Exam week is upon Grand Valley State University, and with an excess purchase of caffeine for all-nighters comes a large influx of stress – and a jump in people visiting the University Counseling Center.

“The reality of the struggle and stress of academics all hits at the same time,” said Eric Klingensmith, assistant director for the center. “So we do see an increase in clients and crises at certain times in the semester.”

But some students’ struggles aren’t confined to exam week.

While many work through stress throughout the semester, some students also struggle with depression and thoughts of suicide. Christy Buck, executive director of the Mental Health Foundation of West Michigan, said suicide is the second leading cause of death among college students.

It is surpassed only by accidental deaths, which include overdoses and drinking and driving deaths, some of which might be linked to depression and anxiety. However, some experts suspect that suicide may be the first leading cause of death, not second.

“Sometimes it’s hard to tell if something was a suicide,” Klingensmith said. “Unless you have key evidence that says it was a suicide, sometimes they have to rule it as an accident.”

This semester at GVSU, there have been 18 instances of suicidal ideation, intent or attempt, said Capt. Brandon DeHaan, assistant director of the Department of Public Safety.

“There are a number of stressors in college, including academics, relationships and changes in environment,” DeHaan said.

Suicide is usually not the result of a single factor or event, such as failing an exam, according to the World Health Organization’s Department of Mental Health and Substance Abuse. Mental disorders, such as depression and substance use disorders, may influence a person’s ability to cope with various life stressors. However, single events can serve as triggers for suicidal thoughts in people with these disorders.

“For most people, suicidal thoughts exist for a short period of time,” Klingensmith said. “Things are building, they hit a peak, they have those thoughts, and then once that stressor is either relieved, or they get support, then those feelings go away.”

The most important thing is for others to recognize the warning signs and to ask questions, he said.

“People thinking about suicide may not want to talk because they think their friends will be scared or they’re afraid they’ll be locked up just because they’re having some thoughts,” Klingensmith said.

There is a common myth that talking about suicide may give a person the idea.

“Talking about suicide is not going to put the idea into someone’s head,” Buck said. “It’s already there. Opening up a conversation can actually help someone. We need to continue to talk about this.”

Klingensmith said at least 70 percent of all people committing suicide give some clue as to their intentions before they make an attempt.

People thinking about suicide may withdraw from friends and family, change eating or sleeping patterns, or lose interest in activities or relationships. Often they will give away prized possessions.

A sudden lift in spirits can also be a danger signal, as it could indicate the person is relieved about making the decision to commit suicide. Other signs include frequently skipping class or work and increased use of alcohol or other drugs.

Throughout the semester the University Counseling Center offers a free training session – “Question, Persuade, Refer” – to students, faculty and staff. The training teaches people the QPR method of suicide prevention and how to ask the question, “Are you thinking about suicide?”

The center has locations on the Allendale, Pew and Meijer campuses. If there is an emergency, students can walk in during regular office hours. After hours, students can contact housing staff or the Grand Valley Police Department if they are on campus. Off-campus students should call 911.

“Calling the police is not getting someone in trouble. It’s getting someone some help,” Klingensmith said. “A lot of people think that suicide is a crime, and a long time ago there were places that it was a crime. We’re trying to take that stigma away from it. It’s someone who needs help, not someone who needs to be criminalized.”