How to Recognize Warning Signs of Suicide: Red Flags for Friends and Family

We know suicidal thoughts most often stem from severe depression, although there are other health issues that may also increase the risk of suicide. Depression symptoms include low mood, irritability, changes in appetite, problems with sleep, feelings of hopelessness, guilt, difficulty with concentration, and thoughts about death or dying in more serious cases.

Other mental and physical health issues that may influence suicide include bipolar disorder, substance use disorders, traumatic brain injury, and serious physical health conditions like chronic pain. With regard to bipolar disorder, a person experiencing a mixed episode (the presence of both manic and depressed symptoms) is at a much higher risk for potential suicide because the increased energy and impulsivity from the manic symptoms provide a surge in motivation to act on the feelings of depression.

Across the world and in the US, suicide is a growing problem. Estimates from the World Health Organization suggest that every year approximately one million people die from suicide. Suicide accounts for more firearm deaths each year than homicide. Knowing the warning signs of suicide can save a life.

Research suggests the number of people struggling with depression has tripled since last year. The increase is likely due in part to lack of social connection, more financial stress, and intensification of other mental health symptoms due to COVID.

Warning Signs of Suicide

It is important for friends and family to recognize potential warning signs for when a loved one may be at risk. Most people will give warning signs about suicide.

• Pay attention to the language used in your conversations. If someone you know is talking about ending their life, feeling hopeless, or like they are a burden to others, it could be a sign they are considering suicide.
• Behavior can also be a sign someone is in need of help. Taking steps to research methods for suicide online, isolating from others, giving away belongings, writing suicide letters, and visiting friends and family to say goodbye are concerning behaviors to watch.
• Changes in mood can also signal a risk; for example, some people suddenly appear to be feeling much better or happy shortly before attempting suicide.

If you’re worried someone you know may be suicidal there are a few steps you can take to help them through the situation.

• First, always take the person seriously. It’s easy to dismiss the quiet comments that sometimes give us clues to how people are feeling inside.
• Don’t be afraid to ask questions about how your loved one is feeling and coping with life’s challenges. There is an assumption if we ask people about suicide it might encourage them to act on those feelings. Research has shown this is not the case.
• Be direct but compassionate and ask difficult questions like, “I’ve been worried about you lately and you haven’t seemed like yourself. Do you ever feel like just giving up?” If the answer is yes then it’s important to keep asking questions. “Have you thought about how you would do it?” “Have you tried to hurt yourself in the past?”
• Encourage your loved one to communicate with you by showing them you want to listen.

Steps to Take to Prevent a Suicide

Once you identify your loved one is at risk, there are actions you can take to help keep them safe.

• If someone has threatened suicide, stay with them.
• Encourage them to get treatment and remind them this feeling is not necessarily a permanent one.
• If you think you can get the person to the emergency room safely, bring them right away. Stay with them in the waiting room until they are able to meet with a professional.
• Tell a family member right away; this helps increase the number of people who can offer support and highlights the severity of the problem.
• If possible, encourage the person to call a suicide hotline. The suicide prevention hotline is staffed 24/7 and can be accessed by calling 800-273-TALK. Veterans can also receive specialized support by calling this number and entering 1 which will direct the call to the Veterans Crisis Line.

What should you do if the person you’re concerned about isn’t answering your calls or texts? This situation can be extremely concerning and potentially dangerous. If you’re concerned that someone may be at risk you can call the police and ask for a welfare check. The police will pay a visit to the person’s home to see if the person is safe. If you have information you can pass along like whether or not there are firearms in the home or if the person has a history of attempting suicide this can be extremely helpful.

As critical as it may be to identify steps to help someone who may be feeling suicidal, it is of equal importance to know what not to say or do during this kind of situation.

• Avoid interrupting people when they are talking about suicide; it can send the message you are either not listening or don’t value the significance of what’s being shared.
• Do your best to be open-minded and respectful of the person’s feelings. Statements like, “You have a great life, there is no reason to be depressed,” or “That would be a selfish decision” are the opposite of helpful.
• Don’t assume the person has a therapist or partner to talk to about these issues or that it’s not your responsibility to do something.
• Never promise to keep someone’s plan or thoughts about suicide a secret.

Trying to help someone who is struggling with severe depression can be exhausting; be sure to engage in self-care activities. When you make time to care for your own mental health it helps replenish the energy you expend helping your loved one. Ultimately, the choice of living lies within the person struggling and despite the pain that follows a suicide, it is important to recognize you are not responsible.

We look for a way to comprehend what happened and we often blame ourselves, which only serves to amplify the grief. If you’re having difficulty coping with the loss of a loved one, it may be helpful to know you aren’t alone. There are online support groups, therapists that specialize in grief and loss, and people who have been through similar experiences. Again, the best thing you can do when you’re trying to support someone is to be sure to take care of yourself along the way.

Keep reading: “The Complicated Grief of Suicide.”