4 Signs Indicating Thoughts of Suicide

4 Signs Indicating Thoughts of Suicide

Understanding Suicide

Suicide often has no single cause, rather thoughts of suicide appear from a culmination of adverse life experiences that influence one another. Such adverse experiences can be viewed as “risk-factors” that influence an individual’s worldview and perspective and may lead to thoughts of suicide. Some risk-factors associated with thoughts of suicide are adverse childhood experiences such as chronic poverty, food and housing insecurity, experiencing family violence, underlying mental health conditions and/or substance abuse, as well as physical, sexual, and emotional abuse. 

Adverse childhood experiences are not the only factor contributing to an individual’s probability of developing thoughts of suicide. Suicide often develops from feelings of hopelessness, lack of healthy coping skills when facing challenging life circumstances, and experiencing one or more mental health conditions such as depression, anxiety, posttraumatic stress, and other psychiatric disorders. 

Suicide is a Reality

In 2019, the Bexar County Medical Examiner’s Annual Autopsy Report documented 261 deaths by suicide. Data published on February 2021 by the Center for Disease Control and Prevention reports there were 3,891 deaths by suicide in Texas in 2019. National data provided by the National Institute of Mental Health cites suicide as the 10th leading cause of death in the United States, with a total of 47,511 deaths by suicide in 2019. This all-to-real mental health issue is preventable by understanding key elements in recognizing persons experiencing thoughts of suicide. 

4 Signs Indicating Thoughts of Suicide

Fortunately, there are universal signs to recognize when an individual is experiencing thoughts of suicide. These signs are the indicators that signals an individual is experiencing difficult thoughts and emotions and may be thinking about suicide. Discussing these difficult thoughts and emotions openly, honestly, and free of judgement increases the likelihood of identifying a person struggling with suicide. Let’s review the four elements. 

Words. The first element are the words expressed by an individual with possible thoughts of suicide. Words are often the first indicator that someone is struggling with difficult emotions, thoughts, or circumstances. Examples of these words (or phrases) may sound like:

  • “All of my problems will end soon”
  • “No one can do anything to help me”
  • “Now I understand what they were going through”
  • “I just can’t keep going on like this”
  • “I am a burden to everyone”
  • “I can’t do anything right”
  • “I can’t think clearly anymore”

Feelings. Words often have an emotion attached to them—listening to the words (or phrases), spoken by an individual experiencing thoughts of suicide, with empathy—helps identify their current emotional state. The second element, emotional state or feelings, can often be described as:

  • Desperate 
  • Angry
  • Guilty
  • Worthless
  • Lonely
  • Sad
  • Hopeless
  • Helpless

Physical. The third element to be aware of in a person experiencing thoughts of suicide in addition to thoughts (words) and feelings are physical symptoms. Physical symptoms are some of the visible indicators signaling that something is wrong. Changes in behaviors can manifest as follows:

  • Lack of interest in appearance
  • A change or loss in sex interest
  • Disturbed sleep
  • A change or loss of appetite and/or weight
  • Physical health complaints

Actions. Behaviors are the fourth element and perhaps the most visible indicator that signals someone may be struggling with thoughts of suicide. The following behavior changes are some of the actions taken by someone thinking about suicide:

  • Giving away possessions
  • Withdrawal from friends, family, school, or work 
  • Loss of interest in sports, hobbies, leisure, or activities once found enjoyable
  • Misuse of drugs or alcohol 
  • Impulsive or reckless behavior
  • Self-mutilation
  • Extreme behavior changes

The Big Ask: “Are You Thinking About Suicide”

Now that we examined the four recognizable elements involved with thoughts of suicide, you may be asking yourself, “What can I do?” The first step in assisting a person with thoughts of suicide is to make a connection by discussing their experience and exploring their current situation. 

That may sound something like this:

“I hear your pain when you talk about struggling with your situation right now. That you feel worthless and sad, and that you can’t keep going on like this…”

This statement reflects back what an individual with thoughts of suicide has disclosed to you and lets the person know that you are listening to what they have to say. The next step is to ask about suicide.

Asking about suicide can be a terrifying experience. One may feel as if they are crossing a line and that the other person may become offended. In my experience, this is not the case. Two scenarios often unfold when I ask about suicide openly. The first, they may say, “no.” The second is, they may say, “Yes,” and often times feel relieved to be opening up about their experience. So how does one approach the big ask gently? 

It may sound like this: 

“I hear your pain when you talk about your struggles with your situation right now. That you feel worthless and sad, and that you can’t keep going on like this. Given what I know about people struggling with life’s challenges and what you told me about not being able to keep going on like this. I have to ask: Are you thinking about suicide.”

After the big ask, the possibility of receiving a suicide endorsement becomes reality and even though it is a frightening reality, you have taken the biggest step to helping a person thinking about suicide. Stay with them! 

Turn to Safety and Seek Professional Help

Continue listening to their story and their experience. Chances are there may be uncertainty about their choices or options available to them, they may be hopeful for something (things to change, future possibilities, etc.), or they may reject the notion of suicide altogether for personal reasons (religious beliefs, social responsibility, against their values) and just feel so much pain that suicide becomes passing thoughts they struggling with frequently. 

Turning to safety when the individual expresses uncertainty about their choices, hope, or rejects suicide as an option, or voices their willingness to get help is the key to preventing suicide. Partner with the person experiencing thoughts of suicide and plan to keep them safe by removing possible means to suicide (e.g., firearms, drugs). Ways to enhance safety is by providing ongoing social support (with the individual’s consent, letting another trusting person know what they are going through and asking them to help keep them safe), agreeing to seek help from a mental health professional or seeking emergency assistance by calling 911, if needed. 

Help is available and suicide is preventable. If you or someone you know is experiencing thoughts of suicide, call the National Suicide Prevention Hotline at 1-800-273-8255, or text “HOME” to 741741 to speak with a trained professional.


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