MOST PEOPLE think of physical illness when asked about the most common causes of death. But suicide, which is almost always the result of mental illness, is the 11th leading cause of death in the United States.

Among young people between the ages 10 and 24 years of age, suicide is the second leading cause of death.

In actual numbers, 32,637 Americans died by suicide in 2005 and 866 of these deaths occurred in Virginia. It is estimated that for every person who dies by suicide, another 25 people attempt suicide. That's more than 800,000 attempts each year. These numbers are rarely discussed and painful to read. Fortunately, prevention efforts have led to moderate decreases in the rate of suicide in youth (ages 10-24) and the elderly (ages 65 and over) over the past 10 years.

Oct. 8 is National Depression Screening Day. Last night Germanna Community College featured an event on "Depression and Suicide: Lifting the Stigma," which discussed what to do if someone you are close to is considering suicide. But any discussion about suicide and its prevention must address the problem of pain.

When psychological pain is coupled with stress, agitation, hopelessness, or self-hatred, the risk of suicide increases. For some, living has become painfully exhausting and the idea of suicide is viewed as a solution to their suffering. Sadly, too many fail to recognize that other options exist for solving problems and finding relief. They may desperately want to live, but they cannot see other solutions.

Treating depression and other psychological problems is one solution. Effective treatment exists, but unfortunately, the problems often go undetected. People mistakenly assume that children cannot be depressed. Adolescent depression is often wrongly attributed to teenage drama. Depression in the elderly is frequently viewed as a normal part of aging. These are dangerous myths. When psychological pain is suspected, the suffering individual deserves evaluation and treatment by a health care professional.

One path to treatment is identification of risk factors. One way to remember common warning signs of suicide is the mnemonic "IS PATH WARM?"

I--Ideas or thoughts about suicide

S--Substance use

P--Purposelessness and difficulty identifying reasons to live

A--Anxiety, worry, agitation, sleeplessness, or an anxiety disorder