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A lot of people think about suicide. They may say things like “I wish I was dead,” at times of great stress. Casual thoughts of suicide that don’t last may not be a sign of a problem. For most people, they are a way to express anger and other strong feelings. The signs and symptoms that follow need medical care.

Signs & Symptoms

1. •Writing a suicide note.
   

2. •Suicidal threats, gestures, or attempts.
   

3. •Thoughts of suicide that don’t go away or occur often.
   

Causes

1. •Depression.
   

2. •Bipolar disorder.
   

3. •Schizophrenia.
   

4. •Grief. Loss of a loved one.
   

5. •A side effect of some medicines. One is isotretinoin. This is prescribed for severe acne. Some antidepressant medicines can increase the risk for suicidal thoughts and behaviors, too. This is especially noted in children and adolescents. This risk may be higher within the first days to a month after starting the medicine. Persons who take antidepressants should be closely monitored.
   

6. •A family history of suicide or depression.
   

7. •Money and relationship problems.

Self-Care / Prevention

For Suicidal Thoughts

1. •Call the National Suicide Prevention Lifeline at 800.273.8255.
   

2. •Let someone know. Talk to your doctor, a trusted family member, friend, or teacher. If it is hard for you to talk to someone, write your thoughts down. Let someone else read them.
   

To Help Prevent a Suicide

1. •Keep firearms, drugs, etc., away from persons at risk.
   

2. •Take courses that teach problem solving, coping skills, and suicide awareness.
   

3. •If you think the person is serious about suicide, get help. Watch and protect him or her until you get help. Keep the person talking. Ask questions such as, “Are you thinking about hurting or killing yourself?”
   

4. •Urge the person to call for help (e.g., his or her health care provider, a suicide prevention hotline, EMS, etc.) Make the call yourself if the person can’t or won’t.
   

5. •Express concern. The person needs to know that someone cares. Most suicidal persons feel alone. Tell the person how much he or she means to you and others. Talk about reasons to stay alive. Don’t judge. The person needs someone to listen, not preach moral values.
   

6. •Tell the person that depression and thinking about suicide can be treated. Urge him or her to get professional care. Offer help in seeking care.

Questions to Ask

With thoughts of suicide or death, are any of these conditions present?

1. •Depression or bipolar disorder.
   

2. •Schizophrenia.
   

3. •Any other mental health or medical condition.

At this time, are any of the following present?

1. •Suicide attempts.
   

2. •Suicidal gestures (e.g., standing on the edge of a bridge, cutting the wrists with a dull instrument, or driving recklessly on purpose).
   

3. •Plans are being made for suicide (e.g., the person has purchased or gotten a weapon or pills that could be used for suicide).
   

4. •Repeated thoughts of suicide or death.

Have thoughts of suicide occurred after taking, stopping, or changing the dose of a prescribed medicine (this includes certain antidepressants) or using drugs and/or alcohol?

Has the person recently done any of the following?

1. •Given repeated statements that indicate suicidal thoughts, such as “I don’t want to live anymore,” or “The world would be better off without me.”
   

2. •Given away things he or she values most, gotten legal matters in order, etc.

1. •Emergency care.
   

2. •Treating the mental and/or physical problems that lead to thoughts and attempts of suicide. Examples are bipolar disorder and depression.
   

3. •Counseling.
   

4. •Talking with family and friends often.

Have suicidal thoughts come as a result of any of the following (or any other) upsets in life?

1. •A relationship breakup.
   

2. •The death of a loved one.
   

3. •A rejection or being ridiculed.

Does the person thinking about suicide have signs and symptoms of depression?

Resources

American Foundation for Suicide Prevention

888.333.AFSP (2377)

www.afsp.org (This is not a crisis hotline)

{Note: In some suicides, no warning signs are shown or noticed.}

Does the person thinking about suicide have other blood relatives who attempted or died from suicide?

Metanoia Communications

www.metanoia.org/suicide

National Suicide Prevention Lifeline

800.273.TALK (273.8255)

www.suicidepreventionlifeline.org