Preventing Suicide: Know the Warning Signs and How to Help
Suicide presents a major challenge to public health in the US and the world. The US is a global leader in suicide rates and suicide is the second leading cause of death in people between the ages of 10-24, with rates rising steadily over the the past two decades.
As concerning as these trends are, it’s important to remember that suicide is preventable. Knowing the warning signs is a critical first step in preventing suicide.
Signs and Symptoms of Suicide
There’s a lot you can do to recognize and respond to the warning signs in yourself and people around you. Some are more overt but others can be more subtle so it is useful to be aware of and alert for the less obvious signs.
Outward signs and symptoms
- Past suicide attempt
- Talking about wanting to die or to kill oneself
- Mentioning specific plans or ways that one has thought about ending one’s life
- Talking about feeling hopeless or having no purpose, feeling trapped, being a burden to others
- Giving away personal items or wrapping up loose ends
- Saying goodbye to friends and family
- Displaying extreme mood swings
- Increased use of alcohol or drugs
- Acting anxious, agitated, or reckless
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing extreme anger or seeking revenge for perceived injustices
Subtle signs and symptoms
Even people who are close to people who are suicidal may not always recognize how hopeless they feel. In these cases, it’s useful to look for:
Unusual behavior changes
Unusual emotional swings, even if they don’t seem related to depression or a sense of hopelessness, can be an indicator. For example, if someone you know is usually agitated or sad and they suddenly seem at peace or calm. Or someone who’s usually steady and even-keeled that now seems anxious and/or aggressive.
Seeming indifferent when faced with emotionally provocative situations may not seem like suicidal behavior, but it can be a warning sign of depression and of feeling detached from life in general. This can be accompanied by loss of interest in daily activities, people, work, or things they once enjoyed.
Pain is sometimes a symptom of depression and risk for suicide. Unusual physical discomfort, in particular when there’s no previous history, can be a red flag, especially if other symptoms are present as well.
Treatment: Talking to Someone Who Might Be Suicidal
If you think someone you know is considering suicide, it’s important to determine the urgency of the situation by asking them directly. Here are some questions that can help you assess whether they’ve moved beyond thinking about it and into planning:
- Are you having thoughts of suicide?
- Do you have a plan to kill yourself?
- Do you have everything you need to carry out your plan?
Don’t worry, asking someone directly about suicide won’t lead to suicide. In fact, you’re much more likely to help someone feel less alone if they were considering it. You should also know that just because they don’t have a plan doesn’t mean someone isn’t in danger. If someone you know is considering suicide, try to be sure that they aren’t alone or have someone to talk to.
If someone is having suicidal thoughts, but there’s no immediate danger, stay closely connected and assure them that they have support in place and you’re there for them. If they have a plan and are ready to carry out that plan, call 911 immediately. How you respond to other answers will depend on the situation, but always call 911 if you’re unsure. It’s better to be safe than for someone to lose their life.
It can be hard to listen to someone that you know or care about who’s suffering. But it’s really helpful for people to feel heard, especially without judgment. Try to convey that you authentically care and stay present for them. If you can, ask open and honest questions. Sometimes the simple act of talking to someone who authentically listens can make a big difference.
Provide information and encourage professional help
Having suicidal thoughts often means there’s something deeper going on that needs to be worked through. Friends and family can be helpful, but it’s most useful to seek professional help. If someone already has a therapist, encourage them to reach out and make an appointment. If they don’t, be sure that they have crisis numbers and resources on hand. And, if they’re open to professional help and don’t have one, you can offer to assist them in finding someone, making an appointment, or accompanying them to a first appointment.
Encourage the use of coping and support strategies
It is not uncommon for someone who is having suicidal thoughts to have previously considered suicide. If they do have previous experience, they may have strategies they can lean on. Perhaps a particular therapist, family member, friend, or spiritual leader has given them support, or maybe a particular community, like a church or club, has been there for them. Encourage them to tap into their support system as much as possible during this time and to use whatever other healthy self-soothing and problem solving techniques they can access.
And as always, if you’re worried about a friend and not sure how to help, you can text START to 741741 or call 1-800-273-TALK (8255) to chat with a trained counselor anytime.
How You Can Be Prepared
The best way to help someone who might be struggling is to learn the signs and symptoms of suicidal thoughts and actions. Since these are sometimes subtle, you will need to trust your instincts. Remember, if you think someone is struggling, ask them directly and have resources on hand. Sometimes the small act of knowing someone cares is all they need.
Be mindful that if someone has had suicidal thoughts or behaviors in the past, that increases their risk in the future, so try to stay connected and check in on them if someone you know has recently struggled.
And lastly, if you’re not sure what to do, get help: you can text START to 741741 or call 1-800-273-TALK (8255) to chat with a trained counselor anytime.