How to Diagnose if Someone Is Truly Suicidal

How to Diagnose if Someone Is Truly Suicidal

By In Nutrition and Mental Health
Posted February 19, 2018

On average, 123 people commit suicide in the United States daily. It’s the 10th leading cause of death in the nation.

Although large-scale interventions are needed, you can make a difference in the lives of your loved ones. Suicide prevention begins with recognizing the warning signs and taking action.

In this article, we’ll detail how to diagnose if someone is truly suicidal—and what you can do about it.

Major Warning Signs

The American Association of Suicidology has developed a mnemonic to help people remember the most significant warning signs for suicide: IS PATH WARM?


Ideation (suicidal thoughts)

Substance Abuse










Mood Changes


Other warning signs include (but aren’t limited to):

  • Verbal expressions such as, “I don’t want to live anymore,” “I won’t be around to deal with that,” or, “People will be better off without me.”
  • Loss of interest in previously enjoyed activities and/or staying in the house more
  • Agitation
  • Increase in drug and alcohol use
  • Aggressive, impulsive, and/or violent actions
  • Lack of self-care and/or poor hygiene (neglecting to shower or brush teeth)
  • Too much or too little sleep
  • Constantly feeling tired or demonstrating a loss of energy
  • Changes in eating patterns and significant weight changes
  • Giving away prized possessions
  • Making a will
  • Writing notes and tidying up personal affairs
  • Reconnecting with friends and extended family (as if to say goodbye)
  • Unusual peace and happiness that suddenly occurs after a display of the above characteristics

Have a Conversation

If you observe these signs in a loved one, ask them directly about suicidal thoughts. This may seem uncomfortable, but confidently addressing the risk of suicide can actually be reassuring for your friend or family member.

Be straightforward and to the point. Ask something like, “Are you having thoughts of suicide?”

Having a conversation with someone who is suicidal

Try to deliver these questions without dread or judgment. This may be difficult, so perhaps you’ll want to practice saying these words aloud in advance.

Don’t worry that you’ll inadvertently “suggest” suicide by having this conversation. Also keep in mind that, despite popular opinion, it’s not true that someone who openly discusses suicide isn’t serious.

In order to determine how serious your loved one is about suicide, ask them if they’ve decided how or when to commit suicide. Have they taken any steps to put this plan into action? A higher level of planning indicates a higher risk. But someone who hasn’t made a plan yet isn’t necessarily safe.

How to Discuss Suicide

Often, people with suicidal thoughts keep them hidden due to the stigma associated with suicide. It may be a great relief for your loved one to be able to discuss their feelings and the reasoning behind their thoughts of suicide. If they’re willing, try to let them do most of the talking.

Your role in the conversation should be expressing empathy, explaining that you care deeply about your loved one and will do what you can to help. Remind your friend or family member that suicidal thoughts are common and that they’re often associated with treatable mental disorders. Suicidal thoughts don’t have to be carried out.

Ask your loved one about the specific problems fueling their suicidal thoughts. These problems likely seem impossible for your loved one to cope with or solve, so it can be helpful to discuss possible solutions or helpful actions. Don’t try to solve the problems for your loved one, but help them brainstorm actions they can take other than suicide.

Seek Help

Of course, you’re not a professional, and you don’t have to handle this situation alone if you feel your loved one is truly suicidal.

In an emergency, you should immediately dial 911. If the situation is a non-emergency, you can put your loved one in contact with the National Suicide Hotline at 1-800-273-TALK (8255). The hotline is available 24/7. If your friend or family member is willing, you can also contact a therapist or other mental health professional.

Someone who is suicidal should not be left alone. Try to stay with them or ensure that someone is with them at all times. Tell them to call you or the suicide hotline any time they need to talk.

Seeking help


Being aware of the warning signs of suicide and having proactive conversations can save your loved one’s life. If your loved one struggles with substance abuse disorder, understand that they’re more vulnerable to suicidal thoughts, and watch carefully for the signs mentioned above.

Remember that despite their loved ones’ best efforts, some people do ultimately commit suicide. The choices your loved one makes are not your responsibility or your fault, but there are clear steps you can take to help.

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