By Aileen Kim, MD


Recent current events may be bringing up some thoughts and questions about suicide. This is part I of III of an educational series that addresses some common questions and concerns about suicide.**

What are the differences between suicide risk factors and suicide warning signs?

Risk factors are characteristics or conditions that increase the chance that a person may try to end his or her life. For example, we know that people who try to end their life are more likely to have these variables present:

Health Factors

  • Mental health conditions

    • Depression

    • Substance use problems

    • Bipolar disorder

    • Schizophrenia

    • Personality traits of aggression, mood changes and poor relationships

    • Conduct disorder

    • Anxiety disorders

  • Serious physical health conditions including pain

  • Traumatic brain injury

Environmental Factors

  • Access to lethal means including firearms and drugs

  • Prolonged stress, such as harassment, bullying, relationship problems or unemployment

  • Stressful life events, like rejection, divorce, financial crisis, other life transitions or loss

  • Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide

Historical Factors

  • Previous suicide attempts

  • Family history of suicide

  • Childhood abuse, neglect or trauma

Warning signs are new or different behaviors in an individual person who might be at risk for ending his or her life in the near future. An individual who demonstrates these signs may be at risk:


If a person talks about:

  • Killing themselves

  • Feeling hopeless

  • Having no reason to live

  • Being a burden to others

  • Feeling trapped

  • Unbearable pain


Behaviors that may signal risk, especially if related to a painful event, loss or change:

  • Increased use of alcohol or drugs

  • Looking for a way to end their lives, such as searching online for methods

  • Withdrawing from activities

  • Isolating from family and friends

  • Sleeping too much or too little

  • Visiting or calling people to say goodbye

  • Giving away prized possessions

  • Aggression

  • Fatigue


People who are considering suicide often display one or more of the following moods:

  • Depression

  • Anxiety

  • Loss of interest

  • Irritability

  • Humiliation/Shame

  • Agitation/Anger

  • Relief/Sudden Improvement

What causes suicide?

There is no single answer to this question. For any individual whose life ends in suicide, any combination of the risk factors listed above can play a part. People who commit suicide may genuinely believe that their survivors are better off without them or that their death would not have a negative impact on others. Conditions that create risk for suicide can affect a person’s perception, reasoning or judgment.

Is suicide always foreseeable and preventable?

Unfortunately the answer is no. People who attempt suicide can sometimes do so impulsively. They may not necessarily tell others that they want to end their life or intend to do so. Additionally, people with multiple risk factors and warning signs may not attempt suicide. Even when people with risk factors and warning signs seek and receive appropriate treatment, suicide is not always foreseeable and preventable. That doesn’t mean it is futile to try to help someone in your life when you are concerned they might have risk factors or warning signs for suicide, and it does not mean getting help from a professional cannot make a difference.


**Disclaimer: The content of this blog is intended as general educational material and is not a substitute for medical evaluation or advice in the context of a healthcare relationship. If you or someone you know is suicidal, call 1-800-273-8255 or seek immediate medical attention by calling 911.


References: accessed June 11, 2018 accessed June 11, 2018

Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk

Cheryl A. King, Adam Horwitz, Ewa Czyz, Rebecca Lindsay J Clin Psychol Med Settings. 2017 Mar; 24(1): 8–20.