Recognizing Suicidal Behavior

What is suicide?

Suicide is death caused by self-inflicted injury with the intent to die.

Suicide is the tenth leading cause of death in the U.S. One person dies by suicide about every 11 minutes. It is the second leading cause of death among people ages 10 to 34, the fourth leading cause of death among people ages 34 to 54 and the fifth leading cause of death among people ages among those ages 45 to 54.

Groups of people who have higher rates of suicide include:

• American Indian/Alaska Native and non-Hispanic White people.
• Veterans.
• Rural dwellers.
• Young people who are lesbian, gay, bisexual, transgender.

What are the situations– risk factors – that could lead someone to consider suicide?

Although you may not know what might cause a friend or loved one to attempt suicide, there are at least some common characteristics to be aware of.

Known factors that increase an individual’s risk of suicide include:

Individual factors

• Has attempted suicide in the past.
• Has a mental health condition, such as depression and mood disorders, schizophrenia, anxiety disorders.
• Has long-term pain or a disabling or terminal illness.
• Expresses feelings of hopelessness.
• Has money or legal problems.
• Has violent or impulsive behavior.
• Has alcohol or other substance abuse problems.
• Has easy access to self-harm methods, such as firearms or medications.

Relationship factors

• Has a history of physical, emotional or sexual abuse; or neglect or bullying.
• Has lost relationships through break-up, divorce or death.
• Has a family history of death by suicide.
• Is socially isolated; lacks support.

Community, cultural, societal factors

• Is ashamed to ask for help, especially help for mental health conditions.
• Lacks access to healthcare services, especially mental health and substance abuse treatment.
• Holds cultural or religious belief that suicide is a noble option to resolving a personal dilemma.
• Has become aware of an increased number of local suicides or an increase in media coverage of deaths by suicide.

What are some of the most common suicide warning signs?

Some of the more common warning signs that a person may be thinking of ending their life include:

• Being sad or moody: The person has long-lasting sadness and mood swings. Depression is a major risk factor for suicide.
• Sudden calmness: The person suddenly becomes calm after a period of depression or moodiness.
• Withdrawing from others: The person chooses to be alone and avoids friends or social activities. They also lose of interest or pleasure in activities they previously enjoyed.
• Changes in personality, appearance, sleep pattern: The person’s attitude or behavior changes, such as speaking or moving with unusual speed or slowness. Also, they suddenly become less concerned about their personal appearance. They sleep much more or much less than typical for that person.
• Showing dangerous or self-harmful behavior: The person engages in potentially dangerous behavior, such as driving recklessly, having unsafe sex or increase their use of drugs and/or alcohol.
• Experiencing recent trauma or life crisis: Examples of crises include the death of a loved one or pet, divorce or break-up of a relationship, diagnosis of a major illness, loss of a job or serious financial problems.
• Being in a state of deep despair: The person talks about feeling hopeless, having no reason to live, being a burden to others, feeling trapped or being in severe emotional pain.
• Making preparations: The person begins to put their personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will and cleaning up their room or home. Often the person will search online for ways to die or buy a gun. Some people will write a note before attempting suicide.
• Threatening suicide or talking about wanting to die: Not everyone who is considering suicide will say so, and not everyone who threatens suicide will follow through with it. However, every threat of suicide should be taken seriously.

Can suicide be prevented?

In many cases, suicide can be prevented. The best way you can help prevent suicide is to:

• Learn the risk factors for suicide.
• Be alert to the signs of depression and other mental health conditions.
• Recognize suicide warning signs.
• Provide caring support.
• Ask directly if the person has considered hurting themselves.

People who receive support from caring friends and family and who have access to mental health services are less likely to act on their suicidal impulses than are those who are isolated from support.

What should I do if someone I know is talking about suicide?

If your friend or loved one is not in immediate danger but is talking about suicide and is showing risk factors for harming themselves, take them seriously. If you can, remove any objects that can be used in a suicide attempt. Encourage them to call – or call together – support services such as the Suicide and Crisis Lifeline: 988. Conversations are with a skilled, trained counselor and are free and confidential and available 24 hours a day, seven days a week.

If the friend or loved one appears to be extremely distressed, don’t leave the person alone. Try to keep the person as calm as possible and get immediate help. Call 911 or take the person to an emergency room.

A note from Cleveland Clinic

If someone you know is exhibiting warning signs for suicide, don’t be afraid to ask if he or she is depressed or thinking about suicide. Listen without judging. In some cases, your friend or family member just needs to know that you care and are willing to hear them talk about how they are feeling. Encourage them to seek professional help.