Suicide, taking your own life, is a tragic reaction to stressful life situations — and all the more tragic because suicide can be prevented. Whether you’re considering suicide or know someone who feels suicidal, learn suicide warning signs and how to reach out for immediate help and professional treatment. You may save a life — your own or someone else’s.
It may seem like there’s no way to solve your problems and that suicide is the only way to end the pain. But you can take steps to stay safe — and start enjoying your life again.
Suicide warning signs or suicidal thoughts include:
- Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”
- Getting the means to take your own life, such as buying a gun or stockpiling pills
- Withdrawing from social contact and wanting to be left alone
- Having mood swings, such as being emotionally high one day and deeply discouraged the next
- Being preoccupied with death, dying or violence
- Feeling trapped or hopeless about a situation
- Increasing use of alcohol or drugs
- Changing normal routine, including eating or sleeping patterns
- Doing risky or self-destructive things, such as using drugs or driving recklessly
- Giving away belongings or getting affairs in order when there’s no other logical explanation for doing this
- Saying goodbye to people as if they won’t be seen again
- Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
Warning signs aren’t always obvious, and they may vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.
When to see a doctor
If you’re feeling suicidal, but you aren’t immediately thinking of hurting yourself:
- Reach out to a close friend or loved one — even though it may be hard to talk about your feelings
- Contact a minister, spiritual leader or someone in your faith community
- Call a suicide hotline
- Make an appointment with your doctor, other health care provider or a mental health professional
Suicidal thinking doesn’t get better on its own — so get help.
Suicidal thoughts have many causes. Most often, suicidal thoughts are the result of feeling like you can’t cope when you’re faced with what seems to be an overwhelming life situation. If you don’t have hope for the future, you may mistakenly think suicide is a solution. You may experience a sort of tunnel vision, where in the middle of a crisis you believe suicide is the only way out.
There also may be a genetic link to suicide. People who complete suicide or who have suicidal thoughts or behavior are more likely to have a family history of suicide.
Although attempted suicide is more frequent for women, men are more likely than women to complete suicide because they typically use more-lethal methods, such as a firearm.
You may be at risk of suicide if you:
- Attempted suicide before
- Feel hopeless, worthless, agitated, socially isolated or lonely
- Experience a stressful life event, such as the loss of a loved one, military service, a breakup, or financial or legal problems
- Have a substance abuse problem — alcohol and drug abuse can worsen thoughts of suicide and make you feel reckless or impulsive enough to act on your thoughts
- Have suicidal thoughts and have access to firearms in your home
- Have an underlying psychiatric disorder, such as major depression, post-traumatic stress disorder or bipolar disorder
- Have a family history of mental disorders, substance abuse, suicide, or violence, including physical or sexual abuse
- Have a medical condition that can be linked to depression and suicidal thinking, such as chronic disease, chronic pain or terminal illness
- Are lesbian, gay, bisexual or transgender with an unsupportive family or in a hostile environment
Children and teenagers
Suicide in children and teenagers can follow stressful life events. What a young person sees as serious and insurmountable may seem minor to an adult — such as problems in school or the loss of a friendship. In some cases, a child or teen may feel suicidal due to certain life circumstances that he or she may not want to talk about, such as:
- Having a psychiatric disorder, including depression
- Loss or conflict with close friends or family members
- History of physical or sexual abuse
- Problems with alcohol or drugs
- Physical or medical issues, for example, becoming pregnant or having a sexually transmitted infection
- Being the victim of bullying
- Being uncertain of sexual orientation
- Reading or hearing an account of suicide or knowing a peer who died by suicide
If you have concerns about a friend or family member, asking about suicidal thoughts and intentions is the best way to identify risk.
Murder and suicide
In rare cases, people who are suicidal are at risk of killing others and then themselves. Known as a homicide-suicide or murder-suicide, some risk factors include:
- History of conflict with a spouse or romantic partner
- Current family legal or financial problems
- History of mental health problems, particularly depression
- Alcohol or drug abuse
- Having access to a firearm
Starting antidepressants and increased suicide risk
Most antidepressants are generally safe, but the Food and Drug Administration requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.
However, keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.
Suicidal thoughts and attempted suicide take an emotional toll. For instance, you may be so consumed by suicidal thoughts that you can’t function in your daily life. And while many attempted suicides are impulsive acts during a moment of crisis, they can leave you with permanent serious or severe injuries, such as organ failure or brain damage.
For those left behind after a suicide — people known as survivors of suicide — grief, anger, depression and guilt are common.
To help keep yourself from feeling suicidal:
- Get the treatment you need. If you don’t treat the underlying cause, your suicidal thoughts are likely to return. You may feel embarrassed to seek treatment for mental health problems, but getting the right treatment for depression, substance misuse or another underlying problem will make you feel better about life — and help keep you safe.
- Establish your support network. It may be hard to talk about suicidal feelings, and your friends and family may not fully understand why you feel the way you do. Reach out anyway, and make sure the people who care about you know what’s going on and are there when you need them. You may also want to get help from your place of worship, support groups or other community resources. Feeling connected and supported can help reduce suicide risk.
- Remember, suicidal feelings are temporary. If you feel hopeless or that life’s not worth living anymore, remember that treatment can help you regain your perspective — and life will get better. Take one step at a time and don’t act impulsively.
Your doctor may do a physical exam, tests and in-depth questioning about your mental and physical health to help determine what may be causing your suicidal thinking and to determine the best treatment.
Assessments may include:
- Mental health conditions. In most cases, suicidal thoughts are linked to an underlying mental health issue that can be treated. If this is the case, you may need to see a doctor who specializes in diagnosing and treating mental illness (psychiatrist) or other mental health provider.
- Physical health conditions. In some cases, suicidal thinking may be linked to an underlying physical health problem. You may need blood tests and other tests to determine whether this is the case.
- Alcohol and drug misuse. For many people, alcohol or drugs play a role in suicidal thinking and completed suicide. Your doctor will want to know whether you have any problems with alcohol or drug use — such as bingeing or being unable to cut back or quit using alcohol or drugs on your own. Many people who feel suicidal need treatment to help them stop using alcohol or drugs, to reduce their suicidal feelings.
- Medications. In some people, certain prescription or over-the-counter drugs can cause suicidal feelings. Tell your doctor about any medications you take to see whether they could be linked to your suicidal thinking.
Children and teenagers
Children who are feeling suicidal usually need to see a psychiatrist or psychologist experienced in diagnosing and treating children with mental health problems. In addition to patient discussion, the doctor will want to get an accurate picture of what’s going on from a variety of sources, such as the parents or guardians, others close to the child or teen, school reports, and previous medical or psychiatric evaluations.
If you’re having suicidal thoughts
No matter how much pain you’re experiencing right now, you’re not alone. Many of us have had suicidal thoughts at some point in our lives. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, or weak, or flawed. It only means that you have more pain than you can cope with right now. But with time and support, you can overcome your problems and the pain and suicidal feelings will pass.
Some of the finest, most admired, needed, and talented people have been where you are now. Many of us have thought about taking our own lives when we’ve felt overwhelmed by depression and devoid of all hope. But the pain of depression can be treated and hope can be renewed.
No matter what your situation, there are people who need you, places where you can make a difference, and experiences that can remind you that life is worth living. It takes real courage to face death and step back from the brink. You can use that courage to face life, to learn coping skills for overcoming depression, and for finding the strength to keep going. Remember:
- Your emotions are not fixed—they are constantly changing. How you feel today may not be the same as how you felt yesterday or how you’ll feel tomorrow or next week.
- Your absence would create grief and anguish in the lives of friends and loved ones.
- There are many things you can still accomplish in your life.
- There are sights, sounds, and experiences in life that have the ability to delight and lift you—and that you would miss.
- Your ability to experience pleasurable emotions is equal to your ability to experience distressing emotions.
Why do I feel suicidal?
