Acute Suicidal Affective Disturbance (ASAD) is a suicide-specific, episodic clinical entity that is theorized to characterize acute suicide risk. Little work has examined the role of ASAD in mental health conditions linked to suicide risk. Thus, the current study examined whether depression, social anxiety, panic, and alcohol-related problems were related to suicide risk via ASAD history. A total of 527 undergraduates completed an online survey. Depression, social anxiety, and alcohol problem risk (but not panic) were robustly, significantly related to suicide risk, but only social anxiety and depression were robustly related to ASAD history. Depression and social anxiety symptoms were indirectly related to suicide risk via ASAD. ASAD may serve as a potential explanatory pathway through which some mental health conditions may lead to greater suicide risk.