Suicide: Risk and Prevention

For the past decade, the suicide rate among teens has been increasing. Among teen boys, suicide completion has increased 33 percent over the last 10 years, according to research published in the Journal of the American Medical Association.[1]

The major risk factors for suicide are genetics, mood disorder (major depression), pessimism, misreading social cues, impulsivity, and impaired learning.

Fifty percent of suicide risk is genetic, meaning suicide risk is inheritable and does run in families. This does not mean that a person is predestined to die by suicide if they have family members who have died by suicide, but they do have an increased risk for it. This risk can be mitigated by awareness and purposeful interventions to prevent or treat the other factors that increase risk, thereby reducing suicide risk even in those who have genetic vulnerability. There isn’t a specific gene that increases the risk; instead, it’s the interaction of hundreds if not thousands of genes. Thus, even though the genetic risk is well documented, a specific genetic test is not available.

While we cannot point to a specific gene, it is known that the brain’s serotonin system is involved. Postmortem studies reveal that people at high risk of suicide have fewer serotonin transporters in their brains when compared to people who died in accidents. And brain changes in serotonin receptors predict suicidality and also the lethality of the attempt.

Depression and Suicide

People with a history of recurrent major depression have a 13-fold increased risk of suicide. Major depression is the most important and treatable risk factor for suicide. Many people believe that suicide risk goes up because of some stressful life event while failing to realize that many of the stressful life events are the result of major depression that is not being treated.

When people are depressed, they are more likely to:

  • socially isolate, be unavailable, be easily overwhelmed, and thereby experience relationship problems and breakups
  • call in sick to work, have impaired job performance, and thereby lose their job
  • fail to pay bills either because of lost work and can’t afford to, or lost attention to life’s responsibilities, and thereby lose their car or home or have creditors calling

So, the life stressors people attribute as the cause of suicide may, in reality, be due to underlying depression that is not being treated. Then when these additional life problems hit persons already suffering from depression, they are overwhelmed and pursue suicide as a means to escape their mental and emotional pain. In fact, the data shows that people without depression who face similar life stressors have significantly reduced risk of suicide when compared to someone with depression facing the stressor.

Further, studies show that not all people with depression experience suicidal thoughts, but those who have a pessimistic mindset in addition to being depressed are the ones at increased risk. Even when the depression is treated and remits, those at higher risk for suicide continue to manifest a pessimistic outlook on life compared to depressed people who are not suicidal.

The point here is that hope and hopefulness in the face of depression and real-life stressors reduces suicide risk, whereas pessimism increases the risk.

Four Risk Factors to Look For

Research documents four factors, occurring simultaneously, that work together to drive suicidal behavior. Those four factors are:

  • Recurrent major depression
  • Misreading social cues
  • Impulsivity/reactivity
  • Impaired learning

Brain studies reveal that when given standard tests that require them to determine emotional states by looking at faces, those at high risk for suicide misread the faces in ways that incite fear, hurt, rejection—which is a dysfunction of dorsolateral prefrontal cortex, the part of the brain where we reason, think, and problem solve.

Further, those at increased risk demonstrate impaired response inhibition—the ability to pause, think, and make a wise choice. When given a choice of receiving $50 immediately or $300 in 30 minutes, those at risk for suicide take the $50 right away, whereas those at low risk for suicide wait the 30 minutes. This is impairment in response inhibition, the ability to stop an impulse and wait for a better opportunity.

People at high risk also demonstrate impaired learning from previous events. We have all experienced situations in which something stressful has occurred, inciting anxiety, fear, and worry—but eventually, the problem passed. People at low risk for suicide are able to learn from such events so that when new stressors occur, they are able to remember that things will get better, the stressor will resolve, and life will improve. But people at high risk fail to learn this, and each new stressor is experienced with overwhelming fear and often hopelessness.

It should be noted that all of the above risk factors are worsened by alcohol and drug abuse. Such substances increase mood disorders, damage thinking and learning circuits, increase impulsivity, and often contribute to increased life stress (financial, relational, and legal problems).

