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Helping a Loved One with Bipolar Disorder

Helping a Loved one with Bipolar Disorder In This Article

If someone close to you has bipolar disorder, your love and support can make a difference in treatment and recovery. You can help by learning about the illness, offering hope and encouragement, keeping track of symptoms, and being a partner in treatment. But caring for a person with bipolar disorder will take a toll if you neglect your own needs, so it’s important to find a balance between supporting your loved one and taking care of yourself.

Helping a family member or friend with bipolar disorder

Dealing with the ups and downs of bipolar disorder can be difficult—and not just for the person with the illness. The moods and behaviors of a person with bipolar disorder affect everyone around—especially family members and close friends. During a manic episode, you may have to cope with reckless antics, outrageous demands, explosive outbursts, and irresponsible decisions. And once the whirlwind of mania has passed, it often falls on you to deal with the consequences. During episodes of depression, you may have to pick up the slack for a loved one who doesn’t have the energy to meet responsibilities at home or work.

The good news is that most people with bipolar disorder can stabilize their moods with proper treatment, medication, and support—and you can play a significant role in his or her recovery. Often, just having someone to talk to can make all the difference to your loved one’s outlook and motivation.

Here are some other ways you can help:

  • Learn about bipolar disorder. Learn everything you can about the symptoms and treatment options. The more you know about bipolar disorder, the better equipped you’ll be to help your loved one and keep things in perspective.
  • Encourage the person to get help. The sooner bipolar disorder is treated, the better the prognosis, so urge your loved one to seek professional help right away. Don’t wait to see if the person will get better without treatment.
  • Be understanding. Let your friend or family member know that you’re there if he or she needs a sympathetic ear, encouragement, or assistance with treatment. People with bipolar disorder are often reluctant to seek help because they don’t want to feel like a burden to others, so remind the person that you care and that you’ll do whatever you can to help.
  • Be patient. Getting better takes time, even when a person is committed to treatment. Don’t expect a quick recovery or a permanent cure. Be patient with the pace of recovery and prepare for setbacks and challenges. Managing bipolar disorder is a lifelong process.

The importance of support in bipolar disorder recovery

People with bipolar disorder do better when they have support from family members and friends. Those whose loved ones are involved and supportive tend to recover more quickly, experience fewer manic and depressive episodes, and have milder symptoms.

Bipolar disorder and the family

Living with a person who has bipolar disorder can cause stress and tension in the family. On top of the challenge of dealing with symptoms and their consequences, family members often struggle with feelings of guilt, fear, anger, and helplessness. Ultimately, the strain can cause serious relationship problems. But families can successfully deal with bipolar disorder if they learn to accept the illness and its difficulties.

When you’re feeling frustrated or guilty, it’s important to remember that bipolar disorder isn’t anyone’s fault.

Accepting bipolar disorder involves acknowledging that things may never again be “normal.” Treatment can make a huge difference for your loved one, but it may not take care of all symptoms or impairments. To avoid disappointment and resentments, it’s important to have realistic expectations. Expecting too much of your family member is a recipe for failure. On the other hand, expecting too little can also hinder recovery, so try to find a balance between encouraging independence and providing support.

Tips for coping with bipolar disorder in the family

  • Accept your loved one’s limits – People with bipolar disorder can’t control their moods. They can’t just snap out of a depression or get a hold of themselves during a manic episode. Neither depression nor mania can be overcome through self-control, willpower, or reasoning. Telling a person to “Stop acting crazy” or “Look on the bright side” won’t help.
  • Accept your own limits – You can’t rescue a person with bipolar disorder, nor can you force someone to take responsibility for getting better. You can offer support, but ultimately, recovery is in the hands of the person with the illness.
  • Reduce stress – Stress makes bipolar disorder worse, so try to find ways to reduce stress in your loved one's life. Ask how you can help and volunteer to take over some of the person’s responsibilities if needed. Establishing and enforcing a daily routine—with regular times for getting up, having meals, and going to bed—can also reduce family stress.
  • Communicate openlyOpen and honest communication is essential to coping with bipolar disorder in the family. Share your concerns in a loving way, ask the person how he or she is feeling, and make an effort to truly listen—even if you disagree with your loved one or don’t relate to what’s being said.

