• September 6, 2016

Donald was only 14 years old when he took his own life. Like so many young adolescents, he struggled with changes in his body, an increasing interest in dating, learning the ropes as a high school freshman, being the eldest child, and wanting to win his parents’ admiration. Donald spoke about these concerns in a matter of fact tone — as he had during previous therapy sessions — as if he too knew these were just the normal struggles of a teenager and that all would be ok. But mental health is a fragile thing and all was not ok as Donald shook my hand and left my office for the last time. Two weeks later he shot himself as his family went about their usual evening activities in other parts of their home — unaware that Donald had decided this would be his last day with them.

Every year in the United States, more than 21,300 men and women kill themselves with a gun; two-thirds more than the number who use a gun to kill another person. In 2014, suicide was among the top five leading causes of death among Texans ages 1-54, with 3,254 deaths by suicide among all Texas residents. Suffice it to say, suicide is not an issue that is foreign to us. It is not rare in the United States or Texas. And it is preventable!


According to Kevin Caruso at, untreated depression is the #1 cause of suicide. Depression is a mental condition, classified into four major disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The most significant and prevalent of these is Major Depressive Disorder. Depressive symptoms may also be exhibited in persons suffering from bipolar disorders and psychotic disorders such as Schizophrenia. Common symptoms of depression include dysphoric mood, loss of interest in activities, sleep disruption, appetite changes, loss of energy, poor concentration, and thoughts of death, among others. Depression may be passed on genetically, or may be triggered by negative life events. There is no one sign to look for in a person, to know that for sure he/she is planning to attempt suicide. However, there are clusters of behaviors that when we notice them, should cause us to ask more questions and be more concerned.

Ask and Tell

If a friend or loved one suddenly or gradually exhibits any of the warning signs noted in the box on the left, offer support and encourage him or her to seek help. Then enlist the help of others who are close to them. Things you can do include:

  • Offer to listen.
  • Offer to help with chores and responsibilities.
  • Offer to attend a support group meeting with them.
  • Let the school counselor know you’re worried about your friend.
  • Tell her mother about your concerns.
  • Ask his wife if she has noticed the changes you’ve noticed.
  • Encourage your co-worker to contact the Employee Assistance Program.