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Suicidal Thoughts or Threats

Topic Overview

Suicide occurs almost twice as often as murder. Each year, about 36,000 people in the United States die by suicide. In the U.S.:1

  • Suicide is the 10th leading cause of death.
  • Suicide is the third leading cause of death for people ages 15 to 24 and the second leading cause for people ages 25 to 34.
  • Suicide rates have increased for middle-aged and older adults. One suicide death occurs for every 4 suicide attempts.
  • Women try suicide more often, but men are 4 times more likely to die from a suicide attempt.
  • A gun is the most common method of suicide.

Many people have fleeting thoughts of death. Fleeting thoughts of death are less of a problem and are much different from actively planning to commit suicide. Your risk of committing suicide is increased if you think about death and killing yourself often, or if you have made a suicide plan.

Most people who seriously consider suicide do not want to die. Rather, they see suicide as a solution to a problem and a way to end their pain. People who seriously consider suicide feel hopeless, helpless, and worthless. A person who feels hopeless believes that no one can help with a particular event or problem. A person who feels helpless is immobilized and unable to take steps to solve problems. A person who feels worthless is overwhelmed with a sense of personal failure.

Most people who seriously consider or attempt suicide have one or more of the following risks:

The warning signs of suicide change with age.

Anytime someone talks about suicide or about wanting to die or disappear, even in a joking manner, the conversation must be taken seriously. A suicide attempt—even if the attempt did not harm the person—also must be taken seriously. Don't be afraid to talk to someone you think may be considering suicide. There is no proof that talking about suicide leads to suicidal thinking or suicide. Once you know the person's thoughts on the subject, you may be able to help prevent a suicide.

People who have suicidal thoughts may not seek help because they feel they cannot be helped. This usually is not the case. Many people with suicidal thoughts have medical conditions that can be successfully treated. People who have suicidal thoughts often have depression or substance abuse, and both of these conditions can be treated. It is important to seek help when suicidal thoughts occur because medical treatment usually is successful in diminishing these thoughts.

The possibility of suicide is most serious when a person has a plan for committing suicide that includes:

  • Having the means, such as weapons or medicines, available to commit suicide or do harm to another person.
  • Having set a time and place to commit suicide.
  • Thinking there is no other way to solve the problem or end the pain.

People who are considering suicide often are undecided about choosing life or death. With compassionate help, they may choose to live.

Check your symptoms to decide if and when you should see a doctor or get other help.

Check Your Symptoms

Are you concerned that you or someone you know is thinking about suicide?
Yes
Suicide concern
No
Suicide concern
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Yes
Suicide risk
No
Suicide risk
Have you recently tried to commit suicide?
Yes
Recent suicide attempt
No
Recent suicide attempt
Are you thinking about suicide but do not have a plan?
Yes
Considering suicide but does not have a plan
No
Considering suicide but does not have a plan
Have you been thinking about death or suicide a lot?
Yes
Frequent thoughts of death or suicide
No
Frequent thoughts of death or suicide
Do you think that someone you know has made suicide plans?
Yes
Concern about someone who may have suicide plan
No
Concern about someone who may have suicide plan
Is a concern about abuse causing feelings of anxiety or depression?
Yes
Concern about abuse causing feelings of anxiety or depression
No
Concern about abuse causing feelings of anxiety or depression
Are you concerned about self-harm?
It can include acts like cutting, burning, or choking yourself on purpose, or pushing objects under your skin (like pieces of metal, glass, or wood). People doing these acts usually are not trying to kill themselves, but the results can still be dangerous.
Yes
Concerns about self-harm
No
Concerns about self-harm
Are you worried that feelings of depression or thoughts of suicide are not going away?
Yes
Feelings of depression or thoughts of suicide not going away
No
Feelings of depression or thoughts of suicide not going away

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

The risk of a suicide attempt is highest if:

  • You have the means to kill yourself, such as a weapon or medicines.
  • You have set a time and place to do it.
  • You think there is no other way to solve the problem or end the pain.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Home Treatment

If you are thinking about suicide, talk to someone about your feelings. It is important to remember that there are people who are willing and able to talk with you about your suicidal thoughts. With proper treatment, most suicidal people can be helped to feel better about life.

People for you to consider talking with include:

  • A family member, friend, or spiritual adviser.
  • Your health professional, such as a doctor or counselor.
  • Other mental health resources, such as a community mental health agency or employee assistance program.
  • Your local suicide hotline or the national suicide hotline: 1-800-273-TALK or 1-800-273-8255. You can also find information at www.suicidepreventionlifeline.org.

Tips for family and friends

You may be able to help someone who is considering suicide.