Supporting a person with bipolar disorder

What you can say that helps:

  • You are not alone in this. I'm here for you.
  • I understand you have a real illness and that's what causes these thoughts and feelings.
  • You may not believe it now, but the way you're feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • You are important to me. Your life is important to me.

Adapted from: The Depression and Bipolar Support Alliance

Convincing a person with bipolar disorder to see a doctor

Aside from offering emotional support, the best way to help someone with bipolar disorder is by encouraging and supporting treatment. However, people with bipolar disorder tend to lack insight into their condition, so it’s not always easy to get them to a doctor. When they’re manic, they feel great and don’t realize there’s a problem. When they’re depressed, they may recognize something’s wrong, but lack the energy to seek help.

If your loved one won’t acknowledge the possibility of bipolar disorder, don’t argue about it. The idea may be frightening to the person, so be sensitive. Suggest a routine medical checkup instead, or a doctor’s visit for a specific symptom, such as insomnia, irritability, or fatigue (you can call ahead to tell the doctor of your bipolar disorder concerns).

Things you can say that might help:

  • Bipolar disorder is a real illness, like diabetes. It requires medical treatment.
  • You’re not to blame for bipolar disorder. You didn’t cause it. It’s not your fault.
  • You can feel better. There are many treatments that can help.
  • When bipolar disorder isn’t treated, it usually gets worse.

Supporting a loved one during bipolar disorder treatment

Once your friend or family member agrees to see a doctor, you can help by being a partner in treatment. Your support can make a big difference in treatment success, so offer to be involved in any way the person with bipolar disorder wants or needs.

Things you can do to support a loved one’s bipolar disorder treatment:

  • Find qualified doctors and therapists
  • Set up appointments and go along
  • Offer your insight to the doctor
  • Monitor your loved one’s moods
  • Learn about the person’s medications
  • Track treatment progress
  • Watch for signs of relapse
  • Alert the doctor to problems


Encourage the person to take bipolar disorder medication

Encourage the person to take bipolar disorder medicationMedication is the cornerstone of treatment for bipolar disorder, and most people need it to regulate their moods and avoid relapse. Despite the need for medication, many people with bipolar disorder stop taking it. Some quit because they’re feeling better, others because of side effects, and still others because they enjoy the symptoms of mania. People who don’t think they have a problem are particularly likely to stop taking medication.

You can help a person with bipolar disorder stay on track by emphasizing the importance of medication and making sure all prescriptions are being taken as directed. Also encourage the person to speak to the doctor about any bothersome side effects. Side effects can be very unpleasant if the dose of the medication is too low or too high, but a change in medication or dosage may solve the problem. Remind the person that abruptly stopping medication is dangerous.

Watch for warning signs of bipolar disorder relapse

Even if a person with bipolar disorder is committed to treatment, there may be times when symptoms get worse. Take action right away if you notice any troubling symptoms or mood changes. Point out the emerging bipolar symptoms to your loved one and alert the doctor. With swift intervention, you may be able to prevent an episode of mania or depression from developing fully.

Mania warning signs and symptoms:

  • Sleeping less
  • Elevated mood
  • Restlessness
  • Speaking rapidly
  • Increase in activity level
  • Irritability or aggression


Depression warning signs and symptoms:

  • Fatigue and lethargy
  • Sleeping more
  • Trouble concentrating
  • Loss of interest in activities
  • Withdrawing from others
  • Change in appetite


Coping with mania and depression: Tips for family and friends

If relapse can’t be prevented, there are things you can do to cope during a manic or depressive episode.

  • Don’t take bipolar symptoms personally. When in the midst of a bipolar episode, people often say or do things that are hurtful or embarrassing. When manic, they may be reckless, cruel, critical, and aggressive. When depressed, they may be rejecting, irritable, hostile, and moody. It’s hard not to take such behaviors personally, but try to remember that they’re symptoms of a mental illness, not the result of selfishness or immaturity.
  • Be prepared for destructive behaviors. When manic or depressed, people with bipolar disorder may behave in destructive or irresponsible ways. Planning ahead for how to handle such behavior can help. When your loved one is well, negotiate a treatment contract that gives you advance approval for protecting him or her when symptoms flare up. Agree on specific steps you’ll take, such as removing credit cards or car keys, going together to the doctor, or taking charge of household finances.
  • Know what to do in a crisis. It’s important to plan ahead for times of crisis so you can act quickly and effectively when it occurs. Having a crisis plan can help. Make sure to include a list of emergency contact information for doctors, therapists, and other loved ones who will help. Also include the address and phone number of the hospital you will take the person to if necessary.
  • Call 911 (or your country’s emergency services number) in an emergency. If a person with bipolar disorder is suicidal or violent, don’t try to handle the situation alone. If you’re worried that your loved one may hurt you, get to safety and then call the police. If the person is suicidal, don’t leave him or her alone. Call for an ambulance and stay with the person until it arrives.

