The most unexpected sign of mental health issues is that someone appears joyful and relaxed, suggesting they has made a decision to die by suicide. This may be due to relief over the idea that they won't be in pain longer and the fact they can stop debating their decision with themselves. However, it is also possible that someone may mask their feelings to protect loved ones and mental health providers. The difference between mania and suicidality is noted for other signs such as grandiosity or self-importance. If someone's sudden happy or carefree behavior increases without explanation, it's an indication to inquire further and ask directly about thoughts of suicide.