Warning Signs for Suicide

If you are reading this page out of concern for someone, you've probably observed some of
these warning signs:

• an expression of hopelessness or of feeling trapped,
• increased alcohol or drug use,
• withdrawal from friends, family and others,
• dramatic mood changes, sudden rage, or impulsivity,
• a preoccupation with death,
• intense anxiety or agitation, particular if it is unusually severe,
• difficulty sleeping or sleeping constantly,
• sudden giving away of important possessions,
• hints about wanting to sleep forever or other remarks suggestive of suicide,
• purchase of firearms

People who are thinking of ending their lives often give hints of their emotional pain.
Sometimes, however, they work hard to hide their struggles from loved ones. Either way,
they are generally trying desperately to escape feelings that seem to them unbearable,
outside their control and, perhaps most importantly, feel likely to last forever. The
perception that the intensity of painful feelings will last forever is especially common among
teens and young adults.

People are often afraid to discuss their concerns with a loved one for fear that mentioning
the word "suicide" will cause it to happen This is not the case, but it can be difficult for
anyone — even a mental health professional — to raise the subject with a loved one. For
guidance on how to have such a discussion, please see How to help a loved one.

How common is suicide?

Approximately 32,000 Americans are known to end their lives every year. This is certainly
an underestimate as many car "accidents" and drug overdoses are intentional but not
reported as such. In 2003, suicide was the 11th leading cause of death in the United States
but the third cause of death among people ages 15-24.

For more information on suicide statistics and warning signs, visit websites for the
American Association of Suicidolgy (www.suicidology.org), the American Foundation for
Suicide Prevention (www.afsp.org), and the Suicide Prevention Resource Center
(www.sprc.org).

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How to help a loved one

Many of our hotline callers phone us out of concern for a relative, friend, coworker, or client. Such callers are usually very anxious to help but don't know how. One of their biggest concerns is they will "make matters worse." Typically they envision that mentioning the word "suicide" to people who seem distressed will put the idea into their minds and endanger them.

The truth is that you can best help a friend if you speak openly about your concerns AND your caring. If you're reading this page with the hopes of gaining some guidance, you probably have very good reason to be concerned for someone. You've most likely heard or seen some warning signs, and the person you care about is almost certainly aware of them as well. Describing in a gentle tone of voice what you've observed and stating that you are worried for
the person's well-being is often a good place to start. Then it's best to listen.

Listening to someone talk about feeling very down is not easy, especially when the person is someone you know and love. Witnessing their struggle can be painful and frightening to you, so it's natural to want to interrupt with reassurances. Some common ones include "Tomorrow is another day," or "When one door closes, another one opens," or "You've been through worse and gotten through it."

Such comments — while made with warm intentions — can suggest that you're uncomfortable with what is being said, and the person you've invited to talk may shut down or even become angry. This is why listening is so important.

Next it's very important to acknowledge the emotional pain that you're hearing. You might say "It sounds like you're feeling so much pain right now." If you're concerned that suicide is a possibility (see Suicide Warning Signs for more information) you can then add "I'm wondering if you've been thinking about suicide." Then listen. What you hear next might surprise you.

So often when people are considering suicide, they very much want to talk about it, but are afraid of being criticized. If you're able to be open-minded about whatever answer comes, you're likely to hear a sigh of relief — relief at being honest with someone about a subject that is often taboo, relief at being heard, relief at being accepted — suicidal thoughts and all.

If the answer to your question about suicidal thoughts is "yes," a helpful response is to acknowledge their struggle, show appreciation for their honesty, and then express your caring. Then you can begin to talk about some options. For instance, you might talk about supports that are available, such as a suicide prevention hotline, therapy, and support groups.

Many people have suicidal thoughts when they're going through difficult times but are not at significant risk for acting on them. For others, however, there is imminent risk. The distinction isn't always clear-cut, but there are factors to look for. For instance, a prior suicide attempt, intoxication or a history of substance abuse, a death by suicide in the family, and a tendency to act impulsively are among the most significant risk factors (for a more thorough
listing, see Suicide Warning Signs).

If you've already had conversations with someone about their suicidal thoughts and found yourself giving advice or even getting angry, you're not alone. This kind of conversation is unfamiliar to most people and loaded with emotional content. A call to a suicide hotline can help you determine what your next steps might be, and reinitiating the discussion might be one of them.

For links to other resources, click here.

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