Supporting someone who is manic

  • Spend time with the person. People who are manic often feel isolated from other people. Spending even short periods of time with them helps. If the person has a lot of energy, walk together, which allows the person to keep on the move but share your company.
  • Answer questions honestly. However, do not argue or debate with a person during a manic episode. Avoid intense conversation.
  • Don’t take any comments personally. During periods of high energy, a person often says and does things that he or she would not usually say or do, including focusing on negative aspects of others. If needed, stay away from the person and avoid arguments.
  • Prepare easy-to-eat foods and drinks (such as peanut butter and jelly sandwiches, apples, cheese crackers, and juices), because it is difficult for the person to sit down to a meal during periods of high energy.
  • Avoid subjecting the person to a lot of activity and stimulation. It is best to keep surroundings as quiet as possible.
  • Allow the person to sleep whenever possible. During periods of high energy, sleeping is difficult and short naps may be taken throughout the day. Sometimes the person feels rested after only 2 to 3 hours of sleep.

Adapted from: The Palo Alto Medical Foundation

Taking care of yourself when a loved one is bipolar

It's easy to neglect your own needs when you're supporting someone else. But if you don't take care of yourself, you run the risk of burnout. To cope with the stress of caring for someone with bipolar disorder, you have to take care of yourself both emotionally and physically.

  • Focus on your own life. Supporting your loved one may involve some life adjustments, but make sure you don't lose sight of your own goals and priorities. Don't give up friendships, plans, or activities that bring you joy.
  • Seek support. Dealing with a loved one's mental illness can be painful and isolating. Make sure you're getting the emotional support you need to cope. Talk to someone you trust about what you're going through. It can also help to get your own therapy or join a support group.
  • Set boundaries. Be realistic about the amount of care you're able to provide without feeling overwhelmed and resentful. Set limits on what you're willing and able to do, and stick to them. Letting bipolar disorder take over your life isn't healthy for you or your loved one.
  • Manage stress. Stress takes a toll on the body and mind, so find ways to keep it in check. Make sure you're eating right and getting enough sleep and exercise. You can also keep stress under control by practicing relaxation techniques such as meditation.
  • Ask for help. If your friend or family member needs more assistance than you can give, ask for help from others. Turn to other relatives or close friends, or contact one of the organizations listed under Resources section below.

More help for helping a loved one with bipolar disorder

Bipolar disorder

Related issues

Resources and references

Helping a friend or family member with bipolar disorder

Family Toolkit – An informative and practical resource designed to help families as they care for a family member with mental illness. (HeretoHelp)

Helping a Friend or Family Member with Depression or Bipolar Disorder – Advice for friends and family members on how to help and support a person with bipolar disorder. (Depression and Bipolar Support Alliance)

Helping Someone During a Manic Episode  – Offers tips on dealing with a loved one when they’re having a manic episode. (Palo Alto Medical Foundation)

Coping with a loved one’s bipolar disorder

Family Self-Care and Recovery From Mental Illness – A guide to how families can look after their own wellbeing while caring for a mentally ill family member. (HeretoHelp)

A Family Guide to Psychiatric Hospitalization – Guide to handling a bipolar disorder crisis, including what to say and do and how to get a loved one to check in to a hospital voluntarily. (Depression and Bipolar Support Alliance)

Bipolar disorder in children and teens

About Pediatric Bipolar Disorder – Guide to the specific signs and symptoms of bipolar disorder in children and adolescents. Includes information on diagnosis and treatment. (Child and Adolescent Bipolar Foundation)

The Storm in My Brain: Kids and Mood Disorders – This introduction to mood disorders includes drawings by children suffering from bipolar disorder and tips for parents. (Depression and Bipolar Support Alliance)

TeensHealth: Bipolar Disorder – Article for teens discusses the signs, symptoms, causes, and treatment of bipolar disorder, or manic depression. (Nemours Foundation)

Finding local support for bipolar disorder

In the U.S.:

Internationally:

Authors: Jeanne Segal, Ph.D., and Melinda Smith, M.A. Last updated: April 2015.


