How to tell if someone is suicidal

5 Warning Signs of Suicidal Behavior That Are Easy to Miss – Bridges to Recovery

September 10, 2019, Mary Ellen EllisBridges to Recovery

Suicidal warning signs should be taken very seriously. There are some signs that are obvious, such as talking about suicide and dying, but others are much more subtle and can be easily missed. It is important to know the signs, especially for those who have risk factors for suicide. Early detection of warning signs can lead to professional help and mental health treatment and can even save a life.

Suicide is a terrible tragedy for individuals and the people who care about them. Since hitting a low in 2000, suicides have been rising in the U.S. From 2000 to 2016, suicides went up by 30 percent. Suicide in girls and women increased by 50 percent. It is now the 10th leading cause of death in the country. Why these increases have occurred is not fully understood, but it highlights the need for better mental health care.

The statistics also show that everyone needs to be more aware of the risk of suicide and the warning signs. If someone you care about is showing signs of suicidal behaviors, you can take steps to get help. But, there are signs that are not always clear or easy to see. Some people hide their feelings and intentions very well. Learn more about what suicidal behavior looks like and you could help save a life.

Suicide Risk Factors

Suicide does not discriminate. Anyone of any race, gender, age, or socioeconomic status may feel suicidal at any point in their lives. Even someone who seems to be happy or to “have it all” can be vulnerable to suicide.

There are certain risk factors to be aware of, though. These are situations, conditions, and other factors that put some people at a greater risk of becoming suicidal:

Having a mental illness, particularly depression, bipolar disorder, anxiety disorder, or conduct disorder and especially an untreated mental illness
Having a substance use disorder
Being seriously ill, living with a chronic or terminal illness, or being in significant, long-term pain
Suffering from a traumatic brain injury
Stressful life situations, especially those that are prolonged, including bullying or relationship problems
Sudden stressful or traumatic situations, like the loss of a loved one
Having experienced childhood trauma and abuse
Having access to lethal means
Being exposed to another person’s suicide
Past suicide attempts
A family history of suicide

Having risk factors for suicide does not mean that it is inevitable. If you or someone you care about has one or more of these, though, you need to be especially aware of and on the watch for warning signs.

There isn’t really any typical pattern of behavior for someone who is suicidal, but there are common warning signs. You may see one or more of these in someone contemplating suicide. These are the signs that are generally clear and easy to observe:

Talking about dying or wanting to die
Talking about feeling empty, hopeless, or having no way out of problems
Mentioning strong feelings of guilt and shame
Talking about not having a reason to live or that others would be better off without them
Social withdrawal and isolation
Giving away personal items and wrapping up loose ends
Saying goodbye to friends and family

Unfortunately, there are also signs of suicide that are easy to miss. Even people close to the person feeling suicidal may not realize how deeply hopeless they feel. Here are five signs you need to know about that could indicate someone is thinking about suicide:

Any unusual changes in behavior. This is common for someone who is suicidal, but it’s easy to overlook because the changes may not seem related to depression or hopelessness. For instance, someone you know who is usually kind may become angry and aggressive. Or, someone who has been sad and struggling with depression may suddenly become calm and seemingly happy and at peace. Other changes may include increased substance abuse or unusual mood swings.
Changes in sleeping patterns. A shift in how someone sleeps is a sign of depression but also suicidal behaviors. Someone who is feeling suicidal may sleep more than normal, struggling to get out of bed at all. They may sleep less, experiencing insomnia and staying up until all hours and then struggling the next day from fatigue. Whether it’s a symptom of being suicidal or not, these kinds of changes in sleeping habits are cause for concern and should be addressed.
Accessing lethal means. This sign can potentially be obvious, such as if a loved one tells you they have bought a gun. However, gathering lethal means is also an important warning sign that can be hidden. Someone may start stockpiling pills without anyone noticing. They are easy to hide. It’s important to be aware of any lethal means someone you are concerned about may have access to. With access the risk of suicide goes up.
Emotional distance. Someone who is feeling suicidal may become detached from life in general, from other people, and from typical activities. They may seem emotionally distant from people, whether or not they have isolated themselves socially. Acting indifferent in the face of emotional situations may not seem like a suicidal behavior, so it is important to note this kind of behavior and recognize it as a potential warning sign or a symptom of depression. Along the same lines, someone feeling suicidal may lose interest in normal activities, work and home, and things they once enjoyed.
Physical pain. Physical pain and discomfort are often overlooked as symptoms of depression and also of suicide. If someone you know complains often of any type of pain, like headaches, digestive upset, or just general body pain, be alert to other signs of depression or suicide. If the individual has no easy explanation for the pain, such as a history of migraines or an athletic injury causing achy muscles, you should be especially concerned.

