Verified by Suicide Risk Factors: Social, Economic, and Genetic Influences
Most people conceive of suicide as being caused solely by severe mental illness, and in many cases, a mood disorder or other diagnosable psychological condition did play a significant role. But many people who display no signs of depression, substance abuse, bipolar disorder, or any other mental illness die by suicide, too. While these deaths are often shocking and confusing to their loved ones, the individual's decision to take their own life may be attributable to one or several of a wide range of physical or sociocultural factors, such as chronic pain or illness, unemployment or job loss, or serious legal troubles. Demographic factors such as age, race, or gender, as well as genetics, also appear to play a role in suicidal ideation and completion, though in some cases the root cause of their influence is multifaceted or not yet fully understood.
What we do know, however, is that suicide is complicated and that one need not be severely depressed to contemplate taking one's own life. Anyone who is speaking of death, suicide, or being a burden—especially if one or more additional mitigating factors are present—should be taken seriously and connected to mental health services as soon as possible. (To learn more about how depression and other mental health challenges influence the risk of suicide, see Mental Health Conditions and Suicide.)
For immediate help in the U.S., 24/7: Call 988 or go to 988lifeline.org. Outside of the U.S., visit the International Resources page for suicide hotlines in your country. To find a therapist near you, see the Psychology Today Therapy Directory.
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Human beings do not exist in a vacuum, and over eons, we've evolved to be highly dependent both on other individuals and our communities at large for social contact, resources, sustenance, and countless other needs. When those social or economic connections are severed, the effect can be severe—and in some cases, may drive someone to thoughts of suicide. Anyone experiencing unemployment, isolation, legal troubles, or any of the risk factors listed below—along with warning signs of suicidal behavior—should seek help or be referred to mental healthcare as soon as possible.
Humans are social creatures, and social connection is critical to overcoming depression and suicidal thoughts. When human contact is limited—whether by choice, circumstance, or necessity—individuals struggling with suicidal ideation may find that their emotional burden grows increasingly difficult to bear. Though face-to-face contact is often the ideal choice, in cases where it’s not possible or not advisable, digital forms of communication can be an adequate alternative.
Yes. For many if not most people, their job forms a key part of their identity—when that is lost, they may wonder who they are, what their purpose is, and whether they’ll be able to function in society or provide for themselves or their loved ones. Thus, losing a job—especially in a time period, location, or circumstance in which another one is especially hard to come by, such as during the COVID-19 pandemic—can usher in feelings of helplessness, inadequacy, and depression, all of which can heighten the risk of suicide.
Job loss can also create significant financial challenges that can be hard to overcome and that can themselves worsen the risk of suicide—being evicted because one is unable to pay rent, for instance, is strongly associated with an elevated risk of suicidal thoughts or behaviors. Social support—from loved ones, the larger community, or the government—can help those who have lost their jobs get back on their feet and push back against feelings of despair.
Yes; in fact, as many as 1 in 3 people who die by suicide were unemployed at the time of their death. Though suicide risk is dramatically heightened in the period just after a job is lost, long-term unemployment is strongly linked to suicide as well—indeed, some evidence suggests that suicide risk continues to rise the longer someone is unemployed.
Unemployment—even among those who are unable to work through no fault of their own—can lead to shame, depression, and social isolation; it can also disrupt routines and put individuals at risk of homelessness, burdensome debt, or other economic obstacles. Many people who are unemployed are unable to access needed mental health treatment—and because of the stigma associated with being unemployed in many societies, they may be perceived as being at fault and are often left to struggle in silence. Maintaining social connections, healthy habits, and a regular routine can help an unemployed person maintain their well-being, even if finding a new job proves difficult.
In many cases, yes. Mass layoffs and long-term unemployment are both common features of economic recessions and factors associated with heightened suicide risk. Evidence suggests that the 2008 recession, for example, was associated with a 13 percent increase in suicides, many of which were thought to be attributed to unemployment.
