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Suicide and suicidal thoughts

Suicide, taking your own life, is a tragic reaction to stressful life situations — and all the more tragic because suicide can be prevented. Whether you're considering suicide or know someone who feels suicidal, learn suicide warning signs and how to reach out for immediate help and professional treatment. You may save a life — your own or someone else's.

It may seem like there's no way to solve your problems and that suicide is the only way to end the pain. But you can take steps to stay safe — and start enjoying your life again.

Symptoms Causes Risk factors Complications Prevention

Suicide warning signs or suicidal thoughts include:

  • Talking about suicide — for example, making statements such as "I'm going to kill myself," "I wish I was dead" or "I wish I hadn't been born"
  • Getting the means to commit suicide, such as buying a gun or stockpiling pills
  • Withdrawing from social contact and wanting to be left alone
  • Having mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying or violence
  • Feeling trapped or hopeless about a situation
  • Increasing use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Doing risky or self-destructive things, such as using drugs or driving recklessly
  • Giving away belongings or getting affairs in order when there is no other logical explanation for why this is being done
  • Saying goodbye to people as if they won't be seen again
  • Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

Warning signs aren't always obvious, and they may vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.

When to see a doctor

If you think you may hurt yourself or attempt suicide, get help right now:

  • Call 911 or your local emergency number immediately.
  • Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.

If you're feeling suicidal, but you aren't immediately thinking of hurting yourself:

  • Reach out to a close friend or loved one — even though it may be hard to talk about your feelings
  • Contact a minister, spiritual leader or someone in your faith community
  • Call a suicide crisis center hotline
  • Make an appointment with your doctor, other health care provider or mental health provider

Suicidal thinking doesn't get better on its own — so get help.

Suicidal thoughts have numerous causes. Most often, suicidal thoughts are the result of feeling like you can't cope when you're faced with what seems to be an overwhelming life situation. If you don't have hope for the future, you may mistakenly think suicide is a solution. You may experience a sort of tunnel vision, where in the middle of a crisis you believe suicide is the only way out.

There may also be a genetic link to suicide. People who complete suicide or who have suicidal thoughts or behavior are more likely to have a family history of suicide. While more research is needed to fully understand a possible genetic component, it's thought that there may be a genetic link to impulsive behavior that could contribute to suicidal tendencies.

Although suicide attempts are more frequent for women, men are more likely than women to complete suicide because they typically use more effective methods, such as a firearm.

You may be at risk of suicide if you:

  • Feel hopeless, socially isolated or lonely
  • Experience a stressful life event, such as the loss of a loved one, military service, a breakup, a significant medical illness, or financial or legal problems
  • Have a substance abuse problem — alcohol and drug abuse can worsen thoughts of suicide and make you feel reckless or impulsive enough to act on your thoughts
  • Have suicidal thoughts and have access to firearms in your home
  • Have an underlying psychiatric disorder, such as major depression, post-traumatic stress disorder, bipolar disorder, personality disorder, anxiety or detachment from reality (psychosis), or paranoia
  • Have a family history of mental disorders, substance abuse, suicide or violence, including physical or sexual abuse
  • Have a medical condition that can be linked to depression and suicidal thinking, such as chronic disease, chronic pain or terminal illness
  • Are bisexual, homosexual or transgender with an unsupportive family or in a hostile environment
  • Attempted suicide before

Children and teenagers

Suicide in children and teenagers often follows stressful life events. Keep in mind that what a young person sees as serious and insurmountable may seem minor to an adult — such as problems in school or the loss of a friendship. In some cases, a child or teen may feel suicidal due to certain life circumstances he or she may not want to talk about. Some of these include:

  • Having a psychiatric disorder, including depression
  • Loss or conflict with close friends or family members
  • History of physical or sexual abuse
  • Problems with alcohol or drugs
  • Becoming pregnant
  • Having a sexually transmitted infection
  • Being the victim of bullying
  • Being uncertain of sexual orientation

Murder and suicide

In some cases, people who are suicidal are at risk of killing others and then themselves. This is known as a homicide-suicide or murder-suicide. The types of feelings that trigger this tragic behavior can stem from a number of sources. Some common risk factors for murder-suicide include:

  • History of conflict with a spouse or romantic partner
  • Current family legal or financial problems
  • History of mental health problems, particularly depression
  • Alcohol or drug abuse or addiction
  • Having access to a firearm — nearly all murder-suicides are committed using a gun

Starting antidepressants and increased suicide risk

Some studies have shown a possible link between starting treatment with an antidepressant and an increased risk of suicide. The Food and Drug Administration (FDA) requires manufacturers of all antidepressants to include a warning stating that antidepressants may increase suicide risk in children, adolescents and young adults during the first few months of treatment.

However, the link between antidepressants and suicidal thinking isn't clear — and not taking an antidepressant when it's needed also increases the risk of suicide. To be safe, anyone who starts taking an antidepressant should be watched closely for signs of suicidal thinking. If you — or someone you know — has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.

Suicidal thoughts and attempted suicide take an emotional toll, both for those who want to take their own life and for their loved ones. For instance, you may be so consumed by suicidal thoughts that you can't function in your daily life. And while many suicide attempts are impulsive acts during a moment of crisis, they can leave you with permanent serious or debilitating injuries, such as organ failure or brain damage.

For those left behind after a suicide — people known as survivors of suicide — grief, anger, depression and guilt are common.

To help keep yourself from feeling suicidal:

  • Get the treatment you need. If you don't treat the underlying cause, your suicidal thoughts are likely to return. You may feel embarrassed to seek treatment for your mental health problems, but getting the right treatment for depression, substance abuse or another underlying problem will make you feel better about life — and help keep you safe.
  • Follow your treatment plan. Go to follow-up appointments, take medications exactly as directed, and take the other steps your doctor or mental health provider recommends.
  • Know your warning signs and make a plan. Learn to spot the danger signs early, and decide what steps to take ahead of time. It may help to write out what steps you'll take if you start feeling suicidal. You may want to make a written agreement with a mental health provider or a loved one to help you anticipate the right steps to take when you don't have the best judgment. Clearly stating your suicidal intention with your therapist makes it possible to anticipate it and address it.
  • Eliminate potential means of committing suicide. If you think you might act on suicidal thoughts, immediately get rid of any potential means of committing suicide, such as firearms, knives or dangerous medications. If you take medications that have a potential for overdose, have a family member or friend give you your medications as prescribed.
  • Establish your support network. It may be hard to talk about suicidal feelings, and your friends and family may not fully understand why you feel the way you do. Reach out anyway, and make sure the people who care about you know what's going on and are there when you need them. You may also want to get help from your place of worship, support groups or other community resources.
  • Remember, suicidal feelings are temporary. If you feel hopeless or that life's not worth living anymore, remember that the feelings will pass. Take one step at a time and don't act impulsively. Work to regain your perspective — and life will get better.
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