• Within this article, we are referring to suicide in the conventional sense, in which someone plans out or acts upon self-destructive thoughts and feelings, often while they are experiencing overwhelming stress.
• Suicide is the third leading cause of death for adolescents and young adults from age 15-24.
• Suicide victims under the age of 30 are also more likely to have dual diagnoses (a combination of a mental illness and a substance abuse disorder), impulsive and/or aggressive behavior disorders, and legal problems than people over 30 who commit suicide.
• Older Caucasian males (85 years or older) committed suicide at the highest rate of any age group.
• Whites and Native Americans (especially adolescents) have the highest suicide rates than any other ethnic group in the US. In addition, the rate of suicide among young African American males has been steadily increasing.
• Men are more likely to commit suicide than women and men are more likely than women to use highly lethal methods to commit suicide.
• Women are more likely than men to attempt suicide.
• Living alone and being single both increase the risk of suicide. Marriage is associated with lower overall suicide rates; and divorced, separated and widowed people are more likely to commit suicide.
• Being a parent, particularly for mothers, appears to decrease the risk of suicide.
• The Rocky Mountain and Western states have the highest rates of suicide in the U.S.
• Suicide rates are higher in rural areas.
• Industrialized countries generally have higher rates of suicide than non-industrialized countries.
• Religiosity seems to have a protective effect against suicide.
• Unemployment is associated with increased rates of suicide.
• Sixty percent of all suicides are committed by people with mood disorders.
• Approximately 30% of suicides are committed by people who have psychiatric disorders other than mood disorders.
• There is a significantly higher rate of suicide among people who abuse alcohol and/or drugs.
• People who have access to firearms are more likely to commit suicide.
• Emotional insults, such as rejection, public humiliation or shame, may be experienced as painful enough by some people to push them towards suicide.
• Significant grief and loss can also be associated with suicidality.
• People with a family history of suicidal behavior are more likely to attempt or commit suicide.
• People who were abused or neglected as children have a higher risk of suicide than others.
• Victims of domestic violence are at higher risk of suicide than people who have not had this experience.
• People involved in, or arrested for, committing crimes are at higher risk of committing suicide than other people.

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• Suicidal thoughts and behaviors start when vulnerable individuals encounter stressful events, become overwhelmed, and conclude that suicide is the only reasonable way (given their very likely biased way of thinking) to stop the pain they are experiencing.
• Both negative and positive events can be sources of significant stress.
• The most frequent stressful event leading up to suicide in the US today is mental illness, which is estimated to account for about 90 percent of all suicides.
• Depression is the most common mental illness in people who commit suicide.
• Individuals with anxiety disorders may feel overwhelmed, ashamed, or frustrated that they are unable to control their symptoms. Many individuals with severe anxiety symptoms also become socially isolated and/or try to relieve their feelings by using alcohol and/or other substances. These features of anxiety disorders can lead someone to attempt or commit suicide.
• Individuals with PTSD have the highest rate of suicide when compared to all other anxiety disorders. 4 to 10% of people with schizophrenic disorders commit suicide.
• Between 4 and 8% of people with a personality disorder complete suicide, and approximately 40 to 90% have attempted suicide.

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• Having suicidal thoughts is the most important and most common warning sign for suicidality.
• If you/someone regularly focuses on themes of suicide or death in conversation (e.g., talking about giving up on life, or how others would be better off without you), thinking, writing, music or artwork, the person may be at risk.
• Additional warning signs of suicide can include:
• decreased performance in school or work
• an unusual desire for social isolation
• a significant decrease in self-esteem
• increased emotionality (expressed as anger, agitation, anxiety, hopelessness, sadness, or similar emotion)
• a sudden decrease in emotionality; particularly, a movement from depression or agitation to remarkable and uncharacteristic calm
• uncharacteristic behaviors or emotions
• uncharacteristic carelessness concerning personal safety
• increased drug and/or alcohol use
• losing interest in things that someone used to enjoy
• failing to take prescribed medications or follow required diets
• preparing for death by getting one's affairs "in order"

