Bipolar Disorder is characterized by extreme mood swings between manic highs and depressive lows. In some instances, the intense sadness and hopelessness of the depressive phase may be so severe that the risk of self-injury and suicide become extremely high. It's believed that people affected by Bipolar Disorder are more likely to attempt suicide than those suffering from regular depression, especially those who have frequent depressive episodes, mixed episodes, early onset of the illness, or history of abusing drugs or alcohol. Bipolar depression is associated with reduced levels of brain chemicals called neurotransmitters, particularly serotonin, norepinephrine and dopamine-which regulate mood. This chemical imbalance is believed to contribute to the emotional and physical pain sufferers often experience. Suicide is an especially grave risk for bipolar depression sufferers. It's estimated that 25 to 50 percent of sufferers attempt suicide and approximately 15 percent succeed. As a result, it's extremely important to know the warning signs. Indicators that a person may be contemplating suicide include: preoccupation with death or dying, talking or joking about suicide, giving away prized possessions and visiting or calling people in a way that that appears to be saying goodbye. Other risk factors include deepening depression, previous suicide threats, recent death of a loved one, separation or divorce, hoarding pills or possessing a firearm. Research suggests heightened risk during the early stages of the illness, so any talk of suicide should be taken seriously. Never leave a suicidal person alone or construe a suicide threat as a bid for attention. In some cases, a bipolar depression sufferer may unexpectedly switch from extreme sadness to suddenly appearing happy and calm. This sudden lift in spirits is rarely a change for the positive and may actually be the precursor to suicide, signaling he's decided to end his life. Suicide risk may be heightened if sufferers attempt to cope with feelings of despair by "self-medicating" with alcohol or drugs, which can impair judgment, reduce effectiveness of medication and heighten impulsiveness. Self-injury, like cutting or burning, may also serve as a way to cope with troubling emotions like guilt, anger, anxiety and hopelessness, or serve as a cry for help. Regardless of the intent, self-injury is always serious and may leave deep scars, physically and emotionally. Some studies suggest serious suicidal intent may be present in up to 15 percent of people who use self-injury as a coping mechanism. Warning signs of self-injury include unexplained, frequent cuts or burns, wearing long sleeves even in warm weather, low self-esteem, and poor functioning at home, school or work.If you or someone you know suffers from bipolar disorder and may be considering suicide or self-injury, please get help immediately.