When High Functioning Becomes Too Heavy to Hold : What Suicide Prevention Means for the Person Who Is Still Showing Up
September is Suicide Prevention Month. And I want to begin this four-week series honestly, not with alarming statistics or crisis-ready language, but with the conversation that I think needs to happen most urgently.
Last month I wrote about the high functioning mask: the gap between how capable a person appears and how much they are quietly carrying underneath. That piece was about the adaptation itself, how it forms, why it stays, and what it costs. It was written with compassion for the people who wear it because the mask was built for real reasons and it served real purposes.
This week I want to take that conversation one step further. Not to pathologize high functioning or suggest that appearing capable means something is wrong. But to name honestly what can happen when the mask stays on for a very long time, when the distance between how someone appears and how they actually feel becomes too great to hold.
Because the people I worry about most in my clinical work are rarely the ones who are visibly in distress. They are the ones who are still showing up. Still managing. Still meeting every obligation. And carrying, underneath all of that, something that has not had anywhere to go.
The Myth of the Visible Crisis
We have been taught, culturally and clinically, to look for signs: withdrawal, changes in behavior, giving things away, saying goodbye. And those signs are real and they matter. But they represent one end of a very long spectrum. The other end of that spectrum, the end that gets far less attention, is the person who has learned to manage their pain so completely that no one around them realizes how heavy it has become. This is not a character flaw. As I wrote last month, the high functioning mask was built for good reasons: it earned love, it protected against judgment, and it became part of how someone understands themselves.
The issue is not the capability itself. The issue is what happens when the pain underneath it has nowhere to go. When the management has been going on so long that the person has lost access to what they are actually feeling. When the exhaustion has moved past burnout into something they cannot name out loud to anyone.
In South Asian, immigrant, and Brown communities where composure and strength are especially valued, this gap between external presentation and internal experience can be particularly wide. Not because high functioning is wrong, but because the cultural expectation that strength must be performed can make it very difficult to acknowledge when carrying everything has become too much.
"The most dangerous kind of pain is the kind that is completely invisible. Because the person carrying it has spent years learning to hide it perfectly."
What Passive Suicidal Ideation Actually Is
Not every person who is struggling has clear thoughts of ending their life. For many, the experience sounds less like a plan and more like a wish. A wish to disappear. To pause. To not have to keep going. To not be here for a while, without actually wanting to die.
Clinically, this is called passive suicidal ideation. It is far more common than most people realize, and it is particularly common among people who have been carrying a very heavy load for a very long time.
It can sound like:
• Everyone would be fine without me
• I just need it all to stop for a while
• I am so tired of being tired
• Sometimes I wonder what it would be like to just not wake up
• I do not want to die but I do not really want to be here either
If any of these thoughts have crossed your mind recently, I want you to hear something clearly: having a thought is not the same as having a plan. And having a thought is not a sign that you are dangerous or that something is irrevocably wrong. It is a sign that you are carrying something too heavy, and that you deserve support that matches the weight of what you are carrying.
WHAT THIS CAN LOOK LIKE IN A PROFESSIONAL'S LIFE
Rayan is a 38-year-old attorney. He bills long hours, returns every message, shows up for everyone. His colleagues describe him as steady and unflappable. What they do not know is that he has been going home at night and sitting in silence for hours, not watching anything, not doing anything, just existing in a way that feels like barely. He has not told anyone because he does not know how to ask for help without it meaning that something is terribly wrong. What he does not yet realize is that the silence itself is the message his body has been trying to send.
Why High Functioning People Wait
The high functioning person delays seeking help for the same reasons I described last month: the mask was built to be worn. Asking for support feels like removing an identity, not just a behavior. And for someone whose capability has been their primary way of being loved and accepted, that feels like a profound risk.
There is also the genuine belief that the struggle is not serious enough. Because everything is still functioning. Because they are still showing up. Because people who need help look different from this. That belief, that you have to reach a visible crisis before support is warranted, is one of the most dangerous myths in mental health.
There is also a specific fear that naming this out loud will make it more real. That saying I have been having thoughts about not being here will change how people see them, in their family, their community, their workplace.
In South Asian and immigrant communities, this fear carries particular weight. Where mental health struggles are still associated with weakness or failure, where the family's honor is bound up in individual composure, where asking for help is not modeled as something strong people do, the barrier to reaching out can feel impossibly high.
"You do not have to earn the right to ask for help. You do not have to reach the bottom before you are allowed to reach out. The exhaustion you are feeling right now is enough of a reason."
What I Want You to Do With This
If this piece is describing you, even a little, even in a way you are not ready to say out loud yet, I want you to do one thing today. Just one.
Tell one person. Not the whole story. Not a full disclosure. One honest sentence to one person you trust. I have been struggling more than I have been showing. That sentence, offered to one safe person, can begin to change the weight of what you are carrying.
And if you are not ready to tell a person, call or text 988. It is free, confidential, and available right now. You do not have to be in active crisis to call. You are allowed to call simply because you are tired and you need someone to talk to.
Next week I will be writing about emotional isolation and why chronic loneliness is one of the most underestimated risk factors in suicide prevention. I hope you will stay with me through this series.
If you or someone you love is in crisis right now, please call or text 988 (Suicide and Crisis Lifeline), available 24 hours a day, 7 days a week. Free and confidential.
About the Author
Ashma Hakani, LCSW-S is a licensed clinical social worker and the founder of Renewed Hope Therapy, PLLC. She specializes in grief, trauma, anxiety, and relationship issues, providing compassionate, culturally competent, and trauma-informed care. With over 18 years of experience, she utilizes evidence-based approaches to support her clients in building resilience and coping skills. Ashma also offers clinical supervision and mental health education to individuals and communities. Her work is rooted in the belief that healing is a journey, and she is dedicated to walking alongside her clients every step of the way.
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