Warning signs that someone may be thinking of suicide

Do Not Lose Hope is not a crisis line and does not diagnose anyone. This page is general information, not medical advice. It covers signs to notice. For what to say, see How to talk with someone you love about suicide.

What are the warning signs?

Many people who are thinking about suicide show signs. The signs can be in what they say, how they feel, or what they do. The lists below combine what the 988 Suicide & Crisis Lifeline and the National Institute of Mental Health (NIMH) describe.

What they say. Listen for talk about:

• Wanting to die, or wanting to kill themselves
• Feeling hopeless, or having no reason to live
• Feeling trapped, or being in pain they cannot bear, in body or heart
• Being a burden to others ("You'd be better off without me")
• Great guilt or shame

How they seem to feel.

• Empty, hopeless or trapped
• Very sad, more anxious, agitated, or full of rage
• Talking about revenge
• Big, sudden mood swings

What they do.

• Making a plan, or looking up ways to die, like searching online or buying a gun
• Pulling away from family and friends
• Saying goodbye, giving away things that matter to them, or making a will
• Taking dangerous risks, like driving extremely fast or acting recklessly
• Sleeping too little or too much, or eating more or less
• Drinking or using drugs more often

Not everyone shows every sign. One sign is enough reason to check in.

Which signs mean I should act today?

Some signs mean the danger may be close. If you see any of these, do not wait.

• They talk about wanting to die or kill themselves.
• They have a plan, are looking for a way to do it, or are getting a gun, pills or other means.
• They are saying goodbye, giving away important things, or making a will out of the blue.

Ask them directly, stay with them, and call or text 988 together. If they are in danger right now, call 911. Follow the steps on What to do right now.

When are signs more serious?

988 and NIMH both point to the same pattern. Take signs most seriously when they are:

• New. They were not like this before.
• Getting stronger. The talk, the drinking, or the pulling away is increasing.
• Tied to a painful event, loss or change. A breakup, a job loss, a death, a diagnosis, an arrest, or a family member being detained.

If you are not sure, ask. It is better to ask and be wrong.

What makes suicide more likely over time?

Warning signs are about right now. Risk factors are things that raise the chance over time. The CDC says risk factors can increase the likelihood of an attempt, but may or may not be direct causes. So having risk factors does not mean someone will attempt suicide. It means they may need more care and more check ins.

The Centers for Disease Control and Prevention (CDC) lists risk factors that include:

• Personal: a past suicide attempt, depression or other mental illness, serious illness or chronic pain, legal problems, job or money problems or loss, substance use, hard experiences in childhood, a sense of hopelessness, and violence, as a victim or as the one causing harm.
• Relationships: bullying, a family history of suicide, losing important relationships, high conflict or violent relationships, and being socially isolated.
• Community: not having access to health care, discrimination, community violence, and stress from losing traditions and familiar ways of life.
• Society: shame or stigma about mental illness and asking for help, and easy access to deadly means, like guns, among people at risk.

What pressures do immigrant families face?

The CDC list does not name immigration. This next part is our own reading, not a CDC statement: many of the risk factors CDC does name, like loss of relationships, isolation, job and money problems, legal problems and discrimination, show up in the lives of immigrant families today. We suggest watching more closely when someone you love is living with:

• Separation from family. A parent, partner or child who was detained or deported, or family far away who cannot visit. This is loss of relationships.
• Fear and hiding. Staying home, skipping church, school or work out of fear. This can turn into social isolation.
• Lost work or income. A lost job, unpaid wages, or debt. These are job and money problems.
• Legal stress. Court dates, check ins, or an arrest.
• Discrimination. Being insulted, threatened or treated unfairly for who they are, where they are from, or the language they speak.
• No care. Losing health coverage, or being afraid to see a doctor.
• Past trauma. Violence before or during the trip to the United States.

These pressures are real and heavy. They do not mean someone will end their life. They mean the people around them matter even more. For help with these stresses, see Healing from the trauma of coming to the United States, Living with grief when a loved one was deported and Coping with racism and anti immigrant hate.

What helps protect someone?

The CDC also lists protective factors. These lower risk. Many are things families, friends and faith communities can offer.

• Good ways to cope and solve problems
• Reasons for living, like family, friends or pets
• A strong sense of cultural identity
• Support from partners, friends and family
• Feeling connected to others, and to school and community
• Steady access to good physical and mental health care
• Less access to deadly means for people at risk
• Cultural, religious or moral beliefs against suicide

A call, a visit, a shared meal, a ride to church, or help finding a counselor can all add to these.

Do signs look different in teens?

The signs above apply to teens too. Watch for the same things: talk about death or not wanting to be here, pulling away from friends, and big changes in sleep, eating or mood. Talk to a school counselor, and see When your teen is struggling. If a teen tells you a friend wants to die, see What to do if a friend tells you they want to die.

What should I do if I see signs?

1. Ask. Say: "Are you thinking about suicide?" NIMH says asking does not increase suicidal thoughts or behavior.
2. Listen. Let them talk without judging or arguing.
3. Help keep them safe. Ask if they have a plan. Move guns and pills out of reach.
4. Help them connect. Call or text 988 together, or reach out to a trusted family member, friend, spiritual advisor or counselor.
5. Follow up. Check in again in a day or two.

These five steps come from NIMH. For the full conversation, see How to talk with someone you love about suicide.

You can also call 988 yourself, before you talk to them. A counselor can help you plan what to say.

Questions people ask

If they really meant it, wouldn't they keep it quiet? No. Many people show signs or say something first. Take every mention seriously.

Will asking put the idea in their head? No. Studies show asking directly does not increase suicidal thoughts or behavior.

They said they were joking. Should I let it go? Check in anyway, gently. You can say: "I'm glad. I still want to ask, because I care. Are you thinking about hurting yourself?"

I see signs in myself. What now? Please reach out today. Call or text 988, or tell someone you trust. You deserve support, not just survival.

Is there a sheet to write down what I see?

Who can help

These are free crisis lines and county crisis teams. Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org. Free and confidential, 24/7/365. Spanish: dial 988 and then press 2, or text AYUDA to 988. 988lifeline.org
• San Mateo County Crisis Line, run by StarVista (for county residents): (650) 579-0350, 24 hours. smchealth.org
• Other California counties: DHCS county list
• Santa Clara County Behavioral Health crisis teams (for county residents): (800) 704-0900, then press 1, 24/7. bhsd.santaclaracounty.gov
• Ongoing care: see Mental health care without fear.
• Other kinds of help, like abuse or drugs: see Which helpline to call.

Noticing is a gift. The people we love are worth the awkward question.