Over the last two decades, suicide rates have risen alongside related mental disorders, include depression. Naturally, this has raised concerned for both individuals and loved ones. Throughout this article, we’re going to dive into how you can prevent suicide and the treatment options available.

Suicide Statistics

Since the COVID-19 pandemic, suicide rates among youth have significantly increased. ¹ The same was concluded since the rise in online social networking. ²

When we look at suicide statistics, we get an idea of who’s most effected by this condition:

• Men account for 75% of all suicides. While more women attempt suicide, men are 4 times more likely to die by suicide. ³

• Suicide is the second leading cause of death among individuals aged 10-34, and the fourth leading cause of death for those aged 35-54. ⁴

• Since 2001, the overall suicide rate in the U.S. has risen by 31%. ⁵

• 46% of individuals who die by suicide had a diagnosed mental health condition. Still, research indicates that 90% of all suicides experienced symptoms. ⁶

• American Indian/Alaska Native adults are 20% more likely to commit suicide than non-Hispanic white adults. ⁷

• Lesbian, gay, and bisexual youth are four times more likely to attempt suicide compared to their straight peers. Transgender individuals are 12 times more likely to attempt suicide than the general population. ⁸

• 4.3% of young adults reported having suicidal thoughts in the past year. ⁹

Suicidal Warning Signs

The warning signs for suicidal ideation include: ¹⁰

• Aggressive behavior
• Collecting and saving pills or buying a weapon
• Dramatic mood swings
• Giving away possessions
• Increased alcohol and drug use
• Impulsive or reckless behavior
• Saying goodbye to friends and family
• Tying up loose ends, like organizing personal papers or paying off debts
• Withdrawal from friends, family, and community

Suicidal behaviors are a psychiatric emergency. If you or a loved one starts to show signs of suicide, seek immediate help from a health care provider or call 911.

If you’re unsure, we recommend contacting your healthcare provide. You can also use Know the Signs, an interactive tool that educates you on the signs of suicidal ideation.

Suicidal Risk Factors

Nearly half of people who commit suicide have a known mental health condition. On top of that, 90% all suicide cases show signs of a mental illness. With that, suicidal risk factors include: ¹¹

• Access to a firearm.
• Family history of suicide or other mental disorder. ¹²
• Gender – men are 4 times more likely to die by suicide.
• History of trauma or abuse.
• Intoxication – more than 1 in 3 people who commit suicide are under the influence. ¹³
• Loneliness (and living alone).
• Prolonged stress.
• Recent tragedy or loss.
• Severe chronic mental illness.
• Substance abuse (some drugs can worsen suicidal thoughts). ¹⁴
• Unemployment.

What Can You Do if You Feel Suicidal?

If you feel suicidal, it’s important to seek help immediately. You’re not alone in your struggle and there are many resources available, both online and in-person. Through these resources, you have the option to confidentially share your feelings with others and be led towards the right treatment path.

If you feel you might be at risk of harming yourself and can’t ensure your safety, please go to the nearest emergency room or call 911 for assistance without delay.

If you can ensure your safety, we recommend the following resources:

• The 988 Suicide & Crisis Lifeline features trained crisis workers avalable to talk and help you 24/7.

• If you feel more comfortable communicating through text, you can reach out to Crisis Text Line. Just text home to 741741 and you will be connected with a volunteer crisis counselor. This service is 100% free and confidential.

• If you want more information on this topic, Speaking of Suicide is a resource that provides personal accounts from individuals, their loved ones, and survivors.

Other resources that may help include:

• American Association of Suicidology
• My 3
• Now Matters Now
• The Buddy Project

What Can You Do if a Loved One Feels Suicidal?

If someone you know is in immediate danger of harming themselves or others, please act quickly by taking them to the nearest emergency room or calling 911 for assistance.

If you have a loved one in a suicide-related crisis, it’s naturally to feel unprepared and unsure.
The actions of someone going through a crisis can be erratic, shifting suddenly and without forewarning. However, there are a few ways you can approach this situation:

• Have an open and honest discussion. Don’t hesitate to ask specific questions, such as “Do you have a plan for how you would kill yourself?”
• Remove items from your loved one’s household that can inflict suicide (i.e. guns, knifes, pills, etc.).
• If multiple people are around, ensure each person speaks separately.
• Show concern and support.
• Avoid engaging in arguments, making threats, or raising your voice.
• If you’re feeling anxious, attempt to refrain from fidgeting or pacing.
• Be patient.

Suicide needs to be addressed immediately. While there are no instructions for how you should go about this, there are ways to mitigate your loved one’s pain.

