The largest number of suicides in Summit County involve middle-age men and elderly people, said Barb Medlock, suicide hot­line coordinator for Portage Path Behavioral Health.

Suicides occur all year and don’t go up around the holidays, despite what some people think, she said.

Sometimes people thinking about suicide will show signs, like changes in appetite, sleep or energy levels at work or home; other times, they don’t show any warning signs, Medlock said.

“They’re kind of on a roller coaster,” she said. “They can have really good days and really bad days in struggling with how they’re going to manage the pain.”

It’s OK to ask people if they’re struggling or even ask if they’re thinking of suicide, she said.

“You can’t do any damage by asking somebody. If you’re worried, your gut is telling you something,” Medlock said.

Here are some warning signs of suicide and what you can do to help, provided by the National Suicide Prevention Lifeline:

Warnings signs

• Talking about wanting to die or to kill themselves.

• Looking for a way to kill themselves, like searching online or buying a gun.

• Talking about feeling hopeless or having no reason to live.

• Talking about feeling trapped or in unbearable pain.

• Talking about being a burden to others.

• Increasing the use of alcohol or drugs.

• Acting anxious or agitated; behaving recklessly.

• Sleeping too little or too much.

• Withdrawing or isolating themselves.

• Showing rage or talking about seeking revenge.

• Exhibiting extreme mood swings.

What to do

• Do not leave the person alone.

• Remove any firearms, alcohol, drugs or sharp objects.

• Call the National Suicide Prevention Lifeline at 800-273-TALK (8255), or locally, Portage Path’s Support Hotline at 330-434-9144 or text Text 4HOPE to 741741.

• Take the person to the emergency department or seek help from a medical or mental health professional.

Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ.