What You Can Do to Prevent Suicide

Q: What’s the difference between normal sadness and actual depression?

Dr. Becker: Clinical depression is an illness that follows recognizable patterns. A formal diagnosis of major depressive disorder specifies that a number of symptoms occur every day for at least two weeks. Most prominently, depressed people have little interest in things that used to bring them pleasure, and instead feel despair and hopelessness. Sleep and appetite disturbances are also common.

Certainly not everyone who is depressed will consider suicide, but you must always consider the risk in those with depression.

Q: What can increase someone’s risk for suicide?

Dr. Becker: Suicide risk exists for those with diagnosed mental disorders, including depression and bipolar disease. Substance abuse is also closely tied to suicidal thoughts, as is a family history of attempted or completed suicide.

Suicide risk is also higher when someone has a serious medical history, prolonged pain and major life losses. The risk also increases in people who have a close association with another person’s suicide, and have access to the tools they could use to end their lives.

Q: Is there anything that can reduce suicide risk?

Dr. Becker: Absolutely. Effective care from mental health professionals, possibly including medication, can lower the risk that someone will act on suicidal thoughts.

In addition, having strong ties to family, friends and community can buoy up a depressed person and lessen his or her sense of isolation. Problem-solving skills can also help, and a therapist can help someone build additional skills for coping in tough times.

Q: What are the warning signs of suicide?

Dr. Becker: People who are contemplating suicide often speak out loud about their intentions, declaring their sense of worthlessness or of feeling trapped. Another warning sign is social isolation—avoiding usual activities and withdrawing from friends and family.

Paradoxically, suicidal risk can be highest in people with depression who previously seemed withdrawn and slowed down, but suddenly are more active. Some are preparing—putting their affairs in order or giving away items.

Q: How can a family member or friend help reduce the risk of suicide?

Dr. Becker: Take it seriously. If a loved one mentions suicidal thoughts, believe it. Don’t wait to act.

• If the threat seems imminent, don’t leave the person alone. Call 911 if you need emergency help. Remove any object that could be used—firearms, drugs, sharp objects—if you can do so without endangering yourself. Take the person to a walk-in clinic at a psychiatric hospital or a hospital emergency room. Call the National Suicide Prevention Lifeline at 988.
• If the threat doesn’t seem imminent, take steps to show your love and support. Ask questions. Tell the person of your concern and reassure them that they are not alone. Ask if he has an actual plan for suicide; direct questioning won’t push someone toward suicide if they weren’t considering it. But do not try to argue someone out of their thoughts.
• Encourage professional help. Ask if they are seeing a mental health professional for therapy or medication; if yes, get the name of that person. Urge them to see their therapist or to meet with a new therapist immediately. If you can, help them schedule an appointment—and go with them to the appointment if possible.
• Follow up. A suicidal person needs continued support from friends and family to stay in treatment and track progress. Help the person identify someone who can serve as their primary support. That person needs to encourage taking prescribed medication, watch for side effects, and contact the person’s therapist or prescribing professional if things seem to be getting worse or the person resists taking the medication.

Most people can find effective treatment for depression. With good treatment, many suicides can be prevented.