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Some people find depressive episodes to be so unbearable that they contemplate ending their life as a way to end their suffering. Others consider suicide because they are so riddled with the guilt, stress, or grief that surrounds an event. This is much more common than it should be. Suicide.org cites suicide as the second leading cause of death among college students; the cause of these suicides is often untreated depression.

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What should I do if I’m having suicidal thoughts?

Your life is important. If you are contemplating suicide, please seek help from emergency services or contact the National Suicide Prevention Lifeline as soon as possible. A mental health specialist in your area can be reached at 1-800-273-TALK (8225) any time of day.

You can also turn to friends, family, resident assistants, professors, deans, roommates, classmates, the campus health center, and emergency services. Your support system wants to help you feel better and will withhold judgment. Many people who are considering suicide feel like death is their only option to escape from pain. It’s not. Reach out to loved ones. There is help out there, and they want to help you find it.

What are the signs of suicidal thoughts?

Not everyone considering suicide seeks help, but if you suspect that a friend or loved one is having suicidal thoughts, your intervention could save his or her life. Recognize common signs of suicidal behavior:

• Talking about suicide or death: Your friend might not come right out and say, “I’m thinking about suicide,” although it’s not unheard of. There can be other red flags too, which allude to death and dying. You might hear, “It would be easier if I’d never been born.” Another example is, “No one would notice if I weren’t here.” If you feel upset by any allusion to suicide or death but aren’t sure what to make of it, trust your gut and reach out.
• Talking about unbearable suffering or hopelessness: Constant low self-esteem and persistent emotional pain are unhealthy. Listen to your loved one. Is he or she conveying feelings of worthlessness?
• Seeking out a means to commit suicide: This could include trying to get a gun, rope, knives, or enough pills for a lethal overdose. Intervene as soon as possible by blocking your loved one’s access to drugs and weapons.
• Having a limited view of the future: Take seriously any mysterious comments such as “I’m not sure I’ll be here next year.” If you aren’t sure what your loved one is implying, be direct and ask for clarification.
• Avoiding social gatherings: Someone with suicidal thoughts may withdraw from their friend group and ask to be left alone. Reach out and try to make plans if your loved one loses interest in social events.
• Making arrangements: If your loved one begins drafting secretive letters, giving away possessions, or cleaning out their dorm room or apartment, reach out.
• Behaving recklessly: People who have resolved to commit suicide may worry less about the consequences of their actions. They may indulge in reckless or self-destructive behaviors, including substance abuse.
• Saying final goodbyes: Those considering suicide may phone friends and family members out of the blue to say their last goodbyes. You might intervene if your loved one refuses to make future plans with you or if they say goodbye to you in a way that feels like they never expect to see you again.
• A sudden change in mood: When a person decides to commit suicide, they may suddenly feel calm or at peace with their decision.

For more information on suicidal warning signs, visit HelpGuide.org.

How can I help if I’m worried a loved one is having suicidal thoughts?

A person who is having suicidal thoughts can usually self-assess and self-diagnose his or her behaviors. Simply put, people who are suffering from thoughts of suicide do not need a doctor to tell them what is wrong; they already know. The problem is that not everyone who is contemplating suicide seeks immediate treatment. They may not believe the help will work or they may feel too guilty or ashamed to reach out. They may also think that their feelings of hopelessness are normal or warranted.

That is why it is crucial that friends and family members reach out to someone who seems to be in need. If you are concerned about a loved one, do not delay or ignore the situation. Approach your loved one compassionately and offer to listen, but do not promise to keep secrets, especially if he or she says anything life-threatening. During the conversation, you may want to be direct and ask, “Do you have thoughts of suicide?”

If your loved one is in crisis, call emergency services or the National Suicide Prevention Lifeline at 1-800-273-TALK (8225). It is important to stay with your loved one until help arrives. Take away knives, scissors, guns, and medications that can be used to induce overdose. Steer your loved one away from any lethal means. You can usually do this by getting them out of the house and driving to the emergency room, rather than waiting for an ambulance.

Don’t underestimate how much it means to your loved one that you are physically there during this time of crisis. Reassure your friend that they aren't alone, that there are treatment options, that you aren’t exercising judgment, and that you care.

How are suicidal thoughts diagnosed?

When a person who is considering suicide sees a doctor, the doctor can help determine what underlying issues are causing thoughts of suicide. Major depressive disorder and extreme situational factors (grief, physical health, a lost job, etc.) may be at play. Doctors often use physical exams and lab tests to assess patients, but talking with the patient is often just as effective in coming to a diagnosis when it concerns suicidal thoughts or depression. A doctor may administer questionnaires to learn about a patient’s history of depression or mental illness.

How are suicidal thoughts treated?

Treatment for patients experiencing suicidal thoughts varies. Individuals who have attempted suicide often require immediate medical hospitalization to first treat injuries and wounds.

Once their physical health is stabilized, a person in a mental health crisis may need hospitalization in a psychiatric ward. These words often carry a stigma, but in reality, hospitalization is an extremely effective treatment option, and many patients agree to it on their own. Medical professionals can supervise a patient until suicidal urges pass, monitor progress, administer new drugs, and give referrals for therapy. Hospitalization for suicidal thoughts usually lasts three days, but long-term care is available at private facilities.

It is important to continue treatment after any visit to the hospital for suicidal thoughts or attempted suicide to decrease the likelihood of a second crisis. You may work with your primary care doctor and a mental health specialist. Treatment often involves prescription medication for anxiety or depression and behavioral therapy. The best type of therapy for you will teach you effective strategies for regulating and coping with your emotions. Your doctors will work with you to tailor your treatment to your specific needs.

What resources exists for individuals with suicidal thoughts?

For everyone:

• Crisis Support Services
  • Call 1-800-273-8255 toll-free or text “CARE” to 839863.
  • Helpline is open 24 hours a day, seven days a week.
• Crisis Text Line
  • Text "HOME" to 741741.
  • Text line is open 24 hours a day, seven days a week.
  • Texts are confidential.
• IMAlive
  • Chat with an online representative.
• National Institute of Mental Health
  • Call 1-866-615-6464 toll-free.
  • Helpline is open Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
  • Online chat is available Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
• National Suicide Prevention Lifeline
  • Call 1-800-273-8255 toll-free or chat with an online representative.
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential.
• The Samaritans
  • Call 212-673-3000 toll-free
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential and anonymous. Caller ID is not used.

For Spanish speakers:

• National Institute of Mental Health
  • Call 1-866-615-6464 toll-free.
  • Helpline is open Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
  • Online chat is available Monday through Friday from 8:30 a.m. to 5:00 p.m. (EST).
• National Suicide Prevention Lifeline
• • Call 1-800-273-8255 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
  • Calls are confidential.

For LGBT+ youth:

• The Trevor Project
  • Call 1-866-488-7386 toll-free.
  • Helpline is open 24 hours a day, seven days a week.
  • Chat with a counselor 24 hours a day, seven days a week.
  • Text "START" to 678678 to text with a counselor 24 hours a day, seven days a week.

For transgender individuals:

• Trans Lifeline
  • Call 1-877-565-8860 for support.
  • Helpline is open 24 hours a day, seven days a week.

Page last updated: 04/2019