Warning Signs of Suicide: Risk Factors and How to Help Someone Who Is Suicidal

Suicide is a serious public health concern that can affect people of any age, background or circumstance. While it can be difficult to know what someone is experiencing internally, recognising the warning signs of suicide and responding with compassion can help someone access the support they need.

 

Suicidal thoughts can occur for many different reasons. They may arise during a period of severe emotional distress, depression, trauma, loss, relationship difficulties, financial problems, chronic pain or illness, substance use or other challenging circumstances. Suicide is rarely the result of one factor alone. Understanding this complexity is an important part of prevention.

 

Most importantly, suicidal thoughts should never be dealt with alone. Whether you are concerned about someone else or you are experiencing suicidal thoughts yourself, reaching out to a trusted person and a healthcare professional can be an important first step.

 

In South Africa, an estimated 23 people die by suicide every day, with around 230 serious attempts recorded daily (SADAG). Suicide is not a rare or distant problem – it is one many South African families and communities encounter directly, which is why open, informed conversation matters.

 

Understanding Suicidal Thoughts and Behaviour

 

Suicidal thoughts refer to thinking about death or suicide. They can range from fleeting thoughts about not wanting to be alive to more persistent thoughts about ending one’s life.

 

Having suicidal thoughts does not necessarily mean that someone wants to die. A person may instead be experiencing overwhelming emotional pain and feel unable to see another way of coping with it. This is why taking any expression of suicidal thoughts seriously is so important.

 

Suicidal behaviour can be influenced by multiple interacting factors, including mental health, physical health, relationships, social circumstances and stressful life events. The WHO emphasises that suicide is preventable and that timely emotional support, appropriate healthcare and other evidence-based interventions can save lives.

 

What Are the Warning Signs of Suicide?

 

The warning signs of suicide can be emotional, behavioural or verbal. A person may not display all of them, and some people may show very few outward signs.

 

Potential warning signs include:

 

• Talking about wanting to die, disappear or end their life
• Expressing feelings of hopelessness, worthlessness or being a burden
• Saying that other people would be better off without them
• Withdrawing from friends, family or activities they previously enjoyed
• Significant or sudden changes in mood or behaviour
• Giving away valued possessions or saying goodbye to people
• Looking for ways to end their life
• Increased use of alcohol or other substances
• Experiencing severe emotional distress
• Suddenly becoming unusually calm after a period of severe distress

 

The WHO identifies expressing thoughts or plans about ending one’s life, severe mood changes, social withdrawal, saying goodbye and giving away valued possessions among the warning signs that may indicate someone needs help.

 

It is important not to dismiss statements about suicide as attention-seeking or assume that someone is simply having a bad day. Talking about suicide can be a person’s way of communicating that they are experiencing significant distress.

 

What Are the Risk Factors for Suicide?

 

There is no single profile of someone who will experience suicidal thoughts. However, certain circumstances can increase a person’s risk.

 

Some important suicide risk factors include:

 

1. A previous suicide attempt – a previous attempt is one of the strongest known risk factors for suicide. 
2. Depression and other mental health conditions – severe emotional distress and some mental health disorders can increase risk.
3. Alcohol or substance use – substance use can increase impulsivity and make it more difficult to cope during a crisis.
4. Trauma, abuse or violence – experiencing or witnessing trauma can contribute to suicidal distress.
5. Social isolation or significant loss – loneliness, bereavement, relationship breakdown and feeling disconnected from others can increase vulnerability.

 

Other factors may include chronic pain or illness, financial difficulties, discrimination, conflict and other overwhelming life circumstances. Risk factors can interact, meaning that someone experiencing several simultaneously may need additional support.

 

Having one or more risk factors does not mean that someone will attempt suicide. Similarly, someone without obvious risk factors may still experience suicidal thoughts.

 

Depression and Suicide: What Should You Look For?

 

Depression and suicidal thoughts can occur together, but they are not the same thing. Depression is a mental health condition, while suicidal thoughts are a possible symptom or consequence of severe emotional distress.

 

Signs that someone may be experiencing depression can include persistent sadness, loss of interest or pleasure, changes in sleep or appetite, low energy, difficulty concentrating, feelings of worthlessness and hopelessness.

 

When these symptoms become severe, particularly when accompanied by statements about death or suicide, withdrawing from others or giving away possessions, professional help should be sought.

It is also important to remember that not everyone who experiences suicidal thoughts has depression, and not everyone living with depression experiences suicidal thoughts.

 

How Can You Help Someone Who Is Suicidal?

 

Knowing how to help someone who is suicidal can feel frightening. You do not need to have all the answers, and you are not expected to act as their therapist. Your role is to listen, take their concerns seriously and help connect them with appropriate support.

Ask directly

If you are concerned about someone, it is appropriate to ask whether they are thinking about suicide. Asking about suicide does not put the idea into someone’s head. In fact, talking openly about suicide can help someone feel understood and make it easier for them to seek help.

 

You could say:

“I’ve noticed that you’ve been struggling lately, and I’m worried about you. Are you thinking about suicide?”

 

Ask calmly and without judgement. Give the person an opportunity to speak without immediately trying to solve their problems.

