Before the pandemic, suicide was already among the leading causes of death in the United States with a US Centers for Disease Control and Prevention April 2020 report showing a 25% rise in suicide rates over the past two decades. Now, risk factors for suicide are increasing as the nation deals with the current pandemic, economic stress, social isolation, and widespread anxiety.

“It is extremely important for people to be aware of warning signs that indicate a friend or loved one may be at risk for suicide,” says Nadine A. Chang, Ph.D., a Clinical Psychologist at Gracie Square Hospital. “Despite increases in research and funding for suicide prevention, we are still seeing suicide rates climb. Today people are experiencing job loss, financial stress, natural disasters, and illness, any one of which can lead to feelings of hopelessness and helplessness, the two strongest correlates for suicide.

“The key to suicide prevention is early identification of these warning signs,” she continues. “In the current environment, it is more important than ever that we check on loved ones. The clues are sometimes subtle, but being aware of warning signs can mean the difference between life and death.”

In conjunction with National Suicide Prevention Month, here are the top suicide warning signs:

• Change in behavior: Differences in emotions and thinking patterns are often the earliest indicators of depression and hopelessness. Be aware if someone who has always been sociable stops talking, seems unusually short-tempered, or has mood swings—something more extreme than day-to-day ups and downs, as well as increased alcohol or substance use. Depression also sometimes expresses itself as anger.

• Indications of depression: Notice if someone is depressed. That does not mean having a “down day” or two, but be concerned if someone feels sad for two weeks or more; loses interest in activities and things they previously enjoyed; shows signs of fatigue, insomnia, or loss of appetite; or has feelings of guilt or helplessness.

• Lack of motivation: Does someone withdraw socially, and stop calling people or talking on line. Have they stopped cleaning, showering, or taking care of themselves?

• Phrases that signal depression: Listen to what people say. Someone may say they wish they were not around or want to go to sleep and never wake up. A person who is suicidal may talk about methods for taking their life, such as taking pills, hanging or jumping from a window. Be especially concerned when someone has no deterrents to suicide, such as family, religion or long-term goals.

• Is someone catastrophizing or having an extreme reaction to a distressing event? For example, someone who lost a job may express fears that they will never be able to pay their bills or find another job.

• Is someone making arrangements? Sometime people who are suicidal will start putting their finances in order, give away valued possessions, or write a will or suicide note.

• Suicide can be impulsive or planned. Someone who is intoxicated is more likely to have impaired judgement or engage in impulsive behavior without thinking of the consequences. Planned suicides can be more lethal. Be aware if someone is hoarding medication, or planning a day or time that will decrease the risk of being interrupted or found.

“Take these signs seriously,” says Dr. Chang. “If you notice someone is in trouble, reach out and establish a connection. In cases of imminent danger, don’t be afraid to call 911.”

If you are having thoughts of suicide call 911 or go to the nearest emergency room. Other resources available 24/7 include The National Suicide Prevention Lifeline (800)273-8255, and NYC Well (888)692-9355, or text “WELL” to 6517.

About Gracie Square Hospital:

Gracie Square Hospital has provided advanced, patient-centered inpatient behavioral health services since 1959. The hospital offers a multidisciplinary approach to care for patients with psychiatric disorders who can benefit from inpatient hospitalization to help patients return to the community and live healthy, productive lives. Its diagnostic and treatment programs are provided by skilled, licensed and certified behavioral healthcare professionals.