Suicide Prevention Playing Cards

This full Deck of 52 Cards plus two Jokers contains the clinical warning signs for risk of suicide. In addition, on the face cards are famous people who suffered from depression or other mental health disorders, and either succumbed to them or overcame them. On the back of each card you will find the crisis hotline 1-800-SUICIDE and our website

Click here to see all the cards

The cards were designed by Drew Schorno and are given to each person who donates $50 or more to the Kristin Brooks Hope Center. Link to donation

When you make your donation please specify which item you would like (cards or wristband.) Each $50 donation or more gets both the Suicide Playing Cards and the wristband.

If you would like to purchase several decks as stocking stuffers (or more than 10 for your awareness event), please contact Elena at elena (at)
Glow in the Dark Wristbands

These light blue wristbands with 1-800-SUICIDE and also have our 877-VET2VET hotline on the inside. They will be given to each person who donates $10 or more to the Kristin Brooks Hope Center. When you make your donation please specify which item you would like (cards or wristband.)

If you would like to purchase several wristbands as stocking stuffers or in bulk for your awareness event or school, please contact Elena at elena (at)


Suicide is a permanent solution to a temporary problem. Suicidal behavior is complex, as some risk factors vary with age, gender, and ethnic group and may even change over time. The risk factors for suicide frequently occur in combination. Research has shown that more than 90% of people who commit suicide have depression or another diagnosable mental or substance abuse disorder.

The number one cause of suicide is untreated depression. A depressive disorder is an illness that involves the whole body, mood, and thoughts. It affects the way a person feels about oneself and the way one thinks about things. The taking of ones own life tragically demonstrates the terrible psychological pain experienced by a person who has lost all hope – a person who is no longer able to cope with day to day activities – a person who feels there is no solution to their problem – a person who wants to end the pain by ending their own life.

Much of this kind of suffering is unnecessary. Depression is treatable and as a result, suicide is preventable. Love yourself or a friend enough not to keep thoughts of suicide a secret. If you or a friend of yours is thinking of ending the pain by ending your own life, this is not a secret to keep. Talk to your family, friends or other special people in your life. They can help you find solutions to your problems and to see ways to cope with your pain without ending your life. Help is just a phone call away: 1.800.442-HOPE (4673)

Things to know about suicide:

• 90% of people who commit suicide have depression or another diagnosable mental illness or substance abuse disorder

• The number one cause of suicide is untreated depression

• Suicide has ranked at the 3 rd leading cause of death for young people nationally

• There are three female attempts for every male attempt at suicide. However, males are four times as likely to die from their attempts

What to do if a friend or loved one is suicidal:

• Let that person know you are concerned about their well-being, and that you have observed certain clues that have made you think that they may want to hurt themselves. Ask them if they are depressed or suicidal.

• Listen to your friend, and keep in mind that you must stay calm. Your friend will more than likely be relived that someone noticed their pain, and cared enough to confront them and talk about it.

• Support your friend unconditionally. While you cannot make someone choose to live, and while you aren’t responsible for their life, you can support them and show them that you care while giving them ideas about other choices.

• Remind this friend that suicide is a permanent solution to a temporary problem.

• Be honest with your friend and they will trust your input. Let them know you want to help them, even if it involves calling an adult or a hotline. Call them in front of your friend if necessary.

• Call 9-1-1 if you feel their suicide threat is immediate.

• Become trained as an IMAlive crisis responder


Okay, so you may have seen or heard something about cutting. Or maybe you’re doing it personally. Whatever brought you here, we want you to know more about cutting: what it is; who does it; why people do it; and how to get help for you or a friend to stop hurting inside and out.

What is cutting?
Cutting is when someone takes something sharp, like a razor, knife, scissors or piece of glass, and runs it along a part of their body, usually to the point of bleeding or bruising.

Most cuts are made on arms, wrists and legs. Sometimes, people cut their chest, stomach, face, neck, breasts or genitals. Cutting on the arms and wrists is the most common because it’s often easier to make up excuses for marks on these parts of the body, something like “My cat scratched me,” or “I had an accident in the kitchen.”

Cutting is a form of self-injury, or self-mutilation. Some people also call it slashing or slicing.

Besides cutting, people may hurt themselves in other ways, including scratching, burning skin with a lighter, punching or headbutting.

