Some of us are very aware when a friend or family member is experiencing a mental health crisis and/or suicidal ideation, while others are taken by surprise to find out a friend or loved one has been struggling. Just as we strive to reduce the stigma for those who are suffering, we must not blame or shame ourselves or others for not seeing these signs. In order to best support those around us, we all need to learn to recognize and discuss concerns or red flags when we see them.
Signs someone may be experiencing suicidal ideation can include a change in language, behavior, or emotional states. These behaviors or changes individually do not necessarily indicate suicidal ideation, but they should be taken seriously. They might indicate something is wrong and may even be signs of suicidal ideation. You know your loved ones best, and it is always wise to consult a professional if you have concerns. Following are some common warning signs that may indicate suicidal thoughts:
People who are struggling may or may not talk explicitly about taking their own lives. Concerning language includes the expression of hopelessness, apathy (lack of interest or enthusiasm), feelings of unbearable pain, extreme emotions, or regret, or the wish not to be a burden on others.
Those experiencing suicidality may behave in ways that are or seem to be out of character. For example, they may start to use or begin misusing substances, they might spend more money than they have or they might eat more than usual. Within their communities or with their loved ones, they may withdraw from others or increase contact or dependency with those they think can help. They may stop engaging in activities they previously enjoyed, or they might start to say goodbye to friends and give away favored possessions. They may become aggressive or appear tired all the time, and they may have significant changes in sleep patterns.
Someone experiencing suicidal ideation may become more depressed and anxious, experience uncontrollable anger and irritability, or lose interest in things they have always cared about. They may feel significant shame about any of these feelings or the above behaviors or thoughts. Conversely, a person who has been depressed and is suddenly more energetic might also be at risk.
These warning signs can be indicators of suicidality but also of related or separate challenges or stressors, such as a new or untreated physical or mental health challenge, significant life changes like divorce or loss of financial stability, traumatic experiences such as abuse or harassment, etc. We often don’t know everything that contributes to an individual’s mental health challenges.
What we have been calling “warning signs” or “red flags” can also be called “risk factors,” defined as something that increases the chance that someone is more adversely affected by a challenge.
Risk factors that may contribute to depression or suicidal ideation include:
- Previous suicide attempt
- Mental and/or physical health diagnoses, chronic pain or illness
- Access to lethal means, e.g., firearms or drugs in the home
- High-stress occupations
- Financial or job insecurity, e.g., lower pay, layoffs, or decreased hours
- Prolonged and pervasive stress
- Sudden stressful or traumatic events
- Suicide loss in the family or of friends
- Substance use disorder
- Adverse childhood experiences, such as abuse or neglect
- Social isolation
- Lack of access to appropriate mental and physical health care
- Legal challenges
- Societal oppression, current and historical, of marginalized people and bodies
We also know some of the protective factors that may help protect people from suicidal behaviors or attempts. Just as risk factors add to the chance someone will be adversely affected by a challenge, protective factors decrease these chances. Protective factors include both internal resources and family and community supports, such as:
- Access to effective mental and physical health care
- Close connections with, and support from, friends, family, and community
- Skills for coping, distress tolerance, and problem-solving
- Safe space where there is no access to weapons or lethal substances
- Encouragement from one’s religious, cultural, and/or social community to seek help
- A strong sense of purpose