The pain of depression is real. You wouldn’t think twice about seeking help for a broken leg. If you’re depressed or thinking about suicide, call 2-1-1 or 381-HELP and get the help you need.


Allison sat next to Shantee in her senior English class. Shantee was a quiet young woman who got good grades and was on the track team. She was friendly with most of her classmates, including Allison, but did not seem to have any close friends.

One day Allison realized that Shantee was crying during class. Later, in the hall, Allison noticed that Shantee had gained weight. Allison knew that it was very unusual for someone on the track team to gain weight at that point in the track season. Allison began to pay closer attention to Shantee in English class. She soon realized that Shantee was no longer listening to the teacher and that she always looked sad. One day, Allison offered Shantee a friendly "How are you doing?," which Shantee returned with a shrug, not looking Allison in the eye.

The following week, Allison noticed that Shantee didn't wear her track sweatshirt on the day of a meet like the rest of the team. She could also see from her desk that Shantee got a C on her last English test. For that whole week, Shantee looked like she was on the verge of tears.

Allison was worried, but she didn't know what to do-or even if it was any of her business. Allison decided to talk to Ms. Shaw, her history teacher, about the situation. Allison trusted Ms. Shaw. The teacher listened to what Allison had to say and told Allison that she would talk to the school counselor about Shantee. Ms. Shaw asked Allison if she would talk with the school counselor if he thought it would help. Allison agreed. Ms. Shaw told Allison that she would let her know how her meeting with the school counselor went.

Allison did the right thing. Even though she was not Shantee's close friend-and wasn't even sure that Shantee had a serious problem-she was concerned enough, and brave enough, to help. What would have happened if Allison had not talked to her teacher? Maybe nothing . . . and maybe something terrible. Even if Shantee was not thinking about hurting herself, it was pretty clear that she was in trouble and could use some help.

This publication will help you understand why some teenagers want to hurt themselves, how to tell if someone may be thinking about suicide, and what to do if you think someone may try to kill him- or herself.


If you are thinking about suicide or hurting yourself, or if you think someone you know is seriously thinking about suicide, please talk to a responsible adult or call (800) 273-TALK (8255). This telephone hotline is available 24/7. The people who answer this hotline will help you.


The Role of Teens in Preventing Suicide

It is always shocking to think that anyone-much less a young person-would want to die. Yet more than 1,200 teenagers die by suicide each year in the United States, and more than 72,000 teens are treated in emergency rooms each year because they attempted suicide (CDC, 2003a). One survey (CDC, 2003b) found that in a 12-month period:

  • almost 17 percent of high school students had seriously considered suicide
  • 16.5 percent of high school students made a suicide plan
  • 8.5 percent of high school students tried to kill themselves at least once

Why would someone want to die? Sometimes people want to die because they are suffering from a chemical imbalance that causes depression or another mental disorder, and brings them a great deal of pain. Some young people may be overwhelmed by problems, such as drug or alcohol abuse or family violence.

Young people who feel like they want to die are often in so much emotional pain that they cannot see any other solution to their problems. While you probably can't solve these problems for a friend or classmate, you may be able to help the person find someone who can help. And the first step in doing so is recognizing the signs that someone may be at risk of suicide.


Recognizing the Warning Signs

Teens have their own culture and language. You may know your friends better than their own parents do. And you may be able to tell that something is bothering one of your classmates, even when your teachers and guidance counselors don't have a clue that anything is wrong. You can use your insight to help other teens find help when they are having problems.

While there is no foolproof method of knowing that a teen may be thinking of hurting him- or herself, the following signs might indicate that a young person is considering suicide:

  • A suddenly worsening school performance. Good students who suddenly start ignoring homework, cutting classes, or missing school altogether may have problems-such as depression or drug and alcohol abuse-that can affect their health and happiness and put them at risk of suicide.
  • A fixation with death or violence. Teens with problems may develop an unusual interest in death or violence, expressed through poetry, essays, doodling, or artwork; an obsession with violent movies, video games, and music; or a fascination with weapons. Adults often cannot tell a "normal" teen interest in violent video games or music from an obsession that other teens realize is not typical of this age group.
  • Unhealthy peer relationships. Teens who don't have friends, suddenly reject their friends, or begin associating with other teens known for substance abuse or other risky behaviors may be in trouble. A friend who suddenly stops hanging out with you for no reason or claims that "you just don't understand me any more" may have an emotional problem that he or she is afraid to discuss. That friend may feel isolated and alone and need your help.
  • Violent mood swings or a sudden change in personality. Kids who become sullen, silent, and withdrawn, or angry and acting out, may have problems that can lead to suicide.
  • Indications that the teen is in an abusive relationship. Some teens may be physically or emotionally abused by a member of their family or their girlfriend or boyfriend. Signs that a person may be in an abusive relationship include unexplained bruises or other injuries that the person refuses to discuss.
  • Other risky behaviors. Teens who suddenly start having unprotected or promiscuous sex, using drugs or alcohol, driving recklessly or without a license, stealing, or engaging in vandalism may be acting out self-destructive impulses.
  • Signs of an eating disorder. Anyone who suffers from an eating disorder, or has a dramatic change in weight that is not the result of a medically supervised diet, needs help.
  • Difficulty in adjusting to gender identity. Gay, lesbian, bisexual, and transgendered teens have higher suicide attempt rates than their heterosexual peers. These youth may be faced with social pressures that make life very difficult.
  • Bullying. Kids who are bullied, pushed around, or harassed may be at risk of suicide.
  • Depression. Depression is an emotional problem that increases a person's risk of suicide. The following signs indicate that a teen may be depressed:
    • A sudden worsening in school performance
    • Withdrawal from friends and extracurricular activities
    • Expressions of sadness and hopelessness, or anger and rage
    • A sudden, unexplained decline in enthusiasm and energy
    • Overreaction to criticism
    • Lowered self-esteem, or feelings of guilt
    • Indecision, lack of concentration, and forgetfulness
    • Restlessness and agitation
    • Changes in eating or sleeping patterns
    • Unprovoked episodes of crying
    • Sudden neglect of appearance and hygiene
    • Seeming to feel tired all the time, for no apparent reason
    • Use of alcohol or other drugs

