ABERDEEN PROVING GROUND, Md. (Sept. 3, 2013) -- "What? Are you serious? So-and-so tried to kill himself?"

Unfortunately, at some time in your life, you may have heard these questions spoken in your circle of friends. Suicide is real. Most of us know someone whose life has been affected by suicidal behavior (a completed suicide or a suicide attempt), and the pain and stress of the suicidal behavior spreads like a ripple to family, battle buddies, friends and co-workers. All of those individuals--including you--who could be impacted by suicidal behavior can help to recognize risk factors and stressors and act to increase the chances of saving a life.

There is not one single factor or set of factors that indicate a person is thinking about suicide. Sometimes, we can look back at an incident of suicidal behavior and say, "Wow, we should've seen that coming," but other times, the behavior seems to happen out-of-the-blue. Noticing the signs and risk factors of suicidal behavior is not always easy. Risk factors for suicide vary from person to person and change over time in the same person. An individual can have one or multiple risk factors contributing to a suicidal behavior. Some of these risk factors include:

1. Relationship Problems

If someone has an argument with his significant other, it does not necessarily mean that he is going to hurt himself. However, relationship problems such as the death of a loved one or friend, break-ups and divorces are very stressful and can be associated with suicidal behavior.

2. Substance Use and Abuse

Alcohol and drugs are often abused in a misguided attempt to help cope with life stress. A sudden increase in substance use can signal a problem. Drug and alcohol use can increase the likelihood of risky behaviors, such as being careless or impulsive with weapons, which are associated with completed suicides.

3. Life Stressors

Getting in trouble on the job, having civilian or military legal problems, and dealing with money issues or health problems are both mentally and physically exhausting. Difficulty sleeping can add to the stress. Life stressors alone or coupled with other risk factors can lead to suicidal behaviors.

4. Behavioral Health Issues

Stress can lead to behavioral health problems such as depression, anxiety and adjustment issues. For some individuals, a terrifying event may lead to post-traumatic stress disorder, known as PTSD. Individuals who are feeling depressed or anxious might withdraw from social support, making it more difficult for them to deal with everyday stress. When a person is alone, he may begin to isolate from people making it more difficult for family, battle buddies, friends and coworkers to see that he or she is struggling. Without support from people who care, individuals can feel hopeless about the future and may not ask for help.

Having one or more risk factors does not necessarily mean that a person is going to hurt himself. However, the risk factors described above have been shown to be associated with suicidal behavior. If we can all look for those factors and talk to the individual experiencing those stressors about how he is doing, together we can make a difference and improve the health and well-being of our family members, battle buddies, friends and co-workers.

Counselors treat thousands of people for relationship problems, substance abuse, depression, PTSD and stress each year. Trained therapists are available at behavioral health clinics on post, in the civilian community and in Veterans Administration clinics.

The best way to help prevent suicidal behavior is to pay attention to your loved ones, battle buddies, friends and coworkers and watch for changes in their behavior. Reach out to someone you trust in your organization or in your personal life. Remember ACE: Ask, Care, Escort. If you see changes, or if something just seems "off," say something, ask him or her if he or she is thinking about hurting himself. Show him or her that you care. Take him or her to get help.

Call 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline. Your actions could save a life.