Suicide and suicidal thinking are more widespread than you might think. According to the results of a government survey released in September 2009, roughly 8.3 million adults - or about 3.7 percent of the population age 18 and older - had "serious thoughts of suicide" in 2008.
It can be hard to identify suicidal thinking in a loved one - there is no foolproof checklist to follow. From our friends at Health.com, here are some warnings signs that might mean they are at risk...
If someone you know is talking about harming himself or says that he doesn't want to live, take it seriously.
He may be at risk for a suicide attempt, particularly if he feels trapped or hopeless and is withdrawing from friends and family.
Don't leave that person alone, let him know you're going to get help, and call 1-800-273-TALK to be connected to a crisis center, says the National Suicide Prevention Lifeline.
The painful symptoms of conditions such as depression and bipolar disorder can drive people to consider suicide.
"Depression is the leading illness for suicide, so the deeper the depression gets or the longer it goes on, the more discouraged the person experiencing it feels," says Dr. Paula Clayton, the medical director of the American Foundation for Suicide Prevention.
In bipolar disorder - a condition in which bouts of depression are interspersed with periods of mania - suicide risk may be higher when the person is depressed.
Madelyn Gould, PhD, a professor of clinical epidemiology in psychiatry at Columbia University Medical Center, in New York City, says that excessive and inappropriate feelings of guilt - a common symptom of depression and anxiety - are something to be on the lookout for as well.
"You start to feel guilty about things - letting people down - and someone else who's listening would say, 'But you're not,'" says Gould. "It's just this very unrealistic guilt."
Drug use and excessive alcohol use - which some agitated and anxious people turn to for relief - are warning signs for suicide, says Dr. Clayton. "You might not be an alcoholic or a drug abuser, but if you take things to make yourself feel better or to numb you, that makes you more vulnerable because it impairs your judgment and makes your thinking not as clear," she says.
Substance use can also contribute to impulsivity, Dr. Clayton adds. Studies have shown that up to 80 percent of all suicide attempts are done on the spur of the moment, with very little planning.
Dr. Ken Robbins, a clinical professor of psychiatry at the University of Wisconsin, in Madison, notes that about half of depressed people have "melancholic depression," and are listless, fatigued, and have a loss of appetite.
The other half have "agitated depression." Anxiety is the main symptom, says Dr. Robbins, but these people may also experience restlessness, difficulty sleeping, and trouble focusing.
"People who are agitated are more at risk for suicide because anxiety is so uncomfortable," says Dr. Robbins.
One of the loudest and clearest warning signs is buying a gun. Access to a firearm in the home significantly increases the risk of a suicide - by up to 10 times, according to a 2008 article in the New England Journal of Medicine. Guns account for less than 10 percent of all suicide attempts, but those involving guns are far more likely to be fatal.
"Two to one, men complete suicide more often than women," says Dr. Robbins. "And it's largely because of the method they choose, not because of the intent that they have. Men tend to use firearms; women tend to take overdoses."
Although most people think teens are at higher risk of suicide than others in the population, it's actually people 65 and older who are at greatest risk. The elderly accounted for 16 percent of suicides in 2004, according to the National Institute of Mental Health.
Depression isn't a normal part of aging, but a chronic health condition, a loss of independence, or problems with vision or hearing can increase the risk.
Signs that someone is considering suicide may also show up on a computer. For instance, a Web-browser history may show that a person has been researching suicide and ways to kill himself, Dr. Clayton says. "With a teen, especially, parents should be monitoring Facebook or MySpace," she adds.
Asking about suicidal impulses does not "put ideas" in a person's head, says Dr. Robbins. If you're concerned about suicide, you need to ask the person about it directly. If the person has access to guns, medications, or other items that could be used for self-harm, get rid of them. Most importantly, you should contact a health professional.