How to Recognize the Lesser-Known Suicide Risk Factors and Warning Signs
If you are suicidal or suspect someone else is, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). Or, visit online at suicidepreventionlifeline.org
The all-too-frequent deaths by suicide of high-profile celebrities like designer Kate Spade and chef-turned-television personality Anthony Bourdain, as well as members of local communities across the U.S., mean most Americans have been impacted in some way by suicide. This recent, tragic upswing has spurred increased discussions about suicide prevention and awareness.
Underscoring the importance of this enhanced suicide awareness is a new report from the Centers for Disease Control and Prevention that shows suicide rates have increased in nearly every state since 1999, and, in half of the states, the rate has gone up by more than 30 percent. In Illinois, the increase was 23 percent, according to the CDC, and in California, it was 15 percent. In Palo Alto, clusters of youth suicides that occurred in 2008-09 and 2014-15 prompted a CDC investigation that found high-school students there who had considered suicide had some traits in common such as missing school, being victims of bullying, and having used alcohol or drugs in the past.
Suicide most often occurs when stressors and health issues converge, creating a sense of hopelessness, according to the American Foundation for Suicide Prevention. There’s no single cause for suicide, according to the foundation.
“Sometimes attempts and thoughts of suicide can evolve over time and possible planning is involved,” explains Sarah Farris, LCPC with Chicago Mind and Body. “However, self-harm and suicide attempts can also be sudden and impulsive. This is one aspect that makes suicidality dangerous and sometimes difficult to identify.” As such, a person might not share if they have been planning to hurt or kill themselves, and it’s possible they could make a sudden or impulsive decision, Farris explains.
The CDC, when releasing its report, highlighted a dozen warning signs of suicide. They are:
- Feeling like a burden
- Being isolated
- Increased anxiety
- Feeling trapped or in unbearable pain
- Increased substance use
- Looking for a way to access lethal means
- Increased anger or rage
- Extreme mood swings
- Expressing hopelessness
- Sleeping too little or too much
- Talking or posting about wanting to die and making plans for suicide
We asked mental health experts to share some additional, and perhaps lesser-known, warning signs and risk factors of suicide.
Bipolar disorder and major depression
Common risk factors include alcohol and substance abuse, depression, a family history of suicide, and not being able to receive quality mental treatment, explains Prakash Masand, M.D., a psychiatrist based in New York City and founder of the Centers of Psychiatric Excellence.
Those who are diagnosed with bipolar disorder are unfortunately at greater risk of suicide, explains Masand. “For every suicide, there are 25 attempted suicides,” Masand says. “But for people with bipolar disorder, it’s even worse with one completed suicide for every three attempts.”
Another lesser-known risk factor for suicide is celebrity suicides, says Masand. “In other words, suicide rates can increase among the general population when a celebrity or well-known public figure takes his or her life,” he says.
Drug and alcohol abuse
A big risk factor that Alex Dimitriu, M.D., has seen in work with his clients is drug and alcohol abuse. Oftentimes, the drug and alcohol abuse is being used as an “anesthesia” so that people can avoid feelings, says Dimitriu, who is dual boarded in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine in California.
Explained, quiet sufferers are people who simply don’t communicate the severity of what they’re experiencing. This often leaves them alone, without support, and therefore at risk, says Dimitriu.
Sudden calm or improved mood
Sometimes, when a person has made plans to end their life, they will actually present as more calm and pleasant, explains Kendra Kubala, Psy.D., a licensed psychologist based in Philadelphia. If someone has typically and consistently displayed a depressed or irritable mood for a period of time and suddenly appears markedly more cheerful, then inquire about the mood change, Kubala says.
When someone’s mood or symptoms suddenly improve without cause, it can be a sign to concerned loved ones that the person is trying to convince those around them that “everything is OK,” says Tiffany Young, Ph.D., LPC with Trinity Counseling. Young suggests asking probing questions such as “what has changed for you?” or “what are you doing differently?”
Becoming obsessed with a death
If someone becomes focused on a particular death or the concept of death, it can be a warning sign, Masand says. As an example, he points to Kate Spade, who was reportedly preoccupied with the suicide of Robin Williams. Spade’s sister, in an interview with the Kansas City Star, said that Spade was fixated on Williams’ suicide that happened in August 2014 and that she thinks there was a “plan even as far back as then.”
Nancy Irwin, PsyD., primary therapist at Seasons in Malibu, also explains that a fascination with others who have died by suicide is a warning sign. Copycat action, or “suicide contagion,” seems to give people tacit permission that suicide is a viable way out of pain. “They may really identify with that person and follow their lead, so to speak,” she explains.
Giving away possessions
If someone suddenly wants to begin giving away possessions or form a will, it can be an warning sign, Masand says. The Cleveland Clinic explains that a person who is considering suicide could be making preparations, such as cleaning up their rooms or homes or visiting friends and family members.
How to Help
To help prevent suicide and recognize the warning signs to help people at risk, the CDC recommends BeThe1to.com as a resource. The CDC also recommends reducing access to lethal means, such as firearms and medications, among people who are at risk of suicide.
When it comes to depression, anxiety, and other mental health issues, treatment works, and there are a multitude of resources and organizations at the ready to help you or someone you love who is struggling. Here are some additional helpful resources and expert tips:
Teen Depression: What Parents Should Look For and 10 Ways to Help
Parents often struggle to discern between moodiness that is typical teenage behavior and what could be a larger mental health issue like depression. Here’s what you need to look out for.
How to Talk to Your Kids About Suicide: Expert Share Tips for Parents
There are many conversations that parents are uncomfortable having with their kids, but talking about suicide is particularly challenging. The topic is an important one, though, so we asked experts for their answers to some common questions parents have about whether to even broach the subject and, if they do decide to, what is the best way to do so.
Text-a-Tip: The Text That Can Save a Life
Be sure that your loved ones know they can text 847HELP to 274637. This text reaches Text-A-Tip, a text crisis hotline that provides complete anonymity and access to local licensed mental health professionals.
5 Ways to Help Your Kids Take Charge of Their Mental Health
Prioritizing adolescent mental health is essential to our ability as a society to begin to gain control over this public health crisis. Here are five ways you can support your children by fostering their positive mental health.