Suicide is the most common mental health emergency and a leading cause of death around the world.

According to the CDC, nearly 46,000 lives were lost to suicide in the U.S. in 2020, the equivalent of a large passenger jet falling out of the sky every day for a year. What’s more, there were an estimated 25 attempts for every completed suicide – 1.4 million total. It is the 12th leading cause of death in the country and the 2nd leading cause of death for people ages 10-34.

And yet suicide is preventable – if the person receives timely support and mental healthcare. Often, family and friends miss the warning signs of suicide or don’t know what to do. Truly, we all have a role to play in learning about suicide prevention. Effective prevention starts with you.

Why do people take their own lives?

Through research, we’ve learned there is no single cause for suicide, and anyone can be at risk. Suicide most often occurs because life stressors, health issues, and social isolation overwhelm one’s ability to cope, creating experiences of hopelessness and despair. Thomas Joiner is one of the foremost researchers on the topic, and he has developed an “interpersonal” theory of suicide (shown below).

The first factor in Joiner’s model is called Thwarted Belongingness. Much research shows that social connectedness and a sense of belonging are essential human needs and that if these needs are unmet to a significant degree, suicidal ideation can develop. These thoughts might be expressed in terms of loneliness, or the absence of mutually caring relationships. Someone might say, “I feel disconnected from others,” “I am alone,” or “There’s no one I can turn to.”

The second factor is called Perceived Burdensomeness. Sometimes, when outward forces impose themselves, one might develop a perception that he/she is a burden on others, like family members. The interpersonal theory emphasizes that people who are suicidal think that they are expendable. If you know someone who has expressed a similar thought, you might have wondered, “How they could think that they are a burden?” The answer: It’s based on one’s perception.

Consider that our entire reality is always subjective and that the world we experience is filtered through our perception, which is informed by our experiences and internal narratives. When those who want to help are confronted by our loved one’s expressions of hopelessness, we need to avoid negating the person’s feelings. We need to listen and validate that person’s feelings. People at risk need to be heard, they need to belong and feel connected, and they need to know that what they have to say is not a burden.

The third factor is the Capability for Suicide. Simply put, suicidal desire is not sufficient by itself because killing oneself is not an easy thing to do. Suicidal behavior is frightening and painful, and since humans evolved with a strong fear mechanism towards survival, the capability for suicide often must be developed. This is done through repeated exposure in which the person gains increased tolerance for pain and reduced fear of death. That’s why the number one risk factor of a lethal suicide attempt is a previous suicide attempt. This is also why firearms are a huge risk factor, because they are quick and lethal, and there’s often no time to turn back.

Suicidal Thinking Patterns

Suicidal thoughts are often ridden with uncertainty. When someone is having suicidal thoughts, they are in a state of ambivalence, and the desire to live or die can fluctuate constantly. Numerous accounts of individuals who survive attempting suicide attest to this. For instance, individuals who survived jumping from the Golden Gate Bridge have reported feeling “instant regret” as soon as they jumped. Ambivalence is present even during an active attempt, so delay and distraction can help get the person out of the tunnel vision that leads to the attempt. Researchers say 10-30 minutes is usually enough to bring the person out of crisis mode.

Warning Signs

With all that said, here are the warning signs to look out for:

Talking about wanting to die — even as a joke
Looking for a way to kill oneself, such as searching online or obtaining a gun
Talking about feeling hopeless or having no reason to live
Withdrawal from friends, family, community, and regular activities
Increased alcohol and drug use
Dramatic mood swings or aggressive/irritable behavior (anger is often a sign of depression)
Risky or reckless behavior (such as driving extremely fast)
Sleeping too much or too little
Giving away possessions and “tying up loose ends” like paying off debts
Saying goodbye to friends and family
Sudden “improvement” – the person may feel relief upon knowing they will be free from pain soon. Genuine improvement is a process that takes time.

Risk Factors

Risk factors are characteristics of a person or their environment that may increase their risk for suicide:

Prior suicide attempt
Mental health disorders, especially depression and other mood disorders
PTSD
Childhood or sexual abuse
Access to lethal means
Misuse and abuse of alcohol or other drugs
Knowing someone who died by suicide, particularly a family member
Death of a loved one
Social isolation
Chronic disease, disability, or terminal illness
Lack of access to mental health care
Stressors that challenge one’s identity, such as divorce or unemployment
Serious financial or legal problems
Stress resulting from prejudice (family rejection, bullying)
The historical trauma suffered by American Indians contributes to a high suicide rate in this population

Protective Factors

Protective factors are those characteristics or interventions that lower a person’s risk:

Feeling connected to family and community support
Limiting access to lethal means, like securing firearms or pills
Proactive mental health care for conditions like depression or support for life stressors
Support for personal loss
Problem solving and coping skills
Self-esteem and a sense of purpose or meaning in life
Cultural and religious beliefs that encourage connecting and help-seeking, discourage suicide, or create a strong sense of purpose.

Continue to Part 2

If you or someone you know needs help, dial 988 for the National Suicide Prevention Lifeline. You can also text HOME to 741741 or visit 988lifeline.org/chat/

Here at Atlanta Wellness Collective, we want to help. To talk to someone or schedule an appointment, please contact us at hello@atlwell.com or request an appointment today.

Disclaimer: This blog is not intended to substitute professional therapeutic advice. Talk with your healthcare provider about your health concerns and before starting or stopping therapies. No content on this site, regardless of date, should ever be used as a substitute for direct professional advice from your doctor or other qualified clinician.

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