Suicidal thoughts involve a person thinking about ending their own life. However, there is no universally accepted definition of the term “suicidal ideation” in the medical community.
Some people Trusted Source say that suicidal ideation involves actively planning suicide, whereas suicidal thoughts do not necessarily indicate a person has the intention to end their life.
However, others consider planning as a separate category and believe that suicidal thoughts and ideation are the same.
Suicidal ideation is common. In 2020, 12.2 million Trusted Source people in the United States reported seriously thinking about suicide. Of these, around 10% attempted suicide. With support and treatment, though, suicide is preventable.
This article discusses suicidal ideation, including the symptoms, causes, prevention, diagnosis, and treatment.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
Suicide warning signs or suicidal thoughts include:
Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I were dead” or “I wish I hadn’t been born”
Getting the means to take your own life, such as buying a gun or stockpiling pills
Withdrawing from social contact and wanting to be left alone
Having mood swings, such as being emotionally high one day and deeply discouraged the next
Being preoccupied with death, dying or violence
Feeling trapped or hopeless about a situation
Increasing use of alcohol or drugs
Changing normal routine, including eating or sleeping patterns
Doing risky or self-destructive things, such as using drugs or driving recklessly
Giving away belongings or getting affairs in order when there’s no other logical explanation for doing this
Saying goodbye to people as if they won’t be seen again
Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above
Warning signs aren’t always obvious, and they may vary from person to person. Some people make their intentions clear, while others keep suicidal thoughts and feelings secret.
A person who is thinking about or planning suicide may show changes in their speech, feelings, and behaviour.
May talk about
• their feelings of guilt or shame
• being a burden to others
• death
The person may feel
• unbearable emotional pain
• extremely anxious and sad, full of rage, or agitated
• trapped, hopeless, empty, or that there is no reason to live
• severe fluctuations in mood or mood swings
Their behavior may also change
A person contemplating suicide may:
• withdraw from friends or family
• use alcohol or drugs more frequently
• sleep or eat more or less
• take dangerous risks
• research ways to die
• stockpile medications
• make a plan for their suicide
• purchase a gun
• make a will
• give away important possessions or money
• say goodbye
Not everyone who is thinking about suicide shows these warning signs. Sometimes, the signs may be subtle.
Causes of suicidal ideation
Suicidal ideation often does not have a single cause but occurs due to a combination of different life events, thoughts, and feelings.
Risk factors includes Trusted Source:
• depression or other mental health conditions
• a history of suicide attempts
• a family history of suicide, substance misuse, or mental disorders
• chronic pain
• recent release from prison
• exposure to family violence, including sexual or physical abuse
• direct or indirect exposure to others’ suicidal behavior
• the presence of guns in the home
Suicide prevention
Sometimes family members or friends may notice a person has signs of having suicidal thoughts.
• talking calmly with them in private and expressing care
• taking what they say seriously and assuring them that their life matters
• removing dangerous objects, such as guns and drugs, from their reach
• calling for help and staying with them until help arrives
• following up with them after the crisis is over
Diagnosis
The diagnosis of suicidal thoughts or ideation can happen in a number of ways.
If a person is feeling suicidal and makes an appointment to speak with a doctor or therapist, they will have a conversation to determine how severe the symptoms are and whether the person has suicidal intent. This refers to whether a person has an active plan to take their own life.
An array of suicide screening and risk assessment tools are also available for doctors. However, these tools cannot always predict Trusted Source an imminent risk of suicide accurately. For this reason, a face-to-face interview is vital.
A doctor or therapist may also spot signs of suicidal thoughts in other situations, such as in a routine appointment for chronic pain or depression. If a person is seriously unwell or may be a danger to themselves, diagnosis may take place in a mental health center.
Treatment for suicidal ideation
Treatment for suicidal thoughts and actions involves addressing the underlying cause or causes.
Safety planning
Safety planning is a short-term Trusted Source intervention that reduces the likelihood that a person will try to end their life. This approach limits a person’s access to lethal means of suicide by removing weapons, drugs, and poisonous substances from the home.
Safety planning also provides people with contacts and support resources they can use if they are in a crisis.
Psychotherapy
Psychotherapy, or talk therapy, helps people understand how their thoughts, feelings, and experiences impact their mental health. It then helps people work through their emotions and find ways to move forward.
There are many types of psychotherapy. Some popular options include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).
CBT teaches people to identify and, over time, replace unhelpful thoughts that negatively affect their mood with more balanced, realistic alternatives. DBT helps individuals to recognize negative thoughts and learn skills that boost coping methods in unsettling situations.
There are also some specialized versions of CBT for people who have experienced trauma or have other mental health conditions requiring special attention, such as eating disorders or addiction.
Learn about 14 different types of therapy.
Medication
Many people who think about suicide may have a mental health condition, such as anxiety, depression, or a substance use disorder. Medications may help treat the symptoms of these conditions and regulate a person’s mood.There are different medications a doctor could prescribe, depending on the situation and a person’s circumstances.
However, it is also worth noting that some of these drugs can also cause suicidal ideation as a side effect, particularly in adults under the age of 25 Trusted Source. A person should discuss any medications they already take with a doctor to determine whether adding another, or changing the dose, is likely to benefit them.
Ongoing support
People are less likely Trusted Source to take their own life if they receive ongoing support. This may involve easy access to effective mental health care, should a person need it again, as well as frequent follow-up calls from healthcare professionals.
A person’s family, friends, and community also play an important role in ensuring they stay connected with people.
It can help Trusted Source people to focus on the things that give their life meaning and purpose, such as:
looking after a pet, as they provide unconditional love
faith, as many religions promote the sanctity of life
things to look forward to, such as a wedding, graduation, or vacation
long-term plans or goals
Statistics
Suicide was the cause of 45,979 Trusted Source deaths in the U.S. in 2020. This is one death every 11 minutes.
In the same year, approximately 12.2 million people in the country had suicidal thoughts, and 1.2 million attempted suicide.
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