Dealing With The Risk Of Suicide

Revised: May 21, 2014

By: Michael G. Conner, Psy.D

Patients, family, friends, and health care professionals should always be concerned and compassionate when the possibility of suicide is raised. Suicide can be the result of untreated depression, traumatic experiences, health problems, an injury, or a subtle buildup of events that are stressful or tragic.  Suicidal feelings, thoughts and behavior are almost always associated with symptoms of depression, anxiety or the result of medical problems involving a chemical imbalance.  Understanding more about suicidal thoughts, feelings and behavior is the first step in knowing when to seek help.

Why Do People Commit Suicide?

Several thousand articles and books have been written about the cause and prevention of suicide. For the purpose of understanding, and not research, there are essentially five reasons why people attempt suicide. Understanding these reasons can help you recognize the risk of suicide.

  • Change: Suicide is way to change how the person feels or what is happening in their life or at that moment.
  • Choice: To assert or make a choice during circumstances in which there are no choices or important choices are being taken away.
  • Control: The suicidal act is meant to stop the person’s behavior, to control events or to effect some change in others.
  • Self Punishment: Suicidal behavior is a means to relieve guilt or punish the person for their actions.
  • Punish Others: The suicidal act is intended to inflict harm or punishment on others.
  • Psychotic Illness: The suicidal act is the result of strange and bizarre beliefs that are caused by a mental illness or a severe medical problem.

Critical Suicide Risk Factors

  • Wishing you didn’t exist.
  • Thinking you would like to go to sleep and not wake up.
  • Dwelling on death.
  • Thinking or feeling you would be better off dead.
  • Thinking about suicide or feeling suicidal.
  • Making plans or thinking about plans to commit suicide.
  • Recent suicidal, dangerous or self-harming behavior.

Contributing Risk Factors That Can Cause Suicidal Behavior

  • Alcohol or other drug abuse.
  • Impulsivity or changes in usual behavior.
  • Explosive episodes of anger.
  • Over generalizing, irrational or "all or none" thinking.
  • Depression or worsening depression.
  • Isolation and withdrawal.
  • Feelings of rejection, helplessness or hopelessness.
  • Giving away important belongings.
  • A deep sense of loss or abandonment.
  • Anniversary or recent death of a parent, spouse, relative or friend.
  • Unusual behavior and pre-existing depression.
  • Marital or parental separation or divorce.
  • Loss of friends, relationships or people who are emotionally important.
  • Efforts to obtain or ask for help have been unsuccessful.
  • History of psychiatric problems.
  • Chronic illness or severe impairment in health in past year.
  • Poor communication and inability to resolve conflicts in the home, at work, with peers or friends.
  • Background in armed services, military or police work.
  • Parent, sibling or loved ones committed suicide.
  • Loss or potential loss of ability to met obligations.
  • Loss or potential loss of standing or reputation.

Information And Steps That Can Help

  • Suicidal thoughts, feelings and behaviors should not be ignored or minimized.
  • The presence of any Critical Suicide Risk Factors represents a potential emergency until that person is evaluated by a qualified mental health professional or crisis intervention specialist.
  • Contact a crisis intervention professional or qualified health care professional if you, or someone you know, may be suicidal.
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  • Recognizing the signs of suicide risk will help you know when to seek help and what to say.
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  • If you are feeling suicidal, or know someone who may be suicidal, the best choice is to seek competent help. 
  • Asking a friend, or family member if they are suicidal, and doing so in a caring and confidential manner does not cause people who are not suicidal to become suicidal.
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  • It is always appropriate to seek advice, an evaluation and to develop a plan for treatment when you or another person may be suicidal.
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  • Reducing stress and resolving conflicts in a positive manner, as well as accepting and communicating support, hope and confidence will help - but that is not a permanent solution.
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  • Evaluation and treatment for known or suspected drug and alcohol abuse is a critical part of prevention and treatment.
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  • It is always appropriate to establish a mutually agreed upon plan with a health care professional as well as other caring and responsible people.  The plan should be able to manage and deal with any increase or reoccurrence of suicidal thoughts, feelings or behavior.
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  • When the risk of suicide becomes critical, it is appropriate to get immediate professional assistance.