Patrick M. D'Aliso Foundation
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Warning Signs & Risk Factors




Psychiatric Disorders

At least 90 percent of people who kill themselves have a diagnosable and treatable psychiatric illnesses — such as major depression, bipolar depression, or some other depressive illness, including:

  • Schizophrenia
  • Alcohol or drug abuse, particularly when combined with depression
  • Posttraumatic Stress Disorder, or some other anxiety disorder
  • Bulimia or anorexia nervousa
  • Personality disorders especially borderline or antisocial


Past History of Attempted Suicide

Between 20 and 50 percent of people who kill themselves had previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives.

  • Genetic Predisposition: Family history of suicide, suicide attempts, depression or other psychiatric illness.
  • Neurotransmitters: A clear relationship has been demonstrated between low concentrations of the serotonin metabolite 5-hydroxyindoleactic acid (5-HIAA) in cerebrospinal fluid and an increased incidence of attempted and completed suicide in psychiatric patients.
  • Impulsivity: Impulsive individuals are more apt to act on suicidal impulses.
  • Demographics
    Sex: Males are three to five times more likely to die by suicide than females.
    Age: Elderly Caucasian males have the highest suicide rates.


Suicide Crisis

A suicide crisis is a time-limited occurrence signaling immediate danger of suicide. Suicide risk, by contrast, is a broader term that includes the above factors such as age and sex, psychiatric diagnosis, past suicide attempts, and traits like impulsivity. The signs of crisis are:

  • Precipitating Event: A recent event that is particularly distressing such as loss of loved one or career failure. Sometimes the individuals own behavior precipitates the event: for example, a man's abusive behavior while drinking causes his wife to leave him.
  • Intense Affective State in Addition to Depression: Desperation (anguish plus urgency regarding need for relief), rage, psychic pain or inner tension, anxiety, guilt, hopelessness, acute sense of abandonment.
  • Changes in Behavior:
    - Speech suggesting the individual is close to suicide. Such speech may be indirect. Be alert to such statements as, "My family would be better off without me." Sometimes those contemplating suicide talk as if they are saying goodbye or going away.
    - Actions ranging from buying a gun to suddenly putting one's affairs in order.
    - Deterioration in functioning at work or socially, increasing use of alcohol, other self-destructive behavior, loss of control, rage explosions.




Suicide can be prevented. While some suicides occur without any outward warning, most people who are suicidal do give warnings. Prevent the suicide of loved ones by learning to recognize the signs of someone at risk, taking those signs seriously and knowing how to respond to them.

Warning signs of suicide include:

  • Observable signs of serious depression:
    - Unrelenting low mood
    - Pessimism
    - Hopelessness
    - Desperation
    - Anxiety
    - Psychic pain and inner tension
    - Withdrawal
    - Sleep problems
  • Increased alcohol and/or other drug use
  • Recent impulsiveness and taking unnecessary risks
  • Threatening suicide or expressing a strong wish to die
  • Making a plan:
    - Giving away prized possessions
    - Sudden or impulsive purchase of a firearm
    - Obtaining other means of killing oneself such as poisons or medications
  • Unexpected rage or anger


The emotional crises that usually precede suicide are often recognizable and treatable. Although most depressed people are not suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it is rather expressed as a loss of pleasure or withdrawal from activities that had been enjoyable. One can help prevent suicide through early recognition and treatment of depression and other psychiatric illnesses.


Source: American Foundation for Suicide Prevention