Suicide, the taking of one’s own life, is a growing public health problem and the 10th leading cause of death in the United States. Every day, about 123 Americans die by suicide, which is equivalent to one death every 11 minutes. It affects all ages and is the second leading cause of death for people between the ages of 10 and 34, the fourth leading cause of death for people 35 to 54, and the eighth leading cause of death of people 55 to 64 years old.
Attempted suicide is when someone tries to take his or her own life but does not die. In one recent year alone (2018), 10.7 million American adults seriously considered suicide, 3.3 million devised a plan to commit suicide, and 1.4 million people actually attempted suicide.
A Sad Set of Statistics
Rates of suicide vary by race and ethnicity, age, and other demographics:
- Suicide is higher among people who have experienced violence, which includes child abuse, bullying, or sexual violence.
- The highest rates of suicide are among non-Hispanic American Indian or Alaska Native populations and non-Hispanic White populations.
- Military veterans and other military personnel, as well as workers in certain industries, such as construction, the arts, design, entertainment, sports, and media, have higher rates of suicide than the overall public.
- Youth experiencing sexual identity issues are three times more likely than straight youth to attempt suicide at some point in their lives.
- The rate of suicidal attempts by black youths has increased by 73 percent in recent years. Systemic racism, poverty, and police-involved shootings may be driving up these numbers, says Michael Lindsey, of New York University’s McSilver Institute for Poverty Policy and Research.
The Centers for Disease Control and Prevention (CDC) notes that family and community support, called “connectedness,” and easy access to health care can reduce the risk of suicidal thoughts and behavior. Knowing the signs of risk is important.
Suicide Warning Signs
Despite the dire statistics, suicide is preventable. Suicide warning signs include: 
- Talking about suicide and making statements such as “I’m going to kill myself,” I wish I were dead,” “The world would be better without me,” or “I wish I hadn’t been born”
- Making a plan for ways to kill oneself, such as searching online
- Seeking out tools to take one’s own life, such as buying a gun or stockpiling pills
- Expressing feelings of hopelessness or feeling trapped
- Withdrawing from social contact or asking to be left alone
- Having mood swings of extreme highs or lows
- Being preoccupied with death, dying, or violence
- Increasing the use of alcohol or drugs
- Changing normal routines, such as sleeping or eating patterns
- Acting recklessly
- Giving away belongings or putting affairs in order
- Saying goodbye to people
- Developing personality changes, being severely anxious or agitated
- Showing rage or seeking retribution
Some people may try to hide their thoughts of suicide from others, making it harder for those around them to help.
Who Is at Risk for Suicide?
Suicide can take anyone at any time. But there are certain risk factors that increase the rate at which people may choose to take their own life. These risks include:
- Having previously attempted suicide
- Having a history of depression or other mental health disorders
- Having a substance abuse problem
- Having a family history of mental health disorders, alcohol or drug disorders, physical or sexual abuse, or suicide or attempted suicide
- Having a history of family violence
- Having access to firearms in the home
- Being or having been incarcerated
- Being exposed to others’ suicidal behavior, including family members, peers, or celebrities
- Having a medical illness, such as chronic pain or a terminal disease
- Experiencing a stressful life event (job loss or change, financial burdens, loss of a loved one, relationship breakup)
- Being between the ages of 15 and 24 or being over age 60
- Being lesbian, gay, bisexual, or transgender and having an unsupportive family or living in a hostile environment
Children, Teenagers, and Suicide
In children and teenagers, suicide can follow from stressful life events. Lacking mature brain development and a long lifetime to witness what appear to be crises working out, minors may look at issues as insurmountable. The following circumstances can trigger thoughts of suicide in youth:
- Having a psychiatric disorder, like depression
- A lost friendship or relationship
- Conflict with close friends, a boyfriend or girlfriend, or family members
- History of physical abuse or sexual abuse
- Problems with alcohol or drugs
- Physical or medical issues, such as becoming pregnant or acquiring a sexually transmitted infection
- Being bullied
- Being uncertain about sexual orientation or identity
- Reading or hearing about a recent suicide or knowing someone who died by suicide
In rare cases, but more prevalent now than in the past, people with suicidal ideation may commit homicide-suicide, in which they kill others and then themselves. Risk factors for this include:
- History of conflict with romantic partner
- Current legal or financial problems
- History of mental health issues, especially depression
- Alcohol or drug abuse
- Having access to a firearm
Suicide’s Link to Depression
Suicidal thoughts have many causes, but they are often the result of feeling like there is no solution to a current, overwhelming life problem.
In the United States, depression affects 20 to 25 percent of the adult population, but only half of all Americans who experience an episode of major depression receive treatment. Those who seek treatment, however, have a recovery rate of 80 to 90 percent.
The rate of suicide among the depressed rises with the severity of the illness, but it is estimated that around 60 percent of people who commit suicide have had a mood disorder, such as major depression, bipolar disorder, or dysthymia, persistent mild depression.
Antidepressants and Suicide
Although most antidepressants are safe, unfortunately, some medications can increase the risk of suicidal thoughts and behaviors, particularly in children, teens, and young adults. The U.S. Food and Drug Administration requires these medications to carry a black-box warning, which is the strictest warning, indicating that they have been associated with suicidal thoughts, feelings, or behaviors in young people.