Debt and suicide risk are closely linked. Evidence suggests that people who die by suicide are 8 times more likely to have personal, unsecured debt than the general population; having a mortgage or another form of “secured” debt, however, does not appear to be associated with increased risk. Researchers speculate that worrying about debt or receiving frequent calls from collectors increases stress, which fosters anxiety and depression while chipping away at resilience. Debt may also make mental healthcare more difficult to access, leading some people with mental health disorders to go untreated. Though getting debt under control is often easier said than done, making an effort to do so—and seeking emotional or financial help when needed—can help someone struggling with debt improve their mental state and lower their risk of suicidal thoughts.
Individuals in certain professions do appear to have a heightened risk of suicide. Physicians, dentists, and veterinarians, for example, are all significantly more likely to die by suicide than the general population—likely due to the intense burnout, compassion fatigue, and sky-high stress levels that healthcare workers often grapple with. Other first responders, such as EMTs or firefighters, may also be at greater risk. Additional evidence suggests that construction workers or those who work in manual industries such as farming or fishing may also be more likely to die by suicide.
Yes. Some people who are accused or convicted of a crime—whether rightly or wrongly—may see suicide as the only way to escape the shame, guilt, or social backlash of being perceived as a criminal. Some guilty individuals—including some well-known serial killers—take their own life, either before or after they’re arrested, so as to not be held accountable for their crimes. This is why jails and prisons often place incarcerated individuals under “suicide watch,” in which inmates who are perceived to be at risk of dying by suicide are more closely monitored for a period of time.
Despite these precautions, however, many inmates do attempt or complete suicide after being arrested or convicted; according to statistics from the Department of Justice, the suicide rate in prisons and jails has been steadily rising since 2013. Those whose loved ones are facing legal troubles are advised to monitor their emotional well-being—paying attention to comments about death or how everyone would be “better off without them”—and to seek appropriate mental healthcare when necessary.
Yes; evidence suggests that incarcerated people are significantly more likely to die by suicide than others. Incarcerated men are three times more likely to die by suicide than non-incarcerated men, one systematic review found, while incarcerated women are approximately nine times more likely to die by suicide than other women. Those incarcerated for certain crimes, like homicide or sexual offenses, appear to be at even greater risk, as are those with a history of psychiatric illness and/or self-harm.
Unmet mental health and social needs are likely related to an increased risk of suicide among the incarcerated. Mental health services in prisons are often difficult to access, despite the fact that incarcerated individuals are typically diagnosed with psychiatric disorders at greater rates than the general population. Visits from loved ones appear to be linked to decreased risk of suicide, suggesting that regular contact with family and friends can help someone navigate the stress of imprisonment. Making mental healthcare and regular socialization both more accessible to prisoners, experts argue, may help reduce the risk of suicide and help incarcerated individuals maintain their connections with the outside world.
Evidence suggests that military veterans do display a suicide risk that is approximately 1.5 times greater than that of the general population. Male veterans, and especially older male veterans, comprise the greatest number of veteran suicides. But both men and women are at risk, and some evidence suggests that compared to civilian women, female veterans are at greater risk than their male counterparts.
Suicide's connection to genetic or familial factors is complicated, and experts caution that there is no foolproof way to tell whether a particular individual is at heightened risk of suicide based on their family history alone. But on a population level, the evidence does suggest that genes do appear to play a role in suicide risk, and the mental illnesses that can heighten the chance of suicide affect some families more severely than others. Thus, it can be useful to be aware of an individual's family history of suicide and take it into account when assessing their own risk.
Many mental health disorders that have a genetic component—such as depression, bipolar disorder, or substance abuse—increase the risk for suicidal behavior. Some studies have also suggested that specific genetic variants appear to increase the risk of suicide in individuals even in the absence of a diagnosable mental illness. Experts caution, however, that the cause of suicide is much more complex than genetics alone, and the presence or absence of a single genetic variant cannot determine whether someone will die by suicide.
Many of the mental health problems that contribute to suicide risk run in families; so too does the risk of suicide. Individuals with a family member who has died by suicide appear to be at greater risk of suicidal attempts themselves and evidence suggests that suicidal ideation has a genetic component. But experts emphasize that individuals whose family members have died by suicide are not destined to do the same; rather, they should simply be cognizant of the fact that they may be more vulnerable and make a concerted effort to seek help when needed.
