Recent divorce or separation
	Recent bereavement
	Experiencing a major life stress such as job loss or retirement
	Isolation and having a poor support system
	Being a child in a family with major mental illness, substance abuse, physical or sexual abuse
	Experiencing a major, especially chronic, medical illness
	Experiencing the loss of parent in childhood

In addition, the AAS has identified specific warning signs:

	Sudden, extreme, unexplained changes in behavior and personality
	Withdrawal from family, friends & others
	Preoccupation with death and suicidal thoughts
	Making final arrangements
	Increased use of alcohol/drugs
	Talking about committing suicide—having a plan possession of lethal means (gun, pills) having attempted before

And the AAS has identified the most common symptoms present for someone at risk including emotional, cognitive, motivational and physical symptoms:

	Emotional: sadness, apathy, crying spells, self-dislike, anhedonia—difficulty enjoying life, loss of feelings of affection or humor, sudden elevation in moods, sudden boredom, unusually long grief
	Cognitive: cognitive constriction (tunnel vision), overgeneralization, poor reality testing, misattribution, negative self-concept, negative expectations, exaggerated view of problems, lots of self blame, either/or thinking
	Motivational: low frustration tolerance, lowered impulse control, loss/lessening of object relations, increased dependency, loss of motivation, avoidance, indecisiveness, suicidal wishes, presence of closure behavior, hopeless, helpless, hapless
	Physical: loss of appetite, sleep disturbance, fatigue, loss of sexual interest, a change in behavior that lasts more than two weeks

See, I have set before you today life and prosperity, death and adversity... Choose life so that you and your descendants may live, loving the Lord your God, obeying him, and holding fast to him... Deuteronomy 30:15,19 (NRSV)

When making an assessment of risk of suicide, we need to keep in mind these characteristics, signs and symptoms. However, all thoughts and feelings about suicide need to be taken seriously. Referral for professional assessment and intervention is essential when someone we care about is having suicidal thoughts and feelings. We need to remain faithful to our belief that life is a gift from God, that it is too precious to throw away no matter what the immediate pain is.

If it is clear from the characteristics, signs and symptoms present that the one you care about is suicidal, it is important to respond in ways that support and not judge. Depression and suicidal thoughts and feelings (which are a part of clinical depression), need to be viewed as an illness, one that requires compassion and treatment. Encouraging the one you love to seek professional help, to take themselves to an emergency room in urgent situations or allow you to take them are all appropriate responses. If the one you care about is unwilling, rally support of family and friends to encourage them to seek help. If all else fails, call the police to assist you in getting them to an emergency room for evaluation and observation or immediate hospitalization.

Once medical, psychiatric and psychotherapy treatments begin, it may take awhile for improvement to occur. Antidepressant medications take from one to eight weeks for good results, for depression to lift and suicidal thoughts and feeling to diminish. During this time, staying supportive and in touch with the person is important. Isolation is always a danger. Encourage the one you care about to continue treatment when they feel better. It is recommended that antidepressant medications be taken four to nine months after patient is feeling better. Psychotherapy should continue for three to six months minimally, often longer. Eighty percent of patients respond well to antidepressant medication, psychotherapy or a combination of the two. If after eight weeks, improvement is not seen, other treatments may need to be considered. Support the one you care about to be active in working with their treatment team to get the best results.

In the USA, one suicide every 20 minutes.
Ten attempted suicides for every successfully committed one.
Risk 30xs higher for psychiatric population.

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