Overall, antidepressants are more likely to help reduce suicidal thoughts and behaviors by improving mood. It is advised, however, to monitor young people in the first weeks after starting the medication or when a dose change has begun, which is when suicidal thoughts and behaviors may increase.
How to Seek Help 
If you are having suicidal thoughts:
- Tell a close friend or loved one
- Contact a minister, spiritual leader, or someone in the faith community
- Call the National Suicide Prevention Lifeline at 800-273-8255 (TALK) (Federal approval was given for the shorthand number of 9-8-8, but it will not be fully operational until July 2022.)
- In San Diego, call the county’s Access and Crisis line at 888-724-7240
- Make an appointment with a doctor or other health care provider or a mental health professional
Because suicidal thinking does not improve on its own, it is important that people get help.
For Immediate Help
If you are feeling overwhelmed with thoughts of suicide, get help right away by:
- Calling 9-1-1
- Calling the National Suicide Prevention Lifeline at 800-273-8255 (TALK); 888-799-4889 en español; or in San Diego, 888-724-7240 for the San Diego County Access and Crisis line
- Use Lifeline Chat
- Use the SD County Access and Crisis Line Live Chat in the evenings, 4 pm to 10 pm local time
- Text HOME to 741741 to reach the Crisis Text Line
- Visit the county’s walk-in crisis clinic at 1000 Broadway, Suite 210, El Cajon (East County) or call 619-401-5500
How to Help Someone Who Appears to Be Suicidal
Suicide is a tragedy but one that can be prevented. By knowing what to do for a troubled friend or family member, you may save a life. You can help someone by:
- Listening, letting them know you are available to lean on without judgment
- Asking how you can help, giving the power back to the person who is struggling
- Avoiding giving guidance, which can come off as not wanting to listen but just wanting to solve a problem
- Keeping it casual, not putting the other person on the spot
- Letting them open up when they feel comfortable, especially if they are not ready to talk just yet
- Encouraging them to reach out for help if not to you, then to others
Support for Survivors and How Everyone Can Help
The following groups are for friends and family members of a loved one who has died by suicide:
- In San Diego, Survivors of Suicide (SOSL) offers comfort and resources in a judgment-free environment. SOSL currently offers online support groups and sponsors an annual Walk in Remembrance with Hope every September. See the SOSL Facebook page for timely information
- American Foundation for Suicide Prevention (AFSP) offers fellowship and sponsors the Out of the Darkness Community Experience to be held virtually on October 24 (register here)
On a societal level, all people can do their part in trying to prevent suicide by:
- Voting for legislation that encourages affordable and accessible health care and mental health services
- Contacting legislators to vote on bills that increase funding for mental health services
Herrick Library Resources
The following resources are available at Herrick Library to reserve and check out via curbside pickup:
- Cry for Help: This PBS documentary is a look at teen suicide, whose rate has tripled over the past 60 years.
- It’s Kind of a Funny Story: This movie is based on a novel about a suicidal teen who spends five days in a psych ward, where he learns valuable life lessons and makes friends. This film treats the subject matter with humor.
- Long Walk Out of the Woods by Adam Hill, M.D.: The true story of a medical doctor who risked his career and reputation to seek medical help for depression and suicidal tendencies.
- Sanity and Grace: A Journey of Suicide, Survival, and Strength by Judy Collins: Singer, songwriter Collins’s book is about the loss of her son, who committed suicide at age 33.
The following electronic items can be checked out via Overdrive:
- (Don’t) Call Me Crazy, edited by Kelly Jensen: A collection of 33 essays on mental health by athletes, actors, and writers.
- Perfectly Hidden Depression, by Margaret Robinson Rutherford: This ebook about perfectionistic tendencies that can lead to suppressed emotions and depression offers coping strategies and tips on quieting the critical inner voice.
Sources: AFSP, https://afsp.org/chapter/san-diego; CDC, Violence Prevention, Fast Facts: What Is Suicide? https://www.cdc.gov/violenceprevention/suicide/fastfact.html; Crisis Text Line, https://www.crisistextline.org/topics/suicide/#how-to-get-help-if-youre-thinking-about-ending-your-life-1; Mayo Clinic, Suicide and Suicidal Thoughts, https://www.mayoclinic.org/diseases-conditions/suicide/symptoms-causes/syc-20378048; MedlinePlus, Suicide, https://medlineplus.gov/suicide.html; National Suicide Prevention Lifeline, https://suicidepreventionlifeline.org/chat/; PBS NewsHour, Youth Suicide Rates Are on the Rise in the U.S., https://www.pbs.org/newshour/health/youth-suicide-rates-are-on-the-rise-in-the-u-s; SAVE, Suicide Facts, https://save.org/about-suicide/suicide-facts/; SOSL, https://www.soslsd.org/; U.S. Department of Health and Human Services, Does Depression Increase the Risk of Suicide? https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html
Graphics: https://suicidepreventionlifeline.org/; https://afsp.org/social-shareables; https://www.nimh.nih.gov/health/education-awareness/shareable-resources-on-suicide-prevention.shtml
