Suicide and suicidal thoughts

Overview

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.

Symptoms

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.

Causes

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.

Risk factors

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.

Complications

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.

Prevention

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.