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• If you are presently assembling the means of your own death, the time to go to the hospital so as to prevent yourself from killing yourself is now.
• You need a safe environment to be in for a while where you can be protected from acting upon suicidal urges.
• You may also benefit from medication to calm you, help you sleep or to serve as an anti-depressant.
• Most acute suicidal urges pass, or at least decrease in urgency, after a period of time has gone by, so if you can hold out and not act, there is a very good likelihood that you will shortly feel better.
• It is much easier to hold out and not attempt suicide if you are hospitalized in an environment designed to keep you safe, than if you are out and about in your normal environment.
• Unless you have pre-existing arrangements set up already with a therapist or doctor, the only surefire way to get the care and safe environment you need is to go to a local Emergency Room (ER).
• Go to the hospital immediately if you are acutely suicidal. Recruit a friend to take you if you cannot get yourself there safely.
• As a last resort, you should call the emergency operator who can dispatch an ambulance or police officers to your location. This can be a rather expensive way to go, but if it is the only reasonable way to get yourself to the hospital, then don't let the expense get in your way.
• It may cross your mind to call an emergency telephone crisis line and this is a good idea if you are just feeling vaguely suicidal and want human contact with someone who can help you work through your thoughts.
• If you are acutely and dangerously suicidal, however, calling a crisis line is not the best thing to do, as it will distract you from getting the hands-on assistance you need.

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• Continue to practice your newly-learned problem solving and adaptive coping skills.
• Go back to your psychotherapist if you need a "tune up" and you find yourself sliding backward into old, negative habits.
• Consider joining a support group and/or using the Internet to remind yourself that you are not alone, obtain new ideas for coping with difficult times, and reach out to other people who need assistance.
• Keep a copy of your anti-suicide plan handy.
• Identify your triggers and develop a list of preventative strategies.
• Follow through with referrals to other resources, such as a substance abuse program or rehabilitation program to help you address addiction issues.
• If you are suicidal and own guns, take steps to get those guns out of your house so that they cannot tempt you.
• Alter the components of your environment that are stressful (as much as possible).
• Reconnect with family and friends who you find supportive to be around, and ask them for help before your next suicidal crisis gets out of hand.
• Make use of crisis telephone hotlines and online support communities.

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• You can help interrupt and help disarm any active suicide attempts and defuse the danger of the immediate crisis situation.
• You can help the suicidal person get connected to a mental health professional who can offer him or her effective support and intervention.
• You can provide ongoing support and "cheerleading" as the person participates in treatment, practices new methods of coping and continues on with the often stressful business of day to day living.
• You must keep in mind that stress effects each person differently, and that just because you might be able to handle something doesn't mean that everyone else can too with similar ease.
• Do what you can to put judgment aside and simply act compassionately.
• Try to provide true assistance by helping the suicidal person find the professional help that he or she needs in order to safely resolve the crisis.
• Having an honest and open conversation about your concerns with regard to medication safety, storage and proper use may help.
• Be sure to remove guns, knives and other lethal weapons from the suicidal person's house or otherwise secure guns and weapons in a manner that makes it inconvenient for the potentially suicidal person to get at them.
• You can help the suicidal person to anticipate likely suicide triggers.
• You can watch for new signs of suicidal thinking (e.g., a suicide relapse), or watch for a worsening of someone's level of suicidality.
• It is also important to keep in mind that despite your best efforts; no matter how helpful and loving you are toward suicidal people, they still may feel badly about themselves and their situation, and they may still ultimately take their life.

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• Suicide goes way beyond the pain of the suicidal individual and affects all of the people who care about or who depend upon that suicidal person.
• If you are trying to help a suicidal person to feel better, odds are that you yourself will have a difficult time as well.
• If you have recently lost someone to suicide, odds are that you will be devastated or at least experience a grief reaction for some time.
• Don't underestimate the emotional impact on yourself of the work you do to support someone through a suicidal crisis.
• You may end up feeling angry, guilty, helpless or depressed yourself in the wake of a suicide attempt or a completed suicide.
• You may benefit from speaking with a therapist so as to help work through your powerful emotional reactions.
• Take care to balance the effort you put into supporting the suicidal person with the demands of keeping your own family and work commitments running, and supporting and nurturing your own mental health.
• Don't try to be the sole support for a suicidal person. Instead, enlist the help of competent others around you who can share the load.
• If the situation requires professional intervention, then go about arranging for that professional intervention and do so without feeling guilty.
• While you may need to over-extend yourself during the immediate crisis, don't try to operate that way for an extended period. Make it a priority to recover your normal rhythms as soon as you can.

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