Suicide is the act of intentionally ending one’s own life. It is a major public health concern worldwide, with more than 720,000 people dying by suicide every year. Globally, it is the third leading cause of death among people aged 15 to 29. Suicide is not a single event but the end point of a process that typically involves emotional pain, mental health challenges, and a narrowing sense of options.
If you or someone you know is in crisis, you can call or text 988 in the United States to reach the Suicide & Crisis Lifeline, available 24/7 in over 240 languages.
How Suicide Differs From Self-Harm
Suicide involves the intent to die. That distinguishes it from non-suicidal self-injury, where someone may hurt themselves to cope with emotional pain but without the goal of ending their life. The two can overlap, and a history of self-harm does increase later suicide risk, but they are clinically distinct behaviors with different motivations.
Suicidal behavior exists on a spectrum. At one end is suicidal ideation: persistent thoughts about death or wanting to die, which can range from fleeting and passive (“I wish I weren’t here”) to active and specific (“I have a plan”). Further along the spectrum are suicide attempts, which vary in lethality and intent. Understanding this spectrum matters because intervention is possible at every stage.
Who Is Most Affected
Suicide touches every demographic group, but the rates are not evenly distributed. In the United States in 2023, men died by suicide at roughly four times the rate of women: 22.7 per 100,000 compared to 5.9. Men make up about half the population but account for nearly 80% of all suicide deaths. Women, however, attempt suicide more frequently. The gap is largely explained by differences in method, with men more often using highly lethal means.
Age plays a significant role. Adults 85 and older had the highest suicide rate in 2023, at 22.7 per 100,000, followed by those aged 75 to 84 (19.4) and 35 to 44 (19.2). The rate among young people aged 15 to 24 was 13.5 per 100,000, lower than older groups in absolute terms but still alarmingly high given that suicide ranks as one of the top causes of death in that age range.
Racial and ethnic disparities are stark. American Indian and Alaska Native people had the highest age-adjusted rate in 2023 at 23.8 per 100,000, followed by white (17.6) and Native Hawaiian/Pacific Islander (17.3) populations. These elevated rates reflect the compounding effects of historical trauma, geographic isolation, limited healthcare access, and community-level stressors rather than any inherent vulnerability.
What Happens in the Brain
Suicide is not simply a choice. Research using brain imaging and post-mortem studies has identified measurable differences in the brains of people who attempt or die by suicide. Two systems are consistently implicated: the brain’s serotonin network, which helps regulate mood and impulse control, and the body’s stress-response system, which governs how you react to threats and pressure.
In people with suicidal behavior, the stress-response system often functions abnormally, remaining in a heightened state that makes ordinary challenges feel overwhelming. Meanwhile, disruptions in serotonin signaling, particularly in the front of the brain where decision-making and emotional regulation happen, can impair a person’s ability to generate alternative solutions during a crisis. Brain imaging studies have found structural changes in these frontal regions, as well as in areas involved in processing emotions, among people who have attempted suicide.
Early-life adversity, including childhood abuse, neglect, or household instability, appears to alter how genes related to stress and mood are expressed. These changes can persist into adulthood, helping explain why adverse childhood experiences are among the strongest long-term predictors of suicidal behavior.
Risk Factors at Every Level
No single factor causes suicide. Risk accumulates across layers of a person’s life, from individual psychology to broad societal conditions.
At the individual level, the strongest predictor of a future attempt is a previous attempt. Other significant factors include depression and other mental health conditions, chronic pain or serious illness, substance use, impulsive or aggressive tendencies, job or financial loss, criminal or legal problems, and a pervasive sense of hopelessness. Adverse childhood experiences, including abuse, neglect, or growing up in a household with domestic violence or substance misuse, compound risk over a lifetime.
Relationships matter enormously. Social isolation, loss of a close relationship, high-conflict or violent partnerships, bullying, and having a family member who died by suicide all increase vulnerability. On the community level, lack of healthcare access, exposure to community violence, discrimination, historical trauma, and even a recent cluster of suicides in a local area can elevate risk. At the societal level, stigma around mental illness and help-seeking, unsafe media coverage of suicide, and easy access to lethal means all play a role.
Warning Signs to Recognize
People considering suicide often communicate their distress, though not always directly. Verbal indicators include talking about wanting to die, expressing feelings of being a burden to others, or describing great guilt or shame. Emotional shifts are also telling: feeling empty, hopeless, or trapped, experiencing unbearable emotional or physical pain, or showing sudden intense anxiety, agitation, or rage.
Behavioral changes can be especially important to notice:
- Withdrawal from friends or loved ones, saying goodbye, giving away valued possessions, or making a will
- Reckless behavior such as driving dangerously or increasing drug and alcohol use
- Changes in daily patterns like sleeping or eating significantly more or less than usual
- Extreme mood swings, particularly a sudden shift to calm after a period of deep depression
- Active planning, including researching methods or acquiring means
None of these signs in isolation confirms suicidal intent, but clusters of them, especially when combined with known risk factors, warrant direct, compassionate conversation.
What Protects People
Just as risk factors build on each other, so do protective factors. At the personal level, having strong problem-solving and coping skills, a sense of cultural identity, and concrete reasons for living (family, friends, pets, goals) all buffer against suicidal behavior.
Feeling connected to others is one of the most consistent protective factors across research. Support from a partner, friends, or family reduces risk, as does feeling a sense of belonging to a school, workplace, religious community, or neighborhood. Access to consistent, quality mental and physical healthcare makes a measurable difference at the community level. And at the broadest level, cultural or moral frameworks that discourage suicide and, critically, policies that reduce access to lethal means have shown the most dramatic effects on population-level suicide rates.
Why Restricting Access to Means Works
One of the most effective and well-documented prevention strategies is reducing access to the most common and lethal methods of suicide. This works because suicidal crises are often brief. Many people who survive an attempt do not go on to die by suicide, suggesting that if the acute moment passes without access to a highly lethal method, many lives are saved.
The evidence is striking. When the United Kingdom switched from toxic coal gas to a nontoxic natural gas supply, gas-related suicides dropped to nearly zero, and the overall suicide rate fell by about 30%, even accounting for some shifting to other methods. In Sri Lanka, government restrictions on the most toxic pesticides led to a 50% reduction in the national suicide rate. An Israeli military policy requiring soldiers to leave firearms on base during weekend leave reduced the military suicide rate by 40%, with weekend firearm suicides dropping sharply and no compensating increase in other methods.
These examples from different countries, time periods, and methods consistently show the same pattern: when access to the most lethal means is restricted, overall suicide rates decline by 30% to 50%. People do not simply switch to another method at the same rate.
Crisis Support Resources
In the United States, you can call or text 988 to reach the Suicide & Crisis Lifeline, or chat online at 988lifeline.org. The service is available 24/7 in English and Spanish, with interpreter services in more than 240 languages. Veterans, service members, and their families can press 1 after dialing 988 to reach the Veterans Crisis Line. People who are deaf or hard of hearing can dial 988 on a videophone to connect with counselors trained in ASL, or use relay service by dialing 711 then 1-800-273-8255.