The Link Between Depression and Suicide, According to Therapists

How to identify if a person is living with depression or experiencing suicidal thoughts and what to do about it.

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Trigger warning: Suicide. If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

Depression and suicide are two topics that can be painful to discuss. But being informed and aware of their symptoms, connections, and risks can make a huge difference in your and your loved one’s lives. Read on to learn how to identify the warning signs of depression, how depression can increase suicide risk, and the actions you can take to support someone in crisis.

Data: The link between depression and suicide

Research consistently shows a link between depression and suicide. A 2021 review using data from 15 studies with over 85,000 participants found that people with major depressive disorder (MDD) were 14 times more likely to have suicidal thoughts in the past year as compared to people without depression. Similarly, people with MDD were 9.5 times more likely to have a suicide plan and 7.3 times more likely to have attempted suicide in the past year compared to those without the condition. 

An earlier study exploring suicide risk factors in chronically depressed people seeking therapy identified depression severity and the length of time someone had been depressed as key risk factors for suicide risk. While the study suggested that risk factors for suicide can vary depending on the type of depression, it concluded that chronic depression may increase suicide risk.

Signs of a depressive disorder

As mentioned, suicidal ideation and attempts can co-occur with multiple mental health conditions, but they often present in people with depression. Therefore, understanding depression’s symptoms can position you to spot warning signs for the condition and potential suicidal ideation, allowing for timely intervention and support.

According to the National Alliance on Mental Illness (NAMI), someone living with a depressive disorder might exhibit symptoms such as:

• Changes in sleep 
• Changes in appetite 
• Lack of concentration or interest in activities
• Being less active
• Hopelessness or guilt
• Physical pains
• Suicidal thoughts

A person might also struggle to function at home, work, or school. They might feel unable to get out of bed, take care of their basic needs, or make any decisions, says Charlie Health Group Facilitator Chris Hinton, MS, M.Ed., LPC, CLC, CTP. 

It’s worth noting that different depressive disorders—such as postpartum depression or persistent depressive disorder—can have distinct symptoms. Also, depressive symptoms can occur in mood disorders like bipolar disorder.

Warning signs someone living with depression is suicidal 

No, experiencing depression doesn’t mean someone will experience suicidal ideation. But it does increase the risk. Depression can reduce someone’s willpower or ability to argue with their own dangerous impulses. “People suffering from depression may not see but one way out of their suffering, and therefore depression may lower their impulse control, which increases their risk of acting on their suicidal thoughts,” says Hinton. 

Charlie Health Group Facilitator Nicole Lonano, MS, seconds this, “When hope for the future is lost, suicidal ideation might creep in. This can also occur when feeling overwhelmed and having feelings of not being able to cope and viewing suicide as the only way out of the situation.” Lonano. According to Lonano and Hinton, there are a range of signs that someone is feeling suicidal. 

1. Engaging in risky behavior 

A person with suicidal feelings might take dangerous risks, not caring about the consequences. These actions could include substance use, reckless driving, or other threatening actions. When done in tandem with other behaviors (as outlined below), these risks may be considered a form of suicidal behavior. 

2. Voicing suicidal thoughts or suicidal feelings

It’s not uncommon to hear someone say, “I want to kill myself” or “Kill me” if they’re feeling stressed or embarrassed. But, a person who is suicidal might say things like,” I wish I weren’t here,” or “Everyone would be better off without me.” They might mention that they feel like a burden to others or that they want to die. In some instances, a person planning to attempt suicide might even say goodbye to their loved ones. Their language can also be concerning, even if their intention is less clear. A person might express suicidal feelings like hopelessness, guilt, shame, emptiness, being trapped, and not believing that things will improve overall. 

3. Withdrawing from loved ones 

A person with suicidal thoughts might withdraw from their loved ones and avoid social activities. These would be events that the individual would typically enjoy but suddenly has no interest in attending.  

4. Mood changes

It might seem backward, but if a person living with severe depression suddenly appears happy or calm, then it can be a warning sign. This quick shift in their mood could indicate that they’ve decided to act on their suicidal thoughts and that they’re experiencing a sense of relief. While emotional distress often manifests as sadness or irritability, a sudden calmness can signal that the person has made a decision to end their pain, making this change in mood an important signal for those around them to take it seriously. 

Additionally, other mood changes, such as intense anger, agitation, or withdrawal, can also be signs of emotional distress and may indicate that someone is struggling with suicidal thoughts.

5. Taking concrete steps

A person with plans to attempt suicide might take steps such as giving away their important belongings, gathering supplies, writing a note, and creating a will. As Hinton emphasizes, “If any of these signs are noticed in someone, take them seriously. Encourage them to talk to someone they trust and seek professional help immediately. If they are in immediate danger, don’t hesitate to call emergency services or a crisis hotline.” 

What to do when someone intends to attempt suicide

It is absolutely critical that someone with severe depression or at risk of a suicide attempt gets professional care immediately. Lonano states that you should “reach out for help by contacting the crisis line at 988 if it is imminent danger or go to the nearest emergency room. Seeking professional help is imperative through partial hospitalization or an Intensive outpatient program to get proper treatment and to also develop a safety plan.” 

Lean on a family member, friend, crisis center, or other close trusted support to help you navigate getting your loved one the care they need for suicide prevention, says Hinton. It’s also important to remove the person’s access to anything that could cause them harm, including medications and firearms. 

Hinton adds: “Long-term management of depression should include ongoing therapy and regular, consistent check-ins to help prevent relapses and recognizing triggers and steps to take when a crisis arises.” 

How Charlie Health can help 

If you or a loved one are struggling with suicidal behavior, thoughts, or depression, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides mental health treatment for people dealing with serious mental health conditions, including persistent depressive disorder, postpartum depression, bipolar disorder, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With this kind of holistic approach, managing your mental health is possible. Fill out the form below or give us a call to start healing today.