Sadly, suicide is the 10th-leading cause of death in the United States, and the second-leading cause of death among those aged 10 to 34.1 Suicide impacts not only the person who has taken their life, but all of those they’ve left behind—family members, friends, neighbors, classmates and coworkers. And it’s heartbreaking to know that almost every suicide can be prevented.

Since this can be a difficult subject to discuss, let this be a safe space to explore it further without shame or fear. We encourage you to take as much time as you need to read this article, and learn about the organizations and people you or someone you know can turn to for help.

Signs of suicidal thoughts

How do you know if someone is considering suicide? “Most people who attempt it are internally dealing with conditions such as depression or PTSD,” says Dr. Aron S. Wolf, lead psychiatrist with Teladoc. “The individual may show a change in their behavior. They may become quieter, more withdrawn or even sullen or angry with little or no provocation.”

Some of the warning signs may seem obvious, but others are more subtle. Take a look at the signs2 listed below, split into three categories: talk, behavior and mood.

Talk:
Someone with suicidal thoughts may talk about:

  • Killing themselves
  • Feeling hopeless
  • Having no reason to live
  • Being a burden to others
  • Feeling trapped
  • Being in unbearable pain (emotional or physical)

Behavior:
Someone actively contemplating suicide might act impulsively or recklessly. It might look like:

  • Increased use of alcohol or drugs
  • Looking for a way to end their lives, such as searching online for methods
  • Withdrawing from activities
  • Isolating from family and friends
  • Sleeping too much or too little
  • Visiting or calling people to say goodbye
  • Giving away valued possessions
  • Being aggressive

Mood:
Someone thinking about ending their life might struggle with many overwhelming emotions. These include feeling:

  • Depressed
  • Anxiety
  • Uninterested
  • Irritable
  • Humiliated
  • Agitated
  • Tired

While some of these signs may seem minor and are common with other emotional and mental health conditions, they all deserve attention.

“People didn’t recognize that anything was wrong when I started turning down offers to do things socially,” says Michael, a 31-year-old who once struggled with suicidal thoughts. “Eventually, they stopped asking me to hang out altogether. I called a couple of friends now and then, but for the most part, I remained in isolation on my couch.”

When a friend reached out to him, Michael shared how down he had been feeling. His buddy, who had no idea what Michael was going through, had initially assumed he needed space. He responded by telling Michael how much he and their friends loved and trusted him. “He also suggested that I ‘move a muscle, change a thought.’ So, I got up and took a short walk around the block. For me personally, it was amazing to see how fresh air and a change of scenery could shift my perspective, even just a little,” Michael says.

Every time he felt suicidal, Michael, who was battling a chronic illness when the suicidal thoughts began, followed his friend’s advice to move and change his thoughts. He started to list at least one thing he could be grateful for each day, including that he had a support system of people who genuinely cared about him. “I realized how far off my thinking was when my friends started inviting me to show up just as I was, no matter how sad I felt,” he says. Michael also started thinking about other people who could use a phone call or a quick visit, which helped him get out of his own head. Today he is happily married and thankful that he didn’t take his own life.

How to help someone thinking about suicide

Jennifer’s world was turned upside down when her college-age daughter committed suicide. “I was shocked because we had just talked earlier in the day,” Jennifer remembers, “and she mentioned that she was going to talk with her psychiatrist the next day.” The loss of her daughter devastated Jennifer, her family and her daughter’s soccer team. “To this day, I miss my ‘friend,'” Jennifer says. “When I think of her, I also wonder if I could have helped her.”

Jennifer visited the American Foundation for Suicide Prevention (AFSP) as part of her healing process. She also attended support groups, where she and others shared their stories and helped each other come to terms with their experience.