Just because there is likely a genetic component to suicide does not mean that suicidal thoughts or behaviors are inevitable for those with a family history of suicide; it only means that heritable factors may contribute to greater risk. Those with a familial history of suicide may still want to take steps to guard their mental health, however—including seeking mental healthcare when necessary, maintaining social connections, and prioritizing physical and emotional health to the greatest extent possible.
Suicide does not discriminate. It affects men, women, and transgender or non-binary individuals; children, teens, and adults of any age; and people of any race or ethnicity. But on a larger scale, data suggests that gender, age, and race do play a part in both suicide attempts and completed suicide, and certain populations do appear to be at greater risk than others. Why this is is a complicated question, but researchers suspect that a combination of social influences, economic pressures, mental health challenges, and genetics explain why suicide risk varies across demographic groups.
Data suggest that men are more likely to die by suicide than women. In 2018, the CDC reported that the male suicide rate was 3.7 times greater than the female suicide rate; in the U.S., men make up approximately 75 percent of suicide deaths.
One explanation for this disparity is that men are more likely to attempt suicide using extremely lethal means, such as firearms, while women tend to be more likely to attempt using less lethal (but still dangerous) means, such as pills. Other evidence suggests that men who attempt suicide may be more intent on dying than women—one study, for example, found that of men and women admitted to a hospital for self-harm, the men reported, on average, significantly more suicidal intent than did the women. Men also tend to be more impulsive than women, leading some experts to hypothesize that they may be more likely to engage in rash, deadly behavior, even if they were not previously experiencing suicidal thoughts or a serious desire to die. Men are also more likely to abuse drugs or alcohol, which further increases the risk of impulsive, dangerous behaviors.
In what is known as suicide’s “gender paradox,” women are far more likely to attempt suicide than men while men are more likely to die by it. (Recent data suggest that the gender gap in completed suicide rates may be narrowing, however, especially among certain age groups.)
The suicide gender paradox is likely at least partially explained by the fact that women are more prone than men to attempting suicide by medication overdose, a less lethal method, while men tend to choose firearms or hanging, strangling, or suffocation, all of which are more likely to result in death. Some research suggests that women and girls who attempt suicide have, on average, less suicidal intent than men who attempt, which may play a part in the means chosen and how the attempt is carried out. But experts caution that despite overall trends in the data, both men and women who attempt suicide are at serious risk of dying. Regardless of the individual’s gender, any warning signs of suicidal thoughts or behavior should be taken seriously and responded to appropriately.
Individuals who identify as transgender are at significantly higher risk of mental health issues, suicidal ideation, and suicide attempts than the general population. Nearly half of transgender individuals experience either depression or an anxiety disorder, research estimates—and over 40 percent of transgender people have attempted suicide, a rate that’s nearly 9 times higher than cisgender people. Non-binary people appear to be at similarly high risk.
Research suggests that much of this disparity is due to discrimination, stigma, lack of acceptance, and violence that transgender and non-binary people face; they also are more likely than cisgender individuals to be unemployed, homeless, or to struggle to access needed physical and mental healthcare, all of which further exacerbates their risk.
Acceptance, by contrast, appears to be highly protective in many cases; one study found that transgender youth whose gender identity was accepted by family, friends, and teachers demonstrated a developmentally normal risk of depression and only slightly heightened risk of anxiety. Another study found that LGBTQ youth with at least one accepting adult in their lives were 40 percent less likely to report a recent suicide attempt.
Individuals who identify as non-heterosexual—whether gay, lesbian, bisexual, or otherwise—do appear to be at heightened risk of suicidal ideation or behavior. This risk is especially worrisome during adolescence; between the ages of 10 and 14, the likelihood of death by suicide is estimated to be 2 to 7 times greater for LGBT youth than it is for heterosexual, cisgender youth, and sexual minority youth are twice as likely to express a desire to die as heterosexual youth. Lack of social support, bullying, and feeling isolated or "different" are all thought to contribute to the heightened risk of suicide among LGBT youth. LGBT adults—especially gay and bisexual men—continue to be at higher risk of suicide than their heterosexual peers, the CDC reports, though this risk appears to lessen over time.
Among LGBT youth, research has found that family cohesion, school safety, and support from adults outside one’s family have all been associated with reduced suicide risk. Peer support, too, can be protective—having just one or a few close friends can help an LGBT adolescent feel accepted and able to come to terms with their identity safely.
