Suicide Risk of Mental Health Conditions

Suicide is one of the leading causes of death worldwide and affects people of any age or gender. Understanding the risks associated with suicide attempts, including mental illness, can help prevent deaths and support those at risk.

What is the link between suicide and mental health disorders?

Worldwide, suicide is the cause of over 700,000 deaths each year, which equates to 1.4% of all deaths. In the US, over 40,000 people per year die by suicide. On top of these figures are many more individuals who consider or attempt suicide ^[1][2][3].

Studies show that of those who died by suicide, around half had a diagnosed mental health condition for which they sought treatment the previous year ^[2][4]. Studies also show that up to 90% of individuals who die by suicide have a history of one or more mental health diagnoses in their lifetime ^[3].

The mental health diagnoses of those who die by suicide differ between genders and geographic locations. For example, males who die by suicide are more likely to have been diagnosed with substance or alcohol use disorders or personality disorders. Conversely, females are more likely to have been diagnosed with depression or other mood disorders ^[2][3].

Similarly, substance use disorders are associated with more suicide deaths in the US than in other parts of the world ^[3].

Mental health conditions associated with a high suicide risk include ^[2][3][5]:

• Depressive disorders
• Schizophrenia and other psychotic disorders
• Bipolar disorder
• Anxiety disorders
• Substance use disorders, particularly alcohol use disorders
• Personality disorders
• Trauma-related disorders, such as PTSD

Mental illness significantly increases the risk of suicidal thoughts and attempts, although it is not the only risk factor for suicide. Similarly, not all people with mental health conditions will attempt suicide. The risk of suicide can be managed with good mental health care and a strong support network ^[1][6].

Many people who have attempted suicide have later reported that they did not wish to die but felt that it was the only way to manage their distress. Often, people feel so overwhelmed by negative emotions that they feel helpless and see no end to their pain, believing that ending their life is the only option ^[7][8].

However, there is always another option, and treatment such as medication and therapy can be provided to help individuals cope with distressing experiences. Seeking professional help for support and treatment can significantly reduce mental health symptoms and suicide risk ^[1][5].

Are there any other risk factors for suicide?

Mental health conditions are not the only risk factor for suicide; it is often a combination of factors that leads to an attempt. This may include ^[1][4][7]:

• Past attempts: Statistically, individuals who have previously attempted suicide are at the highest risk of further attempts and dying by suicide.
• Genetics: People with a family history of suicide may have an increased risk of experiencing suicidal thoughts.
• Gender: Females are more likely to attempt suicide, while males are around four times more likely to die by suicide, as males tend to use more lethal means.
• Life stressors: Stressful events can trigger or worsen suicidal thoughts, such as relationship issues, financial difficulties, or the loss of a loved one.
• Traumatic experiences: Experiencing abuse, bullying, or other traumatic events can increase the risk of experiencing suicidal thoughts or acting upon suicidal ideation. Similarly, people who experience discrimination, such as racial minorities, immigrants, prisoners, and LGBTQ individuals, are at a higher risk of suicide.
• Substance or alcohol use: As substances and alcohol reduce inhibitions and increase impulsivity, individuals with substance use disorders or who regularly consume drugs or alcohol may be at an increased risk of acting on suicidal thoughts.
• Serious illness: Terminal or severe illness and chronic pain can increase the risk of suicide.
• Antidepressants: Although antidepressants can effectively reduce symptoms of depression and other mental health conditions, some antidepressants can cause an increased risk of suicidal thoughts at the beginning of treatment, particularly in individuals under 25.
• Loneliness: People who are isolated or experience ongoing feelings of loneliness may be at increased risk of suicide.

