Helping to Prevent Suicide
Every 40 seconds, someone attempts suicide. Every 17
minutes, someone succeeds. Over 400,000 failed attempts a year end up with
serious injuries. In most cases, the person who commits suicide has tried
before and made numerous attempts to reach out to others. Ninety percent of
suicides are associated with mental illness, such as depression. And 50% of
suicides are associated with alcohol or drug use.
Signs of Suicidal
A suicidal person may talk of self-destructive behavior:
“Maybe I should just jump from that roof.” or “My family would be better off
without me.” There may be sudden interest in firearms or poisons. They may
write poetry about death or listen to music about suicide. If your friend or
loved one is on medication, you may notice conspicuous overuse that could be
Other Warning Signs
Abuse of alcohol or drugs combined with depression,
dramatic mood swings, statements of hopelessness, acting withdrawn from others,
uncontrollable rage, a desire for revenge, or blatant recklessness represents
emotional states of persons who have committed suicide or made serious
attempts. Feeling trapped and having a high level of cynicism toward others or
the employer are other risk factors associated with persons who have committed
suicide in business and industry.
What Are They
Many people have thoughts about suicide, but most will
never make an attempt. Those that do make attempts may frequently focus on
unresolved life problems. This can offer clues to their desperation. They may
focus on unstoppable pain and say how there is no way out.
They may not be to able sleep, eat, or work. They may experience profound
depression and the inability to make sadness go away. They may not see
themselves as worthwhile, or be unable to get someone’s attention whom they
Who’s at Risk?
Those at greatest risk of suicide have often experienced a
disruptive life event such as the following:
Loss of a loved one
- Divorce, separation, loss of child custody
- Serious or terminal illness
- Serious accident
- Violence: rape, assault, kidnapping
- Verbal, emotional, or sexual abuse
- Chronic illness
- Feeling that things will never get better
- Alcohol or drug abuse
- Ongoing bullying
Do’s and Don’ts
- Do take suicidal comments seriously.
- Do respond to suicidal statements.
- Don’t act shocked or panicked.
- Don’t say, “Oh, you don't mean that.”
- Do ask what means are of killing oneself are
- Don’t intervene alone.
- Do encourage the person to seek professional
help. Help find resources.
- Do offer to take the person to get help.
- Do get rid of any lethal means of committing
suicide: guns, poison, etc.
When a person makes a decision to commit suicide, they may
suddenly become calm. Their decision provides relief because the suicidal
person has found a “solution” to their problems. Do not ignore this state of
calm or apparent wellness. The suicidal person may create a checklist of
“to-dos” or give away belongings. If you think a friend or loved one is
planning suicide, ask. Don’t let your fear of the answer inhibit you from
asking this question. Most people considering suicide will talk about it. If
necessary, act to get emergency help from the police so they can intervene. You
may have to contact the police over the suicidal person’s objection. But if the
suicidal act is imminent, delay will only make the risk of suicide more likely.
Act Fast Resources
If you need immediate help for yourself or a loved one,
call 911, 1-800-SUICIDE or
1-800-273-TALK. Other resources include your employee
assistance program, www.suicide.org, www.afsp.com (American Society for Suicide
Prevention), or www.suicide.org,
Effect on Others
Each suicide affects many other people. Blame and guilt
are common, and so are shock and denial. Some may get angry with the victim for
making that choice. Loneliness and sorrow in those left behind can result in
depression. Support groups are extremely helpful in healing traumatic wounds
caused by suicide.
What the EAP Can Do
It has been said, “Suicide is not chosen, it happens when
pain exceeds resources for coping with pain.” This is also a strong rationale
for getting help from your employee assistance program. The EAP can help you
find resources in the community to help you if you are depressed and suicidal
or know someone who is.
PART 2: Helping
a Friend Experiencing Suicidal Ideation
Suicidal ideation refers to persistent thoughts about
suicide. If you're wondering if you should be concerned if someone you know has
these thought patterns, the answer is yes. Persistent suicidal thoughts are
either severe enough to warrant mental health intervention now, or with intent
or planning, they could lead to a medical emergency.
There are two different kinds of suicidal ideation:
Passive ideation is when someone wants to take
their own life, but they haven’t created a plan to commit suicide.Active suicidal ideation occurs when someone has
the intent, and they have a plan for how to take their life.
