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8 Warning Signs of Suicide

Know the warning signs and how to get help for yourself or a loved one


spinner image Oprah Winfrey interviews Prince Harry and Meghan Markle on A CBS Primetime Special premiering on CBS on March 7, 2021. (Photo by Harpo Productions/Joe Pugliese via Getty Images)
Prince Harry and Meghan Markle talk to Oprah about her thoughts of suicide.
Harpo Productions/Joe Pugliese via Getty Images

When former-actress-turned-royalty Meghan Markle, wife of Britain's Prince Harry, confessed to having had suicidal thoughts in an Oprah Winfrey prime-time special in March 2021, she put a spotlight on a public health crisis that is anything but glamorous.

“I was really ashamed to say it at the time and ashamed to have to admit it to Harry. ... But I knew that if I didn't say it, then I would do it,” she said. “I just didn't want to be alive anymore."​​

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Markle's thoughts about ending her life are what's known as “suicidal ideation,” says Patricia Kaine, M.D., a retired family physician who's now a suicide prevention speaker in Cleveland and has experienced such thoughts herself. “Suicidal ideation is where you have gone beyond the fleeting thought of suicide to, ‘I'm thinking of ways to commit suicide. I'm thinking how suicide will make life better, for either me or the people around me. Meghan Markle's story is more common than people realize."

Kim Ruocco, who lost her husband to suicide in 2005, can relate.

“Meghan said a lot of similar things that you hear from people who are struggling,” says Ruocco, vice president of Suicide Prevention & Postvention for the Tragedy Assistance Program for Survivors (TAPS). “And you think about, if she could get to that place, anybody could."

Beyond fleeting thoughts

Finding help

​If you or someone you care about is considering suicide, call, text or chat the 988 Suicide and Crisis Lifeline to connect with a trained counselor who can provide support and direct them to local resources, if necessary. Veterans who dial 988 can press 1 to reach the Veterans Crisis Line and speak with a responder trained in crisis intervention and military culture.

The line is also available by chat at VeteransCrisisLine.net/Chat or by text at 838255. Find more information at ​​988lifeline.org. The Substance Abuse and Mental Health Services Administration also has a helpline (the Treatment Referral Routing Service) offering information on support groups, treatment options and other assistance: 800-662-HELP (4357).​​

​The data vary, but around 25 to 35 percent of adults in the U.S. have had suicidal thoughts at some point in their lives, says Christine Moutier, M.D., chief medical officer at the American Foundation for Suicide Prevention.

Suicidal thoughts are so widespread, according to the Centers for Disease Control and Prevention (CDC), that in 2021, an estimated 12.3 million adults seriously thought about suicide; 3.5 million made a plan; and 1.7 million made an attempt.

"It does not necessarily indicate anything other than the fact that life is challenging for all human beings,” Moutier says. “Challenges and struggles are kind of universal to the human condition.”

The pandemic exacerbated these challenges, spurring a rise in mental health issues. The number of people in the U.S. reporting symptoms of depression in April through June 2020 increased fourfold over the same period in 2019, according to the CDC. Three times as many people reported symptoms of anxiety disorder in that same period. And 10.7 percent of 5,470 adults surveyed at the end of June 2020 reported having seriously considered suicide in the 30 days before completing the survey.

​​"We do know, based on these CDC surveys, that Americans are feeling more distressed during the pandemic,” Moutier says. “But it's also important to know that suicide is preventable."​

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Warning signs

Signs of suicide ideation include changing patterns in eating or sleeping; engaging in risky or dangerous behaviors; drug or alcohol use; and other symptoms associated with depression (see box for more signs).​​

"[They might do] things like withdrawing or starting to give their things away,” Kaine says. “Or say, ‘When I'm gone, will you take care of my pet?’” ​​Among older adults, warning signs might include a change in their engagement with activities they've always enjoyed, low energy, or flat speech, Moutier says. They may have depression, which, because the symptoms are similar, can sometimes be mistaken for dementia in older people.​

The most common signs of suicidal ideation include: ​

  1. Talking about being a burden or wanting to end their life​
  2. Unusual, risky or dangerous behavior​
  3. A dramatic change in eating or sleeping routines​
  4. Withdrawing from activities they once loved​
  5. Giving things away, even if they have no terminal diagnosis
  6. ​Asking people to take care of their pets when they're gone​
  7. Physical changes, lack of energy, slow speech​
  8. Recent trauma, such as a breakup or job loss​.
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