Recognizing the Warning Signs of Suicide and How to Respond Effectively

John Rossi
Sep 13
4 min read

According to the Centers for Disease Control and Prevention's FastStats on Suicide and Self-Inflicted Injury, the United States recorded 49,316 suicide deaths in 2023, marking a mortality rate of 14.7 per 100,000 population and positioning suicide as the 11th leading cause of death nationwide. Firearms emerged as the predominant method, accounting for 27,300 fatalities at a rate of 8.2 per 100,000, followed by suffocation with 12,023 deaths (3.6 per 100,000) and poisoning with 5,944 deaths (1.8 per 100,000). These figures, drawn from the National Vital Statistics System – Mortality Data via CDC WONDER, underscore the urgent need for prevention efforts, especially as emergency department visits for self-harm injuries reached 616,000 in 2022, highlighting the broader crisis in mental health support.

September is National Suicide Prevention Month, a time dedicated to raising awareness about mental health and the critical role we all play in supporting those who may be struggling. Suicide is a leading cause of death worldwide, but it's preventable with early recognition and appropriate intervention. By understanding the warning signs and knowing how to respond, you can make a life-saving difference for someone in crisis. This blog draws on evidence from reputable sources like the National Institute of Mental Health (NIMH), the American Foundation for Suicide Prevention (AFSP), and others to provide comprehensive guidance.

Understanding the Warning Signs of Suicide

Warning signs are often the first indicators that someone may be considering suicide. These can manifest in what a person says, how they behave, or changes in their mood. It's important to note that these signs are especially concerning if they are new, have intensified recently, or are linked to a painful event, loss, or change in life circumstances.

What They Might Say (Talk)

People at risk may express their distress verbally. Common statements include:

Talking about wanting to die or kill themselves.
Expressing feelings of hopelessness, having no reason to live, or being a burden to others.
Mentioning feeling trapped, unbearable pain, great guilt, or shame.

Changes in Behavior

Behavioral shifts can signal imminent risk, particularly if they involve planning or preparation:

Making a plan or researching ways to die, such as searching online for methods.
Withdrawing from friends, family, or activities; isolating themselves.
Giving away important items, saying goodbye to people, or making a will.
Taking dangerous risks, like reckless driving.
Increased use of alcohol or drugs.
Displaying extreme mood swings, aggression, or fatigue.
Changes in eating or sleeping patterns (too much or too little).

Mood and Emotional Changes

Emotional warning signs often accompany mental health struggles:

Feeling empty, hopeless, trapped, or extremely sad.
Being more anxious, agitated, full of rage, or experiencing unbearable emotional or physical pain.
Showing depression, anxiety, loss of interest, irritability, humiliation, shame, or sudden relief/improvement (which can indicate a decision has been made).
Preoccupation with death, including in writing or artwork.

These signs don't always mean someone is suicidal, but they warrant attention.

Research shows that most people who die by suicide exhibit one or more warning signs beforehand, often communicated to others.

Risk Factors That Increase Vulnerability

While warning signs indicate immediate risk, certain risk factors can heighten the overall likelihood of suicidal thoughts or attempts. These include:

Health Factors: Mental health conditions like depression, anxiety, bipolar disorder, or substance use disorders; chronic pain or traumatic brain injury.
Environmental Factors: Access to lethal means (e.g., firearms or drugs); prolonged stress from bullying, unemployment, or relationship issues; exposure to others' suicides.
Historical Factors: Previous suicide attempts, family history of suicide, or childhood trauma.

Recognizing these in combination with warning signs can help prioritize support.

How to Respond Effectively: Step-by-Step Guidance

If you notice warning signs, act promptly—your intervention could save a life. Contrary to common myths, talking about suicide does not plant the idea in someone's mind; in fact, it can reduce risk by opening up dialogue. Here's an evidence-based approach based on NIMH's 5 Action Steps and additional expert recommendations.

The 5 Action Steps (NIMH)

Ask Directly: Start the conversation by asking, "Are you thinking about suicide?" or "Are you considering harming yourself?" This shows you care and opens the door for them to share. Studies confirm this doesn't increase suicidal thoughts.
Be There: Listen without judgment. Acknowledge their pain and let them know they're not alone. Simply being present and empathetic can help reduce suicidal ideation.
Help Keep Them Safe: If they have a plan, remove access to lethal means (e.g., secure firearms or medications). Ask about their plan and collaborate on immediate safety measures.
Help Them Connect: Guide them to professional help. Call or text the 988 Suicide & Crisis Lifeline together, or connect with a mental health provider, trusted friend, or family member.
Follow Up: Check in after the initial crisis. Ongoing support, like a phone call or visit, is crucial for prevention and recovery.

Additional Do's and Don'ts

Do: Stay calm, take their concerns seriously, trust your intuition, and provide resources. Encourage professional help and consult others if needed (e.g., a counselor).
Don't: Ignore signs, leave them alone, minimize their feelings, promise confidentiality (if safety is at risk), judge them, or argue about their emotions. Avoid endangering yourself—call emergency services if necessary.

If the situation is urgent (e.g., they have a plan and means), call 911 immediately.

Resources for Immediate and Ongoing Support

988 Suicide & Crisis Lifeline: Call or text 988, or chat at 988lifeline.org. Available 24/7 for confidential support.
National Suicide Prevention Lifeline (legacy): 1-800-273-TALK (8255).
Crisis Text Line: Text HOME to 741741.
For Veterans: Veterans Crisis Line at 1-800-273-8255 (press 1).
For LGBTQ+ Youth: The Trevor Project at 1-866-488-7386 or text START to 678678.
Mental Health Services Locator: Visit samhsa.gov/find-help or nimh.nih.gov/health/find-help.

Conclusion

Recognizing warning signs and responding with compassion and action can prevent tragedy. Remember, you're not expected to be a professional—just a caring individual who takes the first step. If you're struggling yourself, reach out; help is available. Let's commit to fostering open conversations about mental health this September and beyond. Share this post to spread awareness, and together, we can build a more supportive world.