Suicide Prevention: How To Help Someone Who Is Suicidal

A suicidal person may not ask for help, but that doesn't mean that help isn't wanted. Most people who commit suicide don't want to die—they just want to stop hurting. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide, you might be afraid to bring up the subject. But talking openly about suicidal thoughts and feelings can save a life.

If you're thinking about committing suicide, please read Suicide Help or call 1-800-273-TALK in the U.S.! To find a suicide helpline outside the U.S., visit IASP or Suicide.org.

Understanding and preventing suicide

The World Health Organization estimates that approximately 1 million people die each year from suicide. What drives so many individuals to take their own lives? To those not in the grips of suicidal depression and despair, it's difficult to understand what drives so many individuals to take their own lives. But a suicidal person is in so much pain that he or she can see no other option.

Suicide is a desperate attempt to escape suffering that has become unbearable. Blinded by feelings of self-loathing, hopelessness, and isolation, a suicidal person can't see any way of finding relief except through death. But despite their desire for the pain to stop, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative to committing suicide, but they just can't see one.

Common Misconceptions about Suicide

FALSE: People who talk about suicide won't really do it.
Almost everyone who commits or attempts suicide has given some clue or warning. Do not ignore suicide threats. Statements like "you'll be sorry when I'm dead," "I can't see any way out," — no matter how casually or jokingly said may indicate serious suicidal feelings.

FALSE: Anyone who tries to kill him/herself must be crazy.
Most suicidal people are not psychotic or insane. They must be upset, grief-stricken, depressed or despairing, but extreme distress and emotional pain are not necessarily signs of mental illness.

FALSE: If a person is determined to kill him/herself, nothing is going to stop them.
Even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die. Most suicidal people do not want death; they want the pain to stop. The impulse to end it all, however overpowering, does not last forever.

FALSE: People who commit suicide are people who were unwilling to seek help.
Studies of suicide victims have shown that more than half had sought medical help in the six months prior to their deaths.

FALSE: Talking about suicide may give someone the idea.
You don't give a suicidal person morbid ideas by talking about suicide. The opposite is true—bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.

Source: SAVE – Suicide Awareness Voices of Education

Warning signs of suicide

Most suicidal individuals give warning signs or signals of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond if you spot them. If you believe that a friend or family member is suicidal, you can play a role in suicide prevention by pointing out the alternatives, showing that you care, and getting a doctor or psychologist involved.

Major warning signs for suicide include talking about killing or harming oneself, talking or writing a lot about death or dying, and seeking out things that could be used in a suicide attempt, such as weapons and drugs. These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide.

Take any suicidal talk or behavior seriously. It's not just a warning sign that the person is thinking about suicide—it's a cry for help.

A more subtle but equally dangerous warning sign of suicide is hopelessness. Studies have found that hopelessness is a strong predictor of suicide. People who feel hopeless may talk about "unbearable" feelings, predict a bleak future, and state that they have nothing to look forward to.

Other warning signs that point to a suicidal mind frame include dramatic mood swings or sudden personality changes, such as going from outgoing to withdrawn or well-behaved to rebellious. A suicidal person may also lose interest in day-to-day activities, neglect his or her appearance, and show big changes in eating or sleeping habits.

Suicide Warning Signs

Talking about suicide

Any talk about suicide, dying, or self-harm, such as "I wish I hadn't been born," "If I see you again..." and "I'd be better off dead."

Seeking out lethal means

Seeking access to guns, pills, knives, or other objects that could be used in a suicide attempt.

Preoccupation with death

Unusual focus on death, dying, or violence. Writing poems or stories about death.

No hope for the future

Feelings of helplessness, hopelessness, and being trapped ("There's no way out"). Belief that things will never get better or change.

Self-loathing, self-hatred

Feelings of worthlessness, guilt, shame, and self-hatred. Feeling like a burden ("Everyone would be better off without me").

Getting affairs in order

Making out a will. Giving away prized possessions. Making arrangements for family members.

Saying goodbye

Unusual or unexpected visits or calls to family and friends. Saying goodbye to people as if they won't be seen again.

Withdrawing from others

Withdrawing from friends and family. Increasing social isolation. Desire to be left alone.

