Recently, I’ve been diving back in to teen books—many of which I actually read in my teenage years, and am revisiting now. One is the diary of a (fictional) sixteen-year-old boy whose best friend struggles with depression, and the character, Ducky, finds himself struggling with the warning signs, and over his diaries, physically saves his friend’s life more than once after he attempts to end his own life. Next week is National Suicide Prevention Week, and Saturday, September 10, is World Suicide Prevention Day. With inspiration from the Ducky books of the California Diaries series by Ann M. Martin, today we’ll tackle common questions about suicide—and what you can do to help someone who may be considering suicide.

Watching for Warning Signs

While many people who die by suicide or attempt suicide live with diagnosed or undiagnosed mental illness, it is important to realize that not all do—nor is suicide precipitated by just one factor like having mental illness, nor a single traumatic life event. [1] Yes, mental illness can be a risk factor for suicide, however, many people with mental illness like anxiety, bipolar disorder, or even major depressive disorder, for example never consider or attempt suicide. So, this cannot on its own be a warning sign. The American Association of Suicidology (AAS), whose mission is to prevent suicide, lists the mnemonic IS PATH WARM to assist people in remembering the warning signs [2]:

• Ideation – formulating plans of how to end their life. The person may speak of or “threaten” hurting or killing him or herself. They may also look for items with which to harm or kill themselves, such as pills, guns, or knives. (Note, however, that self-harm does not always indicate a person is at risk of suicide.) A person may talk or write about death, dying or suicide in a way that is out of the ordinary for them.
• Substance abuse – beginning or increased use of substances like drugs and alcohol
• Purposelessness – feeling there is no reason for living
• Anxiety – feeling anxious, agitated. As well, being unable to sleep (insomnia) or sleeping all the time.
• Trapped – Expresses or feels as if they are “trapped” in their circumstances or pain
• Hopelessness – they may feel like “a burden” to others [3]
• Withdrawal – Decreased, reluctant, or no interaction with others, including family, friends, coworkers, classmates—society in general.
• Anger – may be atypical for the person, can include feelings or actions of rage, uncontrollable anger/outbursts, and seeking or planning revenge.
• Recklessness – impulsivity or taking risks
• Mood changes

Preventing Suicide

If you have learned a person is at risk of suicide, or is exhibiting warning signs of suicide, here is what to do [3]:

• Do not leave the person alone.
• Remove items or substances that could be used in self-harm or suicide attempts. This can include medication (even over the counter drugs), knives or sharp objects, firearms, or other items a person may have communicated as being potentially dangerous to them.
• Call, or have them call, the National Suicide Prevention Lifeline at 800-273-TALK (8255) for help.
• If you or someone you know is experiencing a mental health crisis, including considering suicide, go to the nearest emergency department. If a person has access to a mental health professional or other medical doctor they are comfortable with and they can be seen immediately, this may also be an option, but do not delay seeking professional help.

Learning that someone has died by or is considering suicide is scary and can be confusing, no matter if you are sixteen like Ducky in the book above, or an adult. Resources like To Write Love on Her Arms, The National Suicide Prevention Lifeline (or Canadian Association for Suicide Prevention), and more, can be helpful. Resources are available for those who have survived suicide, including not just attempt survivors but family, friends, clinicians or others who have experienced a loved one’s death by suicide. These resources may not only help those people in crisis, but also can help larger communities understand what may seem to be a “senseless” death. The more we understand about suicide, the better we are able to act on warning signs, and one day, end suicide.