Basically, people cut to deal with difficult problems or feelings, but there are better, healthier ways to cope.

Who cuts?
About two million people in the U.S. hurt themselves in some way. Most are teenagers or young adults, and they’re from all races and backgrounds. To hide their cutting, they often wear clothing like long pants or shirts, even in warm weather.

Why do people cut?
For most people, it’s hard to understand why anyone would intentionally hurt themselves. But, for those who cut, there are a few reasons.

Some people say they do it because of emotional pain they can’t put into words.
Some say it gives them a sense of control when other things in their life are out of control, like a break-up, a friend who’s sick or a parents’ divorce.
Some people cut to punish themselves for troubling thoughts or acts.
Some find the act soothing, and it makes them feel alive.
Some cut to get a reaction from other people.
No matter the reason, cutting is a serious, dangerous behavior, and may be a sign of another problem.

Many people who cut themselves also have an eating disorder like anorexia or bulimia. Some may be experiencing depression. Others may have been sexually or physically abused.

Is cutting a suicide attempt?
Usually, people who cut aren’t trying to kill themselves. At the same time, cutting can be life-threatening. In fact, sometimes, people can’t control the injury and die accidentally.

If you or someone you know is thinking about killing themselves, contact
1-800-442-HOPE(4673) or 1-877-YOUTHLINE (968-8454) immediately to talk to a crisis center in your area. Suicide is never the answer to your problems.

How can I help a friend with this?
Ask about it. Friends with cutting problems are often glad to be able talk about it. If you bring it up and this person isn’t self-injuring, it won’t start just because you said something about it.
Offer options but don’t tell your friend what to do. If someone’s using cutting or some other kind of self-injury as a way to feel in control, it won’t help if you try to take control. Helping someone see ways to get help – like talking to a parent, teacher, school counselor or mental health professional- may be the best thing you can do.
Seek support. Knowing a friend is going through this can be frightening and stressful. Consider telling a teacher or someone else you trust. And remember, even if you don’t want to share your friend’s secret, you can still talk to a mental health professional about how it is affecting you.
Remember you’re not responsible for ending your friend’s self-abuse. You can’t force someone to stop or to get help from a professional. What you can do, always, is keep being a good friend.

How can I help myself?
Talk to someone you trust. Maybe it’s a parent or a good friend or a school counselor. Tell them you’re cutting yourself, and want to stop. Ask them to help you find help. Know that you may get some tough reactions like denial or sadness or anger, but that will pass. If you’re not comfortable with that, contact a local mental health group or a 1-877-YOUTHLINE (968-8454).

Get help.
Cutting isn’t something to deal with on your own. There are therapists and support groups who can help you work through what makes you cut. Even if you’re nervous about getting help, take this step, because NOW is the best time to do it. If you wait, the problem will only get bigger and harder to hide. And remember, you can stop cutting.


Depression – Depression is a mental illness that is linked to physical changes that occur in the brain. Depression results from an imbalance of certain chemicals, called neurotransmitters, which are responsible for carrying signals in the brain and nerves. While there is no single cause of depression, there are many common factors that can lead to depression. Such factors as: family history, physical conditions, trauma/stress, and other psychological disorders.

Family History – Depression is one of many illnesses that can be passed on to individuals within a family for generations as a result of genetics. Genetics are responsible for all physical and biological traits, and are always inherited from one’s parents.

Physical Conditions – Depression can result from the weakness and stress caused by serious medical conditions like cancer, HIV, or heart disease. Depression can actually increase the severity of such physical conditions, for it weakens the immune system and can make pain harder to tolerate.

Trauma/Stress – Traumatic or stressful experiences can drastically increase ones likelihood of becoming depressed. Changing schools, starting a new job, or dealing with the death of a family member are all extreme changes in ones life that can lead to depression.

Psychological Disorders – When one suffers from other psychological disorders such as anxiety, eating disorders, or substance abuse, depression can arise if these disorders go untreated, as a result of the stress that occurs from living with the illness.

