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Suicidal Thoughts or Threats
Suicide is a leading cause of death for people in most age groups. But often people who seriously consider suicide don't really want to die. They may think that suicide is the only way to solve their problems and end their pain.
People who have suicidal thoughts may not seek help because they feel helpless, hopeless, or worthless. These feelings may come from having a mental health problem, such as depression. These problems can be treated. It's important to seek help when suicidal thoughts occur. With treatment, you can feel better.
Many people have fleeting thoughts of death. These are less of a problem and are different from actively planning to try suicide. The risk of suicide is higher if someone often thinks about death and killing themself or if they have made a suicide plan.
If someone talks about suicide, self-harm, or feeling hopeless, get help right away. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Or text HOME to 741741 to access the Crisis Text Line.
Who's at risk
Most people who seriously consider or attempt suicide have one or more of the following risks:
- A personal history of suicide attempts
- A family history of suicide attempts or completed suicide
- A personal or family history of severe anxiety, depression, or other mental health problem, such as bipolar disorder or schizophrenia
- A drug or alcohol problem (substance use disorder)
The chance of suicide is most serious when a person has a plan for suicide that includes:
- Having the means available to try suicide or to harm another person, such as weapons or pills.
- Having set a time and place to try suicide.
- Thinking there is no other way to solve the problem or end the pain.
People who consider suicide often are undecided about choosing life or death. With compassion and support, they may choose to live.
The warning signs of suicide may change with age. For example:
- In children and teens, they may include the recent breakup of a relationship.
- In adults, they may include a recent job loss or divorce.
- In older adults, they may include the recent death of a partner or being diagnosed with a life-limiting illness.
Don't be afraid to talk to someone if you're worried about them. Talking about suicide may actually help to prevent suicide.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
The risk of a suicide attempt is highest if:
- You have the means to kill yourself, such as a weapon or medicines.
- You have set a time and place to do it.
- You think there is no other way to solve the problem or end the pain.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
The National Suicide Hotline 1-800-273-8255 is also a resource.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
The National Suicide Hotline 1-800-273-8255 is also a resource.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
If you're thinking about suicide, it can help to talk to someone about your feelings. It may not be easy to reach out for help, but it's so important. We all need support from time to time, and there are people who want to help.
Consider talking with:
- A trusted family member, friend, or spiritual advisor.
- A health professional, such as your doctor or counselor.
- Other mental health resources, such as a community mental health agency or employee assistance program.
- A local or national suicide hotline. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Or text HOME to 741741 to access the Crisis Text Line. Think about saving these numbers in your phone.
Family and friends: How to help
You may be able to help someone who is thinking about suicide.
If the person has a plan to harm themself or someone else:
- Call 911 or the police. For advice, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or text HOME to 741741 to access the Crisis Text Line. Consider saving these numbers in your phone.
- Consider your own safety. If you feel safe, stay with the person, or ask someone you trust to stay with them, until help arrives.
- Talk about the situation as openly as possible. Tell the person that you don't want them to die or to harm another person.
- Show understanding and compassion. Don't argue with the person or deny their feelings. Arguing with the person may only increase their feeling of being out of control of their life.
If you think that someone you know is thinking about suicide, encourage them to get counseling.
- You could offer to help them find a therapist. One resource you could try is the National Alliance on Mental Illness (NAMI) website: www.nami.org/help
- You may be able to help the person get to their appointment. You can even offer to go to the sessions if they want you to.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- The suicide threat seems real, with a specific plan and the means at hand.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: June 16, 2021
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
David Messenger MD - Emergency Medicine, Critical Care Medicine