How to Recognize the Warning Signs of Suicide and Step In

The CDC puts the annual number of suicide deaths in the United States at more than 45,000. Break that down and it comes to roughly 123 people a day. Numbers that large can feel abstract until the loss lands close to home, and most of us will know someone touched by it. The question that matters is a practical one: when someone in your life is at risk, what can you actually do? A handful of things, it turns out, and none of them require special training.

Prevention starts with noticing. The signs are not always loud. Depression or a low mood that lingers for days or weeks is one. So is a person quietly giving away belongings they once valued. On their own, these behaviors might mean nothing. Stacked together, they deserve your attention. Some people wear their distress openly; others bury it, which is why a single red flag is rarely the whole picture.

Certain groups carry higher risk, and knowing who they are sharpens your instincts. People who are divorced or widowed die by suicide at higher rates than married people, and the end of a relationship, whether a marriage or a live-in partnership, shows up again and again in the histories of those who take their own lives. Among young people aged 15 to 24, suicide ranks as one of the top causes of death, trailing only accidents. Men die by suicide about three times as often as women. People living with clinical depression also sit squarely in the high-risk category. If you or someone close to you is in a dark stretch, that darkness is not something you are expected to climb out of alone.

Substance abuse belongs in this conversation too, alcohol in particular. Drugs and alcohol, prescription medication included, are frequently the method a person reaches for. The relationship runs both directions: using can pull someone down into depression, and depression can push someone toward using. Carolyn C. Ross, M.D., M.P.H., has written in Psychology Today that doctors sometimes overlook suicidal signs in people with addictions, because the substance abuse hides the mental health problem sitting underneath it.

When hopelessness refuses to lift, counseling is one of the more reliable tools available. A counselor gives you a place to pull apart a tangle of emotions you may not be able to sort out on your own. Most insurance plans cover mental health care, counseling included. Seniors can access these services through Medicare, with broader coverage typically coming through Medicare Advantage plans.

If the danger is immediate, speed matters more than anything. Call 911, or reach a local crisis center through the national hotline. If you can get the person to an emergency room or a psychiatric hospital safely, do it. Do not leave someone in crisis by themselves. It also helps to clear the home of anything that could be used in the moment: firearms, knives, drugs. Lock these away if you live with the person. Be particularly watchful with any medication they take regularly, since medication is so often involved.

Even short of a crisis, when the thoughts are only thoughts and the depression has not tipped into immediate danger, help exists. Anyone already in a rehab or counseling program should tell their doctor everything, especially about depression or suicidal thinking. Mental health struggles make recovery harder, and a provider who knows the full story has a better shot at reaching the real source of an addiction.

It is a tangled subject, and no checklist covers every situation. But recognizing the signs changes what you are able to do. You can tell when someone needs help, and you can act in a way that may keep a person alive, yours or someone else's.

- Melissa Howard