Suicide is a complex, but preventable public health issue with significant personal and societal consequences. Suicide constitutes a global disease burden and is currently the 11^th leading cause of death in the United States. For youth and young adults between the ages of 10 to 24 years, suicide is the second leading cause of death. In honor of Suicide Prevention Awareness Month this September, we aim to highlight warning signs, risk factors, disparities, and discuss ways to help someone who may be experiencing suicidal thoughts.

Warning Signs

Being aware of the warning signs may help you determine whether you or a loved one are at risk for suicide. Some warning signs may include:

Talking about or making social media posts about wanting to die
Looking for a way to access lethal means
Expressing hopelessness or not having a reason to live
Feeling trapped or in excruciating pain
Feeling like a burden to others
Acting increasingly anxious or agitated
Sleeping too little or too much
Increasing substance use
Withdrawing or isolating themselves
Making plans for suicide

Risk Factors

Although these factors cannot cause or predict a suicide attempt, these characteristics can increase the risk that someone will consider, attempt, or die by suicide. Some risk factors include:

Previous suicide attempt(s)
Mood disorders
Hopelessness
Thwarted belongingness and sense of isolation
History of trauma or abuse
Current or prior history of adverse childhood experiences
Job or financial loss
Lack of access to healthcare
Stigma associated with asking for help
Discrimination

Disparities

In addition to recognizing risk factors and warning signs, it is important to note that certain groups are disproportionately affected by suicide. For example,

Native American and Alaska Native individuals have the highest suicide rate compared to other racial groups
Among high school students, sexual minorities have higher rates of suicide attempts compared to heterosexual students
Suicide rates are higher among veterans compared to non-veteran adults
Suicidal ideation is higher among adults with disabilities compared to adults without disabilities
Older adults aged 75 years and older have one of the highest suicide rates

Protective Factors

There are also many protective factors that can reduce the risk of suicide. For example, protective factors include:

Effective coping and problem-solving skills
Support from friends and family
Feelings of connectedness
Strong sense of cultural identity
Access to healthcare
Reduced access to lethal means

What Can You Do to Help?

Start the conversation if you are worried about a loved one. You may ask, “Are you having thoughts of suicide?” or “Are you having thoughts of killing yourself?” A misconception about suicide is that if you ask someone if they are experiencing suicidal thoughts, then you are increasing the likelihood of a suicide attempt. This is not true. Asking the question and starting a conversation creates an opportunity for the person to share their thoughts, feelings, and experiences.

If you or someone you know is thinking about suicide, help connect them to resources. If there is an immediate crisis, call 911 or go to your local emergency room.

Free and confidential crisis help is available 24/7 by phone:

Suicide and Crisis Lifeline: Call 988
Crisis Text Line: Text HOME to 741741
The Trevor Project Lifeline (LGBTQIA+): Call 1-866-488-7386 or Text START to 678678

Additional Resources

American Foundation for Suicide Prevention: https://afsp.org/
Texas Suicide Prevention Collaborative: https://texassuicideprevention.org/
Society for the Prevention of Teen Suicide: https://sptsusa.org/

Summary

Suicide is a leading cause of death and certain groups are disproportionately affected by suicide. Suicide is preventable; it is important to know the warning signs and risk factors. If you are experiencing mental health-related distress or you are concerned about a loved one, there are many crisis support resources available. In addition to crisis help, you may also wish to work with a mental health provider for more regular support. If you are interested in services, please call 972-519-1692 or email info@upsidetherapy.com.

References

Bernert, R. A., & Nadorff, M. R. (2015). Sleep disturbances and suicide risk. Sleep Med Clin, 10, 35-39. http://dx.doi.org/10.1016/j.jsmc.2014.11.004

Centers for Disease Control and Prevention. (2023). Be there to help prevent suicide. Retrieved from: https://www.cdc.gov/injury/features/be-there-prevent-suicide/index.html

Centers for Disease Control and Prevention. (2023). Disparities in suicide. Retrieved from: https://www.cdc.gov/suicide/facts/disparities-in-suicide.html

Centers for Disease Control and Prevention. (2022). Risk and protective factors. Retrieved from: https://www.cdc.gov/suicide/factors/index.html

De la Garza, A. G., Blanco, C., Olfson, M., & Wall, M. M. (2021). Identification of suicide attempt risk factors in a national US survey using machine learning. JAMA Psychiatry, 78(4), 398-406. https://doi.org/10.1001/jamapsychiatry.2020.4165

Joiner, T. E., Pettit, J. W., Walker, R. L., Voelz, Z. R., Cruz, J., Rudd, M. D., & Lester, D. (2002). Perceived burdensomeness and suicidality: Two studies on the suicide notes of those attempting and those completing suicide. Journal of Social and Clinical Psychology, 21(5), 531–545. https://doi.org/10.1521/jscp.21.5.531.22624

Segal, D. L. (2000). Levels of knowledge about suicide facts and myths among younger and older adults. Clinical Gerontologist, 22(2).