Suicide is the tenth leading cause of death in the U.S., and while some demographics suffer are more likely to commit suicide, no type of person is immune to the risk. Suicide is closely related to mental health conditions, particularly major depression, to substance abuse and addiction, and to experiencing something extremely stressful, either once or repeatedly.

Signs that someone is suicidal should always be taken seriously. A person struggling with suicide can get help from their doctor, at the emergency room, or through a hotline or crisis center, like the National Suicide Prevention Line, available 24 hours a day, seven days a week at 1-800-273-TALK (8255).

Facts about Suicide in the U.S.

Across all age groups and demographics in the U.S., suicide is the tenth leading cause of death. More than 44,000 people die each year from suicide, and for every death from suicide there are 25 unsuccessful attempts at suicide. This amounts to 121 suicides per day across the country. The highest rates of suicide deaths are seen in middle aged populations, especially white men.

Montana, Alaska, and Wyoming have the highest suicide rates. Suicide rates are lowest in Maryland, New Jersey, and New York. Nearly half of all suicides are committed with guns. While the number of suicide deaths among males is higher, females attempt suicide three times as often. Women tend to use methods like pills, which may be reversible with emergency treatment, while men tend to use more permanent methods, like guns.

Although teenage suicide is a problem, people under the age of 20 have the lowest suicide rates overall, followed by people between the ages of 20 and 34. The second highest suicide rate is in people over 85. Teens have a lower number of suicide deaths than elderly or middle-aged Americans, but they make more suicide attempts. In terms of ethnicity, Native Americans have the highest rates of suicide, followed by Caucasians.

Suicides on the Rise

Perhaps the most troubling of all facts about suicide is that it is on the rise. The suicide rate in the U.S. has been steadily increasing for more than ten years. In some demographics, such as black men, suicide is down. In others it keeps going up. This includes kids, girls between 10 and 14, middle-aged men, and all racial groups other than black men. Some explanations include economic stagnation, antidepressants that can trigger suicidal thoughts in young people, and lack of health insurance or good mental health care. The last is especially important because recognizing and treating mental illnesses significantly reduces the risk of suicide.

What Causes Suicide and Suicidal Thoughts?

There is no single cause for suicide, but there are many known risk factors. For instance, struggling with a mental health condition, like depression or anxiety, increases the risk of suicide. This is especially true if the condition is not being treated. Other risk factors include experiencing chronic pain, having a substance use disorder, having a family history of suicide, experiencing family violence or abuse, having guns in the home, having been recently released from prison, and experiencing the suicidal behaviors of a friend or family member.

Signs of Suicidal Thoughts

Any sign of suicidal thoughts should be taken seriously and should be considered a potential sign of suicidal actions. In other words, if someone is thinking about suicide, he or she may actually make an attempt and it is important to take action before it is too late. It can be very difficult to recognize the seriousness of these signs in oneself, which is why it is so crucial to look out for them in others, and to intervene if needed. Signs of suicidal thoughts include:

• Any talk about wanting to die or make a suicide attempt or about being a burden.
• Making any kind of plan, including internet searches for suicide methods.
• Using more drugs or alcohol than usual.
• Buying a gun or hoarding pills.
• Sleeping more or less than usual.
• Unusual behaviors or moods, like being anxious, depressed or agitated.
• Behaving recklessly.
• Withdrawing from activities and loved ones.
• Talking about taking revenge.
• Showing signs of extreme anger.
• Saying goodbye or putting affairs in order, such as giving away possessions.

Some signs that you may be feeling suicidal include the above, but also:

• Going through extreme mood swings.
• Feeling like a burden to your loved ones.
• Feeling like there is no way out, trapped.
• Feeling hopeless and empty.
• Feeling like there is no reason to keep living.
• A preoccupation or obsession with death, dying, and violence.

Medications and Suicide

Prescription antidepressant medications help many people every day, including those that struggle with serious depression and are at risk for suicide. But these medications, paradoxically, may also trigger thoughts of suicide and suicidal behaviors. Studies and adverse event reports have found that antidepressants, including Celexa, Cymbalta, Effexor, Lexapro, Paxil, Prozax, and others, can cause suicidal thoughts and actions in people under the age of 25.

The risk is serious enough that it warranted a black box warning label on all antidepressants, as mandated by the U.S. Food and Drug Administration. The label warns about this risk and urges doctors to only prescribe these medications to children and teens for whom other treatments for depression have not worked. Unfortunately, before the label was added, the medications were prescribed to many children and thousands were put at risk of suicide.

Prevention and Treatment

Treating mental illness is a very important way to prevent suicide, but it is also a treatment. Mental illness may be one of the underlying reasons for suicidal thoughts. Getting an accurate diagnosis from a professional and undergoing treatment can prevent suicide. Treatment of the mental illness is also very important after someone survives an attempted suicide. Treatment may include various types of therapy and medications. Also important are support from family and friends, support groups, learning better coping skills, and treating an addiction if necessary.

How to Help

If you suspect that someone you know is having suicidal thoughts, do not hesitate to act. Many people do hesitate because they are afraid they are wrong, they don’t want to embarrass someone, or because they don’t know what to do. Ultimately, if you feel unable to help, contact someone else who can help, such a closer family member, a respected adult like a teacher, or a professional.

To help, the first and most important thing you can do is speak up. Start a conversation and let the person know that you care and that you are concerned. Ask questions, be prepared to listen, and tell this person that you are there and prepared to help. What is not useful is to lecture this person, get angry, offer fixes, or promise you won’t tell anyone. Offer resources that can help this person you are worried about, and if you feel he or she is in immediate crisis, get help, calling 911 if necessary.

Resources for Help

Sometimes the best thing anyone can do is either reach out for help or offer help. For someone who is struggling with thoughts of suicide, there are plenty of resources. If you know someone who may need help, have these resources on hand. Loved ones, no matter how much they care, are limited in their ability to help someone who is suicidal. The people standing by on help lines and at help centers are trained and can provide the kind of help that you may not be able to give. Here are some resources that save lives:

• National Suicide Prevention Lifeline. 1-800-273-8255. This is a national network, but one made up of local crisis centers staffed by caring people trained to help those who are having suicidal thoughts. The line is open and there are people available to talk 24 hours a day and seven days a week.
• Crisis Text Line. Text CONNECT to 741741. This is another free and confidential service that is available 24 hours a day and seven days a week. This may be a good option for someone who is not yet ready to actually talk to someone.
• Suicide Prevention Resource Center (SPRC). sprc.org. The SPRC encourages those who need help to call the National Suicide Prevention Lifeline, but also provides a variety of online resources and information.
• National Hopeline Network. 1-800-SUICIDE (784-2433). This free and confidential service will connect you to resources for getting treatment for mental illness or substance abuse and addiction, 24 hours a day, seven days a week.
• The Trevor Project. 1-866-488-7386. The Trevor Project specifically offers support to LGBTQ youth and offers crisis intervention and suicide prevention services 24 hours a day, seven days a week.
• SAMHSA National Helpline. 1-800-662-HELP. (4357). The Substance Abuse and Mental Health Services Administration offers free and confidential 24/7 help for anyone who need referrals for substance abuse or mental health interventions.

Some experts say that suicide is reaching epidemic levels in the U.S. Unfortunately there is no magic cure for suicide or one thing that can prevent it, but there are many things that individuals can do to help themselves or others. Be aware of the signs of suicidal thoughts, know the resources, and be prepared to reach out to either offer help or receive help.