Suicide is a multifaceted problem with many causes, but there are usually warning signs such as depression and substance abuse. The vast majority of suicidal people will give a sign of their intent: some may talk about suicide, call suicide crisis lines, or threaten suicide. Warning signs of suicide include:

• Suicidal ideation (suicidal thoughts or actions)

• Excessive, increased substance abuse

• Expressing or feeling that there is no reason to live

• Anxiety (agitation or insomnia)

• Feeling trapped

• Feeling hopeless

• Withdrawal from friends, family, or society

• Anger

• Recklessness

• Dramatic mood changes

• Personality changes such as strange or unusual behavior

• Decreased interest in things they used to enjoy

• Changes in eating or sleeping habits

• Withdrawal from friends and family

• Increased absences and decreased performance at school or work

• Changes in personal hygiene habits

• Exhibiting a strong sense of guilt, shame, or emptiness

• An obsession with death

• Giving away personal and prized belongings, including pets

Teen Suicide

According to the CDC, teen suicide is the third leading cause of death among teenagers in the United States and has become a critical problem. Nearly 2,000 teens commit suicide every year in the United States. In a school auditorium holding 100 students, statistics show that at least twenty of them have had serious thoughts of suicide and at least eight of them have attempted suicide. Female youths attempt suicide more often than males, but the incidence of actual suicides is four times higher in male teens. Over 60 percent of teens use a gun to commit suicide and the majority of gun-related attempts or suicides with guns occur in the home. That's why it is vital to keep guns away from children of any age.

Depression, alcohol, and substance abuse are factors in 90 percent of teen suicides according to the Journal of Clinical Psychiatry. Because many teen suicides occur in families that have had a family member who has also attempted or committed suicide, it's believed that some disorders such as depression have genetic components. The following events can also influence teen suicide:

• Stress from fighting with friends

• Breaking up with girlfriends or boyfriends

• Getting into trouble at school or with the police

• Substance abuse

• Depression

• A history of physical or sexual abuse

• Poor communication with parents

• Incarceration for any reason

Teens are also influenced by hearing, seeing, and reading about other teen attempts and suicides, so all of these events need careful attention, discussion, and any necessary treatment.

First Aid for Suicide Attempts and Self-Harm

If you come across someone who has attempted suicide, or suspect an attempt, take note of whether the person may be under the influence of a drug, such as exhibiting slurred speech and lethargy, or self-inflicted injuries. Take the following steps; stay safe and away from any scenes with guns, weapons, or extremely violent behavior; and use universal precautions if you are able:

• In the case of a hanging, get the person down as quickly as possible.

• Call 911, check for breathing, and start CPR and other first-aid measures for injuries.

• Look for pills, look at the date of any prescriptions, and note the number of pills left and type of medication so that you can report to EMS.

• Look for a note to bring to the hospital or to give to EMS.

• Don't disturb the scene; in the event of death there will be a death-scene evaluation.

• Refrain from any judgmental remarks.

If the person is conscious, calm them, explaining that you are getting help and someone to talk to and they don't have to be afraid, while you administer any necessary first aid and wait for help to arrive.