How to Recognize Signs of Suicidal Thoughts

The number of suicide cases worldwide is alarmingly high. In the United States alone, suicide was the leading cause of death, with 37,500 cases recorded in 2010. On average, one person dies by suicide every 13 minutes in the U.S. However, this tragic situation can be prevented. Individuals contemplating suicide often show warning signs, and you can follow the guidelines below to detect suicidal tendencies and take action to prevent them. If you or someone you know is contemplating or attempting suicide, immediate medical attention is necessary.

Identifying suicidal thoughts. People contemplating suicide often exhibit specific thought patterns. If someone shares that they are experiencing any of the following, it's essential to pay close attention. For example:

• Recurring, obsessive thoughts constantly filling the mind.
• Believing there is no hope left, and the only solution to end the pain is through suicide.
• Feeling life has lost meaning or seems uncontrollable.
• Experiencing a foggy mind or difficulty focusing.

Recognizing Emotional States Linked to Suicidal Thoughts. Individuals contemplating suicide often experience emotional phases that push them to take drastic actions. For example:

• Sudden mood changes.
• Frequently irritable, angry, or harboring thoughts of revenge.
• Constant, extreme anxiety, and easily triggered anger.
• Feeling guilty or ashamed, or viewing themselves as a burden to others.
• Often feeling isolated or alienated, even when surrounded by people, with feelings of embarrassment or humiliation.

Recognizing Suicidal Thoughts Through Speech. Those enduring emotional pain often express unusual statements reflecting their desire to end their life. If someone frequently mentions death, this is a clear indicator, as such talk is uncommon in regular conversation. Be cautious if someone says the following:

• "This is not good at all," "Life is not worth living," or "It doesn't matter anymore."
• "They can't hurt me anymore."
• "They'll remember me when I’m gone," or "You’ll miss me when I’m gone."
• "I can't take this pain anymore," or "I can’t solve everything. Life is too hard for me."
• "I feel so alone I just want to die."
• "You/my family/friends/boyfriend or girlfriend will be better off without me."
• "Next time, I'll take more pills to fix this."
• "Don't worry, I won't be here to face this."
• "I won’t bother you anymore."
• "No one understands me. No one knows how I feel."
• "I feel like there’s no way out," or "I can't do anything to make things better."
• "I'd rather be dead," or "I wish I was never born."

Don’t Be Misled by Sudden Improvement. Remember, a person preparing for suicide doesn’t always show extreme emotional distress. Instead, they may appear unexpectedly more positive and upbeat.

• A sudden mood improvement could indicate that someone has made the decision to end their life and may have already planned it.
• Therefore, if someone shows signs of depression or suicidal thoughts and suddenly becomes happier, take preventive action immediately.

Look for Signs of ‘Trying to Solve Everything.’ People contemplating suicide often attempt to resolve all their issues before acting. This is a serious warning sign because someone working hard to address their problems has likely planned their suicide. A suicidal person may do the following:

• Give away valuable possessions.
• Arrange financial matters, such as unexpectedly writing a will.
• Say goodbye to loved ones. Someone planning suicide often bids farewell emotionally at various times.

Watch for Dangerous and Risky Behaviors. Individuals contemplating suicide may not find a reason to continue living and often engage in life-threatening activities, such as reckless driving. Here are some warning signs to watch for:

• Using drugs (both legal and illegal) or excessive alcohol consumption.
• Reckless driving, such as speeding or driving under the influence.
• Engaging in unsafe sexual activities, often with multiple partners.

Pay Attention to Suicide Methods. Be aware if someone recently buys a gun or stockpiles legal or illegal medications.

• If a person begins hoarding medication or purchasing weapons unexpectedly, take immediate action. Once the plan is in place, they may attempt suicide at any time.

Notice a Lack of Social Interaction. People contemplating suicide often withdraw from friends, family, or colleagues, quietly distancing themselves from social connections.

• Act if someone says, "I just want to be alone." Don’t just sit there and listen.

Be Aware of Extreme Changes in Daily Habits. If someone suddenly stops playing weekly basketball or their favorite nightly game, it may be a warning sign.

• Ceasing regular leisure activities can indicate they are feeling unhappy, depressed, or may be contemplating suicide.

