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Suicide Content Supplied by NHS Choices
Introduction

Suicide is the act of intentionally ending your life.

If you're reading this because you have, or have had, thoughts about taking your own life, it's important you ask someone for help. It's probably difficult for you to see at this time, but you're not alone and not beyond help.

Many people who have had suicidal thoughts say they were so overwhelmed by negative feelings they felt they had no other option. However, with support and treatment they were able to allow the negative feelings to pass.

Getting help

If you are feeling suicidal, there are people you can talk to who want to help:

  • speak to a friend, family member or someone you trust as they may be able to help you calm down and find some breathing space
  • call the Samaritans 24-hour support service on 116 123
  • go to your nearest accident and emergency (A&E) department and tell the staff how you are feeling
  • contact NHS 111
  • make an urgent appointment to see your GP

Read more about getting help if you're feeling suicidal.

Worried someone else is suicidal

If you're worried that someone you know may be considering suicide, try to encourage them to talk about how they are feeling. Listening is the best way to help. Try to avoid offering solutions and try not to judge.

If they've previously been diagnosed with a mental health condition, such as depression, you can speak to a member of their care team for help and advice.

Read more about suicide warning signs and how you can help someone with suicidal thoughts.

Why do some people take their own life

There's no single reason why someone may try to take their own life, but certain things can increase the risk.

A person may be more likely to have suicidal thoughts if they have a mental health condition, such as depression, bipolar disorder or schizophrenia. Misusing alcohol or drugs and having poor job security can also make a person more vulnerable.

It's not always possible to prevent suicidal thoughts, but keeping your mind healthy with regular exercise, healthy eating and maintaining friendships can help you cope better with stressful or upsetting situations.

Read more about the causes of suicide and preventing suicide.

Self-harm

Many people who self-harm don't want to kill themselves. Self-harming can be a kind of "survival strategy", providing a person with a way of coping with overwhelming emotions.

However, self-harming is usually a sign that a person needs immediate help and support.

Read about self-harm for more information and advice.


Why people attempt suicide

Despite being a leading cause of death, both in the UK and worldwide, there is little hard evidence to explain why some people attempt suicide.

Most people who choose to end their lives do so for complex reasons. In the UK, research has shown many people who die by suicide have a mental illness, most commonly depression or an alcohol problem.

In many cases, suicide is also linked to feelings of hopelessness and worthlessness.

Vulnerability to suicide

Many experts believe a number of things determine how vulnerable a person is to suicidal thinking and behaviour. These include:

  • life history - for example, having a traumatic experience during childhood, a history of sexual or physical abuse, or a history of parental neglect
  • mental health - for example, developing a serious mental health condition, such as schizophrenia
  • lifestyle - for example, if you misuse drugs or misuse alcohol
  • employment - such as poor job security, low levels of job satisfaction or being unemployed 
  • relationships - being socially isolated, being a victim of bullying or having few close relationships
  • genetics and family history 

In addition, a stressful event may push a person "over the edge", leading to suicidal thinking and behaviour.

It may only take a minor event, such as having an argument with a partner. Or it may take one or more stressful or upsetting events before a person feels suicidal, such as the break-up of a significant relationship, a partner dying or being diagnosed with a terminal illness. 

Mental health conditions

It's estimated 90% of people who attempt or die by suicide have one or more mental health conditions. However, in some cases, the condition may not have been formally diagnosed by a clinician. Conditions leading to the biggest risk of suicide are described below.

Severe depression

Severe depression causes symptoms of low mood, tiredness, loss of interest, despair and hopelessness that interfere with a person's life. People with severe depression are much more likely to attempt suicide than the general population.

Bipolar disorder

Bipolar disorder causes a person's mood to swing from feeling very high and happy to feeling very low and depressed. About one in three people with bipolar disorder will attempt suicide at least once. People with bipolar disorder are 20 times more likely to attempt suicide than the general population.

Schizophrenia

Schizophrenia is a long-term mental health condition that typically causes hallucinations (seeing or hearing things that are not real), delusions (believing in things that are not true) and changes in behaviour. It's estimated that one in 20 people with schizophrenia will take their own life.

People with schizophrenia are most at risk of suicide when their symptoms first begin. This is because they frequently suffer loss at this time - for example, loss of employment and relationships. It's also increased when people with schizophrenia experience depression. The risk tends to reduce over time.

People with schizophrenia are also at increased risk of self-harm.

