Suicide is the 10th leading cause of death in the United States. Suicide was the second leading cause of death in individuals 10-34 and fourth leading cause in individuals 34-54. There were more than twice as many suicides in the United States as there were homicides. And the issue is only getting worse, according to the CDC, with suicides increasing by 30 percent in the past twenty years. In order to bring awareness to the issue, the month of September is recognized as National Suicide Prevention Month. Its mission is to bring awareness to suicide and prevent it. Yet, we are all too aware that suicide exists, aren’t we? We still need a month. A month. One out of 12 month of the year set aside to keep our loved ones from dying. Such a short time, however, that’s all the more reason we must focus on this issue. My father died when I was a little girl; a victim of suicide. One of my best friends from middle and high school attempted it. I’ve attempted it. And I’ll bet that I shock many by that statement. However, we cannot stay silent in the face of such an avoidable death. Allowing ourselves and our loved ones to have open, non-judgmental conversations and checking in during difficult times are just a few ways to raise awareness and save lives. It’s no secret 2020 is different. Underemployment, student loan debt, issues obtaining housing, social unrest and COVID-19 all contribute why this year adds layers of nuance not seen in years before. In essence, we are struggling to survive. Quarantine has isolated us ever further. So, that begs the question: How can we help? First we need to know the signs. According to the American Foundation for Suicide Prevention, there are three types of risk factors: health, environmental and historical. Risk factor: Health Mental health conditions: Depression Substance use problems (such as those of the opioid crisis) Bipolar disorder Schizophrenia Personality traits of aggression, mood changes and poor relationships Conduct disorder Anxiety disorders Serious physical health conditions including pain Traumatic brain injury Risk factor: Environmental Access to lethal means including firearms and drugs Prolonged stress, such as harassment, bullying, relationship problems or unemployment Stressful life events, like rejection, divorce, financial crisis, other life transitions or loss (a great deal of stressors in life events, such as those in 2020) Exposure to another person’s suicide, or too graphic or sensationalized accounts of suicide Risk factor: Historical Previous suicide attempts (many people try more than once) Family history of suicide Childhood abuse, neglect or trauma Not all signs are as obvious as depression or a job loss. Some individuals are more subtle in their behavior. Psychiatrist Cesar Figueroa, MD of Southern Hills Hospital and Medical Center states, “Any changes in someone’s personality, behavior, or how they express their emotions can be an indication.” Not all risk factors for suicide will fall under a neat umbrella of clinical terms. Those with a background of military service or an individual who identifies as LGBTQIA+ can be at increased risk due to post-traumatic stress disorder (PTSD) or bullying. A person such as myself, with a chronic illness, can be at increased risk, especially if it’s a chronic pain condition. So how can we help? Please understand, in some cases, the best way to help someone is to call their medical provider or 911, if the loss of life could be imminent. Instead of focusing on what we can’t do, focus on letting that loved one know there are organizations and programs designed specifically to help and support those struggling with mental health issues, life crises and may have suicidal thoughts. Chester Bennington, the lead singer for Linkin Park, died by suicide in 2018. Talinda Bennington told CNN there were signs of hopelessness, a change of behavior and isolation. In 2017, Linkin Park released “One More Light,” a song that’s saved my life. A power lyric plays: “If they say Who cares if one more light goes out? In a sky of a million stars It flickers, flickers Who cares when someone’s time runs out? If a moment is all we are We’re quicker, quicker Who cares if one more light goes out? Well I do…” One life can mean everything. Please don’t let your light flicker out, and if you wonder who cares… well, I do. If you are having thoughts of suicide, please know that you are not alone. If you are in danger of acting on suicidal thoughts, call 911. For support and resources, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741-741 for the Crisis Text Line.