Observe Unusual Decline in Behavior. Those considering suicide or dealing with depression often appear lifeless in both mental and physical activities. Specifically, watch for behaviors like:

• Struggling with making even simple decisions.
• Lack of interest in sexual activities.
• Low energy, such as lying in bed all day.

Notice Warning Signs in Adolescents. If the individual is a teenager, it’s important to observe common warning signs and triggers in this age group. For instance:

• Family or legal troubles.
• Life events such as breaking up with a partner, not being accepted into college, or losing a close friend.
• Social withdrawal, having no friends, or avoiding close companions.
• Personal issues, such as not eating enough or overeating, poor hygiene, or lack of concern for appearance (e.g., a teenager suddenly stops grooming themselves).
• Drawing scenes of death.
• Sudden changes in normal behavior, like a drop in grades, a shift in personality, or rebellious behavior, are also warning signs.
• Eating disorders such as anorexia or binge eating can lead to depression, anxiety, and even suicidal thoughts. Teenagers who are bullied or bully others are at higher risk for suicide.

Consider Past Experiences and Current Circumstances. Recent or past experiences can trigger suicidal thoughts.

• A person may become suicidal after facing events such as the death of a loved one, job loss, serious illness (especially chronic pain), abuse, or stressful life situations.
• Special attention is needed if someone has previously attempted suicide, as they may try again. In fact, one in five suicide deaths are individuals who had previous suicidal intentions.
• Past physical or sexual abuse can also elevate the risk of suicide.

Pay Attention to Mental Health. Mental health issues such as bipolar disorder, depression, or schizophrenia, or a history of these conditions, contribute to higher suicide risk. In fact, 90% of suicides are linked to depression or other mental health disorders, and 66% of those contemplating suicide also suffer from a mental health disorder.

• Stress-induced disorders (e.g., post-traumatic stress disorder) and lack of impulse control (such as bipolar disorder, conduct disorder, substance disorders) are also factors that can lead to suicidal intentions.
• Symptoms of mental illness that increase suicide risk include extreme stress, panic, hopelessness, feeling like a burden, losing interest and pleasure in activities, and experiencing delusional thoughts.
• While there is no exact correlation between suicide and depression, most individuals who die by suicide have severe depression.
• People with multiple mental health disorders are more likely to have suicidal thoughts. Having two mental health conditions doubles the suicide risk, and three conditions increase the risk threefold compared to those with a single mental disorder.

Investigate Family Suicide History. Scientists have not reached a definitive conclusion on whether suicide is caused by the environment, genetics, or both, but it often runs in families.

• Some studies suggest that suicide is linked to genetic factors, so if someone is adopted, this could be a risk factor. Environmental influences from the family setting may also contribute to the risk.

Consider Suicide Statistics. While anyone can have suicidal thoughts statistically, certain groups tend to have a higher suicide rate than others. If you suspect someone may be at risk, keep the following in mind:

• Men are generally at higher risk for suicide. Across all age groups and races, men are four times more likely to die by suicide than women. In fact, 79% of suicides are committed by men.
• The LGBT community (lesbian, gay, bisexual, and transgender individuals) has a suicide risk four times higher than the general population.
• Older adults are more likely to commit suicide than younger people. Those aged 45 to 59 have the highest suicide rates, with individuals over 74 being at the second-highest risk.
• Native Americans and Caucasians also show higher suicide rates compared to other racial groups.
• These statistics don’t mean you should ignore individuals outside of these categories. If someone you care about shows signs of suicidal thoughts, regardless of their gender or age, remain vigilant. However, if they belong to one of these higher-risk groups, they may be at an even greater risk.

Use an Appropriate Tone. If you suspect someone you know is contemplating suicide, it is crucial to speak with them about your concerns with a compassionate and non-judgmental approach.

• Be an attentive listener. Maintain eye contact, stay fully engaged, and respond in a calm, gentle tone.

Address the Issue Directly. You can begin by saying something like: "I’ve noticed you seem very down, and I’m really concerned. Are you thinking about suicide?"

• If they say yes, follow up with: "Do you have a plan for how you would do it?"
• If the answer is yes, call 113 immediately! They need urgent help. Stay with them until help arrives.