Borderline personality disorder

Borderline personality disorder is characterised by unstable emotions, disturbed thinking patterns, impulsive behaviour and intense but unstable relationships with other people. People with a borderline personality disorder often have a history of childhood sexual abuse. They have a particularly high risk of suicide.

Self-harm is often a key symptom of this condition.

It's estimated just over half of people with borderline personality disorder will make at least one suicide attempt.

Anorexia nervosa 

Anorexia nervosa is an eating disorder. People with anorexia feel fat and try to keep their weight as low as possible. They do this by strictly controlling and limiting what they eat, as well as sometimes inducing vomiting. It's estimated around one in five people with anorexia will make at least one suicide attempt. Anorexia is associated with a high risk of suicide.

Other risk factors for suicide

Other things that can make a person more vulnerable to suicidal thoughts include:

  • being gay, lesbian or transgender, arising from the prejudice these groups often face
  • being in debt
  • being homeless
  • being a war veteran
  • being in prison or recently released from prison
  • working in an occupation that provides access to potential ways of dying by suicide, such as working as a doctor, nurse, pharmacist, farmer or as a member of the armed forces
  • exposure to other people with suicidal behaviour, especially close friends or family members

Antidepressants and suicide risk

Some people experience suicidal thoughts when they first take antidepressants. Young people under 25 seem particularly at risk.

Contact your GP immediately or go to your local hospital if you have thoughts of killing or harming yourself at any time while taking antidepressants.

It may be useful to tell a relative or close friend if you have started taking antidepressants. Ask them to read the leaflet that comes with your medication. Also ask them to tell you if they think your symptoms are getting worse or if they are worried about changes in your behaviour.

Genetics and suicide

Suicide and some mental health problems can run in families. This has led to speculation that certain genes may be associated with suicide.

However, it would be too simple to claim there's a "suicide gene" as the factors leading to suicide are complex and wide ranging. Genetics may influence personality factors (such as acting impulsively or aggressively) that may increase the risk of suicidal behaviour, especially when a person is depressed.

Other theories

An American psychologist called Thomas Joiner developed a theory known as the interpersonal theory of suicide. The theory states three main factors which can cause someone to turn to suicide. They are:

  • a perception (usually mistaken) they are alone in the world and no one really cares about them
  • a feeling (again, usually mistaken) they are a burden on others and people would be better off if they were dead
  • fearlessness towards pain and death

The theory argues fearlessness towards pain and self-harm may be learnt over time, which could explain the strong association between self-harming behaviour and suicide.

People who are regularly exposed to the suffering and pain of others may develop this fearlessness over time. This could help explain why suicide rates are higher in occupations linked to such exposure, such as soldiers, nurses and doctors.

How common is suicide

During 2012 there were 5,981 suicides in the UK but the number of attempted suicides is much higher.

Suicide occurs in people of all ages, including children, but adults in middle- and late-middle age have the highest suicide rate.


Warning signs of suicide

Sometimes there may be obvious signs that someone is at risk of attempting suicide. However, this is often not the case.

High-risk warning signs

A person may be at high risk of attempting suicide if they:

  • threaten to hurt or kill themselves
  • talk or write about death, dying or suicide
  • actively look for ways to kill themselves, such as stockpiling tablets

If the person has previously been diagnosed with a mental health condition, contact a member of their care team or the centre or clinic where they were being treated.

If you don't have these details, contact your nearest accident and emergency (A&E) department and ask for the contact details of the nearest crisis resolution team (CRT). CRTs are teams of mental healthcare professionals, such as psychiatrists and psychiatric nurses, who work with people experiencing severe psychological and emotional distress.

While waiting for help to arrive, remove any possible means of suicide from the person's immediate environment, such as medication, knives or other sharp objects, household chemicals, such as bleach and ropes or belts.

For more information about CRTs, the charity Rethink Mental Illness has a crisis teams factsheet you can download.

Other warning signs

A person may also be at risk of attempting suicide if they:

  • complain of feelings of hopelessness
  • have episodes of sudden rage and anger
  • act recklessly and engage in risky activities with an apparent lack of concern about the consequences
  • talk about feeling trapped, such as saying they can't see any way out of their current situation
  • self-harm - including misusing drugs or alcohol, or using more than they usually do
  • noticeably gain or lose weight due to a change in their appetite
  • become increasingly withdrawn from friends, family and society in general
  • appear anxious and agitated
  • are unable to sleep or they sleep all the time
  • have sudden mood swings - a sudden lift in mood after a period of depression could indicate they have made the decision to attempt suicide
  • talk and act in a way that suggests their life has no sense of purpose
  • lose interest in most things, including their appearance
  • put their affairs in order, such as sorting out possessions or making a will

If you notice any of these warning signs in a friend, relative or loved one, encourage them to talk about how they are feeling.

