Suicide grimly reaped an average of 100 Americans each day over the past year. More than double the number of homicides reported each year and the third leading cause of death, suicide knows no boundaries. Suicide claims the rich, the poor, young and old, and people of every race and culture.

Last year alone, more than 8 million people thought, planned or attempted suicide. Emergency rooms treated more than 157,000 for self-inflicted injuries and every day thousands more never seek help. It is a paradox of the human race.

Numbers are staggering, yet shame still prevents society from having an open discussion on the subject.

Suicide is on the rise for active duty military, veterans, gays and lesbians, and college-age males—the highest rate seen in 15 years. Most suicides occur in an age range from 15 to 24. San Diego County’s Medical Examiner’s Office recorded 392 suicides in 2011 and the number is expected to rise pending investigations. This is the highest total in 23 years.

In July, a Time report on suicide among service members read, “Active-duty U.S. troops die by their own hand at the rate of one a day. Among all veterans, the rate is one every 80 minutes.”

War, bullying, abuse, neglect and antidepressant medications are cited as causes of suicide. In most cases there are obvious changes in behavior that, if recognized, could have saved a life.

A suicide prevention organization called It’s Up to Us San Diego provides a valuable resource on the signs of possible suicide and sound advice on beginning the conversation that no one wants to have. Some of the general symptoms are drastic mood swings, long-lasting sadness and irritability, social withdrawal, inability to cope with everyday problems and substance abuse.

With all of its ups and downs, catastrophes and triumphs, successes and failures, life is worth living. No one should feel completely alone and hopeless. Help is out there for those brave enough to seek it.

Suicidal men and women are not alone. There are people who care.

Choose life, whether it be for yourself or for someone you love. Understanding, compassion, love, empathy and courage can save a life.

Close friends and family with concerns must take the extra step to let depressed persons kow they are not alone and guide them to the help they need.

Reach out. It is up to us.

Local Suicide Prevention Action Plan-www.Up2SD.org

Suicide Crisis Hotline-(888)-724-7240

Youth Talk Line-(877)-450-LINE (5463)

Active Duty and Veteran’s Courage to Call-2-1-1

VA’s Suicide Hotline-(800)-273-TALK (8255)