Self-destructive behavior

Increased alcohol or drug use, reckless driving, unsafe sex. Taking unnecessary risks as if they have a "death wish."

Sudden sense of calm

A sudden sense of calm and happiness after being extremely depressed can mean that the person has made a decision to commit suicide.

Suicide prevention tip #1: Speak up if you’re worried

If you spot the warning signs of suicide in someone you care about, you may wonder if it’s a good idea to say anything. What if you’re wrong? What if the person gets angry? In such situations, it's natural to feel uncomfortable or afraid. But anyone who talks about suicide or shows other warning signs needs immediate help—the sooner the better.

Talking to a person about suicide

Talking to a friend or family member about their suicidal thoughts and feelings can be extremely difficult for anyone. But if you're unsure whether someone is suicidal, the best way to find out is to ask. You can't make a person suicidal by showing that you care. In fact, giving a suicidal person the opportunity to express his or her feelings can provide relief from loneliness and pent-up negative feelings, and may prevent a suicide attempt.

Ways to start a conversation about suicide:

  • I have been feeling concerned about you lately.
  • Recently, I have noticed some differences in you and wondered how you are doing.
  • I wanted to check in with you because you haven’t seemed yourself lately.

Questions you can ask:

  • When did you begin feeling like this?
  • Did something happen that made you start feeling this way?
  • How can I best support you right now?
  • Have you thought about getting help?

What you can say that helps:

  • You are not alone in this. I’m here for you.
  • You may not believe it now, but the way you’re feeling will change.
  • I may not be able to understand exactly how you feel, but I care about you and want to help.
  • When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.

When talking to a suicidal person

Do:

  • Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.
  • Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.
  • Be sympathetic, non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.
  • Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.
  • If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.

But don’t:

  • Argue with the suicidal person. Avoid saying things like: "You have so much to live for," "Your suicide will hurt your family," or “Look on the bright side.”
  • Act shocked, lecture on the value of life, or say that suicide is wrong.
  • Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.
  • Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.
  • Blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.

Adapted from: Metanoia.org

Suicide prevention tip #2: Respond quickly in a crisis

If a friend or family member tells you that he or she is thinking about death or suicide, it's important to evaluate the immediate danger the person is in. Those at the highest risk for committing suicide in the near future have a specific suicide PLAN, the MEANS to carry out the plan, a TIME SET for doing it, and an INTENTION to do it.

Level of Suicide Risk

Low – Some suicidal thoughts. No suicide plan. Says he or she won't commit suicide.

Moderate – Suicidal thoughts. Vague plan that isn't very lethal. Says he or she won't commit suicide.

High – Suicidal thoughts. Specific plan that is highly lethal. Says he or she won't commit suicide.

Severe – Suicidal thoughts. Specific plan that is highly lethal. Says he or she will commit suicide.

The following questions can help you assess the immediate risk for suicide:

  • Do you have a suicide plan? (PLAN)
  • Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)
  • Do you know when you would do it? (TIME SET)
  • Do you intend to commit suicide? (INTENTION)

If a suicide attempt seems imminent, call a local crisis center, dial 911, or take the person to an emergency room. Remove guns, drugs, knives, and other potentially lethal objects from the vicinity but do not, under any circumstances, leave a suicidal person alone.

Suicide prevention tip #3: Offer help and support

If a friend or family member is suicidal, the best way to help is by offering an empathetic, listening ear. Let your loved one know that he or she is not alone and that you care. Don't take responsibility, however, for making your loved one well. You can offer support, but you can't get better for a suicidal person. He or she has to make a personal commitment to recovery.

It takes a lot of courage to help someone who is suicidal. Witnessing a loved one dealing with thoughts about ending his or her own life can stir up many difficult emotions. As you're helping a suicidal person, don't forget to take care of yourself. Find someone that you trust—a friend, family member, clergyman, or counselor—to talk to about your feelings and get support of your own.