Also share your concerns with your GP or a member of their care team, if they are being treated for a mental health condition.

Read more about helping someone with suicidal feelings.


Getting help

If you're reading this because you're having suicidal thoughts, try to ask someone for help. It may be difficult at this time, but it's important to know you're not beyond help and you're not alone.

Talking to someone can help you see beyond feelings of loneliness or despair and help you realise there are options.

There are people who want to talk to you and help. Try talking to a family member or friend about how you're feeling.

There are several telephone helplines you can call at any time of the day or night. You can speak to someone who understands how you're feeling and can help you through the immediate crisis.

Helplines and support groups

We know it can be difficult to pick up the phone, but reach out to somebody and let them know how you are feeling.

  • Samaritans (116 123) operates a 24-hour service available every day of the year. If you prefer to write down how you're feeling, or if you're worried about being overheard on the phone, you can email Samaritans at jo@samaritans.org.
  • Childline (0800 1111) runs a helpline for children and young people in the UK. Calls are free and the number won't show up on your phone bill.
  • PAPYRUS (0800 068 41 41) is a voluntary organisation supporting teenagers and young adults who are feeling suicidal.
  • Depression Alliance is a charity for people with depression. It doesn't have a helpline, but offers a wide range of useful resources and links to other relevant information.
  • Students Against Depression is a website for students who are depressed, have a low mood or are having suicidal thoughts.
  • Bullying UK is a website for both children and adults affected by bullying.

Help for young men

Men may be more likely to avoid or ignore problems and many are reluctant to talk about their feelings or seek help when they need it.

A support group called the Campaign Against Living Miserably (CALM) is an excellent resource for young men who are feeling unhappy. As well as their website, CALM also has a helpline (0800 58 58 58).

Talking to someone you trust

If you don't want to speak to someone on a helpline, you could talk to:

  • a member of your family, a friend or someone you trust, such as a teacher
  • your GP, a mental healthcare professional or another healthcare professional
  • a minister, priest or other type of faith leader

Seeing your GP

It would also help to see your GP. They can advise you about appropriate treatment if they think you have a mental health condition, such as depression or anxiety.

Your GP may be able to help you with access to talking therapies. Talking therapies, such as counselling and cognitive behavioural therapy (CBT), are often used to help people who have suicidal thoughts and usually involve talking about your feelings with a professional.

Helping your child

If you are concerned your child may be feeling suicidal or is self-harming, the following advice may help:

  • notice when they seem upset, withdrawn or irritable
  • encourage them to talk about their worries, listen to them and help them find their own solutions
  • keep all medicines locked away, including painkillers such as paracetamol
  • suggest your child talks to their GP or a counsellor about how they feel

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Offering support to someone who's feeling suicidal

One of the best things you can do if you think someone may be feeling suicidal is to encourage them to talk about their feelings and to listen to what they say.

Talking about someone's problems is not always easy and it may be tempting to try to provide a solution. But often the most important thing you can do to help is listen to what they have to say.

If there is an immediate danger, make sure they are not left on their own.

Do not judge

It's also important not to make judgements about how a person is thinking and behaving. You may feel that certain aspects of their thinking and behaviour are making their problems worse. For example, they may be drinking too much alcohol. 

However, pointing this out will not be particularly helpful to them. Reassurance, respect and support can help someone during these difficult periods.

Asking questions

Asking questions can be a useful way of letting a person remain in control while allowing them to talk about how they're feeling. Try not to influence what the person says, but give them the opportunity to talk honestly and openly.

Open ended questions such as "Where did that happen " and "How did that feel " will encourage them to talk. It's best to avoid statements that could possibly end the conversation, such as "I know how you feel" and "Try not to worry about it".

Getting professional help

Although talking to someone about their feelings can help them feel safe and secure, these feelings may not last. It will probably require long-term support to help someone overcome their suicidal thoughts.

This will most likely be easier with professional help. Not only can a professional help deal with the underlying issues behind someone's suicidal thoughts, they can also offer advice and support for yourself.

Find out more about getting help for suicidal thoughts

More information

For more detailed information about helping someone with suicidal thoughts, the charity Rethink Mental Illness has a factsheet available about supporting someone with suicidal thoughts.

