Understanding why anyone kills himself is always complex, but even mental-health experts were puzzled when the CDC released its suicide data in June: Eighty-four percent of men who die by suicide have no known mental-health conditions. “People in general—and men in particular—try to hide having a mental-health problem,” says David A. Jobes, Ph.D., director of the Catholic University of America’s Suicide Prevention Lab. That’s part of the problem.

The suicide rate for men is about three and a half times that of women—probably because men are less likely to seek help or talk to one another when they’re in trouble, and because they’re more likely to own a gun than women and more likely to use one in a suicide attempt. (About 49 percent of suicide deaths in America are the result of using a firearm, and suicide risk is higher in homes where guns are not stored safely.)

In its latest report, the CDC found that in 2012 and 2015, male suicide rates were highest in the construction and extraction fields. However, suicide rates also increased for men working in the arts, entertainment, sports, and media occupations. Pinpointing at-risk occupations can help public health officials develop resources for guys.

“Knowing who is at greater risk for suicide can help save lives through focused prevention efforts," Dr. Debra Houry, director of CDC’s National Center for Injury Prevention and Control, told NBC News.

But experts think there are other ways suicide can be stopped.

“We need prevention strategies that focus not just on helping you not want to die by suicide but on whether or not you can die,” says Michael Anestis, Ph.D., associate professor of clinical psychology at the University of Southern Mississippi. “Locking a gun in a safe doesn’t make you less suicidal—but it makes you less likely to die.”

And while an individual’s suicide can seem surprising, there are usually signs.

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“In my experience, upon honest reflection, most of us would recognize in hindsight that our friend who died by suicide was not doing well—that something was off,” says Jobes. We need to do a better job of looking out for each other.

Use this guide (like, right now) if you’re worried about a friend.

Ask the Tough Questions

Be blunt. If your buddy isn’t bouncing back from a layoff or a breakup or is posting concerning messages, ask how he’s doing. If he says he’s feeling awful, say—and this is tough—“That must be really stressful. How are you handling it? Are you really down? Are you thinking about killing yourself?” Asking if he’s thinking about suicide doesn’t increase his risk of killing himself, says Raymond P. Tucker, Ph.D., assistant professor of clinical psychology at Louisiana State University. It can actually help him feel supported and connected.

“Even if they aren’t thinking about suicide or lie about having those thoughts, they know you’re willing to listen, and they’re more likely to come back to you later.”

Offer Support

Ask what’s going on and why he thinks he feels the way he does. Don’t project judgment. “Sometimes the reason why someone could say they’re suicidal can seem minuscule to you—but it is the biggest thing in the world to them,” says Tucker.

Help: Suggest calling the National Suicide Prevention Lifeline (800-273-8255) together. “Crisis-line workers are expertly trained. They’re used to talking to suicidal people, and they’re good at it,” says Jobes. Or help him make an appointment with his doctor or find a mental-health professional. If he needs immediate help, offer to drive him to the emergency room.

Follow up

Text or call a couple times a day and see how he’s doing. Communicate just how awful it would be to lose him. “The conversation does not always need to be about suicide, but certainly let them know that you’re there to help,” says Tucker.

Teach him to control his response

Tell your friend that just like an ex he fell for, suicidal thoughts can still show up at the door from time to time, says suicide researcher Ursula Whiteside, Ph.D. The trick is how he responds. “Go out for a drink with that ex and you might end up in bed,” she says. “Don’t respond to the ex—instead, cook dinner or do a workout—and you’ll change your relationship to the thoughts. It’s not the thoughts themselves that are dangerous; it’s how you respond.”

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Spot the Danger Signs

While depression is a big risk factor for suicide, it’s not the only one, says Igor Galynker, M.D., Ph.D., director of the Galynker Suicide Research Laboratory at Mount Sinai’s Icahn School of Medicine. People who experience all of the below can be 15 times more likely to attempt suicide in the near future than those who don’t, he says.

Signs that someone may need help include:

Feeling trapped or hopeless

Losing control of thoughts (like he’s locked into a negative loop of thinking that he can’t escape)

Extreme anxiety or rapid mood swings

Insomnia or agitation

Social withdrawal (avoiding social outings he’d normally take part in)

Help Him Reboot

Has your friend been bailing on your pickup-hockey-league games or canceling your weekly poker night? When someone is depressed, they can lose motivation to do the things that make them happy, says Anestis. Behavior therapy says: Do ’em anyway—if your friend changes his behavior, his emotions will follow.

Online Resources That May Help

Tec-Tec: This gamelike version of a psychological technique called evaluative conditioning tasks the user with pairing certain words and images together. Find it on the Apple App Store or Amazon.

Virtual Hope Box: Funded by the Military Suicide Research Consortium, it uses coping strategies such as relaxation, distraction, and positive thinking. Find it on the Apple App Store or Google Play.

NowMattersNow.org: Ursula Whiteside’s tool-packed site includes survivor stories and a YouTube channel that teaches skills to help people get through hard moments.

Man Therapy: This award-winning campaign cuts through the BS and stigma of depression, divorce, anxiety, and suicide in a humorous but helpful way. mantherapy.com

Facebook: The site recently enabled a feature that allows people to connect with counselors on the Crisis Text Line and the National Suicide Prevention Lifeline through Messenger.

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The Future of Mental Health Treatment

Currently antidepressants, lithium, and an antipsychotic called clozapine can be prescribed to depressed and suicidal people. But they take time to work. That’s why researchers are testing faster-acting drugs. One, the party drug ketamine, reduces suicidal thoughts in depressed patients in just a day (but with side effects). A new drug called Rapastinel is now undergoing phase 3 clinical trials. Similar to ketamine, it acts on the neurotransmitter receptors in the brain responsible for learning, memory, and synaptic plasticity, but with minimal ketamine-like side effects, explains Stanford University professor Carolyn Rodriguez, M.D., Ph.D., who studies the drug. “Rapastinel has the potential to open a new avenue for rapid treatments.”

For general information on mental health and to locate treatment services in your area, call the Substance Abuse and Mental Health Services Administration Treatment Referral Helpline at 1-800-662-HELP (4357).

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