Recognizing signs and risk factors to prevent suicide
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Suicide is a devastating crisis that affects thousands of individuals and families each year, but through awareness, understanding, and action, lives can be saved. September is Suicide Prevention Awareness Month and EVMS Medical Group health professionals want to share key signs, risk factors and support channels.
According to the Centers for Disease Control and Prevention (CDC), suicide is the 10th leading cause of death in the United States. In 2022, more than 49,000 people died by suicide.
Experts say thoughts about suicide, often start small with comments such as, "I wish I wasn’t here" or "Nothing matters," but over time, they can become more dangerous and explicit. “It's crucial to understand and identify the warning signs of suicide,” says David Spiegel, MD, the Anne Armistead Robinson Chair in Psychiatry, and Chair of Macon & Joan Brock Virginia Health Sciences Psychiatry and Behavioral Sciences at Old Dominion University. “Some of the warning signs include increased use of alcohol and drugs, withdrawal from loved ones, aggressive behavior, dramatic mood swings, and reckless or impulsive actions.”
Dr. Spiegel says the following behaviors may indicate immediate danger and should prompt urgent intervention:
- Collecting and saving pills or buying a weapon
- Giving away possessions
- Organizing personal papers or tying up loose ends
- Saying goodbye to friends and family
- Often talking or writing about death, dying or suicide
- Making comments about being hopeless, helpless or worthless
- Expressions of having no reason for living; no sense of purpose in life; saying things like "It would be better if I wasn't here" or "I want out”
- Increased alcohol and/or drug use
- Withdrawal from friends, family and community
- Reckless behavior or more risky activities, seemingly without thinking
If these signs appear, experts advise seeking the help of a mental health professional to assess the situation.
Risk factors
CDC research shows that 46% of individuals who die by suicide had a known mental health condition, but many other risk factors can contribute. “A family history of suicide, substance use, intoxication, chronic medical conditions, access to firearms, and prolonged stress or trauma all increase the risk of suicidal thoughts and behaviors.” Dr. Spiegel says. According to the CDC, around one in five people who die by suicide had alcohol in their system at the time of their death, highlighting the role intoxication can play in this crisis.
Support in a crisis
When someone is experiencing a suicide-related crisis, loved ones are often unsure of how to respond. The behaviors of a person in crisis can change unpredictably, making it essential to approach them with care and understanding. The National Alliance on Mental Health (NAMI) offers several recommendations for providing support, such as talking openly and honestly about their thoughts, asking direct questions like, "Do you have a plan?" and calmly offering assistance in contacting a mental health professional.
“Be patient, express support and concern, and avoid arguing or raising your voice,” NAMI advises. Removing potential means of harm, such as firearms, knives, or stockpiled medications, is another key step in reducing risk. “It’s important to treat a mental health crisis like any other health emergency, acting quickly and effectively,” says Dr. Spiegel.
For those struggling with suicidal thoughts daily, Dr. Spiegel says fostering an open, nonjudgmental dialogue can be lifesaving. “Active listening techniques, like reflecting their feelings, can help your loved one feel heard and validated.” He adds that mental health professionals are trained to help individuals recognize unhealthy thinking patterns and learn positive coping strategies.
If you or someone you know is struggling with suicidal thoughts, reach out for help. The Suicide & Crisis Lifeline at 988 is available 24 hours a day to offer support. To make an appointment with Dr. Spiegel or one of the mental health professionals at Macon & Joan Brock Virginia Health Sciences EVMS Medical Group at Old Dominion University Department of Psychiatry & Behavioral Sciences call 757-446-5888.