Passive suicidal ideation can quickly turn to active
ideation, and it isn’t necessarily
less serious than active suicidal ideation. The type of suicidal
thoughts and the degree of severity can vary between individuals and change
over time. Anytime a friend or loved one admits to thinking about suicide, it’s
essential to help them feel safe.
to the CDC, someone dies by suicide every 15 minutes in the United
States—and the number of people who think about suicide is even greater. You
don’t have to feel helpless if a loved one is showing signs of suicidal
thoughts. You can help a friend who
is experiencing suicidal ideation. You can make a positive difference.
Understand the common symptoms and learn the best strategies for giving them
the help they need so you can be an ally.
What do you need to know so you can help? The American
Association of Suicidology recommends memorizing this acronym for
learning the warning signs of suicide: “I.S. P.A.T.H. W.A.R.M.?” This refers to
Ideation, Substance Abuse, Purposelessness, Anxiety, feeling Trapped,
Hopelessness, Withdrawal, Anger, Recklessness, and Mood Changes.
PATH WARM Warning Signs
to the idea of killing oneself or a sudden obsession with death. If someone who
isn’t normally preoccupied with death starts expressing morbid thoughts or
talking about suicide, they may be experiencing suicidal ideation.
is often linked to other symptoms of suicide, such as withdrawal, anger, and
anxiety. People often turn to drugs or alcohol as a way to cope, which means
they aren’t able to cope with life on their own.
If someone says or acts as if they don’t have a reason for
living, they may be experiencing purposelessness.
Sleeping too much, trouble sleeping, and unexplainable
health issues, such as headaches and digestive problems, can all point to anxiety.
When an individual feels trapped in a job, a relationship, or a way of life that they don’t
want to be in, they may turn to suicide as the only way out.
can be overwhelming. If you notice a friend or loved one lose interest in
activities they used to enjoy or if they act as if they feel powerless in their
life, they may have lost hope.
when someone stops engaging with their support network. They may not want to go
out. They’ll talk on the phone and text less and engage less in social media.
Another sign is anger
or rage. They may express anger at the outside world or themselves.
Risky behavior, drug use, and a disregard for one’s
welfare are signs of recklessness.
When someone experiences unusual changes in their mood, they could be experiencing
emotions that are out of their control. Many types of mood changes or
personality changes can indicate suicidal ideation – it’s not just a change
from happy to sad. People who are thinking of suicide can become overly
excited, agitated, or even eerily calm.
Signs of Suicidal Ideation
Additional warning signs of “acute risk” of suicide include
a person threatening to kill himself or herself, or even talking about wanting
to hurt or kill themselves. If they are seeking access to firearms or other
means of killing themselves, or even talking or writing about death and suicide
when this behavior is not usual for them, it is crucial to seek help. These
types of ideation are called “expressed” or “communicated” ideation.
The American Association of Suicidology recommends calling
a mental health professional at 1-800-273-TALK (8255) if you observe someone
exhibiting any of these behaviors. Understanding the common signs and symptoms
thoroughly—as well as what to do when you encounter these signs—could
ultimately save someone’s life.
Suicide Rates in
the United States
It’s easy to overlook or dismiss the warning signs and
symptoms of suicidal ideation. You may think it’s not that bad. However, suicide and suicide attempts are very real. When
you look at the statistics, you can understand why it is worth it to take
action if you think someone you know is reaching out for help.
According to the CDC, suicide is the tenth
leading cause of death for people ten years and older. More than 48,000 people
died in the US in 2018 because of suicide. This is an average of one death
every 11 minutes. 1.4 million Americans attempted suicide in 2018.
The number of people who think about suicide is much
higher. Between 2008 and 2009, 8.3 million adults reported having suicidal
thoughts, which was 3.7% of the adult population. 1% of the adult population,
or 2.2 million adults, reported making plans for suicide within the past year
during that period. In 2018, 10.7 million seriously thought about suicide and
3.3 million went as far as making a plan. ,
(I updated these stats to the more recent ones
The statistics also show that men commit suicide at a much
higher rate than women. In 2018, men died by suicide 3.56 times more often than
women, and white men accounted for nearly 70% of suicide deaths. The demographic
with the highest suicide rate is middle-aged white men. While older adults are
more likely to commit suicide, young adults are impacted as well. In 2018, the
suicide rate for young adults aged 15 to 24 was 14.45 per 100,000.
