Every suicide is a profound tragedy and a loss of human potential. As a public health concern, suicide is the 11th leading cause of death in the U.S. Most persons who die from suicide have underlying mental illnesses – in some cases, not previously recognized. Suicidal thoughts are not choices; they are symptoms of real illnesses and the persons who suffer them deserve care and compassion.

The potential for suicidal thinking exists in all of us. Depression can affect anyone regardless of circumstances, often associated with major life stressors but sometimes without warning. Depression can be particularly difficult in the winter months, primarily due to the lack of exposure to sunlight. If you notice someone struggling or if you are concerned about yourself or a loved one, call or text 988, the Suicide and Crisis Lifeline, for immediate support. Learn more about how you can help someone in crisis.

Permanent solution for temporary problems

We can learn from high-profile losses like Robin Williams and Anthony Bourdain, as well as from families who have experienced this pain. Suicide creates a ripple effect, passing deep grief onto others who may learn to carry it but never fully leave it behind. In moments of intense distress, thinking can narrow into all-or-nothing choices, making suicide feel like the only way out.

Warning signs and risk factors

Early warning signs may include changes in sleep or appetite, shifts in personality or behavior, or withdrawing from others. Someone may begin giving away belongings or turn to substances in risky ways. These changes can signal that a person is struggling more than they may be able to express.

A personal or family history of suicide increases risk, as does access to a gun. The Johns Hopkins report, “Gun Violence in the United States 2023: Examining the Gun Suicide Epidemic,” said total gun suicide deaths reached a new all-time high in 2023 and that there was a 40% increase in gun suicide deaths among youth ages 10-17 between 2014-2023.

If you are a firearm owner, be sure to keep your firearm safely secured to prevent access - locked, unloaded and separate from ammunition - to create time and space between an impulsive thought. 

Agreetoagree.org has additional firearm injury prevention resources:

Other factors include mental health conditions, substance use, past trauma, chronic pain, major loss, job disruption, divorce or legal stress. These experiences can build over time and deepen a sense of hopelessness.

Social factors also play a role, including poverty, bullying, isolation or living in a community where mental health support feels out of reach. Talking about suicide or expressing a desire to die is a serious warning sign that should never be dismissed. Anxiety can also be overwhelming, leaving some people desperate to escape the intensity of what they are feeling.

Judgment and binary choices

Alcohol is involved in many suicides because it lowers inhibitions and clouds judgment. During times of loss or major life change, emotions can intensify and limit the ability to think clearly. This can reduce complex situations into simple either-or decisions and increase the chances of acting on impulse.

Talking about it helps, not hurts

Talking about suicide can reduce risk and open the door to support. Asking someone directly does not plant the idea; it shows care and creates space for honesty. Suicidal thoughts often come from illness, and speaking about them can help bring relief.

If you notice warning signs, ask if the person is thinking about suicide and if they need help. Offer to help connect them with support and remind them they are not alone. You might say, “I would never want to lose you to suicide. What can I do to help?”

Building resilience and protective factors

Strong coping skills and meaningful connections can help prevent suicide. Remind loved ones that they matter and that your connection to them is lasting and genuine. Feeling connected to family, community or faith can help restore a sense of hope and belonging.

Caring for the body also supports mental health. Getting enough sleep, eating well and avoiding alcohol or drugs can strengthen resilience. Small, consistent steps toward health can help create stability during difficult times.

Wait a moment

Intense emotional pain can lead to impulsive decisions in very short moments of time. Encouraging someone to pause, even briefly, can help interrupt that urgency. Giving space for a moment can allow other options to come into view.

In Japan, retired detective Yukio Shige dedicated his life to preventing suicide along coastal cliffs. He would sit with people, gently urging them to pause and consider another path. Known as the “chotto matte” or “wait a moment” man, he is credited with saving hundreds of lives through simple human connection.

Connection is paramount

The urge to withdraw can be part of the illness, but connection is one of the most powerful ways to counter it. Suicidal thoughts can pass, especially with the right care and support. Reaching out to a therapist, doctor or the 988 Lifeline can be a critical first step toward healing.

Speak up and take action if you or someone else is struggling
Endeavor Health urges you to take action if you or someone you know is struggling. Decreasing a person’s risk for suicide is tied to having a growth mindset, being reconnected to community, friends or family and seeing the reasons for living. Ask if you can arrange help for the person in need, then call 988 or take them to the hospital for mental health support. Learn more about the mental health resources offered at Endeavor Health.