Depression, which affects nearly 19 million Americans annually, is also the leading cause of suicide. While not everyone with depression becomes suicidal, more than 60 percent of suicidal people suffer from depression. Depression is a serious medical illness characterized by feelings of persistent sadness, hopelessness and loss of interest in normal activities. These feelings may result in depression going untreated because sufferers may be unable to realize they need help, or think they can't be helped. Depression is associated with reduced levels of brain chemicals called neurotransmitters, particularly serotonin, and to a lesser degree, norepinephrine, which play an important role in regulating mood. This chemical imbalance contributes to the emotional and physical pain often experienced by depression sufferers. Studies show that most people who suffer from depression and attempt suicide don't WANT to die. Instead, they may see suicide as the only way to end their pain. If you think you may be depressed, or know someone who is, it's important to know depression can be treated effectively, typically through a combination of medication and psychotherapy. People DO get better! It's also important to know the risk factors for suicide. According to the American Foundation for Suicide Prevention, up to 50 percent of people who complete suicide made a prior attempt to take their own life. People suffering from depression often "self-medicate" with alcohol or drugs, which can impair judgment, heighten impulsiveness and increase suicide risk. Other risk factors include previous suicide threats, recent death of a loved one, a separation or divorce, or possession of a firearm. Family history also figures prominently in suicide risk, especially if there's a history of a depressive disorder, suicide, or physical or sexual abuse. Teens who suffer from depression are also at increased risk for suicide when alcohol and drug use is involved. Other risk factors in youth are reckless, aggressive or disruptive behaviors. There also are a number of warning signs that may indicate a person is planning suicide: preoccupation with death or dying; talking or joking about suicide; giving away prized possessions; and visiting or calling people in a manner that appears to be saying goodbye. In some cases, depression sufferers may unexpectedly switch from being very sad to suddenly appearing to be happy and calm. However, this sudden lift in spirits may actually be a precursor to suicide, signaling they've made the decision to end their life. ANY TALK OF SUICIDE should be taken seriously. It would be a mistake to leave a suicidal person alone, or construe a suicide threat as a bid for attention. Studies show 70 percent of people who complete suicide tell someone on advance. If you find yourself with a person who's contemplating suicide, listen and let them know you care. Don't try to argue them out of their decision, but do offer to go with them to get help. If you are considering suicide, PLEASE let someone help you, and KNOW that there's treatment available that will help you feel good about life again. If you or someone you know is considering suicide, please get professional immediately.