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What to Do If Someone Seems Suicidal

With greater awareness of these and the less subtle signs of suicidal thoughts it is easier to know when to get help. But what do you do if someone you know is exhibiting these signs? First, if someone is actually threatening suicide, talking about doing it, or has or is actively asking for lethal means, call 911 and get emergency help. Do not leave them alone.

If the situation is not that immediate, but you suspect someone is suicidal, talk to them about it. Mentioning suicide or discussing it is not going to push anyone over the edge and make them take action. Talk to this person privately, listen without judgment, and be compassionate. Ask them directly if they are considering suicide.

Also suggest they get professional help and offer them options to make it an easier step to take. Provide a national suicide hotline number and find out who they might feel most comfortable talking to, such as a trusted doctor or a religious counselor. Enlist the help of other loved ones if you are struggling to get through to someone who seems suicidal.

Suicide is a growing problem and cause of death in the U.S. Unfortunately, some of the signs of suicidal behaviors are subtle and hard to detect until it’s too late. Be aware of all the warning signs, and above all take note if someone you care about seems off or different. Offer help, provide treatment options, and be there as a friend who will listen and support them.

Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned Los Angeles-based program and how we can help you or your loved one start on the path to lasting wellness.

How to Recognize Symptoms of Suicidal Behavior

Written by WebMD Editorial Contributors

Suicide is not a mental illness but a serious potential consequence of treatable mental disorders that include major depression, bipolar disorder, posttraumatic stress disorder, borderline personality disorder, schizophrenia, substance use disorders, anxiety disorders, and eating disorders like bulimia and anorexia nervosa.

Suicide Warning Signs

Any of these could be potential warning signs for suicide:

Severe sadness or moodiness. Long-lasting sadness, mood swings, and unexpected rage.
Hopelessness. Feeling a deep sense of hopelessness about the future, with little expectation that circumstances can improve.
Sleep problems.
Sudden calmness. Suddenly becoming calm after a period of depression or moodiness can be a sign that the person has made a decision to end their life.
Withdrawal. Choosing to be alone and avoiding friends or social activities also are possible symptoms of depression, a leading cause of suicide. This includes the loss of interest or pleasure in activities the person previously enjoyed.
Changes in personality or appearance. A person who is considering suicide might exhibit a change in attitude or behavior, such as speaking or moving with unusual speed or slowness. In addition, the person might suddenly become less concerned about their personal appearance.
Dangerous or self-harmful behavior. Potentially dangerous behavior, such as reckless driving, engaging in unsafe sex, and increased use of drugs or alcohol, might indicate that the person no longer values their life.
Recent trauma or life crisis. A major life crises might trigger a suicide attempt. Crises include the death of a loved one or pet, the end of a relationship, diagnosis of a major illness, loss of a job, or serious financial problems.
Making preparations. Often, a person considering suicide will begin to put their personal business in order. This might include visiting friends and family members, giving away personal possessions, making a will, and cleaning up their room or home. Some people will write a note before taking their own life. Some will buy a firearm or other means like poison.
Threatening or talking about suicide. From 50% to 75% of those considering suicide will give someone -- a friend or relative -- a warning sign. It may not be an outright threat. They may talk an unusual amount about death or say things like “It would be better if I wasn’t here.” However, not everyone who is considering suicide will say so, and not everyone who threatens suicide will follow through with it. Every threat of suicide should be taken seriously.

