Warning signs of suicide risk and self-harm
Observable changes in behaviour, speech and mood that suggest a person may be thinking about suicide or harming themselves. Self-harm (hurting oneself without intent to die) is a separate but related risk; it also signals intense distress and raises later suicide risk.
What drives it
Suicidal thinking usually grows from unbearable pain combined with hopelessness, feeling a burden, and feeling disconnected; self-harm is often used to regulate overwhelming emotion. Both are attempts to escape pain, not to manipulate.
How it shows
Work
Sudden withdrawal, giving away responsibilities or tidying affairs, statements like 'It won't matter soon' or 'You'd be better off without me', unusual calm after a period of distress, increased drinking, absence after a major loss or public failure, sharp drop in performance.
Relationships
Talk of being a burden, of having no reason to live or of feeling trapped; saying goodbye in odd ways; giving away valued possessions; increased isolation; reckless behaviour. For self-harm: covering skin in warm weather, unexplained injuries, secrecy, locked doors.
Self
You think others would be better off without you, see no way out, or feel urges to hurt yourself to make the pain stop. Anyone who recognises this in themselves should talk to someone and contact crisis or professional help now.
What tells it apart
Major depression: Depression raises risk but most depressed people are not suicidal; the warning signs to act on are talk of death or being a burden, hopelessness, preparations, and sudden calm after turmoil.
Emotional dysregulation: Self-harm can be a way of regulating overwhelming emotion; even when there is no intent to die, it is a serious signal and still needs attention.
Primary and secondary gain: Do not interpret self-harm or suicidal talk as attention-seeking; treat it as genuine distress and respond to the risk, whatever other motives may seem present.
A test
Ask directly and calmly, 'Are you thinking about suicide?', because asking does not plant the idea and often brings relief; listen without arguing, stay with them if risk seems immediate, and connect them that day with crisis services, emergency care or their doctor.
How strong the research is
moderate. Warning signs are well established at the group level but individual prediction is poor; evidence that asking about suicide does not increase risk is consistent.
Where it comes from
Edwin Shneidman, 1950s–80s; interpersonal theory of suicide by Thomas Joiner, 2005; American Association of Suicidology warning signs, 2003; review on asking by Dazzi and colleagues, 2014