Some Warning Signs of Depression:

  • Lack of interest in friends or social activities
  • Drastic changes in ones grades
  • Thoughts of running away
  • Alcohol or substance abuse
  • Fear of death
  • Frequent sadness
  • Problems sleeping
  • Changes in eating habits
  • Constant tiredness
  • Increased irritability

Grief/Loss – Grief is the feeling that you experience with the death of a loved one. Loss is the feeling that you experience when a significant absence or change occurs in your life, but isn’t related to death. However, some losses may actually feel worse than a death, (which are the most misunderstood feelings of all). There are several indications of grief and loss, which include: shock, sadness, anger, guilt and sometimes, no feelings at all.

Shock – Shock is the feeling of surprise where you may wonder “why me?”

Sadness – Sadness is the feeling of sorrow where you will miss the person you have loved so much

Anger – Anger is the feeling of rage, where you may wonder “why did this person have to leave”

Guilt – Guilt is the feeling that you could have done something to change the situation, and you may say “I didn’t say enough or do enough when the person was here”

No feelings – Sometimes, when the loss of a loved one is unexpected, you may feel confused and may not even know what to feel, or what to say. These feelings are normal and should not be confused with a dislike for the individual.

What you can do:

  1. If you feel overwhelmed by grief or loss, are having difficulties getting back to a normal routine, or considering taking your own life because of your grief or loss, please make an attempt to get help and call 1-877 YOUTHLINE(968-8454), or call 1-800 442-HOPE(4673)
  2. Talk to an adult that you trust
Postpartum Mood Disorders

Any of the following five postpartum mood disorders can also occur during pregnancy.

  • Depression and/or Anxiety
  • Obsessive-Compulsive Disorder
  • Panic Disorder
  • Psychosis
  • Postpartum Psychiatric Illness Posttraumatic Stress Disorder

“Baby Blues” — Not Considered a Disorder

  • This is not considered a disorder since the majority of mothers experience it.
  • Occurs in about 80 percent of mothers
  • Usual onset within first week postpartum
  • Symptoms may persist up to three weeks


  • Mood instability
  • Weepiness
  • Sadness
  • Anxiety
  • Lack of concentration
  • Feelings of dependency


  • Rapid hormonal changes
  • Physical and emotional stress of birthing
  • Physical discomforts
  • Emotional letdown after pregnancy and birth
  • Awareness and anxiety about increased responsibility
  • Fatigue and sleep deprivation
  • Disappointments including the birth, spousal support, nursing, and the baby

Depression and/or Anxiety

  • Occurs in 15 to 20 percent of mothers
  • Onset is usually gradual, but it can be rapid and begin any time in the first year
  • Excessive worry or anxiety
  • Irritability or short temper
  • Feeling overwhelmed, difficulty making decisions
  • Sad mood, feelings of guilt, phobias
  • Hopelessness
  • Sleep problems (often the woman cannot sleep or sleeps too much), fatigue
  • Physical symptoms or complaints without apparent physical cause
  • Discomfort around the baby or a lack of feeling toward the baby
  • Loss of focus and concentration (may miss appointments, for example)
  • Loss of interest or pleasure, decreased libido
  • Changes in appetite; significant weight loss or gain

Risk factors

  • 50 to 80 percent risk if previous postpartum depression
  • Depression or anxiety during pregnancy
  • Personal or family history of depression/anxiety
  • Abrupt weaning
  • Social isolation or poor support
  • History of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD)
  • Mood changes while taking birth control pill or fertility medication, such as Clomid
  • Thyroid dysfunction


  • Psychotherapy and psychiatrist for medication. Antidepressant and attending a support group for PPD MOMS. If the mom is bi-polar the treatment is mood stabilizers and no anti depressants as they can trigger an SSRI syndrome.

Obsessive-Compulsive Disorder

  • 3 to 5 percent of new mothers develop obsessive symptoms


  • Intrusive, repetitive, and persistent thoughts or mental pictures
  • Thoughts often are about hurting or killing the baby
  • Tremendous sense of horror and disgust about these thoughts (ego-alien)
  • Thoughts may be accompanied by behaviors to reduce the anxiety (for example, hiding knives)
  • Counting, checking, cleaning or other repetitive behaviors

Panic Disorder

  • Occurs in about 10 percent of postpartum women


  • Episodes of extreme anxiety
  • Shortness of breath, chest pain, sensations of choking or smothering, dizziness
  • Hot or cold flashes, trembling, palpitations, numbness or tingling sensations
  • Restlessness, agitation, or irritability
  • During attack the woman may fear she is going crazy, dying, or losing control
  • Panic attack may wake her up
  • Often no identifiable trigger for panic
  • Excessive worry or fears (including fear of more panic attacks)

Risk factors

  • Personal or family history of anxiety or panic disorder
  • Thyroid dysfunction


  • Psychotherapy and psychiatrist for medication. Antidepressant and anti-anxiety medication, attending a support group for PPD MOMS. If the mom is bi-polar the treatment is mood stabilizers and no anti depressants as they can trigger an SSRI syndrome.