 

Listen without judgement

 

Try to listen rather than argue, lecture or tell the person that their problems are not serious. Statements such as, “You have so much to live for” or “Other people have it worse” may unintentionally make someone feel misunderstood.

 

Instead, acknowledge what they are experiencing. You might say, “I’m really glad you told me” or “I can see that you’re hurting, and I want to help you get through this.”

 

Help them connect with professional support

 

A suicidal person needs appropriate support from a healthcare professional or mental health practitioner. Offer to help them make an appointment, accompany them to seek care or contact someone they trust.

 

If you believe they are in immediate danger, do not leave them alone. Contact emergency or crisis support and involve an appropriate healthcare professional or trusted person. The WHO recommends seeking immediate assistance when someone is at risk of harming themselves. 

 

Help create a safer environment

 

If someone is at immediate risk, reducing their access to things they could use to hurt themselves can provide valuable time while professional help is arranged. This should be approached practically and without judgement.

 

Keep checking in

 

Support should not end after one conversation. Continue checking in with the person and encouraging them to stay connected with their healthcare and support network.

 

A Note on Digital Warning Signs

 

Warning signs increasingly show up online as well as in person. These can include:

 

• Posting or searching for content about self-harm, hopelessness or “goodbye” messages on social media
• Sudden changes in online behaviour-going quiet after being very active, or posting unusually dark or final-sounding content
• Engaging with pro-suicide or self-harm communities or forums
• Sharing or reacting to distressing content late at night, repeatedly

 

If you see these signs from someone you know, treat them with the same seriousness as something said in person-reach out directly rather than simply liking, reacting to, or scrolling past the post.

 

The Three Cs of Suicide Prevention: Connect, Communicate and Care

 

The three Cs provide a simple way to think about supporting someone who may be suicidal.

 

Connect: Help the person feel less alone. Stay present, listen and encourage connection with trusted people and professional support.

 

Communicate: Talk openly and compassionately about suicide. Ask direct questions and allow the person to speak honestly about what they are experiencing.

 

Care: Show that you take the person and their distress seriously. Continue offering support while helping them access appropriate professional care.

 

These principles do not mean that one person is responsible for preventing suicide. Suicide prevention requires individuals, families, healthcare professionals, communities and wider systems to work together. 

 

What If You Are the Person Experiencing Suicidal Thoughts?

 

If you are experiencing suicidal thoughts, please do not try to handle them by yourself.

 

You do not need to wait until you have a specific plan or feel that you are “bad enough” to ask for help. Suicidal thoughts are a sign of serious emotional distress and deserve professional attention.

Start by telling someone you trust what is happening. This could be a family member, friend, colleague, doctor, psychologist, psychiatrist, counsellor or another healthcare professional.

 

If talking feels difficult, you can keep it simple:

 

“I’m not feeling safe on my own right now. I’m having thoughts about suicide and I need help.”

If you are in immediate danger of harming yourself, seek emergency medical assistance or contact a crisis service. Do not isolate yourself while you are in crisis. Move towards other people and ask someone you trust to stay with you while professional help is arranged.

 

Most importantly, remember that suicidal thoughts can change. You may not be able to imagine a different future while you are in the middle of overwhelming distress, but that does not mean that the distress will remain at its current intensity. The WHO notes that people experiencing suicidal thoughts can recover and that help is available.

 

In South Africa, the South African Depression and Anxiety Group (SADAG) provides suicide crisis support on 0800 567 567. If you are elsewhere in Southern Africa, contact your local emergency service, healthcare provider or an appropriate crisis service.

 

Can Suicide Be Prevented?

 

There is no single solution to suicide. Asking how to “solve” suicide therefore oversimplifies a complex public health issue.

 

Effective prevention involves several layers of support. These include improving access to mental healthcare, recognising and treating mental health conditions, reducing harmful alcohol and substance use, strengthening social connections, supporting people experiencing crises and addressing wider social and economic factors that contribute to distress. Restricting access to highly lethal means can also provide critical time for a crisis to pass and for support to be provided. 

 

At an individual level, early intervention matters. A person who is struggling does not need to wait until they reach a crisis point before asking for help.

 

How Are Suicidal People Treated?

 

Treatment depends on the person’s circumstances, level of risk and underlying needs. A healthcare professional may assess their immediate safety, mental health, physical health, substance use, support network and other factors contributing to their distress.

 

Treatment may include psychological therapy, psychiatric care, medication where appropriate, support for substance-use problems and practical assistance with circumstances contributing to distress.

 

Someone experiencing an immediate crisis may require urgent assessment and a higher level of care. Treatment should be individualised, compassionate and focused on keeping the person safe while addressing the factors contributing to their distress.

 

World Suicide Prevention Day

 

World Suicide Prevention Day takes place on 10 September each year. It is organised by the International Association for Suicide Prevention (IASP) and co-sponsored by the WHO. The day aims to raise awareness, reduce stigma and reinforce the message that suicide can be prevented. 

 

The theme for the 2024–2026 World Suicide Prevention Day period is “Changing the Narrative on Suicide”, encouraging more open and compassionate conversations about suicide and greater access to appropriate support. 

