The death by apparent suicide of both fashion icon, Kate Spade, known for her brightly colored and whimsical styles, and Anthony Bourdain, remembered for his love of storytelling and food, shocked fans this week. It also shined a spotlight on mental health and suicide awareness. That two people who attained so much success also struggled with mental health is a stark reminder that depression and other psychiatric disorders don’t discriminate.

It shouldn’t take a high-profile loss to spark conversation about mental health and suicide, however. According to the latest data compiled by the Centers for Disease Control and Prevention (CDC), suicide is the tenth leading cause of death in the United States.

The suicide rate was 24% higher in 2014 than in 1999, and increases were observed for both females and males in all age groups under 75. Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death of those between the ages of 35 and 54.

According to the National Alliance on Mental Illness (NAMI), approximately 1 in 5 adults experiences mental illness in a given year. There is a link between mental illness and suicide; in fact, 90% of those who die by suicide experience mental illness, including, but not limited to, depression, bipolar disorder, schizophrenia, anxiety disorders, and substance-related disorders.

If a friend or loved one struggles with a mental disorder, it’s natural to worry about whether or not that person experiences suicidal ideation. When a death by suicide is in the news, it triggers people to think about those they love who might be at risk. You can help a loved one by learning the warning signs, understanding risk factors, and getting help.

Warning signs of suicidal ideation:

Most, but not all, people who die by suicide exhibit some warning signs, and the more signs a person shows, the greater the risk. It’s important to note that warning signs are associated with suicide, but not necessarily the cause. Suicide is complex, and often there are multiple factors underlying the suicidal ideation. Here are the signs to watch for:

  • Talking about wanting to die
  • Looking for a way to die
  • Communicating feelings of hopelessness
  • Talking about being a burden to others
  • Talking about feeling trapped
  • Talking about feeling unbearable pain
  • Increased substance use
  • Acting anxious, agitated, or recklessly
  • Changes in sleep patterns: too much or too little
  • Withdrawing or feeling isolated
  • Showing rage
  • Talking about revenge
  • Extreme mood swings

Some individuals exhibit signs of imminent danger. If your friend or loved one shows any of these warning signs, get help right away:

  • Putting affairs in order
  • Giving away prized possessions
  • Saying goodbye to friends and family
  • Planning suicide by looking for tools needed to complete suicide

Any warning signs should be taken seriously. Do not assume that statements made about wanting to die, feeling hopeless, or feeling like a burden are exaggerated or a plea for attention. Each warning sign exhibited shows that your friend or loved one is struggling and needs help.

Risk factors for suicide:

Suicide affects all people. The strongest risk factor for suicide is a previous suicide attempt, but there are a variety of events, circumstances, and conditions that may increase the risk of suicide.

Consider these additional risks associated with suicide:

  • Family history of suicide
  • Substance abuse
  • Access to firearms
  • Serious or chronic medical illness
  • Mental disorders
  • History of trauma or abuse
  • Gender: Although women are more likely to attempt suicide, men are four times more likely to die by suicide
  • Prolonged stress
  • Isolation
  • A recent tragedy or loss
  • Increased agitation
  • Sleep deprivation

How to help your friend or loved one:

It’s essential to communicate to a suicidal friend or loved one that you are there to help and provide support. This shows the person that his feelings are heard. Not sure where to start? Follow these steps.

1. Talk openly with your friend. There is a misconception that talking about suicide plants the idea in someone’s head. It doesn’t. Talking about suicide by asking direct questions gives your friend or loved one an opportunity to communicate emotions he or she has likely kept hidden for quite some time. It can provide a feeling of relief from isolation, loneliness, and pent-up negative emotions.

Try these questions to communicate that you are there to help:

“Are you having thoughts of suicide?”

“When did you begin feeling this way?

“What can I do to support you?”

“Have you thought about get help?”

“What steps have you already taken to get help?”

Use these statements to offer hope and support:

“You are not alone in this. I am here for you.”

“I might not know exactly how you feel, but I want to understand and I am here to help you.”

“When you are feeling hopeless, I will be here to support you.”

2. Keep your friend or loved one safe. If you believe that she is in imminent danger, follow these safety protocols:

  • Do not leave the person alone
  • Remove firearms, alcohol, drugs, or sharp objects that could be used in a suicide attempt
  • Call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255)
  • Take the person to an emergency room or seek help from a medical or mental health professional

3. Listen with empathy and ask questions to gain understanding. Do not argue with him and resist blanket statements such as, “You have so much to live for!” or “You can’t do this to your family.” The best thing you can do is provide a shoulder to lean on. You don’t have to have all of the answers, you just have to be there to offer hope and support.

4. Reach out for help. One thing you can do is gather a list of resources for her. Help the individual find a support system that includes a licensed mental health practitioner. Cognitive behavioral therapy and dialectical behavior therapy can help individuals with suicidal thoughts recognize unhealthy patterns of thinking and behavior, process and validate feelings, and learn positive coping strategies. Medication and/or hospitalization may be necessary for some individuals.

5. Follow up with your friend. Helping someone you know through suicidal ideation is not a one-time conversation. Follow up. Offer to provide rides to appointments. Help him adapt healthy habits by walking together and offering to assist with other lifestyle changes.

Suicide is complex, but it is preventable. If you are worried about a friend or loved one, reach out for help right away.

If you (or someone you know) are in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741-741.