If you think someone is in danger of committing suicide, AFSP recommends you follow these steps:

  • Take the person seriously. You don’t want to be someone who thought they were simply being dramatic or trying to get attention.
  • Do not leave the person alone. Stay with them and don’t let them out of your sight. If you must leave, ask someone else to come and stay with them before you go.
  • Call the National Suicide Prevention Lifeline at 800-273-TALK (8255). A trained crisis counselor can talk you through what to do until help arrives, or speak directly with the person in crisis. Alternatively, you can text HELLO to the Crisis Text Line at 741741 for free, 24/7.
  • Remove lethal means. Remove firearms, knives, prescription medications and all alcohol from the area.
  • Comfort the person. Do your best to be calm yet caring. Remind them that their suffering is temporary and that they’re not alone.
  • Wait with the person until help arrives. You can also escort them to the emergency room or a dedicated mental health services center.

“Even if they haven’t said anything about suicide, don’t be afraid to ask whether they’ve been thinking about it. Having an honest conversation will help a person in crisis get them the help they need in the moment.” Dr. Aron S. Wolf

How to help yourself if you’re thinking about suicide

First, know that you are worth saving. You’ll probably never fully realize how many people you’ve touched in a positive way throughout your life. You deserve to live—no matter how badly you feel. You are loved and cared for in ways you may not recognize right now.

If you feel you’ve run out of options and taking your life is the only way to resolve a situation or relieve the pain you’re feeling, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (8255) immediately. You can also text HELLO to the Crisis Text Line at 741741. Trained crisis counselors are available to listen to and talk with you without judgment 24 hours a day.

In addition to a hotline or local emergency room, help can come in the form of friends and family staying with you through a critical period. “The situation is almost never as dire or immediate as you may be feeling,” says Dr. Wolf. “If you already have a counselor, contact them to tell them of your concerns or plans.” He also suggests removing any means of committing suicide from your environment “so you’re not tempted to use them impulsively.”

Teladoc confidential counseling is here to help

Whether you suffer from depression or just need to talk with someone about your situation, Teladoc can help. When you reach out to our experienced therapists and psychiatrists, you’ll be met with empathy, compassion, kindness and understanding. Our experts specialize in and support a wide range of needs, and are available for confidential appointments seven days a week, 7 a.m. and 9 p.m. local time.

Find my therapist

Talk to a therapist or psychiatrist of your choice by phone or video from wherever you’re most comfortable. You can work with your chosen expert for as long as you need to.

Follow these steps to get started and have your first visit in as little as three days:

  1. Set up your account and fill out a brief medical history
  2. Choose the expert you think will be the best fit for you
  3. Pick the preferred dates and times that fit your schedule
  4. Meet with your chosen expert and start making progress

Schedule my visit

You are loved and cared for in ways you just may not recognize right now. Our experts are standing by to help you work through whatever is causing you pain.

Learn more at Teladoc.com/therapy, or schedule an appointment now and have your first visit in as little as three days. Teladoc offers online therapy services on your schedule, with experts available to talk by phone or video.

Updated September 7, 2021

SOURCES
1https://www.cdc.gov/nchs/fastats/suicide.htm
2https://afsp.org/risk-factors-protective-factors-and-warning-signs

This portion of the Teladoc website occasionally offers health, fitness, and nutritional information and is provided for educational purposes only. You cannot rely on any information provided here as a substitute for or replacement of professional medical advice, diagnosis or treatment. Teladoc cannot assure that the information contained on this site always includes the most recent findings or developments with respect to the particular subject matter covered.

If you ever have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. Do not disregard, avoid or delay obtaining medical- or health-related advice from your healthcare professional because of something you may have read on this site. The use of any information provided on this site is solely at your own risk.

If you are in the United States and think you are having a medical or health emergency, call your healthcare professional, or 911, immediately.

The COVID-19 pandemic is rapidly evolving. While we are continuously reviewing and updating our content, some of the information in this article may not reflect the most up-to-date scientific information. Please visit the online resources provided by the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and your local public health department to stay informed on the latest news, or reach out to Teladoc to speak with one of our board-certified physicians.