Warning signs of suicide can vary from person to person-some may outwardly talk about thoughts of suicide or wishing they were dead, while others may keep their intensions secret. "Look for changes in pattern," says Christine Moutier, MD, chief medical officer at the American Foundation for Suicide Prevention. "People can only keep things hidden to a certain extent. If you think about it, our behavior patterns are in a pretty tight and narrow range. Your radar will go off if someone you know is acting differently, because you know their patterns."
"It could be that they stay fully engaged, but they’re more easily aggravated, angered, lose their temper, or start drinking more. That’s what some people do when they become depressed and suicidal," she explains.
Look for these common warning signs of suicidal thoughts:
Talking about suicide, hurting themselves, death, or dying. Seeking access to firearms or pills
Withdrawing from friends, family, and society
Having severe mood swings, Feeling hopeless or trapped
Increased use of alcohol or drugs
Sleeping all the time or having issues with sleep
Uncontrolled rage or agitation
Self-destructive and risky behavior
Giving away personal belongings
Telling people goodbye for seemingly no reason
People who suffer from a mental illness, alcoholism or drug abuse, a family history of suicide, history of trauma or abuse, terminal illness, chronic pain, social isolation, or a traumatic life event such as loss of a loved one may be at an increased risk for suicide. Remember that people at any age can experience suicidal thoughts-suicide is the second leading cause of death among teenagers, and the highest suicide rate is among middle-aged people, closely followed by those older than 85, according to AFSP.
How to help a loved one you believe is at risk
If you notice a drastic change in someone's behavior that includes warning signs of suicide, don't hesitate or assume someone else will intervene. Taking an active role to check on them could save their life.
"Even if your instincts are to avoid the person because you're afraid you don’t know enough or that you might offend the person, you may be the only one who is noticing and who will reach out," says Dr. Moutier. "Everyone has a role to play in preventing suicide. The best thing you can do if you're unsure whether someone is suicidal is to start an honest, caring conversation in which you do more listening than you do talking, she says. If you pick up on signs that they're feeling trapped, hopeless, or depressed, don't skirt around the topic-you can ask them directly if they're having suicidal thoughts.
"That’s not going to make them worse; it’s not going to plant a seed. If you’ve created a safe environment to have this conversation, they will feel a sense of relief that they’ve been able to share this experience with someone who’s not judging them," says Dr. Moutier.
Avoid: Lecturing them on the value of life or minimizing their problems
Do: Let them know how deeply you care about them and encourage them to seek treatment from a therapist or their doctor
What to do if you believe someone is in crisis
If you believe someone is at immediate risk for suicide-they're saying they intend to kill themselves and/or they have a plan-call 911 and do not leave the person alone under any circumstances. Remove anything they could use to hurt themselves, and escort them to an emergency room.
You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text TALK to 741741 to message with a trained crisis counselor from the Crisis Text Line for free.