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Warning Signs: Depressive Disorders & Suicide

Updated: Nov 7, 2022

There are many different forms of clinical depression. Some of the symptoms may overlap. However, there are enough differences that each warrants its only specific diagnosis. The various types of clinical depression are:


Major Depressive Disorder

Seasonal Affective Disorder

Bipolar I, Bipolar II, Cyclothymic Disorder (these three separate disorders have overlapping symptoms, including depressive episodes)

Persistent Depressive Disorder

Treatment Resistant Depression

Peripartum (Postpartum) Depression

Psychotic Depression

Premenstrual Dysphoric Disorder

Situational Depression

Atypical Depression


Not only are there many forms, but there are subcategories to most of these. Thus, it’s easy to see that careful diagnosis listing all evident criteria is vital. A practitioner must not only closely review the DSM-V-TR when diagnosing, but actively listen to a patient’s words and make note of their body language. A patient’s treatment plan will contain the type of depression(s) the person is experiencing, as well as goals geared towards easing symptoms over time.




Often, treatment for depression, especially treatment resistant or persistent depression, must include medication in order to be successful. Medication along with psychotherapy can be especially helpful in managing symptoms long-term.


One symptom of depression that tends to show up in each of these diagnoses is suicidal ideation (i.e., suicidal thoughts). Suicidal thoughts or ideation are when a person thinks about taking their own life. Because of the severity of this situation, clinicians are trained to directly ask clients if they are suicidal.


One way to determine the level of severity is by administering the SLAP test. This stands for: Specific; Lethal; Available; Proximity. The theory is that individuals who have a specific plan with lethal intent, access to a weapon, pills, etc. that they will use, and are relatively separated or far away from a support system and other resources are at high risk of acting on their suicidal intentions.


There are other means of administering assessments to determine how intentional a person is in acting on suicidal thoughts. It is important that clinicians never assume that they don’t have enough information to get a person help. It’s better to be safe than sorry.

While some people do not act on those thoughts, even when it appears they might, many people become overwhelmed by the thoughts and act on them. Constant and consistent check-ins with a person expressing suicidal intent are important. Any progression should be duly noted and warrants a discussion about taking action steps to stop the individual from following through.


Many people who experience these thoughts may be too scared to reach out for help, or may not want help because they have come to terms with the idea of ending their life. This is why it is crucial to look out for the many warning signs and to be direct in any questioning. Sometimes it takes another person being direct for the person to feel comfortable confirming that they were thinking about ending their life.


When someone with depression is expressing their feelings to you, you should take how and what they say into careful consideration. Sometimes it may be a simple phrase such as, “I can be such a burden.” Most people would simply console the person, but when phrases are used that hint towards self-hatred, guilt, or hopelessness, it can be cause for concern.


You should also be concerned if your friend or family member starts to say goodbye to their loved ones in a more sincere way, as if they aren’t going to see them again, or start to give away their belongings. They may also begin to cancel memberships, disengage from others and stop making future plans.


When considering suicide, many people also begin using drugs or alcohol more excessively, display increased aggression and impulsive or reckless behavior , and withdraw from family or friends.


After witnessing signs of distress, you may feel confused about what to do next, but it is important to remember your loved one’s safety is your first concern. Some people may deny your concern when confronted, however this does not mean they aren’t considering suicide. In some situations, it is necessary for a person to be involuntarily committed to an ER or mental health treatment center in order to save their life. If you cannot do so, try to make time to be with the individual as much as possible for the next several days or weeks. Make yourself available. Best case scenario, you can stay right by their side and offer words of encouragement.


There is now a hotline that can be called when individuals are considering suicide or has a loved one who is, which can be reached simply by dialing ‘988.’ The crisis response professionals can help with next steps.


If you are concerned about a family member or friend, don’t delay. Get your loved one help immediately.


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