Risk factors

Although attempted suicide is more frequent for women, men are more likely than women to complete suicide because they typically use more-lethal methods, such as a firearm.

You may be at risk of suicide if you:

• Attempted suicide before
• Feel hopeless, worthless, agitated, socially isolated or lonely
• Experience a stressful life event, such as the loss of a loved one, military service, a breakup, or financial or legal problems
• Have a substance abuse problem — alcohol and drug abuse can worsen thoughts of suicide and make you feel reckless or impulsive enough to act on your thoughts
• Have suicidal thoughts and have access to firearms in your home
• Have an underlying psychiatric disorder, such as major depression, post-traumatic stress disorder or bipolar disorder
• Have a family history of mental disorders, substance abuse, suicide, or violence, including physical or sexual abuse
• Have a medical condition that can be linked to depression and suicidal thinking, such as chronic disease, chronic pain or terminal illness
• Are lesbian, gay, bisexual or transgender with an unsupportive family or in a hostile environment

Children and teenagers

Suicide in children and teenagers can follow stressful life events. What a young person sees as serious and insurmountable may seem minor to an adult — such as problems in school or the loss of a friendship. In some cases, a child or teen may feel suicidal due to certain life circumstances that he or she may not want to talk about, such as:

• Having a psychiatric disorder, including depression
• Loss or conflict with close friends or family members
• History of physical or sexual abuse
• Problems with alcohol or drugs
• Physical or medical issues, for example, becoming pregnant or having a sexually transmitted infection
• Being the victim of bullying
• Being uncertain of sexual orientation
• Reading or hearing an account of suicide or knowing a peer who died by suicide

If you have concerns about a friend or family member, asking about suicidal thoughts and intentions is the best way to identify risk.

Murder and suicide

In rare cases, people who are suicidal are at risk of killing others and then themselves. Known as a homicide-suicide or murder-suicide, some risk factors include:

• History of conflict with a spouse or romantic partner
• Current family legal or financial problems
• History of mental health problems, particularly depression
• Alcohol or drug abuse
• Having access to a firearm

Starting antidepressants and increased suicide risk

Most antidepressants are generally safe, but the Food and Drug Administration requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

However, keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.