Mental Wellness

Recognizing These 10 “Suicide Cues” Can Save a Life

It was a Tuesday evening and I just got home from work. My phone rang and my college athletic director was on the line. The conversation didn’t start out with the usual cheery “Hey H! How are ya?” My stomach sank when she said, “Are you sitting down?” Nothing could prepare me for the next words she said: our friend and teammate Lexi had committed suicide.

I froze in disbelief. Not my Lexi? The one who I played doubles tennis with four years? The one who always lit up a room and gave the team a good laugh? The one who just finished her master’s degree? The one who I wished a happy birthday to not even a month before?

After I hung up the phone, I closed my eyes and sat in silence. I felt my face go flush, and I could hear my heartbeat pounding in my ears; anger came to a boil rising up from my feet to my head.  I held my breath and squeezed my hands so tightly that my fingernails left an indent in my palms. I burst into tears and cried for hours with one question rolling through my mind: why didn’t Lexi tell me she was struggling?

Suicide: A Public Health Crisis

Unfortunately, suicide is not uncommon:1

  • One person dies by suicide every 10.9 minutes.
  • There are 1,208,600 suicide attempts each year in the U.S., or one attempt every 26 seconds.
  • On average, one death by suicide impacts 147 people.
  • Suicide is the 10th ranking cause of death for adults and the second-highest cause of death for youths.

And very worrisome is a new trend: the coronavirus pandemic is pushing the nation into a mental health crisis.2 Nearly half of Americans report the coronavirus crisis is harming their mental health, according to a Kaiser Family Foundation poll taken last spring, shortly after stay-at-home orders were enacted.

National Suicide Prevention Lifeline Available 24 hours. Languages: English and Spanish.

A newly released survey by the Centers for Disease Control and Prevention (CDC) paints another sobering picture of the impact of the pandemic crisis on mental health. The report says the number of Americans contemplating suicide is soaring, and many more are showing signs of mental disorders. Nearly 41% of the 5,412 people who responded to the June 2020 CDC survey reported at least one adverse mental or behavioral health condition.3 The American Psychological Association calls the pandemic a perfect storm of intense new mental health stressors coupled with the removal of many of the resources people typically use to cope:4

  • Millions have lost their jobs; some have lost their homes or businesses.
  • Families are cooped up together, which may increase the risk of domestic violence and child abuse.
  • Disrupted routines and the fear of contracting a life-threatening virus may be exacerbating pre-existing mental illness or substance use.
  • People in a mental health crisis may avoid hospitals, whether for fear of adding to the burden of already overwhelmed facilities or of catching the virus.
  • Gun sales are up.

10 Suicide Cues

Suicide is a desperate attempt to escape suffering that has become unbearable. How can you help prevent a loved one from becoming a statistic? Here are cues that are important to pay attention to and to act on when you notice something is off with a friend, family member or colleague:5
Learn the Signs and Cues of Suicide to Help Save a Life

  1. Talking about suicide: Saying or contemplating self-harm, dying or suicide. Examples can include statements such as “I wish I hadn’t been born,” “If I see you again…” and “I’d be better off dead.”
  2. Seeking out lethal means: Looking into purchasing weapons, drugs or other means to attempt self-harm.
  3. Obsessing about death: Focusing on death, dying or violence. Sometimes people write about the topic of death.
  4. Thinking there is no way out: Feeling like there is no hope for the future or believing things will never get better.
  5. Self-hating: Having and/or expressing feelings of self-loathing, guilt and shame.
  6. Making arrangements: Creating a will, giving away possessions and getting affairs in order.
  7. Saying goodbye: Making rare or unexpected visits or calls to family and friends as if they won’t be seeing them again.
  8. Self-isolating: Withdrawing from friends and family on normal occasions and functions by wanting to be alone.
  9. Taking risks: Demonstrating self-destructive behavior by increasing substance abuse and reckless actions.
  10. Becoming calm suddenly: Making an abrupt change to calm and happiness after showing signs of extreme depression can indicate a decision to attempt suicide.

How do you help someone who is trapped in their own mind? Don’t be afraid to talk to them. What if someone says they need help? When is the best time to confront them if they are exhibiting suicide cues? If you’re unsure whether someone is suicidal, the best way to find out is to ask. According to the Suicide Prevention HelpGuide, here are ways to start a conversation about self-harm:

“I have been feeling concerned about you lately.”
“Recently, I have noticed some differences in you and wondered how you are doing.”
“I wanted to check in with you because you haven’t seemed yourself lately.”

Coping with Suicidal Thoughts

If you’re thinking about suicide, there are ways to get help. Cognitive therapy for suicide prevention is a one-on-one type of therapy.6 This approach helps by developing skills and alternative ways of dealing with suicidal thoughts as well as working through a crisis.7 Group therapy is another option that can lead to a support network by listening to others’ experiences and putting problems into perspective.8 Find a support group here.9

In addition, consulting with a primary care physician, guidance counselor, clinic or hospital are good resources for help.10 Mental health access through telemedicine has emerged as an option during the coronavirus pandemic. Research suggests that telemedicine can be as effective as face-to-face care, and some people prefer it.11  You can talk with a mental health professional on the phone or over a video conference.

My friend Lexi’s suicide left me with many unanswered questions, and I will never be able to get a response for them. Looking back, I didn’t know what was going on in her mind.

I miss my friend. Reminders of her are everywhere. Sometimes it’s a certain song, or I’ll have a vivid dream. Even though she isn’t physically here anymore, she will always be with me. “Yes, Lexi,” I want to tell her. “I hear you!”

If you or someone you know is suicidal, please reach out to a mental health professional for help, or call the National Suicide Prevention Lifeline at 1-800-273-8255. Suicide is a permanent solution to an often temporary problem. Don’t let the hurting last forever.

Author Heather Gartside (left) and Lexi (right)

1American Association of Suicidology, “U.S.A Suicide: 2018 Official Final Data”
2Washington Post, “The Coronavirus Pandemic is Pushing America Into A Mental Health Crisis”
3CDC, “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic”
4American Phycological Association, “COVID-19 and Suicide”
5HelpGuide, “Suicide Prevention”
6Suicide Prevention Resource Center, “Cognitive Therapy for Suicide Prevention”
8American Psychological Association, “Psychotherapy: Understanding Group Therapy”
9Psychology Today, “Find A Support Group”
10American Foundation for Suicide, “Find A Mental Health Professional”
11Zero Suicide Institute, “Telehealth and Suicide Care During the COVID-19 Pandemic”

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National Institute of Mental Health, “Suicide in America” Frequently Asked Questions,” and “Treatments and Therapies”

National Alliance on Mental Illness, “Risk of Suicide”

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