How to Identify Suicide Risk Before It's Too Late

When someone you love is depressed, what are the warning signs that suicide is a possibility?

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Every 17 minutes, someone dies by suicide in the United States, according to the Centers for Disease Control and Prevention. Suicide is the 11th-leading cause of death for Americans, and while it often comes as a surprise to friends and loved ones, it is largely considered to be preventable if warning signs are heeded. "The tragedy of completed suicide is that most could have been prevented if family members knew what to look for," says Lisa Boesky, a psychologist and author of When to Worry: How to Tell if Your Teen Needs Help--And What to Do About It. "Research shows that most people who die by suicide have a mood disorder like depression or bipolar disorder, or [have] a substance abuse problem, or both," either diagnosed or undiagnosed, she says.

Suicide has no "face," no race, no age or income level that determines who is at risk. Recent celebrity-related deaths make this clear. Andrew Koenig, 41, an actor who once starred on the TV show Growing Pains, hanged himself from a tree in Canada last month after battling depression for years. And Marie Osmond's son, Michael Bryan, 18, died after jumping from his Los Angeles apartment building on February 26. A note Bryan reportedly left behind said he'd been dealing with severe depression and alienation. More than 90,000 people were hospitalized in 2002 after attempting to take their own lives. The issue is costly in dollars—$25 billion annually is spent on suicide-related healthcare, funerals, autopsies, investigations, and lost productivity, according to the CDC.

Often, experts say, it's a stressful or negative event that drives a person already struggling with depression to harm himself—including bad breakups, financial problems, or loss of a job or home. Such events can be a "very high-risk time," Boesky says. So the optimal way to intervene is to encourage a depressed person to get treatment early on. But because depression can bring a feeling of hopelessness, those affected sometimes don't believe that getting proper treatment will make them feel better, says Jeffrey Borenstein, a psychiatrist and CEO and medical director of Holliswood Hospital, a psychiatric facility in Queens, N.Y. If people with depression get help, he says, "they can regain their health and live a full, healthy life."

What behavior may indicate a person is at risk for death by suicide? Boesky and Borenstein suggest a number of warning signs, changes in behavior lasting for two weeks or more:

Talk of suicide. If your loved one has talked about suicide or wanting to be dead, don't assume he or she won't follow through. "If someone is using suicidal statements to get attention, it is important to take it seriously because they may really feel suicidal and because the way they're going about getting attention is scary and serious," Boesky says.

Previous suicide attempts.

Being overly self-critical or preoccupied with failures or mistakes.

Listening to or reading music, books, or poetry with themes of death or destruction.

Giving away valuable possessions, as Koenig reportedly did before traveling to Canada.

Serious alcohol or substance abuse.

[The CDC lists more warning signs.]

If you notice any of these warning signs, experts say you should not hesitate to speak up. "Say, 'I'm concerned about you,' and spell out the reasons. 'You seem to be depressed. You seem to be anxious. I'm concerned that you may have depression, and this is a condition that's treatable, and we need to help you get treatment for it,' " Borenstein says. "Often, family members are hesitant to bring up their concerns. But once they do, people often respond in a positive way."