3 Warning Signs Someone You Love May Be Thinking About Suicide (Or Is At Risk)

Were you in shock when you heard about TV chef and travel adventurer Anthony Bourdain's suicide or that fashion designer Kate Spade had taken her life? I was.

Famous, gifted, creative, successful, wealthy, and only 55 years old — I own a few of her designer bags, but what did I really know about her personally? Actually, not much.

So, why should I be shocked? Is it perhaps that we are always surprised when someone chooses to die? We ask ourselves why and wonder what we should have known.

While we cannot really predict a suicide attempt, there are sometimes factors and suicide warning signs to look for. Do you think your loved one may be at risk?

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Here are three areas to consider when assessing risk factors and causes of suicide:

1. Health

• Mental health: There are certain mental and emotional disorders that predict suicidal behavior. These include schizophrenia, mood disorders, anxiety disorders, and certain personality disorders.
• Substance abuse: Addictions correlate to suicide risk. This includes the abuse of alcohol, drugs, and prescription medications.
• Health conditions: Major physical illnesses, chronic pain, and/or inability to access medical care can signal suicidal tendencies.
• Sleep disorders: Chronic sleep disturbances can create depression and an inability to cope.

2. Environment

• Relationships: Lack of a stable support system, loneliness, death of a friend or family member or divorce can cause hopelessness and despair.
• Occupation: Watch for the impact of career changes, job loss, or any negative changes at work.
• Prolonged stress: Especially in young people, prolonged exposure to bullying, harassment, or school problems can spell trouble.
• Financial difficulties: Money problems have historically been a cause of suicide. People are profoundly impacted, at times, by sudden or catastrophic changes in their finances. Also, an inability to pay bills or losing one’s home can predict suicide.
• Access to means: As therapists, we always want to assess a client’s access to firearms, razor blades, and drugs that could be used to cause self-harm. If you are worried about your loved one, be sure to limit their access.
• Exposure to suicide: Exposure to suicide in a loved one, the community, or in the media has been shown to increase the suicide rate. "There’s no doubt that there is a contagion effect," says Dr. J. Raymond DePaulo, Jr., Henry Phipps Professor and director of the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. "As a culture, we saw a rise in suicides following the deaths of Marilyn Monroe, Kurt Cobain, and Robin Williams. Suicide prevention lines are most likely experiencing a higher than average call volume today."

3. History

• Previous attempts: It’s never a good sign if your loved one has made attempts on their life in the past.
• Family history: A family history of suicide can spell trouble. There’s a familiarity with the act. ("This is what people in our family do when we feel hopeless or despondent.")
• History of self-harm: Any incidences of self-harm including, intentional injury to tissue or bones, cutting, carving, burning, and hair pulling might be precursors to suicidal behavior.

There is fairly universal agreement that these three factors — health, environment, and history — set the conditions for suicidal behavior.

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Here are three specific warning signs that your loved one might be considering suicide — or is at risk:

1. They express chronic hopelessness

Watch for expressions of hopelessness–that life is not worth living, that their pain is unbearable, and that they feel trapped or like a burden.

2. They become reckless or careless about their connections to others

Many people become reckless when planning suicide. Others withdraw from their relationships, isolating themselves. Beware if your loved one starts calling or visiting people to "say goodbye" or begins giving away some of their favorite possessions. When depressed, people tend to sleep less or more than usual and change their eating habits.

3. They display dramatic emotional changes

Suicidal people tend to display a wide array of emotions from depression and despair to anger and rage. Watch for unexplained mood swings or a general worsening of mood.

I hope that we can all become more aware of the signs that our loved ones are in trouble. The American Foundation for Suicide Prevention tells us that suicide is the 10th leading cause of death in the U.S. and that for every suicide there are 25 attempts.

My heart goes out to anyone affected by the experience of losing a loved one to suicide.

If you are concerned about someone, contact a mental health professional or get them to a nearby treatment center or hospital emergency room. If you are having suicidal thoughts yourself, contact the Suicide & Crisis Lifeline at 988. There are trained, caring professionals ready to help.

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Mary Kay Cocharo is a licensed marriage and family therapist in private practice in West Los Angeles, California.