Learn the warning signs that someone may be considering suicide

September is Suicide Prevention Awareness Month. Share the news about 988 - a 24/7 suicide and mental health crisis line available in Illinois, all other states and U.S. territories.

It came out of the blue. 

Sure, they had been going through a rough period, but there was no indication that they would do anything quite so extreme as to take their own life.

Or was there?

Suicide is an enormously difficult subject for us to get our heads around. The severity and finality of the act means that we can tend to deny that it’s even a possibility. Many of us don’t want to even entertain the idea that someone we love would do this. This is part of what contributes to the culture of silence that surrounds the topic.

The result is that, when someone does take their own life, it comes as a shock to their family. As part of the grieving process, it is natural to begin looking back retrospectively to see what they could have done differently. It is only then that they may notice, clear as day, the warning signs that they didn’t want to believe at the time. 

This was Dr Dimple Patel’s experience, a Board Member for American Foundation for Suicide Prevention. In a podcast interview with MHAI, Dr Patel discussed her own experience with loss through suicide after her mother took her own life. 

“It was something I never expected and it was a hard thing to grasp,” she says, before asking herself, “What did I not see?” Almost immediately, however, Dr Patel recognized that “There were signs.” In fact, her family even intervened and had taken her to a doctor.

Dr Dimple Patel holding a picture of her mother, Bhavana

The truth about suicide

According to the World Health Organization, over 720,000 people die due to suicide every year, making it the third leading cause of death among 15–29 year olds. 

In the United States alone, over 49,000 people died by suicide in 2023 in the United States, amounting to a death every 11 minutes. 

Although a substantial portion of suicides occur after warning signs – there were 1.5 million attempts in total in 2023 – many appear to happen out of the blue. As the WHO says, “Many suicides happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, relationship disputes, or chronic pain and illness.”

For this reason, it’s essential to know the warning signs, both big and small, to give you the best chance of identifying the issue and stepping in to help your loved one. 

Warning signs that someone is considering suicide

As Dr Patel says, “and there were signs.” With regard to her mother, Dr Patel recalls that “My mom had anxiety driving. Her behavior had changed. She was anxious a lot, worrying. Worrying about what other people were going to say, related to our family, about random stuff.”

Any one of these may appear inconsequential or even normal. But put together they paint a different picture. The key, as Dr Patel says, is to intervene early. 

“After going to grad school, I know the most important part is intervening early, understanding the signs and symptoms of depression, that someone might be struggling with suicidal ideations and really making an active effort to say something without judging or making comments overall.”

This means that we shouldn’t look at different warning signs as a checklist, waiting until we see something we consider “worrying enough” to take action. As soon as you expect someone may be struggling with suicidal ideation – act. Find a support system.

But what are the clues that someone may be struggling? 

Some of the most common include:

1. Their words.

When someone speaks, believe them. It is common for people who are struggling with suicidal feelings to mention death in various forms. This may be serious or it may be done in a joking or sarcastic fashion. Fans of the chef and travel documentary maker Anthony Bourdain, who ended his life in 2018, may have noticed he would often make apparently light-hearted comments about suicide.

Other common topics for people struggling with these feelings are mentions of feeling guilt or being burdens to others. 

2. Their feelings

Some of this may come from their words, but also try to notice if someone appears sad, dejected, agitated, or full of rage. If they appear to be experiencing extreme emotions of any kind – beyond what is considered normal – it could be a warning sign. 

It is especially important to watch out for a friend or loved one if they appear to be in a good mood after a period of extreme dejection or depression. Sometimes this is a warning sign that they have made their decision and have a plan in place. 

3. Their behavior changes

This is what Dr. Patel cited, saying that the family noticed a distinct change in what was normal for her mother. For Dr Patel’s mother, this manifested as anxiety, but it could take almost any form. 

For some, they begin to take dangerous risks, such as reckless driving, or mood swings where they didn’t use to. Others eat more or less, sleep more or less, or turn to drugs and alcohol as an escape. 

Again, the sign here is based on your knowledge of the person. 

The road to recovery

The road to recovery after a loss is a personal one that requires reflection, outside support, and above all time. One of our contributors Michael Vinton discussed his own experiences in a personal and evocative article after his brother took his own life.

It is not easy. Dr Patel still says that “I think one of the biggest regrets I have was not picking up my phone.” These feelings of what ifs may stay with us for the rest of our lives. 

But that doesn’t mean there isn’t a way forward. Dr Patel has also, importantly, found a way to confront her trauma and come out the other side stronger. 

She says, “I learned to forgive myself for things I didn’t see – or didn’t know. I didn’t know at that point.” 

This is a highly important point that is testament to the journey of healing that she went through, which she attributed largely to therapy. “I ended up falling in love with the process of therapy,” she says. “It gave me an outlet.”

Affected by suicide?

If you are feeling an urge to take your own life, please, before anything else, call the 988 hotline. This suicide and crisis line is available every day of the week, 24 hours a day, either by phone call or via text. It's is available in all 50 states and U.S. territories. Please note that any calls placed in Illinois will be routed to a local or regional center staffed with mental health professionals. 

However, if you aren’t connected immediately, do not hang up as you will be routed to an out-of-state counselor. 

For anyone else who is worried about someone close to them, you can contact Dr Patel’s organization for further support. It is called the American Foundation for Suicide Prevention, and this link will take you to the Illinois chapter.

For any other questions, feel free to contact us directly at MHAI.