All of these data show that suicide is a very real threat,
and we shouldn’t ignore warning signs. Recognizing the signs of suicidal
ideation and taking them seriously can save a life.
Helping Teens Who
Are at Risk
Suicide is the second leading cause of death for 10- to
24-year-olds in the US. The reality is, teens and young adults face a variety
of challenges, but they may not have had the chance to develop coping skills
that many adults have already developed. Every day, over 3,000 teens in grades
9 through 12 attempt to take their life. This is an alarming statistic, but it
is possible to bring these numbers down through suicide prevention efforts.
What Are the
Warning Signs for Teens?
The warning signs of suicide for teens are similar to the
symptoms of depression:Loss of interest in activities they used to
enjoyActing outWithdrawal from friends and familyUnexplained fatigue, headaches, or stomachaches,
which could indicate emotional distressObsession with dyingBeing unresponsive to praiseSigns that a teen is making suicide plans
include:Writing a suicide noteMaking statements about killing themselves or
posting on social mediaExpressing strange or alarming thoughtsBecoming suddenly cheerful after seeming
depressed for a period of time
If you notice these signs in your child or a friend,
take action to make sure they are ok.
Offering emotional support and empathy can make a positive
difference for a teen who is thinking about ending their life. One survey of
teens and young adults who attempted suicide found that most teens prefer to
talk to a friend or family member when they are depressed and want help. After
face-to-face communication, they’ll turn to texting, phone calls, instant
messaging, or posting on social media over talking to a healthcare provider or
calling a suicide prevention hotline.
(source: the consider a text for
teen suicide doc)
How Teens Can Help
Their FriendsListen to what they are saying and take them
seriously if they talk about suicide.If you're worried about a friend, ask them if
they are ok and let them know you care.Encourage them to reach out for expert help.
Offer to accompany them when seeking help, so they don’t feel alone.Talk with a trusted adult such as a teacher,
school counselor, coach, or parent.
How Parents Can
Help Prevent SuicideOne of the best things you can do as a parent is
to let your teen know they can talk to you without being judged. The more open
your relationship with your teen and their friends, the more likely you’ll know
if your child or one of their friends needs help.
Be supportive. Listen and refrain from
criticizing and make a habit of knowing if they are struggling with anything
such as social pressure, academic pressure, or relationships.
Seek professional help for your teen if they are
suffering from mental health or substance abuse problems.
Keep any guns or medications in the home
securely locked away and out of reach.
Teens who have attempted suicide before have said there
isn’t one specific reason that compelled them to try and take their life. It’s
more a state of despair that develops rather than one trigger event. These
young people have also indicated that not having a way to express or communicate
their emotions is one of the biggest drivers of these developing emotions.
Teaching adolescents and teens better problem-solving skills and providing
channels for expressing emotions are two prevention strategies that can help.
(source: the provided teens no
Preventing Teen Suicide
Talk to your teen or your friend about mobile apps for
teen suicide prevention. You can also download them on your smartphone. Apps
such as A Friend Asks, MY3, Operation Reach Out, and HELP Prevent Suicide are
useful resources. They offer prevention strategy plans, tips for friends and
family, and easy access to prevention hotlines, support groups, and community
Risk Factors: An
Important Variable to Understand
In addition to knowing how to recognize the warning signs
of suicide, it’s also important to understand what the risk factors are. If
someone you know has experienced or is currently facing any of these risk
factors, they could be more at risk for suicidal ideation.A personal history of alcohol and substance
abuse. If your friend or a family member has abused drugs or alcohol in the
past, this can be a risk factor—especially if that abuse is getting worse.Family history of suicide. Although a family
history of suicide is not an outright indicator that any individual will attempt suicide, don’t overlook it,
especially if there are other risk factors present.Child abuse. If there is history in the family
of any abuse, this can increase the risk of suicide. It amplifies feelings of
hopelessness and aggression or anger, which are two warning signs to watch out
for.Suffering from recent losses or problems.