Helping a suicidal person:

  • Get professional help. Do everything in your power to get a suicidal person the help he or she needs. Call a crisis line for advice and referrals. Encourage the person to see a mental health professional, help locate a treatment facility, or take them to a doctor's appointment.
  • Follow-up on treatment. If the doctor prescribes medication, make sure your friend or loved one takes it as directed. Be aware of possible side effects and be sure to notify the physician if the person seems to be getting worse. It often takes time and persistence to find the medication or therapy that’s right for a particular person.
  • Be proactive. Those contemplating suicide often don't believe they can be helped, so you may have to be more proactive at offering assistance. Saying, “Call me if you need anything” is too vague. Don’t wait for the person to call you or even to return your calls. Drop by, call again, invite the person out.
  • Encourage positive lifestyle changes, such as a healthy diet, plenty of sleep, and getting out in the sun or into nature for at least 30 minutes each day. Exercise is also extremely important as it releases endorphins, relieves stress, and promotes emotional well-being.
  • Make a safety plan. Help the person develop a set of steps he or she promises to follow during a suicidal crisis. It should identify any triggers that may lead to a suicidal crisis, such as an anniversary of a loss, alcohol, or stress from relationships. Also include contact numbers for the person's doctor or therapist, as well as friends and family members who will help in an emergency.
  • Remove potential means of suicide, such as pills, knives, razors, or firearms. If the person is likely to take an overdose, keep medications locked away or give out only as the person needs them.
  • Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person, periodically checking in or dropping by. Your support is vital to ensure your friend or loved one remains on the recovery track.

Risk factors for suicide

According to the U.S. Department of Health and Human Services, at least 90 percent of all people who commit suicide suffer from one or more mental disorders such as depression, bipolar disorder, schizophrenia, or alcoholism. Depression in particular plays a large role in suicide. The difficulty suicidal people have imagining a solution to their suffering is due in part to the distorted thinking caused by depression.

Antidepressants and Suicide

For some, depression medication causes an increase—rather than a decrease—in depression and suicidal thoughts and feelings. Because of this risk, the FDA advises that anyone on antidepressants should be watched for increases in suicidal thoughts and behaviors. Monitoring is especially important if this is the person's first time on depression medication or if the dose has recently been changed. The risk of suicide is the greatest during the first two months of antidepressant treatment.

Common suicide risk factors include:

  • Mental illness
  • Alcoholism or drug abuse
  • Previous suicide attempts
  • Family history of suicide
  • Terminal illness or chronic pain
  • Recent loss or stressful life event
  • Social isolation and loneliness
  • History of trauma or abuse

Suicide in teens and older adults

In addition to the general risk factors for suicide, both teenagers and older adults are at a higher risk of suicide.

Suicide in Teens

Teenage suicide is a serious and growing problem. The teenage years can be emotionally turbulent and stressful. Teenagers face pressures to succeed and fit in. They may struggle with self-esteem issues, self-doubt, and feelings of alienation. For some, this leads to suicide. Depression is also a major risk factor for teen suicide.

Other risk factors for teenage suicide include:

  • Childhood abuse
  • Recent traumatic event
  • Lack of a support network
  • Availability of a gun
  • Hostile social or school environment
  • Exposure to other teen suicides

Suicide warning signs in teens

Additional warning signs that a teen may be considering suicide:

  • Change in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent or rebellious behavior, running away
  • Drug and alcohol use
  • Unusual neglect of personal appearance
  • Persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Not tolerating praise or rewards

Source: American Academy of Child & Adolescent Psychiatry

Suicide in the Elderly

The highest suicide rates of any age group occur among persons aged 65 years and older. One contributing factor is depression in the elderly that is undiagnosed and untreated.

Other risk factors for suicide in the elderly include:

  • Recent death of a loved one
  • Physical illness, disability, or pain
  • Isolation and loneliness
  • Major life changes, such as retirement
  • Loss of independence
  • Loss of sense of purpose

Suicide warning signs in older adults

Additional warning signs that an elderly person may be contemplating suicide:

  • Reading material about death and suicide
  • Disruption of sleep patterns
  • Increased alcohol or prescription drug use
  • Failure to take care of self or follow medical orders
  • Stockpiling medications
  • Sudden interest in firearms
  • Social withdrawal or elaborate good-byes
  • Rush to complete or revise a will

Source: University of Florida

More help for suicide prevention

Resources and references

General information about suicide

Understanding Suicidal Thinking (PDF) – Learn about preventing suicide attempts and offering help and support. (Depression and Bipolar Support Alliance)

Suicide in America: Frequently Asked Questions – Find answers to common questions about suicide, including who is at the highest risk and how to help. (National Institute of Mental Health)

Suicide and Mental Illness – Facts on the link between suicide and mental illnesses such as depression, substance abuse, schizophrenia, and bipolar disorder. (StopaSuicide.org)

Suicide and Suicide in Youth – Suicide fact sheets answer questions about whose at risk and what friends and family can do to prevent suicide. (The National Alliance for the Mentally Ill).

