How to Identify Suicide Risk Before It's Too Late

By January W. Payne

Every 17 minutes, someone commits suicide in the United States, according to the U.S. Centers for Disease Control and Prevention. Suicide is the 11th-leading cause of death for Americans, and while it often comes as a surprise to friends and loved ones, it is largely considered to be preventable if warning signs are heeded.

"The tragedy of completed suicide is that most could have been prevented if family members knew what to look for," says Lisa Boesky, a psychologist and author of "When to Worry: How to Tell if Your Teen Needs Help -- And What to Do About It" (AMACON, 2007)

"Research shows that most people who die by suicide have a mood disorder like depression or bipolar disorder, or (have) a substance abuse problem, or both," either diagnosed or undiagnosed, she says.

Suicide has no "face," no race, no age or income level that determines who is at risk. Recent celebrity-related deaths make this clear. Andrew Koenig, 41, an actor who once starred on the TV show "Growing Pains," hanged himself from a tree in Canada last month after battling depression for years. And Marie Osmond's son, Michael Bryan, 18, died after jumping from his Los Angeles apartment building on February 26. A note Bryan reportedly left behind said he'd been dealing with severe depression and alienation.

More than 90,000 people were hospitalized after attempting to take their own lives. The issue is costly in dollars -- $25 billion annually is spent on suicide-related healthcare, funerals, autopsies, investigations, and lost productivity, according to the CDC.

Often, experts say, it's a stressful or negative event that drives a person already struggling with depression to harm himself -- including bad breakups, financial problems, or loss of a job or home. Such events can be a "very high-risk time," Boesky says. So the optimal way to intervene is to encourage a depressed person to get treatment early on.

But because depression can bring a feeling of hopelessness, those affected sometimes don't believe that getting proper treatment will make them feel better, says Jeffrey Borenstein, a psychiatrist and CEO and medical director of Holliswood Hospital, a psychiatric facility in Queens, New York. If people with depression get help, he says, "they can regain their health and live a full, healthy life."

Suicidal Warning Signs

What behavior may indicate a person is at risk for death by suicide? Boesky and Borenstein suggest a number of warning signs, changes in behavior lasting for two weeks or more:

Talk of suicide. If your loved one has talked about suicide or wanting to be dead, don't assume he or she won't follow through. "If someone is using suicidal statements to get attention, it's important to take it seriously because they may really feel suicidal and because the way they're going about getting attention is scary and serious," Boesky says.

It is important to take any mention or indication of suicide seriously. Some warning signs that someone may be at risk for suicide include:

- Talking about wanting to die or feeling hopeless

- Expressing feelings of worthlessness or being a burden to others

- Increased use of alcohol or drugs

- Social withdrawal or isolation

- Giving away prized possessions

- Expressing a lack of interest in the future

- Increased anger or irritability

- Acting recklessly or engaging in risky behaviors

- Changes in sleep patterns, including sleeping too much or too little

- Sudden improvement in mood after a period of depression, which could indicate a person has made a decision to attempt suicide.

Additional risk factors listed by the CDC:

- Family history of suicide

- Family history of child maltreatment

- History of mental disorders, particularly depression

- Feelings of hopelessness

- Impulsive or aggressive tendencies

- Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal dilemma)

- Local epidemics of suicide

- Isolation, a feeling of being cut off from other people

- Barriers to accessing mental health treatment

- Loss (relational, social, work, or financial)

- Physical illness

- Easy access to lethal methods

- Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts

If you or someone you know is exhibiting any of these warning signs, it is important to seek help immediately. Call a crisis line, a mental health professional, or take the person to an emergency room. Suicide prevention is possible with early intervention and appropriate treatment.

"Say, 'I'm concerned about you,' and spell out the reasons: 'You seem to be depressed. You seem to be anxious. I'm concerned that you may have depression, and this is a condition that's treatable, and we need to help you get treatment for it,'" Borenstein says. "Often, family members are hesitant to bring up their concerns. But once they do, people often respond in a positive way."

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