The surprise deaths of Kate Spade and Anthony Bourdain in June, both by apparent suicide, put the national spotlight on suicide, one of the 10 leading causes of death in the United States.
This week marks National Suicide Prevention Week, a chance to add your voice to the conversation, spread awareness, protect your own mental health and potentially save lives.
The statistics are sobering. Suicide rates have been on the rise since 2006, according to data released in June by the CDC.
Among women, the suicide rate increased by a staggering 50 percent between 2000 and 2016.
"Whether you’re at church or at school or in an office, some portion of the room is having thoughts of suicide, now or recently," Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention (AFSP), told "Good Morning America" in June. "The fact is that if you think your life has not been touched by suicide ever, it probably means that it’s just not being talked about.
Talking about suicide, and about mental health more broadly, can make all the difference, experts say.
There's no better time than now to talk about the warning signs for suicide and the steps people can take to spread awareness and potentially save lives.
Questioning suicide? Call someone, anyone: A friend, neighbor, family member, religious figure, hospital, doctor, mental health specialist, the police department or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
It is important to remember you are not alone and people do want to help you, regardless of what you think.
The strongest risk factor for suicide is a previous attempt at suicide, according to the American Psychiatric Association.
Nearly 9 percent of youth in grades nine through 12 reported that they had made at least one suicide attempt in the past 12 months, according to the AFSP, based on the 2015 Youth Risk Behaviors Survey.
Suicide is linked, but not limited to, mental disorders, particularly depression and alcohol use disorders.
Certain events and circumstances may increase risk for suicide, such as having a psychiatric illness including, but not limited to, depression, bipolar disorder, schizophrenia and anxiety disorders.
While depression is a contributory factor for most suicides, it does not need to be present for a suicide to be attempted or completed, according to the AFSP.
Other risk factors for suicide include chronic physical illnesses, family history of suicide, history of exposure to trauma or abuse, recent losses or life stressors, military service, hopelessness and impulsivity, misuse of alcohol and drugs and access to lethal means such as firearms, experts say.
Suicide risk also increases with age.
Significant changes in behavior are major warning signs that a person, especially one with depression, may be slipping into suicide, according to Dr. Dan Reidenberg, executive director of Suicide Awareness Voices of Education (SAVE).
If someone with depression is acting out of character, it is time to ask more questions, get others involved and take action, he explained.
Other changes in behavior that may be red flags are withdrawal from family, friends, work and social activities, a change in activity level, increased anxiety, which can be restlessness or agitation, and a lack of sleep.
"Look and listen for warning signs because it is not as if just one morning someone wakes up and says, 'Today is the day I’m going to do this,'" Reidenberg told "GMA" in June. "It happens over time and falls on a continuum."
The most important thing loved ones can do is to be available, experts say.
Being available can mean being there to listen, without judgment, and to check in continually to say something as simple as, "'Hi, how are you doing? I'm available and around,'" explained Reidenberg.
"Reassure them that they are important to you, you want them to be around and want them to be well," he said. "The reassurance that people care by statements and words mean a lot to someone who emotionally is drained from the depression."
Interested in ways to protect your own mental health? Read how a coffee date and five other tips can help you thrive.
Being willing to move past the stigma of speaking about depression and ask the person direct questions is also important.
"If you care about someone, it’s really important to ask, ‘What are you doing about this? Are you talking to someone? Have you tried medication?'" Reidenberg said, adding that checking in on those three questions later is also important.
The National Suicide Prevention Lifeline offers five steps to help someone who may be considering suicide.
1. Ask: There is a common misconception that asking someone if they have/ are considering killing themselves puts the idea in their head — it does not. Do not be afraid to ask!
2. Keep them safe: If someone admits to considering suicide, it is important to seek immediate medical attention, especially if they shared their plan with you or have access to firearms, the number one cause of suicide (50 percent).
3. Be there: Listen without judgment and with empathy. Let them know they have a shoulder to lean on when they need.
4. Help them connect: Help them find a support system to reach out to. Support is very important for someone battling the idea of suicide. Those who have attempted to harm themselves are often at risk of another attempt at suicide.
5. Follow up: Following up could mean preventing thoughts of suicide or another attempt.
If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741-741. You can reach Trans Lifeline at 877-565-8860 (U.S.) or 877-330-6366 (Canada) and The Trevor Project at 866-488-7386.
