Suicidal Thoughts or Threats

Topic Overview

Suicide occurs almost twice as often as murder. Each year, about 32,000 people in the United States die by suicide. In the United States:¹

• Suicide is the third leading cause of death for people ages 15 to 24 and the second leading cause for people ages 25 to 34.
• A gun is the most common method of suicide.
• Suicide rates have increased for females ages 10 to 19 and males ages 15 to 19.
• Suicide rates have increased for adults older than 65. One suicide death occurs for every 4 suicide attempts.
• Women try suicide more often, but men are 4 times more likely to die from a suicide attempt.

Many people have fleeting thoughts of death. Fleeting thoughts of death are less of a problem and are much different from actively planning to commit suicide. Your risk of committing suicide is increased if you think about death and killing yourself often, or if you have made a suicide plan.

Most people who seriously consider suicide do not want to die. Rather, they see suicide as a solution to a problem and a way to end their pain. People who seriously consider suicide feel hopeless, helpless, and worthless. A person who feels hopeless believes that no one can help with a particular event or problem. A person who feels helpless is immobilized and unable to take steps to solve problems. A person who feels worthless is overwhelmed with a sense of personal failure.

Most people who seriously consider or attempt suicide have one or more of the following risks:

• A personal or family history of suicide attempts
• A family history of suicide attempts or completed suicide
• A personal or family history of severe anxiety, depression, or other mental health problem, such as bipolar disorder (manic-depressive illness) or schizophrenia
• An alcohol or drug problem (substance abuse problem), such as alcoholism

The warning signs of suicide change with age.

• Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.
• Warning signs of suicide in adults may include alcohol or substance abuse, recent job loss, or divorce.
• Warning signs of suicide in older adults may include the recent death of a partner or diagnosis of a life-limiting illness.

Anytime someone talks about suicide or about wanting to die or disappear, even in a joking manner, the conversation must be taken seriously. A suicide attempt—even if the attempt did not harm the person—also must be taken seriously. Don't be afraid to talk to someone you think may be considering suicide. There is no evidence that talking about suicide leads to suicidal thinking or suicide. Once you know the person's thoughts on the subject, you may be able to help prevent a suicide.

People who have suicidal thoughts may not seek help because they feel they cannot be helped. This usually is not the case. Many people with suicidal thoughts have medical conditions that can be successfully treated. People who have suicidal thoughts often have depression or substance abuse; both of these conditions can be treated. It is important to seek help when suicidal thoughts occur because medical treatment usually is successful in diminishing these thoughts.

The possibility of suicide is most serious when a person has a plan for committing suicide that includes:

• Having the means, such as weapons or medicines, available to commit suicide or do harm to another person.
• Having set a time and place to commit suicide.
• Thinking there is no other way to solve the problem or end the pain.

People who are considering suicide often are undecided about choosing life or death. With compassionate help, they may choose to live.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

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Author:	Jan Nissl, RN, BS	Last Updated: December 8, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Lisa S. Weinstock, MD - Psychiatry
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