotion for them. In high achievers, it hides behind performance. Some of the most severe distress I have seen sits inside people who are excelling at work, replying to every message and holding everyone else together. Competence is not evidence of wellbeing.Why we keep missing itPart of the answer is that we are watching for the wrong thing. We expect crisis to look dramatic, and instead it looks mundane. Part of it is stigma, which teaches people to hide their pain and teaches the rest of us not to ask about it. And part of it is a dangerous myth that refuses to die, the belief that asking someone directly about suicidal thoughts might plant the idea in their head. Decades of clinical experience and the WHO’s own guidance say the opposite. Asking openly and compassionately does not create risk. If anything, it opens a door, because it tells the person that their pain has finally been seen and can be spoken about safely.We also dismiss too easily. Even when someone appears to be seeking attention, distress should not be dismissed. The need for attention can itself be a need for care, connection or support.What each of us can doYou do not need a degree in psychology to notice distress or start a conversation that could help someone find support. You need to notice, and you need to ask. Ask directly, gently and without panic. Are you okay, really? Have things felt too heavy lately? Then do the hardest thing of all, which is to listen without rushing to fix, judge or minimise. Stay in touch afterwards, because one conversation is a door and not a destination. And when the pain is beyond what friendship can hold, help the person reach professional support instead of leaving them to find it alone.That support exists, and Indians are using it in growing numbers. The Government of India’s free national tele mental health helpline Tele MANAS, available round the clock on 14416, has handled more than 32.84 lakh calls since its launch in October 2022, as per information shared by the Ministry of Health and Family Welfare in February this year. Every one of those calls is a person who reached out because a door existed. Our job, as families, friends, colleagues and employers, is to make sure people find those doors sooner.The theme chosen by the International Association for Suicide Prevention and the WHO for World Suicide Prevention Day this year is Changing the Narrative on Suicide. This change happens at dinner tables, in office corridors, in classrooms and in late night phone calls, one honest conversation at a time. Suicide is not inevitable. Suicidal distress can change, and with timely support, many people can and do move through periods of intense pain. The signs are almost always there. This 10th of September, let us commit to becoming people who see them.Nupoor Mohan, Founder and CEO of The Full Circle, Co Founder and COO of Flexisales Inc and the Founder of Phulwaa.If you or someone you know is struggling, free and confidential support is available 24×7 on the Government of India’s Tele MANAS helpline at 14416 or 1800 891 4416.