Many kinds of emotional pain can lead to thoughts of suicide. The reasons for this pain are unique to each one of us, and the ability to cope with the pain differs from person to person. We are all different. There are, however, some common causes that may lead us to experience suicidal thoughts and feelings.
Why suicide can seem like the only option
If you are unable to think of solutions other than suicide, it is not that other solutions don’t exist, but rather that you are currently unable to see them. The intense emotional pain that you’re experiencing right now can distort your thinking so it becomes harder to see possible solutions to problems—or to connect with those who can offer support.
Therapists, counselors, friends, or loved ones can help you to see solutions that otherwise may not be apparent to you. Please give them a chance to help.
A suicidal crisis is almost always temporary
Although it might seem as if your pain and unhappiness will never end, it is important to realize that crises are usually temporary. Solutions are often found, feelings change, unexpected positive events occur. Remember: suicide is a permanent solution to a temporary problem. Give yourself the time necessary for things to change and the pain to subside.
Even problems that seem hopeless have solutions
Mental health conditions such as depression, schizophrenia, and bipolar disorder are all treatable with changes in lifestyle, therapy, and medication. Most people who seek help can improve their situation and recover.
Even if you have received treatment for a disorder before, or if you’ve already made attempts to solve your problems, know that it’s often necessary to try different approaches before finding the right solution or combination of solutions. When medication is prescribed, for example, finding the right dosage often requires an ongoing process of adjustment. Don’t give up before you’ve found the solution that works for you. Virtually all problems can be treated or resolved.
Take these immediate actions
If you’re feeling suicidal at this moment, please follow these five steps:
Step #1: Promise not to do anything right now
Even though you’re in a lot of pain right now, give yourself some distance between thoughts and action. Make a promise to yourself: “I will wait 24 hours and won’t do anything drastic during that time.” Or, wait a week.
Thoughts and actions are two different things—your suicidal thoughts do not have to become a reality. There is no deadline, no one’s pushing you to act on these thoughts immediately. Wait. Wait and put some distance between your suicidal thoughts and suicidal action.
Step #2: Avoid drugs and alcohol
Suicidal thoughts can become even stronger if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol when you feel hopeless or are thinking about suicide.
Step #3: Make your home safe
Remove things you could use to hurt yourself, such as pills, knives, razors, or firearms. If you are unable to do so, go to a place where you can feel safe. If you are thinking of taking an overdose, give your medicines to someone who can return them to you one day at a time as you need them.
Step #4: Don’t keep these suicidal feelings to yourself
Many of us have found that the first step to coping with suicidal thoughts and feelings is to share them with someone we trust. It may be a family member, friend, therapist, member of the clergy, teacher, family doctor, coach, or an experienced counselor at the end of a helpline.
Find someone you trust and let them know how bad things are. Don’t let fear, shame, or embarrassment prevent you from seeking help. And if the first person you reach out to doesn’t seem to understand, try someone else. Just talking about how you got to this point in your life can release a lot of the pressure that’s building up and help you find a way to cope.
Step #5: Take hope – people DO get through this
Even people who feel as badly as you are feeling now manage to survive these feelings. Take hope in this. There is a very good chance that you are going to live through these feelings, no matter how much self-loathing, hopelessness, or isolation you are currently experiencing. Just give yourself the time needed and don’t try to go it alone.
If you have suicidal thoughts, but aren’t in a crisis situation, you may need outpatient treatment. This treatment may include:
- Psychotherapy. In psychotherapy, also called psychological counseling or talk therapy, you explore the issues that make you feel suicidal and learn skills to help manage emotions more effectively. You and your therapist can work together to develop a treatment plan and goals.
- Medications. Antidepressants, antipsychotic medications, anti-anxiety medications and other medications for mental illness can help reduce symptoms, which can help you feel less suicidal.
- Addiction treatment. Treatment for drug or alcohol addiction can include detoxification, addiction treatment programs and self-help group meetings.
