Suicide Risk Factors
and Warning Signs...
and Warning Signs
Risk Factors for Suicide
Risk factors for suicide
are characteristics or conditions that increase the chance that a person may try
to take her or his life. Suicide risk tends to be highest when someone has
several risk factors at the same time.
The most frequently
cited risk factors for suicide are:
disorders, in particular:
or bipolar (manic-depressive) disorder
- Alcohol or
substance abuse or dependence
or antisocial personality disorder
disorder (in youth)
disorders; psychotic symptoms in the context of any disorder
Impulsivity and aggression, especially in the context of the above mental
history of attempted or completed suicide
medical condition and/or pain
It is important to bear
in mind that the large majority of people with mental disorders or other suicide
risk factors do not engage in suicidal behavior.
That Increase Suicide Risk
Some people who have
one or more of the major risk factors above can become suicidal in the face of
factors in their environment, such as:
- A highly
stressful life event such as losing someone close, financial loss, or trouble
with the law
stress due to adversities such as unemployment, serious relationship conflict,
harassment or bullying
- Exposure to
another person’s suicide, or to graphic or sensationalized accounts of suicide
- Access to
lethal methods of suicide during a time of increased risk
Again, though, it is
important to remember that these factors do not usually increase suicide risk
for people who are not already vulnerable because of a preexisting mental
disorder or other major risk factors. Exposure to extreme or prolonged
environmental stress, however, can lead to depression, anxiety, and other
disorders that in turn, can increase risk for suicide.
Protective Factors for
Protective factors for
suicide are characteristics or conditions that may help to decrease a person’s
suicide risk. While these factors do not eliminate the possibility of suicide,
especially in someone with risk factors, they may help to reduce that risk.
Protective factors for suicide have not been studied as thoroughly as risk
factors, so less is known about them.
for suicide include:
effective mental health care
connections to family, peers, community, and social institutions such as
marriage and religion that foster resilience
- The skills
and ability to solve problems
Protective factors may
reduce suicide risk by helping people cope with negative life events, even when
those events continue over a period of time. The ability to cope or solve
problems reduces the chance that a person will become overwhelmed, depressed, or
anxious. Protective factors do not entirely remove risk, however, especially
when there is a personal or family history of depression or other mental
Warning Signs for
In contrast to longer
term risk and protective factors, warning signs are indicators of more acute
Thinking about heart
disease helps to make this clear. Risk factors for heart disease include
smoking, obesity, and high cholesterol. Having these factors does not mean that
someone is having a heart attack right now, but rather that there is an
increased chance that they will have heart attack at some time. Warning signs of
a heart attack are chest pain, shortness of breath, and nausea. These signs mean
that the person may be having a heart attack right now and needs immediate help.
As with heart attacks,
people who die by suicide usually show some indication of immediate risk before
their deaths. Recognizing the warning signs for suicide can help us to intervene
to save a life.
A person who is thinking
about suicide may say so directly: “I’m going to kill myself.” More commonly,
they may say something more indirect: “I just want the pain to end,” or “I can’t
see any way out.”
Most of the time,
people who kill themselves show one or more of these warning signs before they
about wanting to kill themselves, or saying they wish they were dead
- Looking for
a way to kill themselves, such as hoarding medicine or buying a gun
about a specific suicide plan
hopeless or having no reason to live
trapped, desperate, or needing to escape from an intolerable situation
- Having the
feeling of being a burden to others
intense anxiety and/or panic attacks
interest in things, or losing the ability to experience pleasure
socially isolated and withdrawn from friends, family, and others
irritable or agitated
rage, or talking about seeking revenge for being victimized or rejected,
whether or not the situations the person describes seem real
Individuals who show
such behaviors should be evaluated for possible suicide risk by a medical doctor
or mental health professional.
What To Do When You
Suspect Someone May Be at Risk for Suicide
Take it Seriously
- 50% to 75%
of all people who attempt suicide tell someone about their intention.
- If someone
you know shows the warning signs above, the time to act is now.
- Begin by
telling the suicidal person you are concerned about them.
- Tell them
specifically what they have said or done that makes you feel concerned about
- Don't be
afraid to ask whether the person is considering suicide, and whether they have
a particular plan or method in mind. These questions will not push them toward
suicide if they were not considering it.
- Ask if they
are seeing a clinician or are taking medication so the treating person can be
- Do not try
to argue someone out of suicide. Instead, let them know that you care, that
they are not alone and that they can get help. Avoid pleading and preaching to
them with statements such as, “You have so much to live for,” or “Your suicide
will hurt your family.”
encourage the person to see a physician or mental health professional
considering suicide often believe they cannot be helped. If you can, assist
them to identify a professional and schedule an appointment. If they will let
you, go to the appointment with them.
- If the
person is threatening, talking about, or making specific plans for suicide,
this is a crisis requiring immediate attention. Do not leave the person alone.
- Remove any
firearms, drugs, or sharp objects that could be used for suicide from the
- Take the
person to a walk-in clinic at a psychiatric hospital or a hospital emergency
- If these
options are not available, call 911 or the National Suicide Prevention
Lifeline at 1-800-273-TALK (8255) for assistance.
skeptical that they can be helped, the suicidal person may need your support
to continue with treatment after the first session.
medication is prescribed, support the person to take it exactly as prescribed.
Be aware of possible side effects, and notify the person who prescribed the
medicine if the suicidal person seems to be getting worse, or resists taking
the medicine. The doctor can often adjust the medications or dosage to work
better for them.
- Help the
person understand that it may take time and persistence to find the right
medication and the right therapist. Offer your encouragement and support
throughout the process, until the suicidal crisis has passed.