There’s a myth that people who talk about suicide won't really do it. This is wrong. Before attempting suicide, many people make direct statements about their intention to end their lives or less direct comments about how they might as well be dead or that their friends and family will be better off without them. Any reference to suicide should be taken seriously.

People who’ve tried to kill themselves before are especially at risk, even if their previous attempts didn't seem serious. Four out of five people who die by suicide have attempted it before. Unless they’re helped, they may try again and the next time could be fatal.

Helping a Suicidal Person

If someone tells you that he or she is contemplating suicide or shows signs of being suicidal, don't be afraid to talk about it. Your willingness to discuss suicide shows the person that you care and are willing to be a friend. Ask questions about how the person feels. “You seem really down. Is there a reason?” Ask questions about suicide itself. "Do you know how you’d do it?" Determine whether the person has the means to carry out a plan, such as access to a gun or pills. The more specific the plan, the higher the risk. Discuss suicide as you would any other topic of concern. Don't offer advice such as, "Think how much better off you are than most people. You should appreciate how lucky you are." Comments like this only increase feelings of guilt and make the suicidal person feel worse. Instead, convey hope. With time, things probably will get better. Recognize, however, what you can't do. You can't bring back a lover, for example, or talk someone out of depression. Whenever possible, get help. Suggest that the person contact the local suicide prevention center or talk with a teacher, counselor, minister, rabbi, coach, or other trusted adult. If the person refuses, call yourself and ask for guidance.

Many suicidal people have given up hope, believing that they can't be helped. With time, though, most suicidal people find reasons to live.  It's up to others to see that they get the help they need. Don’t be afraid to be disloyal. Suicidal feelings often are transitory, while suicide is permanent. What may seem like an act of betrayal or the breaking of a promise can be the favor of a lifetime.

Suicide Warning Signs

There’s no typical suicide victim. Suicide transcends all ages beginning with adolescence, all ethnicities and cultures, all socio-economic groups, and all religions, as well as gender, sexual orientation, and able bodiness. There are common warning signs, however:

• Talking about suicide or making statements revealing a desire to die.
• Drastic changes in behavior (withdrawal, apathy, moodiness).
• Losing interest in hobbies and in personal appearance.
• Depression (crying, sleeplessness, loss of appetite, hopelessness)
• Worsening academic or job performance and sudden failure to complete assignments.
• Lack of interest in activities and surroundings (dropping out of sports and clubs).
• Settling affairs (giving away prized possessions such as books or a CD collection).
• Increased moodiness, irritability, or aggressiveness.
• Remarks suggesting profound unhappiness, despair, or feelings of worthlessness.
• Death and suicidal themes in written work.
• Self-destructive behavior (taking unnecessary risks or increased drug or alcohol use).

Suicide Myths and Facts

Suicide Statistics

Suicide rates are based on the number of suicides in a group, divided by the group’s population and then multiplied by 100,000. One suicide at a school of 5,000 students, for example, produces a suicide rate at the school of 20.0 for the year.

Suicides are underreported because coroners can't always determine whether a person's death resulted from accident or suicide. A driver who crashes into a tree, drives off a cliff, or runs into another vehicle may have fallen asleep at the wheel, lost control of the car, or deliberately planned the accident—it’s not always clear. Moreover, there may be strong pressure from family members to attribute a questionable death to accident rather than suicide.

• Nationally, more people die by suicide (32,000 per year) than homicide (18,000 per year). The number of suicides is equivalent to a fully loaded passenger plane crashing every two days.
• Suicide is the eighth leading case of death for adults, and third for youths.
• Firearms are used in 60 percent of all suicides. People living in households with a firearm are five times more likely to die by suicide than people living in gun-free homes.
• Each suicide affects at least six other people—family and friends. About 3.7 million people in the U.S. currently mourn a loved one’s death by suicide, and the number grows by 190,000 each year.

Youth Suicide

Nationwide, suicide is the third leading cause of death among youth, after accidents and homicides. One out of 10 teenagers in America attempts suicide by age 24.

Teens who attempt suicide are more impulsive than adults. Their attempts tend to derive from anger, risk taking, and drug abuse, and are influenced by romantic, mystic, and idealistic factors. Oftentimes they have lower self-esteem and are more affected by personal relationships.