Helping a suicidal person

What Can I Do To Help Someone Who Might be Suicidal? – Discusses possible warning signs of suicidal thoughts and ways to prevent suicide attempts. (Metanoia)

Frequently Asked Questions – Questions and answers about suicide prevention, including what you should do if you’re worried and what to do if someone refuses help. (American Foundation for Suicide Prevention)

Handling a Call From a Suicidal Person – How to handle a phone call from a friend or family member who is suicidal. Features tips on what to say and how to help. (Metanoia.org)

Suicide hotlines and crisis support

National Suicide Prevention Lifeline – Suicide prevention telephone hotline funded by the U.S. government. Provides free, 24-hour assistance. 1-800-273-TALK (8255).

National Hopeline Network – Toll-free telephone number offering 24-hour suicide crisis support. 1-800-SUICIDE (784-2433). (National Hopeline Network)

The Trevor Project - Crisis intervention and suicide prevention services for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. Includes a 24/7 hotline: 1-866-488-7386.

State Prevention Programs – Browse through a database of suicide prevention programs, organized by state. (National Strategy for Suicide Prevention)

Crisis Centers in Canada – Locate suicide crisis centers in Canada by province. (Canadian Association for Suicide Prevention)

IASP – Find crisis centers and helplines around the world. (International Association for Suicide Prevention).

International Suicide Hotlines – Find a helpline in different countries around the world. (Suicide.org)

Befrienders Worldwide – International suicide prevention organization connects people to crisis hotlines in their country. (Befrienders Worldwide)

Samaritans UK – 24-hour suicide support for people in the UK (call 08457 90 90 90) and Ireland (call 1850 60 90 90). (Samaritans)

Lifeline Australia – 24-hour suicide crisis support service at 13 11 14. (Lifeline Australia)

Coping after a suicide attempt

After an Attempt (PDF) – Guide for taking care of a family member following a suicide attempt and treatment in an emergency room. (National Suicide Prevention Lifeline)

Authors: Melinda Smith, M.A., Jeanne Segal, Ph.D., and Lawrence Robinson. Last updated: February 2015.


Mental Health First Aid Act introduced in House

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Mental Health First Aid Act introduced in House

Rep. Lynn Jenkins

U.S. Reps. Lynn Jenkins (R-KS) and Doris Matsui (D-CA) introduced the Mental Health First Aid Act on Thursday. The legislation, which has bipartisan support, would increase access to mental health first aid training to assist the public in identifying, understanding and interacting with mental health patients and disorders.

“Teachers, first-responders, law enforcement officers, veterans and many other public servants are often on the front lines of persons living with mental illness,” Jenkins said. “Until recently, these individuals had little or no training on how to adequately respond to mental health crises, but the Mental Health First Aid education program is helping train the public to identify, understand and support someone suffering from mental health. Mental Health First Aid is making a real difference in our communities, and this legislation will ensure that more Americans have access to mental health resources – including our veterans – and that more communities have the tools needed to help those struggling with mental illness.”

“Mental health has been ignored in our country for far too long,” Matsui said. “We must increase mental health awareness and knowledge, and decrease stigma. The Mental Health First Aid Act is an important step toward ensuring that our law enforcement, first-responders, teachers and other members of the community receive the training needed to respond appropriately to someone struggling with mental illness. Mental Health First Aid is currently being used with great success in Sacramento, and this legislation will support those efforts, and help others get started across the country.”

Jenkins’ bill is almost identical to the one she developed during the 113th Congress, working with Rep. Ron Barber (D-AZ). Companion legislation was introduced in the U.S. Senate last month by Sens. Kelly Ayotte (R-NH) and Richard Blumenthal (D-CT) along with co-sponsoring Sens. Marco Rubio (R-FL), Chuck Grassley (R-IA), Michael Bennet (D-CO), Chris Coons (D-DE), Rob Portman (R-OH) Jack Reed (D-RI), Dean Heller (R-NV), Heidi Heitkamp (D-ND) and Jeanne Shaheen (D-NH).


PBHM - Annual Report 2014


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