Risk Factors

There are many risk factors for suicide. Some risk factors are genetic and cannot be changed; others are short lived and situational. Because risk factors are present does not mean that someone will attempt or complete suicide; however, any warning signs that are associated with a change in behavior should be closely monitored.

Chronic risk factors

Perpetuating risk factors-permanent and non-modifiable:

• Demographics: White, American Indian, male, older age, separation or divorce, early widowhood
• History of suicide attempts-especially if more than one attempt
• Prior suicidal ideation
• History of self-harming behavior
• History of suicide or suicidal behavior in the family
• Parental history of violence, substance abuse, hospitalization for major psychotic disorders and divorce
• History of trauma or physical or sexual abuse
• History of psychiatric hospitalization
• History of violent behaviors
• History of impulsive and reckless behaviors

Predisposing and potentially modifiable risk factors:

•   Major Axis I psychiatric disorder, especially:
  • Mood disorder
  • Anxiety disorder
  • Schizophrenia
  • Substance use disorders (drug and alcohol abuse or dependence)
  • Eating disorders
  • Body dysmorphic disorder
  • Conduct disorder
• Axis II Personality disorder, especially cluster B
• Axis III Medical disorder, especially if involves functional impairment and/or chronic pain
  • Traumatic brain injury
• Comorbity of Axis I disorders (especially depression and alcohol abuse and dependence)
• Low self-esteem
• Accepting attitudes toward suicide
• Exposure to another's death by suicide
• Lack of self or familial acceptance of sexual orientation
• Smoking
• Perfectionism

Acute risk factors. If these are present they increase the risk of a potential attempt or death in the near future:

• Demographics, recently divorced, or separated with feelings of victimization or rage
• Suicide ideation (threatened, communicated, planned or prepared for suicide)
• Current self harming behavior
• Recent suicide attempt
• Excessive or increased use of drugs or alcohol
• Acute distress due to perceived loss, defeat, rejection, etc.
• Recent discharge from a psychiatric hospital
• Anger, rage, seeking revenge or other aggressive behavior
• Withdrawal from usual activities, friends, interests, school or work and isolation
• Anhedonia- the inability to experience pleasure
• Anxiety or panic
• Agitation
• Insomnia
• Persistent nightmares
• Suspiciousness, paranoia, ideas of persecution
• Severe feelings of confusion or disorganization 
• Command hallucinations, especially ones urging harm to self or others
• Intense affect states (desperation, intolerable aloneness, self-hate, etc.)
• Dramatic mood changes
• Hopelessness
• Poor problem solving
• Cognitive constriction (thinking in black and white terms and not able to see shades of gray)
• Rumination, continuously focusing on the distress
• Inability to see reasons for living
• Inability to imagine possible positive future events
• Perceived burdensomeness
• Recent diagnosis of chronic or terminal condition
• Feeling trapped, like there is no way out other than death
• Sense of purposelessness or loss of meaning
• Negative or mixed attitude toward help-receiving
• Recklessness or excessive risk taking behavior, especially out of character
• Any real or perceived events causing shame, guilt, despair, humiliation, unacceptable loss of face or status, legal problems, financial problems, and feelings of rejection and abandonment

Information adapted from the Centers for Disease Control and Prevention.