There are many warning signs of possible suicide risk that might seem obvious – such as depressed mood, eating/sleeping much too little or too much, withdrawing from others, and discontinuing activities that were once enjoyed. Other signs are not at all obvious and may in fact be quite surprising.

One of the biggest warning signs of suicide is having thoughts about ending one’s life, even without any intention of acting on them. Understandably people who are outside the mental health field are often afraid to ask about such thoughts.

The truth is that people tend to feel relieved when a friend or family member asks if they’ve been thinking about suicide or imagined sleeping forever. That is because if you’re thinking of asking the question, you probably have good reason. You will open the door to honest discussion by gently inquiring about such thoughts. If you’re told “No, I’m not thinking about that” don’t assume this is true or false. Keep your eyes open for warning signs. And don’t worry about raising the subject of suicidal thoughts – researchers strongly recommend open discussion rather than avoiding the subject.

Many people periodically have thoughts of suicide over the course of their lives. This can make it very difficult for loved ones – and even professionals – to know when hospitalization may be necessary.

One warning sign that you might not have connected to suicide is agitation. If the person you’re concerned about shows signs of agitation or anxiety in combination with recent suicidal thoughts, you should contact a mental health professional right away and do what you can to stay with the person until given professional advice. This is because agitation can lead to impulsive behavior.

The same is true if you hear your loved one express feelings of shame or guilt (e.g. over losing a job or a break-up in a relationship) while also having had recent thoughts of suicide.

In addition, if your loved one has made a suicide attempt in the past – even the far distant past – you should consider him/her to be at higher risk, particularly when showing signs of anxiety or shame.

Another risk factor that often goes under the radar is medication. Medications used for mental illness can be very helpful, but they take time – usually several weeks – to kick in. Some medications – including anti-depressants – are believed to increase the likelihood of suicide when they are first started. One reason is that some people will feel their energy level increasing before their mood improves. They may now have the energy to act on their thoughts. This means that you should pay extra attention to changes in mood and behavior whenever a person alters their medication or dosages.

Perhaps one of the most surprising warning signs of suicide risk is a sudden improvement in mood that occurs without explanation following a prolonged period of sadness. Sometimes this happens because the person has made a decision about how to end their life and feels in having a plan. Quite understandably, family members are often relieved to see their loved one smiling for a change and typically do not question why this is happening. Rather than assuming that everything is okay now, it is best to seek professional advice immediately.

• Sudden improvement in mood without clear explanation
• Stopped taking any prescribed meds
• Giving possessions away
• New medications or new dosages
• Agitation with recent suicidal thoughts
• Feelings of shame or guilt
• Intoxication or other impairment in someone who has been depressed