Suicide and PTSD

This fact sheet discusses the relation between trauma, PTSD, and suicide. It may help you understand more about suicide.

For immediate help, call 24/7

• National Suicide Prevention Lifeline: 1-800-273-8255
• Veterans Crisis Line: 1-800-273-8255, press “1”

How common is suicide?

No matter how rare it is, suicide is always very tragic. It is hard to say exactly how many suicides occur.

• Often suicides are not reported.
• It can be hard to know whether or not a person meant to die by suicide. For a death to be recorded as suicide, examiners must be able to say that the deceased meant to die.
• The way deaths are recorded (in general) has changed over time.

Overall, men are more likely to die by suicide than women. For example, from 1999-2010, the average suicide rate among U.S. males was 19.4 out of every 100,000, compared to 4.9 out of every 100,000 females. The difference in suicide rates between men and women is also true among Veterans.

Does trauma increase a person’s suicide risk?

Going through a trauma may increase a person’s suicide risk. For example, there is evidence that childhood abuse and sexual trauma may increase a person’s suicide risk. Among Veterans, some studies have found that combat trauma is related to suicide, while other studies have not. In this research, combat trauma survivors who were wounded more than once or put in the hospital for a wound had the highest suicide risk. This suggests suicide risk in Veterans may be affected by how intense and how often the combat trauma was. Does PTSD increase a person’s suicide risk?

Why is suicide risk higher in trauma survivors? It may be because of the symptoms of PTSD or it may be due to other mental health problems, like depression. Studies show that suicide risk is higher in persons with PTSD. Some studies link suicide risk in those with PTSD to distressing trauma memories, anger, and poor control of impulses. Further, suicide risk is higher for those with PTSD who have certain styles of coping with stress, such as not expressing feelings.

Research suggests that for Veterans with PTSD, the strongest link to both suicide attempts and thinking about suicide is guilt related to combat. Many Veterans have very disturbing thoughts and extreme guilt about actions taken during times of war. These thoughts can often overwhelm the Veteran and make it hard for him or her to deal with the intense feelings.

Can PTSD treatment help?

A person can benefit from cognitive behavioral treatments (CBT) for PTSD if suicidal thoughts are able to be managed on an outpatient basis. For example, a study of female rape survivors who received such treatment found that as PTSD symptoms decreased during treatment, suicidal thoughts also became less common. This effect lasted for 5-10 years after treatment ended. More research is needed, but having a good relationship with a mental health provider can help persons with PTSD make the best treatment decisions.

Given the link between PTSD and suicidal thoughts/behaviors, if you have PTSD and are involved in mental health treatment, your suicide risk will likely be regularly assessed. If the provider learns that immediate risk for suicide is high based on his/her assessment, they will make appropriate treatment decisions to ensure safety. If the immediate risk for suicide is not high and suicide risk can be managed safely on an outpatient basis, the provider may suggest treatment for PTSD.

What can I do? I am suicidal

If you are ever thinking about suicide and feel unsafe:

• Call 1-800-273-TALK (1-800-273-8255). The National Suicide Prevention Lifeline is available 24 hours a day.
• Veterans, press “1” after being connected, to be routed to the Veterans Crisis Line.
• Veterans can also chat live online with a crisis counselor to get help at any time of day or night. Go to Veterans Crisis Line*.
• The Veterans Crisis Line also responds to text messages. Send a text to 838255.
• En Español 1-888-628-9454

Everyone feels down from time to time. If you have thoughts about hurting yourself, seek professional help. Many people who have thoughts of suicide also struggle with depression or with drinking or drug problems. There are many places to get help. See Where to Get Help for resources.

Someone I know is suicidal

You may come in contact with a family member, friend, or coworker who is thinking about suicide. When someone tells you they have these thoughts, you may feel scared and unsure what to do. It is even harder if the person tells you in secret and you feel pressure not to tell others.

If someone you know is thinking about suicide, this is a serious matter. It can be very hard to gauge the level of danger. A mental health professional is the best person to decide how much danger there is.

• You can help the person by staying calm and telling them about mental health options in the area.
• Often the hardest part of getting treatment is making the first call to a mental health provider. It is usually easier if the person who is thinking about suicide has help with this contact.
• Please see the resources listed above for phone numbers you can call for help. While helping someone who is thinking about suicide can be hard, keep in mind that the help you give could save someone’s life.

Someone I know has died by suicide

It is very upsetting when someone you know dies by suicide. Getting over the shock and distress will be especially hard if you felt close to them, if you saw the event, or if you have your own mental health issues.

Grieving the loss of a loved one is a natural process. It may take several months to feel “normal” again after someone you know dies by suicide. Due to the traumatic nature of suicide, you may go through what’s known as “traumatic grief.” If you are feeling intense grief or guilt several months after the suicide, contact a mental health provider for help. Many people feel guilty about not having prevented the suicide. Be aware, though, that suicide is never your fault. Suicide is complex with many factors that contribute.

It can also be difficult to cope when a loved one has made a suicide attempt. You can access fact sheets for family members of Veterans who have made a suicide attempt, Materials are also available for how to talk to children about a suicide attempt in the family. These materials are also available in Spanish. Although these fact sheets were created with military families in mind, resources and information included in them may be useful for non-military families as well.