Anything from suffering in relationships to losing work can be a risk factor
for suicide. This effect can be further amplified if someone loses more than
one thing within a short time.A personal and/or family history of mental
health problems and disorders. Clinical depression, anxiety, and any mental
problem that can cause pain and anguish are risk factors. Encourage the people in
your life to seek suitable treatment for any mental illness they may be
suffering from.Exposure to weapons. People with guns and
firearms in the home have access to some of the most common suicide methods
available.Prior suicide attempts. Although it is easy to
look at someone who has made a suicide attempt in the past as someone who is
merely “crying out for attention,” people don’t usually attempt to take their
life because they want attention. They truly are having trouble coping. If they
struggled before, they might struggle again when life becomes more challenging.
Know these risk factors. Being aware of them could help
save someone’s life.
Friend: What Are the Best Suicide Prevention Strategies?
If you believe your friend is thinking of suicide, you can
Step one, seek expert help. If you aren’t a professional,
you don’t have the expertise or training necessary to deal with someone who is
experiencing suicidal ideation. Instead of trying to handle the situation
alone, get help. Seek the appropriate resources to make sure you’re approaching
the situation in the best way possible.
If there is an immediate threat of suicide, you can call
911. If the threat isn't imminent, you can start by referring him or her to an
expert, encouraging them to talk to their doctor or mental health professional,
or offering to go with them to a suicide support group.
Giving them the number of the National Suicide Prevention
Lifeline (1-800-273-8255) is another way to encourage them to speak to someone
experienced in dealing with suicidal ideation.
The Mayo Clinic recommends that if you encounter someone
who is in immediate need of help, that you shouldn’t leave them alone. Instead,
stay with them and consult the proper authorities—call 911 if it’s an emergency.
You can even take your friend to a hospital emergency room yourself if you want
to make sure they get the treatment they need.
If possible, find out if your friend has taken any drugs
or alcohol—or both. And be sure to alert any of their family as to what is
When there appears to be no imminent threat to suicide, but you are concerned about your
friend, you can still help. Offering them your support as they take steps
toward treatment can be invaluable to someone who feels like they’re alone in
the world. Encouraging them to communicate with you will also help them not
only to feel better about their bottled-up feelings but can also help you figure out how much help your friend
If you suspect suicidal ideation in a friend but aren’t
sure if you should take action, the Mayo Clinic
recommends first asking them a series of direct questions such as
“Do you ever feel like just giving up?” and “Are you thinking about dying?”
These pointed questions can be difficult to ask, but coupled with the warning
signs you learned above, they can be a way to determine whether you should take
It’s important that during this process, you aren't
judgmental. Platitudes such as “you have everything to live for” often do not
help. In fact, they may make your friend feel more isolated because they think
you can’t understand what they’re going through. Instead, be sure that you’re
open, direct, caring, and honest—and as part of that honesty, do not promise to
keep their suicidal ideation a secret. You may have to share the information
about their ideation with a professional if you want your friend to get the
Most importantly, take suicidal behavior and its
associated warning signs as seriously as possible. There are too many suicides
nationwide to act as if there is no real threat to your friend. In the long
run, you won’t regret stepping in to help. Your help may be the difference that
makes all the difference in the world.
When There Are
Thoughts of Suicide
You are not alone.
You are not broken. People love you, and there is hope.
If you’ve ever had thoughts of suicide, know that you are
not alone—according to the Centers for Disease Control, 3.7% of U.S. adults
have suicidal thoughts in a given year.
Second, you aren’t broken. Suicidal thoughts occur when
you have more pain than you can cope with. Thinking about suicide doesn’t mean
you have a character flaw; that you’re weak-willed or crazy. Suicidal thoughts
happen to all kinds of people, of all ages, gender, and background.
Third, there is help, and there is hope. No matter how
overwhelmed you feel right now, there are people who care about you and know
how to help you recover. You will get better.
If you’re thinking
about hurting yourself right now:
Follow these four steps:
1.Promise yourself not to do anything to harm
yourself in the next 24 hours. No matter how hopeless or overwhelmed you feel,
remember that suicidal feelings are NOT permanent. You WILL get better. Give
yourself a chance to get to a better mental state before doing something you
can never take back.
2.Avoid drugs and alcohol. If you’re currently
under the influence, stop right now.
3.Make your surroundings safe. Hide, destroy, or
get rid of potentially dangerous objects like firearms, knives, and medication.
