What is suicide and suicidal behavior?
Suicide is the act of taking one’s own life. According to the American Foundation for Suicide Prevention, suicide is one of the leading causes of death in the United States, taking the lives of approximately 43,000 Americans each year.
There’s no single reason why someone may try to take their own life, but certain factors can increase the risk. Someone may be more likely to attempt suicide if they have a mental health disorder. About 90 percent of people who commit suicide have a mental illness at the time of their death. Depression is the top risk factor, but there are various other mental health disorders that can contribute to suicide, including bipolar disorder and schizophrenia.
Aside from mental illnesses, there are several risk factors that may contribute to thoughts of suicide, attempted suicide, and actual suicide. They include:
- previous suicide attempts
- substance abuse
- family history of suicide
- poor job security or low levels of job satisfaction
- history of being abused or witnessing continuous abuse
- being diagnosed with a serious medical condition, such as cancer or HIV
- being socially isolated or a victim of bullying
- being exposed to suicidal behavior
Those who have been shown to be at a higher risk for suicide are:
- people over age 45
- Caucasians, American Indians, or Alaskan Natives
People who have suicidal thoughts are often so overwhelmed by feelings of sadness and hopelessness that they think they have no other option. While it can be hard to know how someone is feeling on the inside, there are various behaviors that can indicate suicidal tendencies. It’s important to recognize these warning signs so you can help a family member or a friend who may be experiencing suicidal thoughts. Taking action and getting someone the help they need may help prevent a tragic suicide attempt or death.
Recognizing the signs and symptoms of suicidal behavior
Call 911 or your local emergency number right away if you:
- feel hopeless
- feel trapped
- feel alone
- feel anxious or agitated
- feel as if there is no reason to go on living
- think of suicide as a way out
- experience mood swings
- are abusing alcohol or drugs
Signs That Someone May Attempt Suicide
You can’t see what a person is feeling on the inside, so it isn’t always easy to identify someone who is having suicidal thoughts. However, some outward warning signs that a person may be contemplating suicide include:
- talking about feeling hopeless
- talking about having no reason to go on living
- making a will or giving away personal possessions
- searching for a means of doing personal harm, such as buying a gun
- sleeping too much or too little
- eating too little or eating too much, resulting in significant weight gain or weight loss
- engaging in reckless behaviors, including excessive alcohol or drug consumption
- avoiding social interactions with others
- expressing rage or intentions to seek revenge
- showing signs of anxiousness or agitation
Causes for increased suicide risk
Many factors increase the risk for suicide. These factors are separated into three categories: biopsychosocial, environmental, and sociocultural.
Biopsychosocial causes account for most suicides and attempted suicides. These causes include mental health disorders such as:
- bipolar disorder
- anxiety disorders
- personality disorders
Additional biopsychosocial causes include:
- substance abuse
- childhood abuse or trauma
- family history of suicide
- previous suicide attempts
- having a chronic disease
Environmental factors that increase the risk for suicide often occur due to a stressful life event. This may include the loss of a person, pet, or job. Other causes include:
- social loss, such as the loss of a significant relationship
- access to lethal means, including firearms and drugs
- being exposed to suicide
- being a victim of harassment, bullying, or physical abuse
One of the main sociocultural causes of suicide is the feeling of being isolated or of not being accepted by others. Feelings of isolation can be caused by sexual orientation, religious beliefs, and gender identity.
Other possible suicide catalysts in this category include:
- difficulty seeking help or support
- lack of access to mental health or substance abuse treatment
- following belief systems that accept suicide as a solution to personal problems
- exposure to suicidal behavior
Diagnosing and assessing people who are at risk for
Your health care provider may be able to determine whether you are at a high risk for suicide based on your symptoms, personal history, and family history.
Your health care provider will want to know when your symptoms started and how often you experience them. They will also ask you about any past or current medical problems and about certain conditions that may run in your family. This can help them determine possible explanations for your symptoms and which tests will be needed to make a diagnosis.
Assessments may include:
Mental health conditions: In many cases, thoughts of suicide are caused by an underlying mental health disorder. If your health care provider suspects that a mental health disorder is contributing to suicidal thoughts, they will refer you to a mental health professional. This person can provide an accurate diagnosis and determine an effective treatment plan for your particular condition.
Substance abuse: Alcohol or drug abuse can often contribute to suicidal thinking and acts of suicide. It’s important to tell your health care provider about any problems you may be having with alcohol or drug use, such as binge drinking or using drugs on daily basis. If substance abuse is causing you to have suicidal thoughts, then you will likely need to enroll in an alcohol or rehabilitation program.