Some warning signs demand immediate action:

  • Announcing that the person has made a plan to kill him- or herself
  • Talking or writing about suicide or death
  • Saying things like:
    • I wish I were dead.
    • I'm going to end it all.
    • You will be better off without me.
    • What's the point of living?
    • Soon you won't have to worry about me.
    • Who cares if I'm dead, anyway?
  • Staying by him- or herself rather than hanging out with friends and family
  • Expressing the belief that life is meaningless
  • Giving away prized possessions
  • Neglecting his or her appearance and hygiene
  • Dropping out of school or social, athletic, and/or community activities
  • Obtaining a weapon or another means of hurting him- or herself (such as prescription medications)

Again, there is no foolproof way of knowing for sure that a teen is thinking of hurting him- or herself. But even if the person isn't thinking of suicide, these warning signs can mean that he or she has other serious problems. By taking action, you can help that person become happier and healthier.


Helping Peers

If you think that any of your friends or classmates may be thinking of killing themselves-or have serious problems that they have not told anyone about-tell a responsible adult. Find someone who is concerned with and understands young people and can help. This may be a teacher, guidance counselor, or other member of the school staff. It might also be your parents, the parents or sibling of a friend, a member of the clergy, or someone who works at the local youth center. If this adult doesn't take you or your friend's problem seriously, or doesn't know what to do, talk to someone else. If you need help finding someone who can help, call (800) 273-TALK (8255).

Don't be afraid of being wrong. It is often hard to tell if someone is really thinking about killing or hurting him- or herself. Some of the warning signs for suicide could also be signs of drug or alcohol use, serious family problems, or depression or another mental illness. People with these problems still need help-and you can help.

Just talking to them can make a big difference. Teens will often share secrets and feelings with other teens that they will not share with adults. However, you may need to be persistent before they are willing to talk. Ask them if they are thinking about killing themselves. Talking about suicide or suicidal thoughts will not push someone to kill him- or herself. It is also not true that people who talk about killing themselves will not actually try it. If a friend says that he or she is thinking about killing him- or herself, take your friend seriously.

You should be especially concerned if people tell you that they have made a detailed suicide plan or obtained a means of hurting themselves. If they announce that they are thinking of taking an overdose of prescription medication or jumping from a particular bridge, stay with them until they are willing to go with you and talk to a responsible adult-or until a responsible adult can be found who will come to you.

Don't pretend you have all the answers. Be honest. The most important thing you can do may be to help them find help. Never promise to keep someone's intention to kill or hurt him- or herself a secret. Let the person know that you would never tell this secret to just anyone, but you will tell a responsible adult if you think the person needs help.


Helping Yourself

If you are having problems and thinking of hurting yourself, tell someone who can help. If you cannot talk to your parents, find someone else: a relative, a friend, a teacher, the school nurse or guidance counselor, or a friend's parents. Or, call the National Suicide Prevention Lifeline at (800) 273-TALK (8255), and they will help you.

Don't be ashamed or embarrassed. A lot of teens and adults have problems that they cannot solve on their own. Finding the courage to get help is often the first step toward solving your problems and becoming a happier person.



Centers for Disease Control and Prevention (CDC). (2003a). Web-based Injury Statistics Query and Reporting System (WISQARS). Retrieved April 14, 2005, from

Centers for Disease Control and Prevention (CDC). (2003b). Youth online: Comprehensive results. Retrieved March 23, 2005, from



If you are thinking about suicide or hurting yourself, or if you think someone you know is seriously thinking about suicide, please talk to a responsible adult or call 1-800-273-TALK (8255). This telephone hotline is available 24/7. The people who answer this hotline will help you.


