Suicide seems to be a hot topic in my practice lately. And, not surprisingly, talk of suicide is never a light or inconsequential matter. Rather, it means there is a serious problem afoot and the person in front of you is suffering extreme distress.

Since I’ve realized that many of the people who are talking about suicide often have misinformation or no information about suicide, I wanted to set things straight.

Suicide is the 11th leading cause of death in the nation, but the third leading cause among those 15-24. And although more women attempt it, guys are four times more likely to die from it. That’s because guys tend to use more lethal means, like guns or suffocation, whereas women tend toward pills or poisons.

Matters get worse if you are one of the LGB variety (especially in high school). LGB high schoolers are three times more likely than their straight peers to have considered suicide in the last year. LGB high schoolers are also over three times more likely to have attempted suicide in the last year, and are twice as likely as straight peers to have attempted suicide altogether.

For our transgender brothers and sisters, things get even rougher. One study found that 30 percent of transgender individuals surveyed reported having attempted suicide. (The national rate is 4.6 percent reporting to have attempted.)

Stigma, shame and prejudice are all thought to play significant roles in the increases. The behavioral manifestations of bullying, family rejection and physical, emotional and even sexual abuse can significantly worsen matters, whereas family connectedness, caring adults and school safety serve as protective factors for LGBT individuals.

There are many myths commonly associated with suicide—for instance, talking about suicide will trigger someone to act. Wow, is this wrong! Not talking about it is more likely to lead to a completed suicide than talking about it. So, if you suspect, ask. If they flip their wig, too bad. But most who are seriously thinking about it will be relieved that they do not have to keep their suffering secret. Keep calm, listen and work with them to get to a professional who can help them find a better way to ease their suffering.

Some think that if they ignore signs of depression it will pass. Nope. Maybe the immediate threat may pass, but the problem remains. The truth is that most people who die by suicide have a mental illness and/or a substance use disorder. Their suffering precedes their desire to die. Suicidal thoughts are like the tip of an iceberg, and anyone who has seen Titanic knows how dangerous those can be.

Many feel that it gets better as we get older, but just because I gave you bigger youth statistics doesn’t mean it gets better with age. Though the suicide rate for women declines after age 60 (after peaking in middle adulthood ages 45-49), the rate for men goes back up—especially for the white oldsters. In fact, white men over 85 have the highest rate of suicide of any group, regardless of age, gender or race. I am sure having a culture that reinforces fierce independence and not discussing one’s problems has something to do with it.

One of the most common misconceptions is that people commit suicide to hurt others. This is rarely, if ever, the case. People who commit suicide are generally not thinking about the harm they are about to do to those around them. If they do, they minimize it (see the next one). Two-thirds of those who commit suicide are depressed. And being depressed is like being behind a thick fog. They cannot see the effect they are having or will have on others.

“Everyone will be better off.” This is one that folks who desire suicide often say. Psychologist Thomas Joiner has a theory that people will desire suicide when they hold two beliefs in their heads long enough: 1) I am a burden, and 2) I do not belong. Holding these two beliefs are like mixing fire and gasoline. If you hear someone saying that while talking about suicide, you need to give that person an emotional slap in the face. Grab them by the shoulders, look them in the eyes and tell them how devastated you would be if they took their own life. And, that you would never fully get over it. And you never do.

I think so many of us keep hearing that things are getting better for the LBGT community. And with increasing rights and acceptance, they seem to be. But just because things are better doesn’t mean everything is fine.

If you know someone who is talking about suicide, take all threats seriously. This is not a test. Threats are rarely bids for attention and are often followed by serious attempts.

Get that person help. Get them to a professional pronto. I list some hotlines that are especially helpful below.

Create a safe environment. Get rid of firearms, lethal medications and other means that could be used to kill oneself.

If you are someone who is considering suicide, get help. Your suffering is the problem, not your living. Suffering can be healed. Death cannot. Human beings are social animals and do better with the assistance of others. Tell someone.

Think about the consequences. I understand you are thinking about the ending of your suffering. But you are obviously not aware of the psychological and emotional trauma that you will leave behind. There is no way to avoid it. Suicide is like a bomb that goes off, spewing shrapnel into everyone around it. Your suffering will now be carried by many others and for years and years to come.

Call one of these hotlines: Trevor Lifeline: (866) 488-7386.

Specifically for the LGBTQ folks, Suicide Hotline: (877) 727-4747

Spanish-Speaking Suicide Hotline: (800) SUICIDA (784-2432)

Access to L.A. County Mental Health: (800) 854-7771

All of these hotlines are available 24 hours a day/seven days per week.

P.S. All of my factoids are from the American Association of Suicidology at suicidology.org. Also check out The Trevor Project at TheTrevorProject.org.