Medications: The use of certain prescription or over-the-counter drugs can also trigger thoughts of suicide and suicidal behavior. Make sure to tell your health care provider about any medications you’re currently taking to see if they could be contributing to your symptoms.
Treatment for people who are at risk for suicide
Treatment will depend on the underlying cause of your suicidal thoughts and behavior. In most cases, however, treatment consists of talk therapy and medication.
Talk therapy, also known as psychotherapy, is one possible treatment method for lowering your risk of committing suicide. Cognitive behavioral therapy (CBT) is a form of talk therapy that’s often used for people who are having thoughts of suicide. It teaches you how to work through stressful life events and emotions that may be contributing to your suicidal thoughts and behavior. CBT can also help you replace negative beliefs with positive ones and regain a sense of satisfaction and control in your life.
If talk therapy isn’t enough to successfully lower your risk, then you may be prescribed medication that can ease symptoms caused by certain physical and mental health conditions. Treating the underlying cause of symptoms can help reduce the frequency of suicidal thoughts. You be prescribed one or more of the following types of medication:
- antipsychotic medications
- anti-anxiety medications
In addition to taking medication and participating in talk therapy, you can reduce your risk for suicide by making certain adjustments to your lifestyle. These include:
Avoiding alcohol and drugs: Abstaining from using alcohol and drugs is critical, as these substances can increase the frequency of suicidal thoughts.
Exercising regularly: Exercising at least three times per week, especially outdoors and in moderate sunlight, can also help. Physical activity stimulates the production of certain brain chemicals that make you feel happier and more relaxed.
Sleeping well: It’s also important to get at least six to eight hours of sleep each night. Talk to your health care provider if you’re having trouble sleeping.
How to prevent suicide
To help prevent suicidal thoughts, you should:
Talk to someone. You should never try to manage suicidal feelings entirely on your own. Getting professional help and support from loved ones can make it easier to overcome any challenges that are causing suicidal thoughts or behavior. There are also numerous organizations and support groups that can help you cope with suicidal thoughts and recognize that suicide isn’t the right way to deal with stressful life events. The National Suicide Prevention Lifeline is another great resource. They have trained staff available to speak to you 24 hours a day, seven days a week.
Take medications as directed. You should never change your dosage or stop taking your medications unless your health care provider tells you to do so. Your suicidal feelings may return and you may develop withdrawal symptoms if you suddenly stop taking your medications. If you are experiencing negative side effects from the medication you’re currently taking, speak with your health care provider about switching to another one.
Never skip an appointment. It’s important to attend all your therapy sessions and health care provider’s appointments. Sticking with your treatment plan is the best way to overcome suicidal thoughts and behavior.
Pay attention to warning signs. Work with your health care provider or therapist to learn about the possible triggers for your suicidal feelings. This will help you recognize the signs of danger early on and decide what steps to take ahead of time. It can also be beneficial to tell family members and friends about the warning signs so they can know when you may need help.
Eliminate access to lethal methods of suicide. Get rid of any firearms, knives, or dangerous medications if you worry that you might act on suicidal thoughts.
How to help someone who may be feeling suicidal
If you suspect that a family member or friend may be considering suicide, you should talk to them about your concerns. You can begin the conversation by asking questions in a non-judgmental and non-confrontational way. You may ask them:
- Have you ever thought about committing suicide?
- Have you ever taken steps to commit suicide?
- Have ever attempted to commit suicide in the past?
If they answer “yes” to any of those questions, then they are at a high risk of trying to commit suicide and they should get professional care immediately. Calling 911 or going to a hospital emergency room are good ways to prevent a suicide attempt. You can also get help from a crisis or suicide prevention hotline.
If you live in the United States, try the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255).
If your friend or loved one isn’t in immediate danger but is having suicidal thoughts, then you can simply speak to them about the challenges they may be facing. During the conversation, make sure you:
- stay calm and speak in a reassuring tone
- acknowledge that their feelings are legitimate
- offer support and encouragement
- reassure them that suicidal feelings are temporary
- tell them that help is available and that they can feel better with treatment
You should never minimize their problems or shame them into changing their mind. Listening to them and showing your support is the best way to help them. You can also try encouraging them to seek professional care. Offer to help them find a health care provider or mental health professional, make a phone call, or go with them to their first appointment.
It’s critical to take action if you're in a position to help. Starting a conversation and risking your feelings to help save a life is a risk worth taking.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.