The increasing suicide rate is perhaps the most significant indicator of the mental health crisis in the United States today. In the U.S., suicide is a leading cause of death.

In 2022, 49,449 people died by suicide, according to the U.S. Centers for Disease Control and Prevention. That was a 2.6% increase from 2021. And the number of suicide deaths in 2021 had increased 5% from 2020.

Also in 2021, an estimated 12.3 million American adults seriously thought about suicide, 3.5 million planned a suicide attempt, and 1.7 million attempted suicide.

Suicide was among the top nine causes of death for people ages 10-64 in 2021. And it was the second leading cause of death for people ages 10-14 and 20-34.

Among these concerning trends, there is also this: People with ADHD appear to have a higher risk of suicide and suicidal ideation — or thoughts of suicide — than people without ADHD.

While researchers are still working to define the link between ADHD and suicide risk, the medical realities of ADHD lend insight into the connection between the neurodivergent condition and thoughts of suicide.

Here are some factors that may contribute to the link between ADHD and suicide:

• Impulsivity Creates Risk of Suicide

ADHD inhibits a person’s ability to control or regulate their behavior and emotions. For someone with ADHD and deep depression, impulse control is a factor that influences suicidal thoughts.

As one of the primary symptoms associated with ADHD, impulsivity is a risk factor that can lead neurodivergent individuals to suicide. Other mental health conditions accompanying ADHD can also be contributing risk factors. Depressive episodes, conduct disorder and substance abuse are symptoms that place a person with ADHD at a higher risk of suicidal thoughts or suicide.

• ADHD, Depression and Suicide

Suicide risk among those with ADHD is due in part to the fact that research one in five people with ADHD has also been diagnosed with depression, and up to one in three people with ADHD has been diagnosed with depression or had a depressive epidode. A study in the journal BMJ Mental Health also found that people with ADHD are 30% more likely than others to attempt suicide. And the study found that, once depression is present, a person with ADHD is 42% more likely to attempt suicide.

• The Role of Comorbidities in General

Comorbidities are the existence of multiple health conditions — often chronic or long-term — simultaneously. People with ADHD often have comorbidities, often other mental health conditions like depression, anxiety, or obsessive-compulsive disorder.

Parents of adolescents and health care providers treating adults and children with ADHD must know that ADHD is an early indicator of other mental health disorders. In fact, one study found that “60%–100% of children with ADHD also exhibit one or more comorbid disorders that often continue into adulthood.” Monitoring for these other conditions will help patients get early treatments when needed and can help prevent suicidal thoughts or attempts.

• Genetics

Evidence from research studies supports a relationship between mental health disorders, suicidal thoughts and attempts, and suicide. However, these studies do not support a causation link between ADHD and those mental disorders. Research has not found that ADHD causes these other conditions.

Genetics research has connected depression, ADHD, and suicide in children in the U.S., though additional research is necessary.

Understanding Risk Factors for Suicide

Recognizing risk factors of suicide and knowing the signs could save lives. While the causes related to suicide may differ, there are some signs and symptoms that may help identify those at risk.

Common risk factors associated with suicide include:

• depression
• substance abuse
• a history of suicide attempts
• chronic pain
• family violence
• family history of suicide
• stressful life events (financial or legal trouble, losing a loved one, etc.)
• the presence of guns at home
• a history of incarceration

Risk factors can lead to suicidal thoughts. Even “passive” thoughts of suicide should be taken seriously and investigated. Not everyone with these risk factors attempts suicide, of course. But some will.

Signs of Impending Suicide

The signs of an impending suicide attempt aren’t necessarily overt, though family members and friends might have a gut feeling that something isn’t right with their loved one.

Here are some signs that someone might be seriously contemplating suicide:

• feelings of hopelessness
• acute and unbearable emotional pain and suffering
• withdrawal from people
• taking dangerous risks
• spending excessive time talking or thinking about death
• giving away precious possessions
• subtly saying goodbye to loved ones

Addressing Concerns

Anyone contemplating suicide is having a mental health crisis. Experts say people around them should protect the person’s mental health and their lives by taking a direct approach. That means speaking openly with the person about their experiences and any suicidal thoughts or plans.

Two questions you might ask directly:

• Do you have plans to harm yourself?
• Do you have a suicide plan?

Then immediately seek professional assistance and a mental health assessment for the person if you think it’s needed.

There’s no evidence that a direct approach like this increases a person’s risk of suicide.

“We are seeing a wave of change in our society that destigmatizes openly talking about and seeking help to prevent suicide, and this is giving people more confidence to take action to protect their own and others’ mental health and well-being,” the American Foundation for Suicide Prevention wrote in a February 2023 news release.

When you talk with the person:

• Do not minimize their emotions. You don’t know their feelings, so don’t imply that you do.
• Do not scold them for being ungrateful for what they have.
• Do take what they’re saying about suicidal thoughts seriously.

After You Learn of Someone’s Suicidal Thoughts

After you learn that someone has suicidal thoughts or is contemplating suicide:

• Recommend that they call 988, or the Suicide and Crisis Lifeline. It is free to call for help, and the professionals on the other end are trained in suicide prevention. They’re available to anyone in a mental health crisis or to the person assisting them. The call and all information gained from the conversation are kept confidential. Help is available 7 days a week, 24 hours a day.
• Do not leave the person alone. If they refuse to take steps to ask for help, make the call yourself. Dial 911 if the person is in immediate danger of harming themselves or others.
• Do not keep a person’s suicide attempts, thoughts or plans a secret from professionals who can help them. Even if the person in crisis asks you to keep what they’ve told you to yourself, don’t do it. Quickly getting the appropriate support is important.