Taking Action

Understanding all of these risk factors has led to effective interventions that reduce suicide risk and rates. What are the factors with proven efficacy in reducing suicide?

  • Removing the means—removing guns and lethal pills from home
  • Treating depression with psychotherapies and medications; both reduce suicide
  • In-school education about risks and warning signs and ways to get help
  • Limiting media reporting and coverage of suicides
  • Alcohol- and substance-use treatment

Another factor at play in suicide risk includes loss of meaning, value, and purpose. Neuroscience demonstrates that when the brain’s love circuits activate, they calm the fear/stress circuits. Activities and experiences that increase love, altruism, other-centered connection, and meaning will decrease suicide risk, whereas actions that isolate and increase fear will increase suicide risk.

With this in mind, let’s examine societal trends and infer some potential changes that may be increasing risk. Historically, American values were built on three overriding elements: God, Family, Country. When these elements are valued and esteemed, they create an other-centered worldview—we live to glorify God, to bless and protect our families, and to help our country. As John F. Kennedy said more than 50 years ago, “Ask not what your country can do for you; ask what you can do for your country.”

But today’s generation is taught that there is no God, many families are fractured, and the country is abusive, can’t be trusted, and is supposed to give to “me.” This change in values and mindset means that there is nothing more important than the self, which results in increased fear, which in turn neurobiologically drives increasing depression, hopelessness, and suicide.

How can we reduce suicide risk? By being aware, by removing means from those at risk, by treating mental illness (depression), getting into substance treatment—but also by increasing love, purpose, and meaning. We need to teach young people that they are valued, they are loved, they are precious, and they have purpose, but also that life is not all about them; we teach them that their true joy, happiness, and health will be realized only when they come into harmony with how God built reality to operate. And God built reality to operate upon other-centered love.

Young people must see in their families, churches, schools, and community how genuine compassion, grace, mercy, and altruism functions. They must see love in action, love manifested toward them and those they care about. They must see the God of love, choose to surrender self, and live lives in harmony with God’s design—lives of altruism, compassion, and service—seeking to give, to bless others, rather than seeking to get. When this occurs, the fear circuits of the brain calm and the risk for suicide decreases.

For more read my blog Suicide and the Myth of Lost Salvation.

Notes & References:

[1]Miron, O., et al., Suicide Rates Among Adolescents and Young Adults in the United States, 2000-2017, JAMA. 2019;321(23):2362-2364. doi:10.1001/jama.2019.5054

Dr. Tim Jennings is an international speaker and author of Could It Be This Simple?, The God-Shaped Brain, The God-Shaped Heart, and The Aging Brain. A board-certified, practicing psychiatrist, Dr. Jennings has brought his timely message of God’s healing and remedy to tens of thousands around the world. Learn more about his profound, life-changing message of God’s love at, where this article first appeared (it is reprinted here with permission). He is also a featured speaker at the American Association of Christian Counselors.

Photo courtesy of Dan Meyers on Unsplash

We invite you to join our community through conversation by commenting below. We ask that you engage in courteous and respectful discourse. You can view our full commenting policy by clicking here.

This is a companion discussion topic for the original entry at
1 Like

Unfortunate that even with apparently successful lives supportive and engaged families, some have made up their minds to take a permanent solution to a temporary problem. Religion may play a greater role, particularly when it is a guilt focused hyper religiosity with impossible personal and religious standards , down plays pharmaceutical interventions, prevents healthy disclosure during counseling due to shame and risk to family image.

I would add that other co-pathology, especially untreated and/or undiagnosed bipolar makes a person more likely to succeed completing suicide. A very dear friend of mine, one who personally permitted me to remove several firearms over a period of years from their possession, who should not have been in possession of it due to the BA-52’s and previous ideations and serious attempts finally succeeded after taking a vacation with a mutual friend who convinced the subject to stop all psych meds. Two weeks later they painted the sky black.

I still believe our mutual friend should be held responsible, because as a nurse, she in effect was practicing medicine without a license- and, i might add, also suffers from untreated and very apparent psychiatric condition. Despite that the friend still thinks they acted in a manner with the best intentions of outcomes, I am finding it nearly impossible to forgive.


