Warning Signs

Previous attempts

Statements of suicidal ideations, suicide plans

Self-injurious behaviors that appear to have lethal intent or become progressively more severe (e.g., cutting behavior whereby the cuts become progressively deeper and more dangerous)

Acquiring or seeking to acquire means (guns, drugs, poisons)

Rehearsal behaviors (e.g., noose around neck, gun to head, practicing going to potentially perilous locations like bridges and roofs of high buildings)

Giving away important possessions; unexpectedly making a will

Biological

 Major psychiatric disorder – major depression, chemical dependence, schizophrenia, bipolar, PTSD, borderline personality disorder, panic disorder, eating disorders (esp. anorexia nervosa)

Low levels of serotonin – specifically 5-HIAA (serotonin metabolite in cerebrospinal fluid)

Chronic disease, intense pain with little hope of relief

Nightmares – especially frequent (some research has implicated sleep disturbance – other research indicates sleep disturbance absent nightmares is not directly linked to suicidality)

Life Situations

Trauma history (child abuse, domestic violence, rape and sexual abuse, combat experience, violent crime victimization, bullying)

Loss – deaths; exposure to suicide; job; marriage, other partner relationships, other estrangements; financial; home

Role failure or perceived role failure – job, family, school

 Imprisonment or impending imprisonment – other legal sanctions that may have serious effect on self-image

Other Behaviors

Statements of purposelessness

Feelings of hopelessness and being trapped; powerless to change life situation

 Intense emotional pain – “Psychache”

Sudden and seemingly inexplicable mood changes – (e.g., fits of rage for persons that had not shown them, sudden calm from persons who have been anxious and agitated)

Feelings of constant unrelenting stress (releases excessive cortisol, which regulates stress responses and which may elevate risk of suicide)

Loneliness, isolation, lack of connection (family, friends, school, spiritual, job, etc.)

Self-loathing, unrelenting feelings of guilt, shame, worthlessness, failure

Disinterest in life areas that were important (loss of interest in sexual behavior; carelessness about dress, hygiene, conditions of home, etc.)