Certain racial groups do appear to be at a heightened risk of suicide compared to others. According to the CDC, men of American Indian or Alaskan Native descent are at the greatest risk of suicide in the U.S., at a rate of approximately 35 per 100,000. White males display the second-highest risk, dying by suicide at a rate of 30 per 100,000. Among women, American Indians and Alaskan Natives are again at the greatest risk (10.5 per 100,000) followed by White women (8.3 per 100,000). Black women, and Hispanic women of any race, both appear to be at the least risk of suicide (2.9 per 100,000).
Limited economic opportunities, social and cultural shifts, and greater rates of drug and alcohol abuse are all thought to contribute to inflated suicide rates among certain racial groups.
Suicide is the second leading cause of death for individuals between the ages of 10 and 34. But evidence suggests that younger people actually die by suicide at lower rates than their older counterparts. In fact, CDC data suggests that men over the age of 75 die by suicide at the highest rate (approximately 40 per 100,000), followed by men between 45 and 64 (31 per 100,000). For women, suicide rates are highest between the ages of 45-64 (about 10 per 100,000); in contrast to men, though, older women are less likely than middle-aged women to die by suicide.
For many elderly adults who consider or attempt suicide, loneliness appears to be a major contributing factor. By the time someone has reached old age, they have likely suffered many losses—including, potentially, their spouse, siblings, or other close loved ones—and may feel isolated or cut off from the people and activities they once enjoyed. Many older adults also experience a loss of functioning and may need to rely on others for their care; the loss of independence can be experienced as immensely frustrating or even humiliating, especially in cultures that glorify self-reliance. Loneliness, a loss of self-sufficiency, and declining physical and mental health can all contribute to depression, which greatly increases the risk of suicide among the elderly.
Chronic pain and illness can radically impact someone's life—interfering with jobs, relationships, and day-to-day well-being. In some cases, the consequences of chronic conditions can trigger or worsen thoughts of suicide. But being diagnosed with a chronic condition is not necessarily hopeless. Addressing pain and illness at both a medical and a psychological level can both drastically improve quality of life and guard against suicidal ideation.
To learn more about managing chronic conditions, visit Chronic Pain or Chronic Illness.
Chronic pain can increase the risk of suicide in a number of ways, and evidence suggests that individuals with chronic pain are twice as likely to consider suicide as those without. Long-term pain, especially if it’s severe, can significantly interfere with someone’s ability to work, provide for a family, and take care of themselves. The resulting financial challenges, feelings of inadequacy, and strained relationships—combined with the daily agony of the pain itself—can significantly worsen an individual’s mental health over a period of months or years.
If the cause of the pain is unclear, or treatment is ineffective, the individual may begin to feel hopeless; similarly, some with chronic pain report that their pain was dismissed or ignored by doctors, further damaging their well-being and, in some cases, leading them to see suicide as their only way out. Opioid medication—frequently prescribed to treat pain—can lead to physical or mental dependence; when the medication runs out or is otherwise no longer accessible, withdrawal symptoms can heighten feelings of despair.
Finding an effective medical treatment that reduces or eliminates chronic pain can significantly lower suicide risk. But even if biological treatments are imperfect, psychological treatments—like CBT or mindfulness-based stress reduction—or lifestyle changes that promote physical activity, a healthier diet, or better sleep, can all help build self-efficacy and target the anxiety and rumination that are inherent to chronic pain. For many, the improved mental health that comes with effective treatment (whether biological or psychological) can greatly reduce the frequency of suicidal thoughts or behaviors.
Evidence suggests that suicidal ideation is more common among those with a terminal illness, such as cancer, than those without. Severe pain or the looming prospect of physical or mental deterioration are often the drivers of such behaviors. However, while some individuals with terminal illness attempt suicide impulsively or while in the throes of despair, others make what they consider to be a rational choice to end their life with dignity and on their own terms. In some U.S. states and other countries, terminally ill patients who wish to end their life may request help from a doctor; in other locales, however, assisted suicide is not permitted and may even be criminalized.
To learn more about "death with dignity," visit Assisted Suicide.