  • Occurs in one to two per thousand
  • Onset usually two to three days postpartum
  • This disorder has a 5 percent suicide and 4 percent infanticide rate


  • Visual or auditory hallucinations
  • Delusional thinking (for example, about infant’s death, denial of birth, or need to kill baby)
  • Delirium and/or mania

Risk factors

  • Personal or family history of psychosis, bipolar disorder, or schizophrenia
  • Previous postpartum psychotic or bipolar episode


  • Immediate hospitalization. Psychotherapy and psychiatrist for medication. Antidepressants and attending a support group for PPD MOMS. If the mom is bi-polar the treatment is mood stabilizers and no anti depressants as they can trigger an SSRI syndrome.

Postpartum Psychiatric Illness Posttraumatic Stress Disorder

  • There is no available data regarding the prevalence or onset


  • Recurrent nightmares
  • Extreme anxiety
  • Reliving past traumatic events (for example, sexual, physical, emotional, and childbirth)
The definition for PTSD in DSM-IV:

309.81 DSM-IV Criteria for Posttraumatic Stress Disorder followed by the additions and changes in DSM-V

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person’s response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
(2) recurrent distressing dreams of the event.
(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated).
(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to have loving feelings)
(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Overall, the symptoms of PTSD are mostly the same in DSM-5 as compared to DSM-IV. A few key alterations include:
The three clusters of DSM-IV symptoms are divided into four clusters in DSM-5: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. DSM-IV Criterion C, avoidance and numbing, was separated into two criteria: Criteria C (avoidance) and Criteria D (negative alterations in cognitions and mood). The rationale for this change was based upon factor analytic studies, and now requires at least one avoidance symptom for PTSD diagnosis.
Three new symptoms were added:
Criteria D (negative alterations in cognitions and mood): persistent and distorted blame of self or others, and persistent negative emotional state
Criteria E (alterations in arousal and reactivity): reckless or destructive behavior
Other symptoms were revised to clarify symptom expression.
Criterion A2 (requiring fear, helplessness, or horror happen right after the trauma) was removed in DSM-5. Research suggests that Criterion A2 did not improve diagnostic accuracy (2).
A clinical subtype “with dissociative symptoms” was added. The dissociative subtype is applicable to individuals who meet the criteria for PTSD and experience additional depersonalization and derealization symptoms (3).
Separate diagnostic criteria are included for children ages 6 years or younger (preschool subtype) (4).
What are the implications of these revisions?


PTSD assessment measures, such as the PC-PTSD, CAPS, and PCL, are being revised by the National Center for PTSD to be made available upon validation of the instruments. Please see our Assessments section for more information.
Prevalence rates

Based on initial analyses of the DSM-5 criteria, the prevalence of PTSD will be similar to what it is currently in DSM-IV (5,6). Research also suggests that similarly to DSM-IV, prevalence of PTSD for DSM-5 was higher among women than men, and prevalence increased with multiple traumatic event exposure (6).
National estimates of PTSD prevalence suggest that DSM-5 rates were slightly lower than DSM-IV (6). Discordant findings in diagnostic prevalence were attributable to three major changes in the DSM-5 criteria for PTSD:
The revision of Criterion A1 in DSM-5 narrowed qualifying traumatic events such that the unexpected death of family or a close friend due to natural causes is no longer included. Research suggests this is the greatest contributor (>50%) to discrepancy for meeting DSM-IV but not DSM-5 PTSD criteria.
Splitting DSM-IV Criterion C into two criteria in DSM-5 now requires that a PTSD diagnosis must include at least one avoidance symptom.
Criterion A2, response to traumatic event involved intense fear, hopelessness, or horror, was removed from DSM-5.