Author: Dr Frank Gonzales is a clinical psychologist at the National Center for Telehealth & Technology.

Suicide is a growing problem in the military. A person who is suicidal often feels alone, trapped, or hopeless. The person may feel that the world would be better off without them, that their family and friends will quickly get over their loss, or that their death would be the solution to their problems. Nothing could be further from the truth. In fact, the damage to family and friends that are left behind can be devastating, and the harm permanent. The loss of a loved one to suicide complicates the grieving process and makes recovery from grief much more difficult, if not impossible. In a military setting, suicide impacts morale, unit cohesion, and ultimately unit effectiveness. Because it has such devastating and far-reaching effects, it is important to be informed about suicide, what factors increase the risk for suicide, and how it may be prevented.

Suicide attempts can occur after weeks or even months of preparation (planned suicide), or they can occur in a moment of desperation in which lethal means are easily accessible (impulsive suicide). Research indicates that approximately 23 percent of suicide attempts are classified as impulsive acts, while the majority of attempts indicate at least some prior intent and planning. Cases of impulsive suicide can be reduced by restricting access to lethal means, such as firearms and medications, for persons at risk for suicide (those with a previous history of suicide attempts or self-injury, or who have displayed signs of depression, post-traumatic stress disorder, or intent to self-harm).

The leading cause of suicide is untreated depression. According to the Centers for Disease Control, approximately 80 percent of suicides occur during an episode of depression in which the person is feeling hopeless or worthless and their suffering is experienced as unbearable.

Signs of depression include a prolonged period of sadness or inability to experience pleasure that interferes with day-to-day functioning, social withdrawal, sleep or appetite changes, inability to concentrate, fatigue, excessive guilt, feelings of hopelessness, and thoughts of death or suicide. In addition to depression, other risk factors for suicide include:

• Psychiatric illness, such as bipolar disorder, anxiety, post-traumatic stress disorder, or schizophrenia
• A history of one or more prior suicide attempts
• Chronic physical illness, including chronic pain
• Traumatic brain injury
• Impulsivity
• Aggressive personality
• Lack of adequate social and coping skills
• History of alcohol or drug abuse
• Family history of suicide
• History of physical or sexual abuse
• History of violence within the family
• Family history of mental disorder or substance abuse

Having any of these risk factors does not mean that a person is likely to commit suicide, but rather that they are at greater risk for suicide than someone who does not have these risk factors.

There are also life stressors that increase the risk of suicide, such as:

• Recent breakup of a marriage or relationship
• Loss of job, home, money, status, self-esteem, personal security
• Being faced with a situation of humiliation or failure
• Recent or impending incarceration
• Assignment or placement into a new and/or unfamiliar environment
• Academic, occupational, or social failures
• Ongoing problems with spouse, neighbors, or coworkers
• Exposure to the suicidal behavior of others

If you’re having thoughts of suicide, or know someone who is, the most important thing to remember is that there is help, and that help works. There are resources you can turn to whether you are trying to help a loved one or are trying to get help for yourself. Here are just a few:

• Veterans Crisis Line: 1-800-273-8255 (Press 1)
• Department of Defense (DCoE) Outreach Center: 866-966-1020