Tony Salvatore

Warning signs are the "red flags" of community health. They are indicators of a possibly serious problem that have been identified by research. They are critical tools for prevention and early intervention.

In the 1950s and 1960s, the American Cancer Society got the word out that cancer could be prevented if detected early. Its strategy was to publicize the warning signs of this group of diseases.

At the time, ignorance about cancer feed denial and sometimes stigmatized cancer victims. The public education campaign helped change this and increased understanding.

Suicide and suicide prevention are still poorly understood. Like cancer, suicide too has distinct warning signs. However, they have not been as widely publicized and are unfamiliar to the general public and to many physicians, teachers, and even mental health professionals.

The warning signs of suicide appear clear and concrete, but are often hard to see in someone that we are close to or in ourselves. Warning signs are not always present, but it is important that they be taken very seriously when they are.

Suicide is often thought to be an impulsive event, but most suicides are the outcome of a process over days, weeks, or even months. Gradual changes in attitude and behavior are hard to spot. This is what makes familiarity with the warning signs essential.

It is helpful to separate the early and later warning signs of suicide. This may improve the chances for getting help when the risk level is lowest.

• Difficulties in job/school -- can't concentrate on routine tasks
• Talking about, writing about, or drawing about death
• Neglect of appearance and personal care
• Increased substance use - starting to drink or use drugs or increasing usage
• Dropping out of, or losing interest in, favored activities
• Change in Personality or mood-depression, sadness, irritability, anxiety, apathy

• Changes in sleep habits -- insomnia, often with early waking or oversleeping, nightmares

• Change in eating habits -- loss of appetite and weight, or overeating
• Isolating oneself from others
• Feeling that life is meaningless
• Expressions of hopelessness or despair and helplessness
• Restlessness and agitation

• Low self esteem -- worthlessness, shame, overwhelming guilt, self-hatred

• Overreaction to criticism and being overly self-critical
• Preoccupation with one's real or imagined failures
• Getting a gun or other weapon, poison, pills
• Episodes of anger and rage

• Making a will or stating how affairs should be handled

• Extreme pessimism about life, the future
• Ending significant relationships
• Giving away personal items of personal value - books, tools, CDs
• Describing a plan for completing suicide
• Preoccupation with death
• Unnecessary risks - speeding, picking fights, engaging in dangerous activities

• Threatening suicide or to harm oneself in some way

• Rehearsing or visiting a place to complete suicide

These signs don't necessarily appear in any order, but many people at risk of suicide will show several signs. Usually the greater the focus on death or specific plans or possible means, the greater the danger.

If the signs seem to fit in the early category the individual must see her or his physician or behavioral health provider for a suicide risk assessment. This can lead to treatment and/or medication that may address the underlying problem.

Where the warning signs are more extreme or if they suddenly worsen, or if it appears that the person is suicidal call the Montgomery County Emergency Service anytime at 610-279-6100 or call 9-1-1.

If someone tells you that they are thinking of suicide don't become part of a conspiracy of silence. Young people who may put friendship above a friend's safety must especially heed this advice. Get help or tell someone who can help.

"Understanding the Warning Signs of Suicide" is the theme of this year's Montgomery County Suicide Prevention Awareness Walk. It will take place on Saturday, October 16, from 10:00 AM to 12:30 PM in the Montgomery County Farm Park.

For more information about the walk or suicide call the Montgomery County Suicide Prevention Task Force at 610-278-5117 or visit www.montcopa.org/suicideprevention.