Who Is Most Likely to Commit Suicide?

Suicide rates are highest in teens, young adults, and the elderly. White men over the age of 65 have the highest rate of suicide. Suicide risk also is higher in:

Older people who have lost a spouse through death or divorce
People who have attempted suicide in the past
People with a family history of suicide
People with a friend or co-worker who have killed themselves
People with a history of physical, emotional, or sexual abuse
People who are unmarried, unskilled, or unemployed
People with long-term pain or a disabling or terminal illness
People who are prone to violent or impulsive behavior
People who have recently been released from a psychiatric hospitalization (This often is a very frightening period of transition. )
People in certain professions, such as police officers and health care providers who work with terminally ill patients
People with substance abuse problems

Although women are three times as likely to attempt suicide, men are far more likely to complete the act.

Can Suicide Be Prevented?

Suicide can't be prevented with certainty, but risks can often be reduced with timely intervention. Research suggests that the best way to prevent suicide is to know the risk factors, be alert to the signs of depression and other mental disorders, recognize the warning signs for suicide, and intervene before the person can complete the process of self-destruction.

What Should I Do if I Think Someone is Suicidal?

People who receive support from caring friends and family and who have access to mental health services are less likely to act on their suicidal impulses than are those who are socially isolated. If someone you know is exhibiting warning signs for suicide:

Don't be afraid to ask if they are depressed or thinking about suicide.
Ask if they are seeing a therapist or taking medication.
Rather than trying to talk the person out of suicide, let them know that depression is temporary and treatable.
In some cases, the person just needs to know that someone cares and is looking for the chance to talk about their feelings. You can then encourage the person to seek professional help.

What Should I Do if I See the Warning Signs of Suicide?

If you believe someone you know is in immediate danger of killing themselves:

Do not leave the person alone. If possible, ask for help from friends or other family members.
Ask the person to give you any weapons they might have. Take away or remove sharp objects or anything else that the person could use to hurt themselves.
If the person is already in psychiatric treatment, help them to contact the doctor or therapist for guidance and help.
Try to keep the person as calm as possible.
Call 911 or take the person to an emergency room.
Call your local suicide prevention hotline or the Substance Abuse and Mental Health (SAMHSA) National Suicide Prevention Hotline at 800-273-TALK (8255).

Get help & support for suicide

If you’re in emotional distress or suicidal crisis, find help in your area with Find a helpline.

If you believe that someone else is in danger of suicide and you have their contact information, contact your local law enforcement for immediate help. You can also encourage the person to contact a suicide prevention hotline using the information above.

Learn more about personal crisis information with Google Search.

Google’s crisis information comes from high-quality websites, partnerships, medical professionals, and search results.

Important: Partnerships vary by country and region.

