Particularly stressful is the threat of suicide.  When a family member is overtly suicidal, most families realize the importance of immediate professional help.  However, suicidal tendencies are also expressed in more subtle ways.  As suicide is often and impulsive act, quite unexpected by the family, it is important to be aware of some of the common warning signs:

	feelings of worthlessness, hopelessness
	feelings of anguish or desperation
	preoccupation with death or other morbid topics
	social withdrawal
	increased risk-taking, (speeding while driving, handling weapons, drinking heavily)
	sudden burst of energy or brightened mood after being seriously depressed
	putting affairs in order (writing a will, giving possessions away)
	having an actual plan by which to commit suicide
	hearing voices that command self-mutilation or suicide
	having a family history of suicidal behavior

	removal of all weapons, even cars and other potentially dangerous vehicles
	search for a staff of drugs to guard against an over-dose.  Insure patient is taking medication
	calm communication with person to assess the situation without condemnation.  The person may feel less cut off and both may judge more easily whether protective hospitalization is in order
	communication with helping professionals re: concerns
	decision whether constant supervision would be useful