Man sitting alone in a chairBefore he died, Bob’s behavior changed. Always proud of his 30-plus year vinyl album collection, Bob started giving away his cherished albums. His friends and I were relieved when the depression that had plagued him, on and off for years, seemed to lift during the last month. He seemed to find a “direction” in his life. What we didn’t know was that Bob was stockpiling his prescription pills before he took the overdose that killed him.

Bob committed suicide last December without leaving a note, or asking for help, or telling any of us how despondent he felt. Or did he? Was his death really the complete surprise we all said it was? Did he actually signal his intentions but we didn’t get the message?

The Centers for Disease Control and Prevention say that more than 41,000 Americans commit suicide every year. All too often, their family, friends and health care providers say they “didn’t see it coming.”

Newer research tells us that people who are thinking about suicide very often signal their intentions or leave behavior clues. If we know what to look for, there’s a good chance we can prevent suicides and help our friends and loved ones get the mental health attention they need.

Mental illness can be fatal. About 90 percent of individuals who commit suicide have a mental illness. In almost half of the deaths from suicide, the person had earlier attempts to end their life.

Take action now

Most suicides are preventable, but immediate action is critical. If you or a loved one are in crisis and need help:

  • Do not leave a person alone if he or she is talking about suicide, is severely depressed, or threatening or actually attempting to commit suicide.
  • Get immediate help at an emergency room or call 9-1-1. If you feel suicidal or hopeless, contact someone or call a suicide prevention hotline.
  • Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). It’s a free call and available 24 hours a day, every day. All calls are confidential and you may call on behalf of someone else.  Their website is
  • Don’t be afraid or hesitant to take action. Research has shown that asking about suicide and encouraging a loved one to seek help do not increase the risk of suicide. Intervening is a courageous thing to do and can prevent a suicide death.
  • Remove their access to firearms or prescription medications.

Watch for these symptoms

The following signs or behaviors may be reason for concern. Do not ignore these signs and hope the mood will pass. This is a crisis and you must take action to prevent a tragedy.

  • Talking about wanting to die or to kill oneself
  • Looking for a way to kill oneself, such as searching online or buying a gun
  • Talking about feeling hopeless or having no reason to live
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Writing or thinking about death
  • Increasing the use of alcohol or drugs
  • Acting anxious or agitated; behaving recklessly or impulsively
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge or other aggressive behavior
  • Displaying extreme or dramatic mood swings
  • Social withdrawal from friends, family and the community

Mental health experts say a person may be in imminent danger of committing suicide if they exhibit these behaviors:

  • Putting their personal, financial and/or business affairs in order
  • Giving away their possessions
  • Saying goodbye to family and friends
  • Mood shifts from despair to calm
  • Planning a suicide by looking for ways to kill themselves, including buying, borrowing or stealing prescription medication, guns, knives, etc.

Who is at risk?

These things can put a person at risk of suicide:

  • Family history of suicide
  • Gender – men are four times more likely to die by suicide, however, more women than men attempt suicide
  • History of trauma or abuse; prolonged stress
  • Substance abuse – about 35 percent of suicide victims are intoxicated when they die
  • Access to firearms
  • Isolation
  • Age – people under age 24 and above age 65 are at highest risk for suicide
  • A recent tragedy or loss
  • Anxiety and/or sleep deprivation

Risk factors for suicide include:

  • Depression and other mental disorders
  • Abuse of and/or addiction to alcohol or drugs, especially prescription medications
  • Access to firearms, especially in the home. Most completed suicides are by firearms and are highly associated with alcohol intoxication or opiate use (heroin, oxycodone, Percocet and other prescription meds)
  • Prior attempts at suicide and/or a family history of suicide
  • Family violence, including physical or sexual abuse
  • Incarceration
  • Exposure to suicidal behavior of family or peers