Suicide Warning Signs: How to Recognize Them and What to Do Next

If you're worried about someone you care about, knowing the suicide warning signs can help you act with confidence instead of fear. Suicide is preventable, and you don't need to be a mental health expert to help. You only need to notice when someone is struggling, ask, and help them connect with support.

If you or someone you know is in crisis: call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. Call 911 if there's immediate danger, or text HOME to 741741 to reach the Crisis Text Line. More options are on our crisis resources page.

Key takeaways

• Warning signs usually show up as changes in what a person says, does or feels.
• All talk of suicide should be taken seriously, every time.
• Asking someone directly about suicide does not plant the idea or raise their risk.
• If someone is in immediate danger, stay with them and call 988 or 911.
• Depression and other conditions are treatable, and people can and do recover from suicidal crises.

Understanding suicide risk

Suicide is rarely caused by one thing. It most often happens when stress, loss and health problems pile up and create a sense of hopelessness. Psychological pain can make it hard to see solutions or believe the pain will ever end.

Suicide can affect anyone. In one CDC analysis, more than half of the people who died by suicide did not have a known mental health condition. Some may have had struggles that were never diagnosed. Prevention isn't about being strong or weak. It's about noticing when someone's ability to cope is overwhelmed.

Suicide warning signs to watch for

A change in behavior, or a brand-new behavior, is often the clearest signal. The American Foundation for Suicide Prevention groups warning signs into three areas: talk, behavior and mood.

What they say

All talk of suicide deserves attention. Listen for someone:

• Talking about wanting to die or to end their life
• Saying they feel hopeless, helpless or worthless
• Saying they have no reason to live, such as "It would be better if I wasn't here" or "I want out"
• Talking about feeling trapped or seeing no way out of a problem
• Talking about being a burden to others

Don't dismiss these comments as attention-seeking. The person is telling you they're in pain.

What they do

Changes in behavior can be just as telling. The American Psychiatric Association and other experts point to signs such as:

• Drinking more or using more drugs
• Pulling away from friends, family and activities
• Acting recklessly or taking more risks
• Giving away prized possessions or putting affairs in order
• Looking for ways to end their life, such as searching online
• A sudden lift in mood after a long stretch of depression

That last sign can be confusing. Sudden calm after deep depression can sometimes mean a person has decided to end their life, so it's worth checking in.

How they feel

Emotional warning signs can be subtle but are just as important:

• Deep hopelessness or despair
• Extreme mood swings
• Strong guilt or shame
• Feeling there's no purpose or meaning in life
• Saying their emotional pain is unbearable

Moods can shift quickly. Take any concerning mood seriously, even if the person seemed fine earlier in the day.

Risk factors vs. warning signs

Risk factors are things that raise someone's chances of suicide over time. Warning signs suggest someone may be at risk right now. According to NIMH, most people with risk factors will not attempt suicide, and it's hard to predict who will act on suicidal thoughts.

Common risk factors include:

• Mental health conditions such as depression, anxiety or substance use problems, especially when untreated
• A previous suicide attempt
• A family history of suicide
• A history of trauma or abuse
• Social isolation or little support
• Access to lethal means
• Recent major losses or life changes
• Chronic illness or pain

Risk factors simply help show who may need extra support during hard times.

What to do if someone is in immediate danger

If you believe someone may harm themselves soon, act right away:

1. Don't leave them alone. Stay with them, or call someone who can be with them now.
2. Make the space safer. If you can do so safely, remove firearms, medications and other items that could be used for self-harm.
3. Get professional help. Call or text 988, call 911 if there's immediate danger, or take them to the nearest emergency room.
4. Stay calm and supportive. Your steady presence can help until help arrives.

Things to avoid:

• Promising to keep their suicidal thoughts a secret
• Debating whether suicide is right or wrong
• Minimizing their pain with lines like "You have so much to live for"
• Leaving them alone to "give them space"

How to ask about suicide

Many people worry that asking will put the idea in someone's head. Research shows it doesn't. Asking directly can help someone feel less alone and more willing to get help.

• Be direct: "Are you having thoughts of suicide?"
• Use a calm, caring tone.
• Ask follow-up questions, such as "How long have you felt this way?" and "Do you have a plan?"
• Listen without judgment, and take their answers seriously.

Helpful things to say include "I'm concerned about you," "You're not alone in this," "Your life matters to me" and "Let's find some help together."

Supporting someone after the crisis

Being there isn't about having all the answers. You can:

• Check in regularly, even with a quick text or call
• Help them keep lethal means out of reach
• Help them find professional care, and go with them to appointments if they'd like
• Help them make a safety plan, a written list of steps to take when thoughts of suicide get stronger
• Connect them with support groups or peer support

You can't be someone's only support. Your role is to be a bridge to professional care. This is draining work, so set limits and lean on your own support system.

The role of psychiatric care

Depression is one of the conditions most often linked with suicide, and it frequently goes undiagnosed or untreated. With the right care, most people with mental health conditions can live full lives.

Depending on the person, care may include a psychiatric evaluation, medication management, intensive outpatient programs, or inpatient treatment for severe symptoms. The right mix is different for everyone, which is why careful assessment and follow-up matter. If you're the one struggling, our guide on how to cope with suicidal thoughts walks through steps you can take now.

Frequently asked questions

Does asking someone about suicide put the idea in their head?

No. Asking someone whether they're having thoughts of suicide does not increase suicidal thoughts or the chance they'll act on them. Asking directly can help them feel less alone and more open to getting help.

What if someone asks me to keep their suicidal thoughts a secret?

You can't keep that promise. Let them know you care about them too much to stay quiet and that you want to help them get support. Their safety matters more than keeping a secret.

Can antidepressants cause suicidal thoughts?

The FDA requires a boxed warning on antidepressants because they can increase suicidal thoughts in some children, teens and young adults under 25, mostly early in treatment. This is why close follow-up with a psychiatric provider matters when starting a new medication. For most people, treating depression lowers risk over time, so never stop a medication on your own; talk with your prescriber before making any change.

How do I know if someone is serious about suicide?

Treat every mention of suicide as serious. Even if you think someone wants attention, they're telling you they're in pain and need help. When in doubt, ask directly and connect them with support.

Getting ongoing support in Chicago

If someone you love is struggling, or you are, getting care before a crisis can make a real difference. Our psychiatrist and psychiatric physician assistants offer psychiatric evaluations and medication management in person in Chicago and by telehealth across Illinois. Request an appointment when you're ready, and if anyone is in danger right now, call or text 988 or call 911.