Korea Suicide Prevention Center nine0033

Country	Hotline organization	Website	Phone number
Argentina	Centro de Asistencia al Suicida	www. asistenciaalsuicida.org	(011) 5275-1135
Australia	Lifeline Australia	www.lifeline.org	13 11 14
Austria	Telefon Seelsorge Osterreich	www.telefonseelsorge.at	142
Belgium	Center de Prevention du Suicide	www.preventionsuicide.be	0800 32 123
Belgium	CHS Helpline	www.chsbelgium.org	02 648 40 14
Belgium	Zelfmoord 1813	www.zelfmoord1813.be	1813
Brazil	Centro de Valorização da Vida	www.cvv.org	188
Canada	Crisis Services Canada	crisisservicescanada. ca	833-456-4566
Chile	Ministry of Health of Chile	www.hospitaldigital.gob	6003607777
China	Beijing Suicide Research and Prevention Center	www.crisis.org	800-810-1117
Costa Rica	Colegio de Profesionales en Psicologia de Costa Rica	psicologiacr.com/aqui-estoy	2272-3774
France	SOS Amitié	www.sos-amitie.org	09 72 39 40 50
Germany	Telefon Seelsorge Deutschland	www.telefonseelsorge.de	0800 1110111
Hong Kong	Suicide Prevention Services	www.sps.org	2382 0000
India	iCall Helpline	icallhelpline. org	9152987821
Ireland	Samaritans Ireland	www.samaritans.org/how-we-can-help	116 123
Israel	[Eran] ער"ן	www.eran.org	1201
Italy	Samaritans Onlus	www.samaritansonlus.org	06 77208977
Japan	Ministry of Education, Culture, Sports, Science and Technology	www.mext.go.jp	81-0120-0-78310
Japan	Ministry of Health, Labor and Welfare of Japan	www.mhlw.go	0570-064-556
Malaysia	Befrienders KL	www.befrienders.org	03-76272929
Netherlands	113Online	www. 113.nl	0800-0113
New Zealand	Lifeline Aotearoa Incorporated	www.lifeline.org	0800 543 354
Norway	Mental Helse	mentalhelse.no	116 123
Pakistan	Umang Pakistan	www.umang.com.pk/	0311-7786264
Peru	Linea 113 Salud	www.gob.pe/555-recibir-informacion-y-orientacion-en-salud	113
Philippines	Department of Health - Republic of the Philippines	doh.gov.ph/NCMH-Crisis-Hotline	0966-351-4518
Portugal	SOS Voz Amiga	www.sosvozamiga.org	213 544 545 963 524 660 912 802 669
Russia	Fund to Support Children in Difficult Life Situations	www. ya-parent.ru	8-800-2000-122
Singapore	Samaritans of Singapore	www.sos.org	1-767
South Africa	South African Depression and Anxiety Group	www.sadag.org	0800 567 567
South Korea	중앙자살예방센터	www.spckorea.or	1393
Spain	Telefono de la Esperanza	www.telefonodelaesperanza.org	717 003 717
Switzerland	Die Dargebotene Hand	www.143.ch	143
Taiwan	国际生命线台湾总会 [International Lifeline Taiwan Association]	www.life1995.org	1995
Ukraine	Lifeline Ukraine	lifelineukraine. com	7333
United Kingdom	Samaritans	www.samaritans.org/how-we-can-help	116 123
United States	988 Suicide & Crisis Lifeline	988lifeline.org	988

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Helpline

Information about the unified all-Russian children's helpline

0444 8-800-2000-122 .

When calling this number in any locality of the Russian Federation from fixed or mobile phones, children in difficult life situations, adolescents and their parents, other citizens can receive emergency psychological assistance, which is provided by specialists of services already operating in the constituent entities of the Russian Federation that provide services for telephone counseling and connected to a single all-Russian number of children's helpline.

Confidentiality and free of charge are the two main principles of the children's helpline. This means that every child and parent can anonymously and free of charge receive psychological assistance and the secrecy of his call to the helpline is guaranteed.

Working hours of the children's helpline in the constituent entities of the Russian Federation

(as of October 1, 2013) 38 -PIC AO

	Name of the subject of the Russian Federation 9Arkhangelsk region 09.00-22.00
22	with Nenets Autonomous Okrug	daily 09.00-17.30
23	Vologda region	around the clock
24	Kaliningrad region	daily0039	around the clock
35	Chechen Republic 08.30-20.00
	Southern Federal District
37	Republic of Adygea
Kalmykia	PON-PIP. 8.00-17.00
3
80	Magadan region	Pon.-Pon. 10.00.22.00
81	Sakhalin Region
900
83	Chukotka AO	Mon-Fri 09.00-22.00, closed 16.00-22.00

Infographics. The principle of operation of a single federal helpline number for children, adolescents and their parents

Information from the regions about the work of the children's helpline

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