If you have a loved one that struggles with suicidal ideation, let them know you are a safe space to talk to and express what they’re going through. Attempt to adopt and open and compassionate conversation with your loved one. Avoid arguing and really try to listen to what they tell you.

It’s also beneficial to remind them that there are professional resources to help them overcome suicidal ideation.

Psychotherapy for Suicide

Suicidal ideation is often addressed through therapy. In most instances, just having someone to talk to and work out your emotions can make all the difference. The most common types of therapy include:

Cognitive Behavior for Suicide Prevention (CBT-SP/CT-SP)

This therapy sees problematic coping behavior as the primary issue with suicide. Therefore, it’s also the main target for treatment (rather than a specific symptom of a disorder).

The treatment primarily aims to prevent future suicidal crises. It involves assisting individuals in altering their responses to automatic thoughts and breaking negative thought-behavior-mood patterns, leading to personal transformation. The treatment comprises three phases: acute, skill-building, and continuation following the acute phase. ¹⁵

Strategies for CBT-SP include:

• Considering the pros and cons of decisions to improve decision-making
• Developing a Hope Kit filled with reminders of their personal reasons for living
• Monitoring activities to work towards activities and actions that make life better
• Restructuring thinking, especially in suicidal crises
• Use of Coping Cards to serve as reminders of helpful strategies and thoughts in a crisis

Dialectical Behavior Therapy (DBT)

This therapy centers around interactions between the environment and basic biological functions that revolve around emotional regulation and behavioral control. The idea is in emotional situations, opposite perspectives compete. DBT seeks to conform those opposing perspectives and allow for less emotional reactivity and better understanding. ¹⁶

These dialectics encompass situations like problem-solving versus accepting a problem, self-improvement versus accepting oneself as is, regulating emotions versus experiencing them fully, meditation versus taking action, and balancing independence with acknowledging dependency at times.

The goal is to create a life worth living. To strengthen skills, learn new ones, and develop better relationships with those around you. DBT has had a lot of success, especially in suicidal individuals who struggle with borderline personality disorder (BPD). ¹⁷

Prolonged Grief Therapy (PGT)

Previously known as Complicated Grief Therapy, PGT aims to help you process grief after you’ve experienced death of a loved one. While grief is a natural part of the healing process, it’s possible to get “stuck” in its intensity. ¹⁸ This can result in a lack of interest in activities you once enjoyed and social isolation. As such, it can lead to suicidal ideation.

PGT directly targets prolonged grief symptoms, using a variety of techniques and strategies. These include: ¹⁹

• Addressing trauma associated with loss
• Balancing grief, adjusting to loss, coping, and personal life goals
• Information about normal and prolonged or complicated grief
• Restoration

Medication for Suicide

If you have a severe case of suicide or an identifiable mental illness, you may be recommended medication. The most common for suicide prevention include:

Lithium

As one of the oldest treatments in modern psychiatry, lithium can help prevent suicide in the long-term treatment of depression and mood disorders (i.e. bipolar disorder). However, lithium may lead to severe side effects and needs to be closely monitored by medical professionals. ²⁰

Clozapine

As of this time, clozapine is the only medication the Food and Drug Administration (FDA) approves for suicide risk reduction. While it’s primarily used to treat schizophrenia patients, many medical professionals believe it’s being underutilized. ²¹

Ketamine

While ketamine is still being investigated for its long-term effects, research has found it can rapidly reduce depressive symptoms and suicidal thoughts. Currently, esketamine is approved by the FDA for treatment-resistant depression. ²²

Antidepressants

If you struggle with anxiety or depression, you may be recommended antidepressants. These have been found to reduce suicidal rates in the general population. However, in some instances, antidepressants may increase the chance of suicide. ²³

References

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² Memon AM, Sharma SG, Mohite SS, Jain S. The role of online social networking on deliberate self-harm and suicidality in adolescents: A systematized review of literature. Indian J Psychiatry. 2018 Oct-Dec;60(4):384-392. doi: 10.4103/psychiatry.IndianJPsychiatry_414_17. PMID: 30581202; PMCID: PMC6278213.

³ River J, Flood M. Masculinities, emotions and men’s suicide. Sociol Health Illn. 2021 May;43(4):910-927. doi: 10.1111/1467-9566.13257. Epub 2021 Mar 10. PMID: 33751613.

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⁷ Stone D, Trinh E, Zhou H, Welder L, End Of Horn P, Fowler K, Ivey-Stephenson A. Suicides Among American Indian or Alaska Native Persons – National Violent Death Reporting System, United States, 2015-2020. MMWR Morb Mortal Wkly Rep. 2022 Sep 16;71(37):1161-1168. doi: 10.15585/mmwr.mm7137a1. PMID: 36107803; PMCID: PMC9484806.

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