Help for someone with a mental illness

If someone who has previously been diagnosed with a mental illness has suicidal thoughts, contact a member of their care team or the centre or clinic where they were being treated.

If you don't have these details, contact your nearest accident and emergency (A&E) department and ask for the contact details of the nearest crisis resolution team (CRT).

CRTs are teams of mental healthcare professionals, such as psychiatrists and psychiatric nurses, who work with people experiencing severe psychological and emotional distress.

For more information about CRTs, the charity Rethink Mental Illness has a crisis teams factsheet you can download.


Improving your mental health

It's impossible to guarantee you will never get a mental health condition, but you can take steps to improve your mental health.

If you're stronger emotionally, you may find it easier to cope with stressful or upsetting incidents, reducing your risk of developing a mental health condition, such as depression, and the risk of suicidal thoughts.

Exercise and diet

Research shows that for some people with mild depression, exercise can be as effective as antidepressant medication in reducing depressive symptoms. Being physically active helps to:

  • lift your mood
  • reduce stress and anxiety
  • encourage the release of "feel-good" chemicals, called endorphins
  • improve self-esteem

The National Institute for Health and Care Excellence (NICE) recommends exercise should be used to treat depression in people of all ages.

It's also important to eat a healthy diet. Eating healthily may be as important for maintaining mental health as it is for protecting against physical health problems.

Read more about exercise for depression and healthy eating and depression.

Alcohol

Drinking alcohol can be tempting as a way of trying to cope with problems or unpleasant emotions. But alcohol is a depressant, which means it can make unpleasant emotions worse, such as sadness and hopelessness.

To avoid common mental health problems associated with alcohol misuse, don't drink more than the recommended daily limits of alcohol. These are:

  • three to four units a day for men
  • two to three units a day for women

A unit of alcohol is approximately half a pint of normal-strength lager or a single measure (25ml) of spirits. A small glass of wine (125ml) is 1.5 units.

See your GP if you have difficulty moderating your alcohol consumption.

Read more about alcohol and treating alcohol misuse.

Drugs

People who have problems or unpleasant emotions also commonly use drugs as a way of coping. However, as with alcohol, persistent drug misuse can increase your risk of developing a serious mental health condition, such as depression.

If you find it difficult to stop taking drugs, you may require counselling or medication.

Read more about getting help for drug misuse.

Avoid isolation

Becoming socially isolated is a significant risk factor for suicide. Try to remain engaged as much as possible with the world around you. Talk to someone you trust about how you feel and maintain your friendships and interests, even if you don't feel like it at times.

If you find it difficult to make friends, you may benefit from joining a local activity group, such as a book group or walking group. Your local library, community centre or local council should be able to provide you with details of the various groups and clubs in your community.

Networks of local support groups are run throughout the country by many larger mental health charities, including:

Research has shown that people who regularly spend time helping others through charitable activities or other voluntary work are typically more mentally healthy than the general population. You may benefit from volunteering with a local charity or voluntary organisation.

All charities and most voluntary organisations are grateful for any help. Simply choose an issue you feel strongly about and contact a relevant organisation. The most effective way of finding and contacting an organisation is on the internet.

Read more about volunteering.

Staying positive

Staying positive may sound like a meaningless phrase, particularly to someone with severe depression, but it's important to try to remain as positive as possible.

Persistent negative thinking can mean you risk withdrawing from the world and becoming more isolated.

Breaking this pattern usually requires a conscious effort, such as "stepping back" when an event upsets you and considering how you can respond in a more positive way.

If you can't change negative patterns of thinking, you may benefit from a type of talking treatment called cognitive behavioural therapy (CBT). CBT can help you manage your problems by changing how you think and act.

Self-help

When you are diagnosed with generalised anxiety disorder (GAD) or depression, your GP may recommend trying self-help treatments before having more intensive psychological therapy or medication.

This will usually involve working from a book or computer programme for around six weeks or longer. In some cases, you may be closely supported by a trained therapist who you will speak to every week or two, although some treatments only involve minimal or occasional contact with a therapist who will monitor your progress.

There are a number of different books and courses available that can help you learn to cope with your anxiety, but the National Institute for Health and Care Excellence (NICE) only recommends trying treatments based on the principles of cognitive behavioural therapy (CBT).

CBT is a type of psychological treatment that can help you understand your condition better and how your problems, thoughts, feelings and behaviour affect each other. The aim of CBT-based treatments is to help you learn ways to manage your anxiety by modifying negative or unhelpful behaviour and thoughts.

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