Timo, that is very tragic story and I can see how you are struggling with forgiveness. Even when the nurse/friend thought that she was helping…the outcome was something that can never be undone.

Some of us know stories of well-meaning church members who have told those suffering from depression and other mental illnesses that they should, “Just pray about it.” or “God has a solution”, etc., etc. You mentioned some other issues with “perfectionistic” religion and down-playing or dismissing pharmaceutical interventions as “lack of faith” or somewhat “sinful”.

I have seen some more awareness and education on mental health In the SDA church. However…so much more needs to be done so that those afflicted don’t feel like “less than”. Perhaps more education will led to acceptance that those who are afflicted are not “sinners” and how to best support them. So many people sitting in congregations suffer in silence- and it should not be so.


Kim, thanks. The situation was particularly egregious, the meddlesome nurse repeatedly-and in presence of family and close friends-frequently told my friend that meds were bad. When the mood stabilizer and anti-psychotics were taken the ideations were much reduced and life was manageable. Without them it was horrible, with daily attempts of various severity and potential efficacy.

When my friend told me about who the travel partner was I warned, begged to not go- they are unsafe for you. To no avail, subject went.

“Friend claimed to be BFF, claimed never to have told subject to stop meds, always made sure subject took them”. All lies, all corroborated by myself and subjects parents (physician) and a dozen other in our regular group. All members of our faith community.

So, despite deep love of family and friends and professionals with experience and training (subjects brother is Psych chair at Ivy league med school and DOD forensic psych)
it was not enough. I shudder to think of the pain that folks considering suicide encounter-and i witnessed it first hand. There is so much to do. Life may look good on the outside, but who cares to reach in and sit in that darkness? I have worked on the local tri-county sheriffs CIT crisis team before being FBI certified for federal corrections and have seen some horrible stuff…but…asking, one on one, to have subject give you their loaded firearm is sobering task I wish on no one. And yet, someone must so do, or the cost would be far more. The bright spot? Knowing that, even if but for too brief time, I gave my friend some comfort.
Another bright spot? Knowing i was capable to give more life to others, and not just because they were my friends. In doing so, i faced my own demons.


One of the things that I appreciate about you, Timo…is your understanding and acknowledgement of what we all are- vulnerable human beings. If these tragedies teach us anything, it should be to ameliorate the causes and educate. You have given back in so many ways that others can’t (or won’t) do- thank-you!


@cincerity it has reduced my stomach for entertaining the far too-abounding banalities which surround us


It can be a workplace (and personal) liability issue when you see the “armpit” of humanity for sure. It takes real effort to bring the “positive” aspects of life to balance out the “negative”.

Just a more light-hearted story:

I was chosen as one of the first three “Home Care Providers” in Ma. to pioneer the program in an Agency. This entailed providing a home environment, administering medications, behavioral plans, medical/psych appts., etc. Pretty much providing the whole enchilada to the DD/MH individual…a lot of responsibility decades ago.

The Agency was, of course, very selective of who they thought would be good providers and screened us very well because we were their “pioneers”. We had support from the Agency as well as the individual’s medical and psych doctor’s, guardians, etc. At first, we would meet every week to talk about any issues and our experiences. Eventually, this was extended to every 2 weeks then to once a month.

It was at our first monthly meeting that our sole male Home Care Provider revealed that he had woken up one morning and had said to himself, “Is this what I will be doing the rest of my life?!?” We dissolved into laughter because we had all that the same reaction at some point. It was a good way to share what we all had experienced and felt…and that it was indeed, “normal”. :rofl:

We all need to be able to express and have the opportunity to “connect”. It balances life out in ways that are healthy. Not everyone has that chance…or choice.


