Man sitting on his bed looking out a window

When an individual dies by suicide, it can have long-lasting effects. A death by suicide can affect individuals, families, and communities.

According to the Centers for Disease Control and Prevention (CDC), nearly 48,000 people in the United States died by suicide in 2019. Suicide is the 10th leading cause of death in the U.S., and suicide rates increased 33% between 1999 and 2019.

The CDC estimates nearly 12 million U.S. adults experience thoughts of suicide. Of those individuals, 3.5 million have a plan for how they might die by suicide and 1.4 million attempted suicide.

Recognizing the warning signs is an important step in preventing suicide.

“For folks that may be in a position to help somebody, they don’t always recognize the warning signs of somebody who might be at risk of suicide,” says Jeffrey Magill, MS, manager, Emergency Preparedness and manager, Crisis Training Institute, part of UPMC Western Psychiatric Hospital and UPMC Western Behavioral Health. “They try to explain away what they’re seeing. Then, even if they do identify, they’re not sure what to do.”

Why It’s Important to Talk About Suicide

Yet common myths still exist about suicide in our society.

Most people view suicide as a difficult subject to talk about, Jeffrey says. They may think asking someone if they’re having suicidal thoughts is putting the idea of suicide in that person’s mind. Or maybe they’re worried they don’t have the ability to help or will make the situation worse.

If you suspect someone might be depressed or having suicidal thoughts, asking them about it can open a conversation. It can show that person you’re there for them and want to help.

“As a layperson, you may not have the clinical skills in some cases,” Jeffrey says. “But compassion, empathy, and care often go a long way.”

Jeffrey suggests asking direct questions:

  • “Are you thinking about killing yourself?”
  • “Are you thinking about suicide?”
  • “Have you done anything or prepared to do anything to end your life?”

These questions show you care about them and their risk for suicide, and you’re willing to talk about it. It’s important for them to know you’re not going to judge them for suicidal thoughts.

“I think we have a responsibility to really break through the stigma, to increase awareness that this isn’t a sign of weakness,” Jeffrey says. “It’s like any other medical situation, disease, or disorder.”

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Who Is at Risk for Suicide?

Suicidal thoughts and actions can affect anyone, but people with mental health conditions are especially at risk.

According to the National Alliance on Mental Illness (NAMI), 46% of people who die from suicide have a known mental health condition. Those conditions may include:

  • Depression.
  • Schizophrenia.
  • Bipolar disorder.
  • Post-traumatic stress disorder.
  • Eating disorders like anorexia or bulimia.

While major depression is often associated with suicide and suicidal behaviors, depression is treatable in most cases.

Other factors can put people at risk of suicide, NAMI says. Those factors include:

  • Family history of suicide.
  • History of trauma or abuse.
  • Stress.
  • Recent tragedy or loss.
  • Alcohol or drug use, or intoxication.
  • Access to firearms.
  • Serious or chronic health conditions.
  • Gender — more women attempt suicide than men, but men are much more likely to die by suicide.

Warning Signs for Suicide

Different signs may indicate a person is having suicidal thoughts or making plans for suicide.

The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change.

If you or someone you know exhibits any of these signs, seek help as soon as possible. You can call the National Suicide Prevention Lifeline at 1-800-273-8255. If you live in Allegheny County, call resolve Crisis Services at 1-888-796-8226If you need immediate help, call 911.

Suicide warning signs include:

  • Threatening to or talking about wanting to hurt or kill oneself.
  • Looking for ways to kill oneself by seeking access to firearms, available pills, or other dangerous/lethal means.
  • Talking, writing, or looking up on the internet about death, dying, or suicide, especially when these actions are out of the ordinary or if the person previously thought or talked about suicide.
  • Feelings of hopeless, helplessness, or despair.
  • Expressing a lack of or loss of hope.
  • Anxious or agitated feelings.
  • Feelings of rage or uncontrolled anger, or seeking revenge.
  • Dramatic mood changes.
  • Acting recklessly or engaging in risky activities, seemingly without thinking.
  • Feelings of being “trapped,” like there’s no way out.
  • Increasing alcohol or drug use.
  • Being unable to sleep, or sleeping all the time.
  • Seeing no reason for living or having no sense of purpose in life.
  • Giving away possessions.
  • Making concerning statements like, “I just can’t take it anymore,” “All of my problems will end soon,” or “No one can do anything to help me now.”

If you or someone you know is showing one or more of these signs, get help immediately.

What Can I Do to Prevent Suicide?

The goal of suicide prevention is to recognize warning signs, reduce risk factors, and increase protective factors that may help promote life during a crisis.

“I tell people to trust their gut,” Jeffrey says. “If you notice something, that’s an indicator. It can be a lot of different things, but often, it’s associated with some type of change.”

If you notice a change that concerns you, that may be an opportunity to ask someone how they’re doing and a gateway to ask about suicide.

You can support family and friends with mental health and substance abuse disorders. Encourage them to get help before a suicidal crisis arises.

To learn more about taking action and helping people in crisis, visit the “Be the 1 To” campaign website from the National Suicide Prevention Lifeline. The five action steps for communicating with someone who may be suicidal are supported by evidence in the field of suicide prevention.

Crisis and Support Resources

If you are concerned about someone, it’s OK to ask if they are suicidal or having thoughts about killing themselves. If they say yes — or if they say no and you are still concerned — stay with them and reach out for help.

There are multiple resources you can contact:

  • Crisis Text Line: Text “START” to 741-741.
  • Trevor Lifeline (for LGBTQ+ youth): 1-866-488-7386.
  • resolve Crisis Services (Allegheny County): 1-888-796-8226.
  • National Suicide Prevention Lifeline: 1-800-273-8255.
  • Disaster Distress Hotline: 1-800-985-5990.
  • Veterans Crisis Line: 1-800-273-8255 and select option 1.
  • Emergency: 911.

The Crisis Training Institute at UPMC Western Psychiatric Hospital offers ASIST (Applied Suicide Intervention Skills Training) and other training programs.

It’s important to continue to show support to people who are experiencing suicidal thoughts, Jeffrey says. Continued support will show them you’re still there for them.

“You never know what might be that proverbial ‘straw that broke the camel’s back,’ where we find ourselves in need of support,” Jeffrey says. “Having someone who’s compassionate, empathetic, and caring on the other end, who’s willing to take the time to notice and ask, I think really goes a long way in reducing the risk of suicide and the public health epidemic that’s happening in our community right now.”

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.