8 Signs Someone Is At Risk

What to watch for

By Sarah Klein
Suicide and suicidal thinking are more widespread than you might think. According to the results of a government survey released in September 2009, roughly 8.3 million adults—or about 3.7% of the population age 18 and older—had "serious thoughts of suicide" in 2008.

It can be hard to identify suicidal thinking in a loved one; there is no foolproof checklist to follow. But here are some warnings signs that might mean they are at risk.

Talking about suicide

If someone you know is talking about harming himself or says that he doesn't want to live, take it seriously.

He may be at risk for a suicide attempt, particularly if he feels trapped or hopeless and is withdrawing from friends and family.

Don't leave that person alone, let him know you're going to get help, and call 1-800-273-TALK to be connected to a crisis center, says the National Suicide Prevention Lifeline.

A bipolar or depression diagnosis

The painful symptoms of conditions such as depression and bipolar disorder can drive people to consider suicide.

"Depression is the leading illness for suicide, so the deeper the depression gets or the longer it goes on, the more discouraged the person experiencing it feels," says Paula Clayton, MD, the medical director of the American Foundation for Suicide Prevention.

In bipolar disorder—a condition in which bouts of depression are interspersed with periods of mania—suicide risk may be higher when the person is depressed.

Feelings of guilt

Madelyn Gould, PhD, a professor of clinical epidemiology in psychiatry at Columbia University Medical Center, in New York City, says that excessive and inappropriate feelings of guilt—a common symptom of depression and anxiety—are something to be on the lookout for as well.

"You start to feel guilty about things—letting people down—and someone else who's listening would say, 'But you're not,'" says Gould. "It's just this very unrealistic guilt."

Drinking or drug use

Drug use and excessive alcohol use—which some agitated and anxious people turn to for relief—are warning signs for suicide, says Dr. Clayton. "You might not be an alcoholic or a drug abuser, but if you take things to make yourself feel better or to numb you, that makes you more vulnerable because it impairs your judgment and makes your thinking not as clear," she says.

Substance use can also contribute to impulsivity, Dr. Clayton adds. Studies have shown that up to 80% of all suicide attempts are done on the spur of the moment, with very little planning.