 

But suicide prevention is not limited to one day of the year. Recognising distress, talking openly and helping people access care are actions that can make a difference at any time.

 

Conclusion

 

Recognising the warning signs of suicide and knowing how to respond can help someone access support when they need it most. You do not need to be a mental health professional to ask someone if they are okay, listen without judgement and encourage them to seek professional help.

 

If you are concerned about someone, take expressions of suicidal thoughts seriously. If you are experiencing suicidal thoughts yourself, tell someone and seek professional support rather than trying to manage the situation alone.

 

Suicide prevention is a shared responsibility. Compassionate conversations, strong social connections, accessible healthcare and timely intervention can all play a role in helping people through periods of severe emotional distress.

 

Frequently Asked Questions

 

• What should you not say to someone who is suicidal?

Avoid dismissing their feelings, judging them or telling them to simply “cheer up” or “think positively”. Statements such as “You have nothing to be depressed about”, “Other people have it worse” or “You’re being selfish” can make someone feel misunderstood or ashamed. Instead, listen without judgement, acknowledge their distress and encourage them to seek professional help.

 

• What number do you call for suicide prevention?

In South Africa, the South African Depression and Anxiety Group (SADAG) Suicide Crisis Line can be reached on 0800 567 567. If someone is in immediate danger, seek emergency medical assistance rather than relying solely on a crisis line. If you are outside South Africa, contact an appropriate local crisis service or healthcare provider.

 

• What is the number one warning sign for suicide?

There is no single warning sign that applies to everyone. However, directly expressing thoughts about suicide, wanting to die or having a plan to end one’s life should always be taken seriously. Other warning signs include withdrawal, severe mood changes, saying goodbye and giving away valued possessions.

 

• What do you say to someone who is suicidal?

Start by letting them know that you are concerned and that you are there to listen. You can ask directly, “Are you thinking about suicide?”. If they say yes, listen without judgement and encourage them to get professional help. If you believe they are in immediate danger, stay with them and seek urgent assistance.

 

• When is World Suicide Prevention Day?

World Suicide Prevention Day takes place on 10 September every year. It aims to raise awareness about suicide prevention and encourage open conversations about suicide. 

 

• Can suicidal thoughts go away?

Yes. Suicidal thoughts can change, and people experiencing them can recover. However, they should not be ignored or managed alone. Speaking to someone you trust and seeking support from a healthcare professional or mental health practitioner can help address the underlying distress and provide appropriate care.

 

• Can you help someone who refuses to get help?

You can continue to listen, stay connected and encourage them to seek professional support, but you cannot take responsibility for their recovery yourself. If you believe they are in immediate danger, prioritise their safety by contacting appropriate emergency or crisis support and involving trusted people who can help.

 

• What should I do if I am having suicidal thoughts?

Tell someone you trust as soon as possible and seek professional help from a doctor, mental health professional or crisis service. Do not isolate yourself or try to manage the crisis alone. If you believe you may act on your thoughts or cannot keep yourself safe, seek emergency medical assistance immediately. In South Africa, SADAG’s Suicide Crisis Line is 0800 567 567.

 

1. How can I stay safer online if I’m struggling with suicidal thoughts?

Consider muting or unfollowing accounts that post content glorifying self-harm or suicide, and use platform reporting tools if you encounter content that feels harmful. Many social platforms also link directly to crisis lines when certain terms are searched – use these rather than searching for method-related information. If scrolling late at night tends to worsen your mood, it can help to put your phone in another room and reach out to a person instead.

 

• Where can I get support after losing someone to suicide?

SADAG offers support specifically for people bereaved by suicide, including referrals to grief counsellors and suicide-loss support groups. You can reach SADAG on 0800 567 567 or via their office line on 011 234 4837.

 

If you are worried about someone you love or are experiencing concerning symptoms yourself, such as persistent feelings of hopelessness and/or thoughts of self harm, confide in someone you trust and seek professional help as soon as possible. If you are looking for a healthcare provider who can assist you further, book a consultation with a Lenmed clinical psychologist or psychiatrist. Remember, you don’t have to face this alone and there is absolutely no shame in asking for help – in fact, it’s the bravest thing you can do.

 

Prevention Beyond the Individual

 

Suicide prevention also works at a community level. Some practical, evidence-based approaches include:

 

• Schools and workplaces having clear mental health policies and trained first-responders (teachers, HR, managers) who know how to spot warning signs
• Reducing household access to firearms, stockpiled medication and other lethal means, especially where someone is known to be at risk
• Media and social media literacy – encouraging safe, non-sensationalised conversations about suicide, which reduces the risk of contagion
• Community and faith-based support networks that reduce isolation, particularly in areas with limited access to formal mental healthcare

 

Programmes like SADAG’s Teen Suicide Prevention Week and school-based initiatives are examples of this layered approach in action locally.

 

If you are in crisis right now, please call the SADAG Suicide Crisis Helpline on 0800 567 567, available 24/7.

 

For more information, please contact:

 

Zoya Naidoo

Discipline: Trauma Councillor

Hospital: Ahmed Kathrada Private Hospital

Telephone: 0870878494

Email:  [email protected]