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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


February 19, 2014

Reviewed by the Faculty of Harvard Medical School

Suicide is a rare event — most depressed people do NOT commit suicide. The rarity of suicide, however, makes it impossible to predict which people are most likely to follow through.
Even though suicide is rare, all depressed people are at some risk of suicide. Active treatment of depression makes suicide less likely. Thus, mental-health providers pay attention to thoughts of suicide, aiming to relieve suffering and reduce suicide risk.
Risk Factors
Having risk factors does not mean you will commit suicide. In fact, 99 percent of those who have risk factors for suicide do not kill themselves. A risk factor is a marker for increased risk, not a cause of suicide. The point of identifying risk factors, therefore, is to take action, when possible, to reduce risk. For example, if people are more likely to commit suicide when depressed, then treating depression will reduce that risk.
Certain characteristics are found more frequently among those who commit suicide:
  • Having made previous suicide attempts
  • Having a family member who has attempted suicide
  • Having a mood disorder, such as major depression or bipolar disorder
  • Having psychotic symptoms, such as false beliefs (delusions) or false perceptions (hallucinations)
  • Experiencing sudden or severe anxiety or hopelessness
  • Being male
  • Being single, especially widowed, divorced or separated
  • Being unemployed
  • Being socially isolated
  • Experiencing sudden loss (such as the death of a loved one) or a life crisis (such as bankruptcy)
  • Having a chronic medical illness or chronic pain
  • Being a victim of violence
  • Having a marked downturn in social or economic status
  • Having been in jail or prison
  • Having access to firearms
Identifying risk factors helps with making a plan to reduce suicide risk.

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The risk of suicide will never be completely eliminated, but it can be reduced. The first step is to make a list of risk factors, separating the factors you can do something about (for example, a mood disorder) from the ones you can't do anything about (for example, your age and gender). Work with your health-care provider to address those risk factors that can be treated or modified in a helpful way. For example, if you have depression, anxiety or distorted thinking, drug treatment or psychotherapy may have a very positive effect. Or if you have a problem with alcohol or drugs, counseling or a 12-step program may help you get it under control.
Here are other factors that can help lower the risk of suicide:
  • Treating mental, physical and substance-use problems
  • Improving family and/or community support
  • Getting help with problem solving
  • Getting re-engaged with a meaningful cultural or religious community
  • Removing access to deadly means of suicide, such as firearms
The success of treatment depends on many things. First, a suicidal person will make more progress if he or she is open to getting help. This issue is key, because it is easy for suicidal people to hide thoughts and feelings. Even though they contemplate suicide as a way out, most suicidal people hope to get help and are likely to be open to treatment.
Nonetheless, treatment can be demanding. For example, abstinence can be tough if you are an alcoholic. Psychiatric drug treatment is taxing if you dislike taking medication. Psychotherapy requires attention and work. Yet these efforts cannot only save your life, but may also make your life worth living.

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Related Resources
Suicide Prevention – the Substance Abuse and Mental Health Services Administration.
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