A doctor reveals what you need to know about suicide prevention

September is National Suicide Prevention Awareness Month, and according to the Centers for Disease Control and Prevention, suicide rates have increased more than 30 percent in half of all U.S. states since 1999. The CDC also reports that suicide is the 10th leading cause of death in the U.S., and the 2nd leading cause of death of people ages 10 to 34.

Yahoo Lifestyle spoke to Elizabeth Lombardo, a clinical psychologist, about what everyone needs to know about suicide and what the warning signs are.

“The number one indicator is actually not depression, but hopelessness,” Lombardo says. “Hopelessness is thinking, ‘Things will never get better.’”

“Life is up and down. We all have times when things are going well, and eventually things will not go so well,” says Lombardo. “When you’re in that kind of rut, if you wait it out, you will always go up.”

Other warning signs include withdrawing from friends and family, increased alcohol or drug use, dramatic mood swings, and aggressive or reckless behavior, according to the National Alliance on Mental Illness (NAMI).

So what can you do if you think someone you care about might be at risk? Stay calm, talk openly, and express your concern and support, suggests NAMI. “If you feel comfortable, you can ask the person: ‘On a scale from 0 to 10, how likely are you to hurt yourself?’” says Lombardo. She defines “0” as, “No way, I’m not going to do it” and “10” as “I’m absolutely going to do it.”

Lombardo adds, “If they’re at a low number, it doesn’t mean we say, ‘Forget about it. We move on.’ Then you want to get some help. If they’re at a really high number, that tells us, ‘You need to do something and you need to do something quickly.’”

She says there are options. “It could mean picking up a phone and calling a suicide prevention hotline. It could mean picking up a phone and calling 911. [Or] having a discussion with that person and letting them know, ‘I care a lot about you, and I don’t want you to make a decision right now that we can’t take back.’”

If you or someone you know may be at risk, call the National Suicide Prevention Lifeline at 1-800-273-8255. The lifeline provides free, confidential support 24 hours a day, 7 days a week.