Senior Suicide

Seniors have the highest suicide rate of any age group—even higher than youths. This isn’t because more seniors suffer from terminal illnesses than other age groups, as some people believe. Rather, seniors have the highest suicide rate because they are more likely to be socially isolated, lonely, and depressed than people of other ages and these are the risk factors most directly related to suicide. Most seniors are retired and no longer have daily interaction with co-workers. They may not feel useful anymore, or feel like they’re a burden to others. In addition, they may face financial hardships.

Seniors who attempt suicide are less impulsive than people who are younger, and they’re more likely to plan their deaths. Seniors tend to think that people around them will be better off if they die because they'll stop being a burden. Senior suicide attempts derive more from loneliness and less from anger or drug abuse. Whereas youths average 100 attempts for every completed suicide, seniors average four attempts for each completed suicide.

Assisted Suicide

The "right to die" debate in the U.S. has centered on Dr. Jack Kevorkian. He  and other proponents of assisted suicide maintain that older adults with fatal illnesses who want to die should be allowed to do so with dignity. Their years of experience give them the necessary perspective to decide what kind of life they want and don't want.

Opponents argue that the urge to kill oneself is often transitory and people who are suicidal and receive appropriate support can lead healthy, productive lives. Society shouldn’t allow, much less encourage, people with medical problems to destroy themselves. Instead, we should try harder to alleviate pain and give elders more reason to live.

Says Gil Shepard, a local therapist, "People who feel loved and have a purpose for living continue to desire to live even with great physical pain and disability. But for those who feel isolated, dependent upon other people, or lack purpose in life, depression builds. Alone and desperate, some wonder if suicide is a way out." The unspoken message that assisted suicide conveys, he says, is that while no one may be available to provide support and help you live, there are people available who’ll help you die.

Says Dr. Ezekiel J. Emanuel, formerly of Harvard Medical School, "Most patients who seek euthanasia are motivated by psychological factors—often depression—not by unbearable physical suffering." Anxiety, hopelessness, and the fear of losing control of their lives and burdening others are why patients request aid in dying. "The euthanasia debate has been carried on in almost total ignorance of the facts and data available," he says. "The chief justification is to provide relief for patients suffering from excruciating pain, but these patients are not the ones who want euthanasia."

A woman whose father died at home at age 98 of natural causes after talking periodically about suicide for years says, "Those advocating assisted suicide almost always point to extreme cases, but many cases are not extreme. Many, like my father, experience a number of ups and downs before dying. How does one assess the depth and duration of an ill person's desire to die? A call for suicide can represent such a varying range of motives: pain, fear of future pain, a reluctance to burden a child with one's care, and distress at the limitations imposed by one's illness."

Reporting on Suicide

One reason why suicide rates among youths continue to rise is because teens are vulnerable to the phenomenon of "contagion" or imitative behavior. It's critical for public officials and media representatives to be careful about how they report suicides—especially celebrity suicides—to minimize the likelihood of suicide contagion.

Reporting should be concise and factual. It should avoid presenting simplistic explanations for suicide; after all, lives are complicated and rarely is there a single reason why people kill themselves. Also to be avoided are "how-to" descriptions about the method of suicide and statements that present suicide as painless. Certain methods may cause little pain to the person who’s ending his or her life; however, the kind of pain the person leaves behind is often as deep or worse than the one that he or she fled from. Family members and friends of suicide victims never regain normalcy in their lives and often attempt or die by suicide themselves.

Suicide shouldn’t be presented as an accomplishment, thus saying that someone “successfully killed himself” is inappropriate. So, too, is saying that someone “committed suicide” because this sounds as if the person did something illegal and there’s no law against suicide. It’s best to say that a person “died by suicide” or “killed himself.”

Public eulogies and memorials for the deceased can contribute to suicide contagion, especially if the person died young and always will be remembered that way. Reports of community expressions of grief should: 1) be minimized; 2) avoid glorifying suicide or the person who died; and 3) avoid focusing solely on positive characteristics of the person's life. People kill themselves because they have problems and fears they can't handle. Others need to know this so that people with similar problems receive help before it's too late.