4.Call someone and talk. Whether it’s a trusted
friend or a professional, don’t stop talking until your suicidal thoughts have
passed. Dial either of these numbers, and someone will be there to help you:
If you feel like you can’t talk things out, dial 911 and
ask for someone to take you to the emergency room. Stay on the phone until they
Suicidal thoughts are a crisis point, and they will pass.
You don't have to analyze your feelings in this state. All you have to do is
reach out for help.
What causes my suicidal
Thoughts of suicide can be triggered by one or more
factors. Sometimes these factors work in combination with one another to
trigger a suicidal response.Medication: Some prescription medications such
as anti-depressants can trigger suicidal thoughts. Combinations of some drugs
may also have this effect. Always be alert when using new medications or when
the current dosage is altered.Stressful life events: Losing your job, dealing
with a divorce, or struggling to care for a loved one who has a serious illness
can overwhelm and lead to thoughts of suicide.Drug and/or alcohol abuse: In addition to being
a destructive force in your life, long term abuse can also create brain
chemical imbalances that cause suicidal thoughts.Social isolation and/or loneliness: Feeling
unloved, alone, or unable to connect with others may lead to thoughts of
suicide.Mental disorders: Suicidal thoughts can
accompany some conditions like bipolar disorder, depression, and schizophrenia.Anxiety disorders: Post-traumatic stress
syndrome, panic attacks, and obsessive-compulsive disorder all lead to higher
rates of suicide.Eating disorders: Sufferers of anorexia,
bulimia, or other eating disorders have an increased risk of suicide.Physical and/or health problems: Dealing with
chronic pain or health issues that have a disabling effect can lead to thinking
about suicide.Heredity: Studies suggest that suicidal
tendencies have a genetic component. If someone in your family has attempted
suicide, you’re more likely to think about or attempt suicide yourself.
Why professional help is
It’s hard to see things clearly when you’re in pain,
and multiple factors may be contributing to your mental state. Do not try to
self-diagnose. A qualified professional has the necessary training to help you
If you don’t know where to start, there are several options.
1.Tell your family doctor what’s going on and ask
for a referral.
2.Confide in a trusted friend and ask for help.
3.Use the resources provided by your company’s
Employee Assistance Program. If you don’t know how, ask your HR representative.
Your inquiry will be held in confidence.
Don’t let embarrassment, cost or inconvenience stop you
from seeking out the help you need. Nothing is more important or valuable than
your life, your happiness, and your well-being. Take action today and worry
about the details later—things will work out.
“Tell” to get well
One of the hardest things about seeking help when
you’re feeling suicidal is telling another person what’s going on. For your own
long-term safety and wellness, it’s important that you seek out one or more
trusted friends and family members and let them know what’s going on—your
thoughts, your struggles, and what, if any, suicidal plans you’ve made.
Be honest and upfront about your situation. Vague
statements can be misinterpreted. Specifics are what will allow those who love
you to help you the most. If you find some things are too hard to say, write
them down. It’s ok. There’s no wrong way to let others know what’s happening.
Managing your triggers
While you can’t always control your suicidal thoughts,
you can limit how often they occur and their impact on you.
First, identify your triggers. Only you know which
situations or thoughts are most likely to send you into a downward spiral. Some
people find themselves getting depressed during the holidays. For others, it
can fatigue, job stress, or having too much to drink.
Next, find ways to eliminate, limit, or cope with your
triggers. Here are some tips to help you:
Develop an emergency plan. Make a promise to the most
trusted and supportive people in your life that you will call them immediately
before taking any harmful action when you have suicidal thoughts. Have a list
of suicide prevention numbers you can call readily available. Include your
doctor and any mental health professionals you’re seeing.
Don’t dwell on despairing thoughts. Break the negative
feedback loop that leads to feelings of hopelessness by quickly shifting to a
distracting thought or activity. Plan these ahead of time—whether it’s a book,
a physical activity, or something else. Know exactly what you’re going to use
to help distract you ahead of time.
Schedule weekly activities that get you out of the house
and in contact with other people. Isolation is a common trigger for suicidal
Let your family and friends know about events that trigger
depression and ask them to be on alert and available for you during these
Exercise and stay as physically active as you can. Even 20
minutes of moderate exercise per day can make a positive difference in your
Keep doing the things you love. Everyone has things in
their lives that bring them joy. Give them top priority, and don’t let them go.