- Family support and education. Your loved ones can be both a source of support and conflict. Involving them in treatment can help them understand what you’re going through, give them better coping skills, and improve family communication and relationships.
Helping a loved one
If you have a loved one who has attempted suicide, or if you think your loved one may be in danger of doing so, get emergency help. Don’t leave the person alone.
If you have a loved one you think may be considering suicide, have an open and honest discussion about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You can even offer to go along.
Supporting a loved one who is chronically suicidal can be stressful and exhausting. You may be afraid and feel guilty and helpless. Take advantage of resources about suicide and suicide prevention so that you have information and tools to take action when needed. Also, take care of yourself by getting support from family, friends, organizations and professionals.
Coping and support
Don’t try to manage suicidal thoughts or behavior on your own. You need professional help and support to overcome the problems linked to suicidal thinking. In addition:
- Go to your appointments. Don’t skip therapy sessions or doctor’s appointments, even if you don’t want to go or don’t feel like you need to.
- Take medications as directed. Even if you’re feeling well, don’t skip your medications. If you stop, your suicidal feelings may come back. You could also experience withdrawal-like symptoms from abruptly stopping an antidepressant or other medication.
- Learn about your condition. Learning about your condition can empower and motivate you to stick to your treatment plan. If you have depression, for instance, learn about its causes and treatments.
- Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your suicidal feelings. Learn to spot the danger signs early, and decide what steps to take ahead of time. Contact your doctor or therapist if you notice any changes in how you feel. Consider involving family members or friends in watching for warning signs.
- Make a plan so you know what to do if suicidal thoughts return. You may want to make a written agreement with a mental health provider or a loved one to help you anticipate the right steps to take when you don’t have the best judgment. Clearly stating your suicidal intention with your therapist makes it possible to anticipate it and address it.
- Eliminate potential means of killing yourself. If you think you might act on suicidal thoughts, immediately get rid of any potential means of killing yourself, such as firearms, knives or dangerous medications. If you take medications that have a potential for overdose, have a family member or friend give you your medications as prescribed.
- Seek help from a support group. A number of organizations are available to help you cope with suicidal thinking and recognize that there are many options in your life other than suicide.
Preparing for your appointment
When you call your primary care doctor to set up an appointment, you may be referred immediately to a psychiatrist. If you’re in danger of killing yourself, your doctor may have you get emergency help at the hospital.
What you can do
Take these steps before your appointment:
- Make a list of key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins and other supplements that you’re taking, and the doses. Be honest with your doctor about your alcohol and drug use.
- Ask a family member or friend to the appointment if possible — someone who accompanies you may remember something that you missed or forgot.
- Make a list of questions to ask your doctor.
Some basic questions to ask your doctor include:
- Could my suicidal thoughts be linked to an underlying mental or physical health problem?
- Will I need any tests for possible underlying conditions?
- Do I need immediate treatment of some kind? What will that involve?
- What are the alternatives to the approach that you’re suggesting?
- I have these other mental or physical health problems. How can I best manage them together?
- Is there anything I can do to stay safe and feel better?
- Should I see a psychiatrist?
- Is there a generic alternative to the medicine you’re prescribing me?
- Are there any brochures or other printed material that I can have? What websites do you recommend?
Don’t hesitate to ask additional questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you first begin having suicidal thoughts?
- Have your suicidal thoughts been continuous or occasional?
- Have you ever tried to take your own life?
- Do you have a plan to kill yourself?
- If you have a plan, does it involve a specific method, place or time?
- Have you made any preparations, such as gathering pills or writing suicide notes?
- Do you feel like you can control your impulses when you feel like killing or hurting yourself?
- Do you have friends or family members you can talk to or go to for help?
- Do you drink alcohol, and if so, how much and how often?
- What medications do you take?
- Do you use recreational drugs?
- What, if anything, helps you deal with your suicidal thoughts?
- What, if anything, appears to worsen your suicidal thoughts?
- What are your feelings about the future? Do you have any hope that things will improve?
Preparing and anticipating questions will help you make the most of your time with the doctor.
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