13 suicide warning signs that are easy to miss

The 2018 deaths by suicide of designer Kate Spade and chef Anthony Bourdain brought a troubling trend into the spotlight. In Australia, according to the Bureau of Statistics, suicide rates have increased in the ten years to 2019 from 17.5 to 19.8 in males and from 5.0 to 6.3 in females. Reversing the trend isn’t easy, and according to Beyond Blue, everyone is different and responds differently to suicidal thought and feelings. Knowing the warning signs may help you save a life.

Read on for the things that everyone gets wrong about suicide.

There was an almost 10 per cent increase in suicides – an additional 1841 deaths – recorded in the United States in the four months following comedian Robin Williams’ death by suicide in 2014, according to a study in PLOS ONE. “That indicates just how powerful this kind of ‘contagion’ effect can be on a vulnerable person,” says child and adolescent psychiatrist Dr Elizabeth Berger. When people who may be trying to manage their depression see this person they admire taking his or her own life, they may see it as a way for them to escape their own misery. “The tragedy of Robin Williams’ death is that because he was a beloved public figure, people who were already suffering felt they had gotten permission to relieve their pain,” says clinical social worker Susan T. Lindau.  “The voices decrying his death weren’t strong enough, persuasive enough, or prevalent enough to push those people experiencing suicidal thoughts to reach out for help.” If you’re having suicidal thoughts, don’t suffer in silence.

“Any significant and unexplained changes in behaviour should at least be a cause for inquiry,” says clinical and forensic psychologist Dr Joel A. Dvoskin. “Significant negative changes are especially concerning.” However, behaviour changes don’t mean a person is going to kill himself, he says. “Ask empathic and respectful questions,” he recommends, adding that simply asking, “How are you doing?” is a good start. “When the person says or does anything that suggests or implies an intention to hurt himself or others, ask whether or not the person is intending to hurt himself or anyone else, stating it in the form of a question.” Doing so is neither disrespectful nor intrusive, he says.

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Choosing to be alone and avoiding friends or social activities can be possible symptoms of depression. Any sign that indicates loss of interest in activities the person previously enjoyed is suspicious. “Young people, in particular, like to be around their friends,” says Dr Daniel J. Reidenberg. “So, when we see them pull away from peers, that’s concerning. Adults withdrawing from social activities, family activities, even going out after work with colleagues could be a sign that something is going on.” He says that withdrawal suggests the person is struggling with his or her thoughts and emotions. “They don’t want others to see that, so they avoid those situations,” he explains. “Withdrawal also gives them time to sleep more and ruminate about their situation, which indicates they’re not doing well.”

Often, a person considering suicide will take steps to put his or her personal business in order. They might visit friends and family members or someone they haven’t seen in a long time. “For some, this might seem like an effort to reconnect,” says Reidenberg. “But it could be a way to make amends before an attempt.” They may draft a will or clean up their room or home. The person may give away possessions they previously loved because they don’t think they need them. Some people will write a note before attempting suicide.

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A person who is considering suicide might suddenly become less concerned about how he or she looks and start to neglect personal hygiene. “They’re more focused on survival than their appearance,” says Reidenberg. “They’re doing all that they can just to get through the day. Their appearance isn’t a priority.” They also have less interest in what others think of them, he adds. “They’re too miserable and too depleted to care about how they look,” says Dr Eileen Kennedy-Moore.

“When someone is depressed, nothing feels good or is interesting,” says Reidenberg. “Everything is hard, exhausting, and feels bland. Accomplishments and achievements (related to school, work, or interests) go away because you’re focused on your pain.” These activities feel pointless, says Kennedy-Moore: “They also don’t have the energy to try, and they no longer find pleasure in them.”

People who exhibit this suicide warning sign aren’t simply looking for attention. Whether it’s a conversation with a friend, a writing or art assignment, or a journal entry, any expression of death should be taken seriously and seen as a red flag. They may also be researching about suicide online, asking around about how to buy a gun or where to get lethal drugs, or be interested in TV shows, movies, or songs with suicide themes. “Anyone talking about suicide – directly or indirectly – is a key warning sign,” says Reidenberg. “All statements about suicide are to be taken seriously, even if someone has said it multiple times over several years.”

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“Increased drug or alcohol use is not only an indicator of psychological suffering – it’s a common contributing cause of suicidal acts,” says Dr Berger. Many people who feel anxious, agitated, or distressed turn to drugs and alcohol for relief, escape, and to feel calmer. They may not have previously abused drugs or alcohol, or they may start using more of them. But they take these substances to numb themselves and make themselves feel better. Drugs and alcohol impair judgment, and the person is more likely to make poor decisions and do something impulsive or high risk, says Reidenberg. These decisions may endanger themselves as well as others. “When someone is depressed, adding a substance to an already unhappy mind can lead him to do something fatal,” he says. “This is particularly true for someone who just starts to use alcohol or drugs when he hadn’t before, and now he’s depressed, too. This behaviour change is a warning sign he isn’t doing well.”

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Excessive moodiness can be a symptom of depression and a major risk factor for suicide. Depressed individuals can go from extreme sadness to irritability to intense anger. These mood swings might be out of character, too – the person may look different and sound different, says licensed clinical psychologist Dr Kevin Gilliland.  “They’re not ‘themselves,’” he says. Mood swings can be a sign that they’re emotionally and psychologically unstable, adds Reidenberg: “If these go on too long and without treatment, they can lead to impulsive behaviours that are risky.”