People considering suicide might show signs early on. Here's what to watch for

Extreme changes in mood can be one warning sign that someone is suicidal.

If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the National Suicide Prevention Lifeline at 800-273-8255 (or 988 beginning July 16, 2022) to connect with a trained counselor or visit the NSPL site.

(CNN)Suicide is a leading cause of death among children and adults, but spotting risk factors and warning signs isn't easy.

Nearly 46,000 people in the United States died by suicide in 2020, which is about one death every 11 minutes, according to the US Centers for Disease Control and Prevention. Worldwide, nearly 800,000 people die from suicide yearly, and in 2020, there were 1.2 million attempts globally.
Researchers still haven't nailed down how to better predict who's at risk for attempting suicide, and whether or when vulnerable people will do it, said Justin Baker, clinical director of The Suicide and Trauma Reduction Initiative for Veterans at The Ohio State University Wexner Medical Center.
    "That is extremely, extremely difficult," he said. "You can look back in time, when someone's made an attempt or has died, and go, 'Oh, look at all these things that were going on in their life.' The difficulty is that a lot of people handle or experience those types of stressors as well but never go on to (attempt suicide)."
      Additionally, there isn't always a long timeframe wherein someone is considering suicide and showing signs -- and there can be as little as 5 to 15 minutes between someone deciding to attempt suicide and doing it, Baker added.
        "What we collectively understand is it's an emotional dysregulation and cognitive error that occurs," Baker said. "They can't fix the situation, or they can't think their way through the situation, so suicide becomes a viable option as a way to manage the pain that they're in. So they may take action on it in that really short, brief window."
        But there are some situations wherein a person who is suicidal and planning for a longer period of time will show behavioral changes, Baker added.
          "If you're noticing that kind of stuff, obviously that's someone who is really close to being imminent risk -- someone who's really close to making that decision to end their life," he said. "But I would argue most people don't get that kind of warning."
          If you think you or someone you know is at risk, trained counselors with the 24/7 National Suicide Prevention Lifeline could help you work through any signs you're experiencing or seeing. To increase its accessibility, every state will roll out 988 as the new lifeline starting July 16. The current number is 1-800-273-8255 (TALK), and it will always remain available to people in emotional distress or suicidal crisis, according to the Substance Abuse and Mental Health Services Administration.
          Here are some of the most common behavioral, verbal and emotional signs and risk factors you should pay attention to, according to experts.

          Behaviors to watch for

          Some people might seem like their usual selves in the weeks or days leading up to a suicide attempt, while others might show behavioral changes that don't track with what you know about them, said Michael Roeske, a clinical psychologist and senior director of the Newport Healthcare Center for Research & Innovation.
          Those can include practicing or preparing for suicide, which could look like exhibiting unusual behaviors with guns, pills or other potentially lethal items, according to SAMHSA.
          Other potential behavioral red flags include giving away cherished belongings, sleeping too much or too little, withdrawing or isolating oneself, showing rage or desire to enact revenge, and acting anxious or agitated, according to Roeske, Baker and SAMHSA. Getting really intoxicated one night or driving recklessly could also be signs to watch out for, Roeske said.
          Such behavior might be them "testing themselves to see if they can actually do it," Baker said. "A lot of times people need to kind of work up to that actual making an attempt because it's a biologic thing you have to go against, your own survival."

          Concerning comments

          Talking about wanting to die -- by suicide or otherwise -- is another warning sign that should always be taken seriously, Roeske said. Such comments are sometimes just expressions of discomfort, pain, boredom or desire for closeness rather than a reflection of actually wanting to die, but that doesn't mean you don't monitor the person who's making them, he added.
          Some people might say they feel like they have no reason to live. "If someone is struggling to come up with a reason for living, that's a much higher-risk person than someone who's even able to identify one (reason)," Baker said.
          Others talk about feeling like a burden on those close to them, Roeske said, or like they don't belong anywhere or with anyone. Such comments might include "You don't need me for this anymore" or "I feel like it'd be better if I just wasn't here." Teenagers considering suicide might not want their guardians to use their money for college, he added.