Warning signs of suicidal thoughts

People who are experiencing suicidal thoughts may display varying signs and symptoms. However, common signs that someone is experiencing suicidal ideation include ^{[4][6][7][8][9]}:

• Talking about suicide
• Preoccupation with death
• Increase in feelings of guilt, shame, helplessness, or hopelessness
• Lack of plans or hopes for the future
• Withdrawing from friends and family, becoming isolated
• Extreme mood swings
• Giving away possessions and money
• Sudden changes in behavior, such as behaving recklessly or bizarrely
• Increase in the use of drugs or alcohol
• Making plans or gathering the means to attempt suicide, such as stockpiling pills or purchasing a firearm
• Suddenly spending time with loved ones after being very isolated or saying goodbye to loved ones
• No interest or pleasure in social activities or hobbies
• Changes in sleeping and eating habits
• Suddenly seeming to be very calm or at peace after noticeable distress. Although this can appear to be a positive sign, it could also be a sign that they have decided to end their life.

What to do if you have suicidal thoughts

If you are experiencing thoughts of suicide, there are several things you can do to help you stay safe ^[6][7][8]:

• Call a helpline: There are numerous available helplines you can call to speak to someone who can provide support and advice when you are experiencing suicidal thoughts. These numbers may vary depending on the country you are in but can include organizations such as Samaritans and the National Suicide Prevention Lifeline.
• Talk to someone: Speaking about emotional distress can help to lessen its impact. You could speak to friends, family members, a spiritual or religious person, or attend a support group. Receiving support and feeling connected to others can help to reduce suicide risk.
• Make a safety plan: It may be a good idea to make a safety plan if you regularly experience suicidal thoughts or feel that you are likely to act upon them. This could include going to a friend’s house where you feel safe, a list of telephone numbers to call, techniques you can use to feel calmer, or who to contact in an emergency.
• Remove access to means: If you have access to something that could be used in a suicide attempt, such as stockpiled medications or a firearm, ensure your safety by removing your accessibility to these items. You could give them to someone else or ask someone to lock them away for you where you cannot access them.
• Seek professional help: Asking for help from a doctor, mental health specialist, or other professional can help to reduce your risk, as they can provide treatment and advice to manage your emotional distress and keep you safe.
• Try relaxation or mindfulness: You may find it helpful to utilize relaxation or mindfulness techniques to help you feel calmer and more in control of your emotions. This might include breathing exercises, yoga, meditation, going for a walk, or listening to music.
• Let the thoughts pass: Often, suicidal thoughts will pass, so if you can distract yourself or sit with these thoughts when they arise, you may be able to prevent yourself from acting on them.
• Avoid drugs and alcohol: Many people turn to substances as a coping strategy when they feel low, but drugs and alcohol can worsen mental health and may increase your risk of acting on suicidal thoughts.
• Call 911: If you feel unable to prevent yourself from harm or have attempted to end your life, call 911 immediately.

How to help a loved one with suicidal thoughts

If someone you know appears to be experiencing suicidal thoughts, you can help them by doing the following ^{[4][6][7][8][9]}:

• Listen: Let your loved one express their thoughts and emotions to you and let them know you are there to listen whenever they need to talk.
• Don’t judge: It is important not to tell someone in distress to ‘cheer up’, debate with them about the morals of suicide, or become angry or upset with them if they have harmed themself. This could cause them to feel guilty or overwhelmed and damage relationships. Be non-judgmental and show them you care for and support them.
• Be supportive: Let your loved one know you will support them to help them cope with these feelings. You could provide them with details of helplines or professionals they can contact and reassure them that you can support or be with them if they choose to speak to someone.
• Ask how you can help: It may be helpful to ask what you can do to help your loved one. If they are feeling overwhelmed by negative emotions and suicidal thoughts, it may be that they need practical support as well as emotional support. For example, they might require you to assist in placing a call for professional help or taking them to an appointment.
• Remove dangerous items: If you know that your loved one has access to dangerous things that they could use to harm themselves, such as pills or weapons, it is a good idea to remove these. Inform them that you are doing this for their safety.
• Stay with them: If you think your loved one is likely to act on suicidal thoughts, do not leave them alone. Stay with them until they feel safe or until professional help is available. If necessary, call 911 or take your loved one to the hospital to keep them safe from harm.