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Many emotional changes accompany suicidal thought, and the following changes are common warning signs:  Extreme mood swings Feelings of loneliness and isolation, even in the presence of others Feelings of worthlessness, shame, guilt, self-hatred, and the sense that no one cares. Becoming sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts. Be alert to statements that echo the patterns of thoughts and feelings that accompany suicidality. The following are common to hear from a suicidal person:  "Life isn’t worth living." "You (or another friend or family member) would be better off without me." "Don’t worry, I won’t be around to deal with that." "You’ll be sorry when I’m gone." "I won’t be in your way much longer." "I just can’t deal with everything — what's the point?" "I won’t be a burden much longer." "There’s nothing I can do to change anything." "I’d be better off dead." "I feel like there is no way out." "I never should have been born". Many people who go through with suicide do so when they appear to be feeling significantly better than they have been. You may be seeing the peaceful resoluteness of making the decision to end their life, and should take preventative steps immediately. You can observe many behavioral changes in suicidal individuals. If you see at least a few of the following, you may have cause for concern.:  Declining performance in school, work, or other activities (or occasionally the opposite, filling up time with extra duties and responsibilities) Social isolation Little or no interest in sex, friends, or previously enjoyable activities Carelessness about personal welfare and deteriorating physical appearance Alterations in either direction in sleeping or eating habits. Look for extremes like self-starvation, poor dietary management, or inattention to medical orders (especially in the elderly) Drastic changes to established routines. Lethargy and withdrawal. Having a plan already in place can mean that a successful attempt could happen soon. Watch for all of the following actions:  Tying up loose ends (e.g. saying goodbye to loved ones, giving away valuable belongings, arranging finances) Making reckless or passive decisions about important things Gathering the means to commit suicide, like pill bottles, medications, and weapons
Recognize suicidal emotions. Watch for suggestive comments. Be wary of sudden improvement in mood. Notice unusual behavior. Recognize signs of suicide planning.