Resources for Teens

Go Ask Alice! ( http://www.goaskalice.columbia.edu) is a web-based health question-and-answer service produced by Alice!, Columbia University's Health Education Program. Go Ask Alice! provides information to help young people make better decisions concerning their health and well-being. Go Ask Alice! answers questions about relationships, sexuality, emotional health, alcohol and other drugs, and other topics. The addresses of e-mails sent to Go Ask Alice! are electronically scrambled to preserve the senders' confidentiality. Questions are answered by a team of Columbia University health educators and information and research specialists from other health-related organizations. The Go Ask Alice! archive on emotional health also contains information on suicide and depression.

High School Blues (http://www.highschoolblues.com/) features information and resources for high school students on mental health, anxiety, loneliness, alcohol abuse, coming out, and other social and emotional issues.

Jason Foundation (http://www.jasonfoundation.com/) is a nationally recognized leader in youth suicide awareness, education, and prevention. The Student section of the website (http://www.jasonfoundation.com/student.html) contains information on preventing suicide, suggestions for working in your school or community on suicide prevention projects, basic information about suicide and its warning signs, and other information useful for doing term papers on suicide and suicide prevention.

National Institute of Mental Health (www.nimh.nih.gov/) is a Federal research agency. Its website features several publications for teens on suicide and depression, for example:

Samaritans (http://www.samaritans.org)is an organization based in the United Kingdom that offers 24-hour confidential emotional support to people who are experiencing feelings of distress or despair, including those feelings that may lead to suicide. The Samaritans operate a free and confidential e-mail service, which generally responds to your e-mail within 24 hours. You can send an e-mail to jo@samaritans.org or use the Samaritans website to send a confidential e-mail that cannot be traced back to your address.

Samariteens (http://www.samaritansofboston.org/index2.htm) is a free, confidential, helpline staffed by teenage volunteers who are trained to be compassionate and supportive listeners. Samariteens provides peer support and understanding to those facing the challenges of adolescence. The help line can be reached, toll-free, at (800) 252-TEEN.

TeensHealth Answers & Advice (http://www.kidshealth.org/teen/index.html) offers information for teens on physical and emotional health, food and fitness, and other issues. Information on suicide can be found at
http://www.kidshealth.org/teen/your_mind/mental_health/suicide.html. TeensHealth is produced by the Nemours Foundation's Center for Children's Health Media.

Trevor Project (http://www.thetrevorproject.org/) was established to promote acceptance of gay, lesbian, bisexual, and questioning teens and to aid in suicide prevention among those youth. The Trevor Project website includes information about recognizing and responding to signs of suicide, and an e-mail advice feature. The Trevor Helpline, which can be reached at (866) 488-7386, is a 24-hour toll-free suicide hotline for gay, lesbian, bisexual, and questioning youth.


General Resources on Suicide and Suicide Prevention

Suicide Prevention Resource Center (http://www.sprc.org/). The Suicide Prevention Resource Center (SPRC) provides prevention support, training, and materials to strengthen suicide prevention efforts. Among the resources found on its website is the SPRC Library Catalog (http://library.sprc.org/), a searchable database containing a wealth of information on suicide and suicide prevention, including publications, peer-reviewed research studies, curricula, and web-based resources. Many of these items are available online.

American Association of Suicidology (http://www.suicidology.org/). The American Association of Suicidology is a nonprofit organization dedicated to the understanding and prevention of suicide. It promotes research, public awareness programs, public education, and training for professionals and volunteers and serves as a national clearinghouse for information on suicide.

American Foundation for Suicide Prevention (http://www.afsp.org). The American Foundation for Suicide Prevention (AFSP) is dedicated to advancing our knowledge of suicide and our ability to prevent it. AFSP's activities include supporting research projects; providing information and education about depression and suicide; promoting professional education for the recognition and treatment of depressed and suicidal individuals; publicizing the magnitude of the problems of depression and suicide and the need for research, prevention, and treatment; and supporting programs for suicide survivor treatment, research, and education.

National Center for Injury Prevention and Control (http://www.cdc.gov/ncipc/). The National Center for Injury Prevention and Control (NCIPC), located at the Centers for Disease Control and Prevention, is a valuable source of information and statistics about suicide, suicide risk, and suicide prevention. To locate information on suicide and suicide prevention, scroll down the left-hand navigation bar on the NCIPC website and click on "Suicide" under the "Violence" heading.

National Suicide Prevention Lifeline (http://www.suicidepreventionlifeline.org/). The National Suicide Prevention Lifeline provides immediate assistance to individuals in suicidal crisis by connecting them to the nearest available suicide prevention and mental health service provider through a toll-free telephone number: (800) 273-TALK (8255). Technical assistance, training, and other resources are available to the crisis centers and mental health service providers that participate in the network of services linked to the National Suicide Prevention Lifeline.

Suicide Prevention Action Network USA (http://www.spanusa.org). Suicide Prevention Action Network USA (SPAN USA) is the nation's only suicide prevention organization dedicated to leveraging grassroots support among suicide survivors (those who have lost a loved one to suicide) and others to advance public policies that help prevent suicide.


The pain of depression is real. You wouldn’t think twice about seeking help for a broken leg. If you’re depressed or thinking about suicide, call 2-1-1 or 381-HELP and get the help you need.