  • If the suicide threat seems real, and the person has a specific suicide plan:
    • Call 911 (or the police if 911 is not available) in order to prevent the person from carrying out the threat.
    • Consider your own safety. If you are in a safe environment and the person will not harm you:
      • Stay with the person, or ask someone you trust to stay with the person, until help arrives.
      • Don't argue with the person or make statements like "It's not as bad as you think," and don't challenge the person by saying "You're not the type to commit suicide." Arguing with the person may only increase his or her feelings of being out of control of his or her life.
      • Talk about the situation as openly as possible. Tell the person that you don't want him or her to die or to harm another person. Show understanding and compassion.
    • If you think that someone you know has made a suicide plan, call your health professional.
      • Your health professional may be able to help identify a mental health specialist and arrange an appointment for a person you think is considering suicide. An appointment with your health professional may not be needed.
      • If you are not able to talk with your health professional, call your local suicide hotline or the national suicide hotline: 1-800-273-TALK or 1-800-273-8255. You can also find information at www.suicidepreventionlifeline.org.
      • Once a treatment plan has been developed, you may be able to assist the person get the help he or she needs.

Symptoms to watch for during home treatment

Call your doctor if any of the following symptoms occur before you see your health professional:

  • The warning signs for the suicide threat, such as having a plan for committing suicide, are real.
  • Symptoms become more severe or frequent.

Prevention

Suicide can be prevented. While some suicides occur without warning, most do not. You can learn to recognize the warning signs of suicide and take action when the signs are present. Take action to evaluate your suspicions if you think that someone you know is considering suicide.

  • The warning signs of suicide change with age. Know the warning signs of suicide:
  • Take all warning signs seriously, even if the suicidal threat or attempt seems minor. Take any conversation about suicide seriously, even if the person mentions it in a joking manner.
  • Don't be afraid to ask "What is the matter?" or bring up the subject of suicide. There is no proof that talking about suicide leads to suicidal thinking or suicide.
  • Be willing to listen. If a family member, friend, or coworker talks about suicide or wanting to die or disappear, even in a joking manner, the conversation must be taken seriously. Once you know the person's thoughts on the subject, you may be able to help prevent a suicide.
  • Help the person make arrangements to see a doctor or mental health professional immediately.
    • Since a suicidal person may feel he or she cannot be helped, you may have to take an active role in finding a health professional and getting the person to the appointment.
    • If you are unfamiliar with mental health resources in your area, a doctor, counselor, community mental health agency, local suicide hotline, or the national suicide hotline (1-800-273-TALK or 1-800-273-8255) may be able to help identify a health professional. You can also find information at www.suicidepreventionlifeline.org.
    • Make sure the person will have someone with him or her at all times until contact is made with a mental health professional.
    • Help the person identify other potential sources of support from people who care about him or her, such as family, friends, or spiritual adviser.
  • Follow up to find out how the person's treatment is going. A suicidal person may be reluctant to seek help and may not continue with treatment after the first visit with a health professional. Your support may help the person decide to continue treatment.
  • Remove all guns from the home. Guns are the most common method used. Studies have shown that suicide attempts are more likely to lead to death in homes that have a gun, even if the gun is kept unloaded and securely locked up.
  • Discard all prescription and nonprescription medicines that are not currently being used.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

  • How long have you had suicidal thoughts?
  • How often do you think about committing suicide?
  • What was going on in your life when you first noticed the depressed or suicidal feelings?
  • Have you ever had similar thoughts in the past? If so, did you seek and receive treatment?
  • Have you attempted suicide in the past? If so, did you seek and receive treatment?
  • Have you ever been diagnosed with a mental health problem, such as severe anxiety, depression, or schizophrenia?
  • Has a family member or close friend ever attempted or committed suicide?
  • Has anyone in your family ever been diagnosed with a mental health problem, such as depression or schizophrenia?
  • Have you had a recent stressful event in your life?
  • Do you keep guns in your home?
  • Are you a regular or heavy user of alcohol or illegal drugs? Have you used alcohol or illegal drugs to reduce symptoms of depression?
  • Are you taking any prescription or nonprescription medicine? If so, make a list of your medicines and take it with you.
  • Are you taking a medicine to treat depression? What is the medicine? When did you start the medicine?
  • Do you have any risk factors that make you more likely to have suicidal thoughts?

Other Places To Get Help

Organization

National Suicide Prevention Lifeline
Phone: 1-800-273-TALK (1-800-273-8255)
TDD: 1-800-799-4TTY (1-800-799-4889)
Web Address: www.suicidepreventionlifeline.org
 

The National Suicide Prevention Lifeline is a 24-hour, toll-free suicide prevention service. Crisis centers are located in 130 locations across the United States. Each caller is routed to the closest provider of mental health and suicide prevention services.



References

Citations

  1. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (2012). Suicide: Fact sheet. Available online: http://www.cdc.gov/ViolencePrevention/suicide/index.html.

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer David Messenger, MD
Last Revised November 27, 2012

Last Revised: November 27, 2012

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