Unfortunately the values of business, which healthcare is devolving to, do not include compassion, and seems, competence…

1 Like

I learned a long time ago that there was the “business” side…and the “people” side. It takes a lot of effort to insert the “value” part into human care. I was told by one of my client’s therapist many years ago to: “Make the best decision for the individual- not the business”. It is the best that we can do at any time.


is advice i wish my faith community would endorse institutionally


The Insurance industry has completely changed the face of health care. The 3rd and more wheels of the system burdens all with forms, delays and accepted fee schedules. Gone is the provider patient 1 on 1. We now have employer, employee, Ins./gov. program and finally patient.
The realities of the operational side of a practice/provider demands it.
In the 70’s in the ADA journal I suggested it would be the modus operandi to a single payer.
We’re extremely close.

1 Like

We can only hope and pray…but I understand.

I also feel many have a pollyanna view of life. This can be from a secular or religious platform. Mixed with a self-esteem movement (not to be confused with proper self worth) otherwise normally healthy children and adult individuals arent equipped to deal with lifes difficulties.
When the world disappoints there are few options.

1 Like

The teens are a vulnerable period. I recall a low point in my young life. Trivial now but loomed great at the time. I was the editor of our academy year book. It seems the printer lost my picture so instead of calling for a new copy they simply put a caption — picture not available. One can imagine the razzing I got. the editor can’t Even get his own picture in the book. The long lonely walks I took before I could laugh. Now there is no class reunion, time does that.sorry I won’t get to see my obit picture.


Among other factors related to suicide, the most pervasive appear to be:

  • Loneliness
  • Disconnection from surrounding reality (electronics)
  • Insufficient / ineffective relationship with parents
  • Denied acceptance, rejection, marginalization, discrimination (e.g., gay community, gender issues)
  • Religious frustration (false promises/teachings that may never be fulfilled)
  • Poor future outlook, lack of self-esteem, lack of confidence in self
  • Severe conflicts in marital relationships along with lack of coping / conflict resolution skills
  • Reading / listening to too many absurd political ideas… :laughing: :innocent:

Kim –
I did home health in a rural setting for 2 years.
As you say there are two parts – plan what you do around the client’s needs.
Part 2 – Do documentation for the Business/Insurance reimbursement needs.
NOT always easy, to do. Sometimes needs creative writing sad to say.


My observation with Bi-Polar among the homeless is that it
can cause extreme Unmanageability in life and decision making.
Other friends with it seem to manage life in spite of it.

1 Like

Oh, “creative writing” is certainly true. I recall that were some insane individual “goals” that the client didn’t even want and would never happen. I hated what I called “Mickey Mouse” work because there had to be “measurable goals”. :roll_eyes:

Also…I remember there was once a Program Director who “neglected” to do documentation for 6 MONTHS! We spent hours and hours “creating” notes because otherwise the whole program there was in jeopardy. :anguished:


Risk factors are commonly divided between what is described as distal, an underlying vulnerability, and proximal, which are precipitating factors. The interplay between distal and proximal risk factors increase the likelihood of suicide attempts. No one can predict suicide for certainty and the best hope for suicide prevention is to recognize the risk factors involved. The strongest risk factors for completed and attempted suicide is the presence of mental psychopathology, addictive disorders and personality disorders. Psychological autopsy have consistently found that over 90 percent of all completed suicides in all groups are associated with mental pathology. Mood disorders were more common among elderly suicides whereas substance abuse and behavioral disorders among adolescent and young adult suicides. Access to firearm at home is the strongest proximal risk factor and increase the risk of suicide for both men and women across all age groups.


After a long career as a church employee who worked as an international aid worker, I came to a point where the pain I witnessed and the trauma I experienced was so overwhelming that I had to put an end to my unbearable suffering. I didn’t know about PTSD, nor did my employers. We thought were all strong and resilient, and nothing bothered us. Except it did, at least me. Maybe I was the weak one. Before a dose of 28 Ambien tablets could finish my escape plan, someone accidentally found me. As I recovered, a process that only added to the pain I so desperately wanted to end, I was lectured on my lack of faith, my selfishness, and my mortal sin. Sometimes I really regretted waking up from that sweet release, but I am slowly learning to live with the trauma I experienced. I envy the help available to members of the military. There is no help for traumatized church employees, and there is no place for me in the church; I’m unclean, like a modern day leper, and besides, the few times I tried to find a place there again, it was a non-stop trigger that made me relive the trauma all over again.