Don’t Make Things Worse. Some things you might think are helpful can actually increase feelings of guilt or shame in someone who is suicidal. For example, avoid saying things like:

• "Tomorrow is a new day. Things will get better."
• "It could always be worse. You should be thankful for what you have."
• "You have so much that others would envy/You have everything you need."
• "Don’t worry. Everything/You will be fine."

Avoid Dismissing Their Feelings. Certain remarks can make it seem like you don't take someone's emotions seriously. Avoid saying things like:

• "It's not that bad."
• "You wouldn't hurt yourself."
• "I’ve been in your shoes before, and I got through it."

Don’t Keep It a Secret. If someone confides in you that they are contemplating suicide, you must not agree to keep it confidential.

• That person needs help as soon as possible. Keeping it secret only delays the necessary support.

Call 113. If you believe someone is at high risk for suicide, you must call 113 immediately.

Call the Suicide Helpline. This helpline is not only for those contemplating suicide but also assists those trying to prevent someone else's suicidal plans.

• By knowing what to do, the suicide helpline can guide you through the situation and recommend more direct actions. They will also connect with doctors and counselors nationwide.
• In the U.S., you can reach out to 800-SUICIDE (800-784-2433) or 800-273-TALK (800-273-8255).
• In the UK, you can call 08457 90 90 90.

Take the person considering suicide to a specialist. It’s important to get them a mental health consultation as soon as possible. The suicide helpline mentioned earlier can help you find a psychologist or psychiatrist, or you can look for specialists in this field online.

• You can prevent a suicide attempt and save a life by staying with the person and taking them to see a doctor.
• Time is crucial. Sometimes stopping a suicide attempt may take days or hours, so it’s vital to act as quickly as possible to help the person in need.

Inform a family member. It’s essential to reach out to the parents, guardians, or other close relatives of the person planning suicide.

• This will relieve some of the burden from you, as they can share the responsibility of preventing the suicide attempt.
• Getting their support also shows the person contemplating suicide that there are people who care about them.

Remove any means of suicide. If possible, remove dangerous items from the home of the person contemplating suicide, such as firearms, drugs, or any other weapons or toxins.

• Be thorough in removing any potential suicide tools. People can end their lives with items you might not think are dangerous.
• Items like rat poison, cleaning products, and even kitchen utensils can be lethal.
• Approximately 25% of suicides are carried out by hanging. Therefore, remove items like belts, straps, ropes, and sheets.
• Let them know that you will keep these items safe until they are feeling better.

Continue offering support. Even after the immediate danger has passed, it’s important to remain close to the person. Those struggling with depression or isolation often won’t ask for help, so you need to stay present for them. Call, check in, and regularly monitor their well-being. Here are some ways you can support them:

• Ensure they are receiving treatment. Offer to drive them to appointments to make sure they follow through with therapy.
• Make sure they are taking their prescribed medication.
• Do not allow the person to consume alcohol or drugs.
• Help create a safety plan in case the person still has suicidal thoughts. Suggest activities to prevent suicide, like calling a loved one, staying with friends, or visiting the hospital.

Call 113. If you are having suicidal thoughts and believe you are about to take action (meaning you have a plan and means to attempt suicide), you need to call 113 immediately. You require urgent assistance.

Call the suicide prevention hotline. While waiting for help, you can reach out to the suicide prevention hotline at 043-627-5762. This action can help pass the time and reduce the risk of suicide until assistance is available.

Visit a mental health professional. If you are experiencing suicidal thoughts but have not yet made a plan, you should contact a therapist or counselor.

• If things worsen while waiting to see the doctor and you have made a suicide plan, you need to call 113 immediately.

• Don’t wait for someone to approach you and say, "I want to commit suicide." People with a suicide plan rarely disclose it. If they show unusual signs, you should offer immediate help.
• Some people may not show much. Therefore, you need to be especially observant with those at risk of suicide, such as those who have recently suffered a serious injury, are using substances, or have a history of mental health issues, to recognize any warning signs.
• Be aware that not everyone with suicidal thoughts displays clear signs. In fact, about 25% of suicide victims show no warning signs at all.

• If you've done everything you can and the person still proceeds with their suicide plan, do not blame yourself.
• Never take action without professional help. If someone is contemplating suicide, you should not try to handle the situation alone. People in such circumstances require the expertise of professionals.