Suicidal ideation
Learning that a loved one is thinking about suicide can be scary. While we must take these thoughts seriously and take action in finding the appropriate treatment, it’s important to understand the difference between suicidal ideation and suicidal intent.
Suicidal ideation
Suicidal ideation is simply having thoughts about suicide, while suicidal intent indicates a clear plan and desire to complete suicide. If someone you know is exhibiting signs of either, it’s vital to get them professional help immediately.
This can range from a casual thought such as “I wish I were dead” to more detailed fantasies or thoughts about how they die, what life would be like for people without them, and what their legacy would be.
As “recurrent thoughts that are focused on active plans to kill oneself.”
Suicidal intent
Refers to a clear desire and plan to complete suicide. This may be accompanied by specific steps taken to prepare for suicide, such as obtaining the means to do so, writing goodbye letters, or making final arrangements. That “the person must have made active preparations for death (e.g., collecting pills, buying a gun, researching methods).” It’s important to remember that suicidal ideation and intent can be fluid; someone who is only thinking about suicide may develop intent, and vice versa.
Fortunately, the majority of ideators globally will never attempt suicide, and fewer will use lethal means that result in death. Studies have shown that 2 – 3% of individuals who experience Suicidal ideation will go on to die by suicidal intention. This does not mean that suicidal ideation should be ignored or taken lightly. The ideation will convert into intent and the intent will leads to commit it.
Learn Little more about the timing sense
The intent will be executed within seconds in so many cases. A Second can be Split into possibly A second, millisecond, microsecond, and nanosecond are all units of time. A second is the smallest unit of time that is commonly used on clocks and watches.
Explanation
Second: The smallest unit of time commonly used on clocks and watches
Millisecond: One-thousandth of a second, written as ms or msec
Microsecond: One-millionth of a second, written as μs (Greek letter mu plus s)
Nanosecond: One-billionth of a second, written as ns
Other units of time include:
Picosecond: One-trillionth of a second, written as ps
Femtosecond: One-quadrillionth of a second, written as fs
Attosecond: One-quintillionth of a second
Zeptosecond: One sextillionth of a second, written as zs
In the Suicidal intent of a second can be split into 4 equal portions as D,E,F & G.
D for Decision as a Primary portion.
E for Execution followed by Primary Portion.
F for Finishing, can be considered as Done.
G for Gone.
Signs of suicidal intent
In addition to the signs of suicidal ideation, there are several warning signs that someone may be planning to attempt suicide. These include making final arrangements such as writing a will, putting affairs in order, or giving away possessions; expressing a sense of calm or peace after making plans; and increasing drug or alcohol abuse.
Forms of suicidal ideation
There are two forms of suicidal ideation. These can look and feel different for each person who experiences it.
Active and Passive Suicidal ideation
Passive suicidal ideation
Suicidal thoughts occur without any desire to make a plan of action to harm yourself.
Active suicidal ideation
Suicidal thoughts motivate you to create an action plan of self-harm. When a plan is in place, you may feel at ease or withdrawn. Warning signs of suicide, like giving away valued belongings and writing a note, may occur. This usually requires emergency treatment.
Suicidal ideation always prevalent
Suicidal ideation is not uncommon
Older adults and suicide
11.83% of young adults aged 18-25.
18.8% of high school students.
42% of LGBTQ youth.
52% of LGBTQ youth that identify as non-binary or transgender.
It is estimated by the Center for Disease Control and Prevention (CDC) that in 2017 there were approximately 10 million people in the USA who experienced suicidal thoughts.
This means that suicidal ideation is actually quite common and does not necessarily indicate that a person is in danger of harming themselves.
It is estimated that in 2017 there were 1.4 million suicide attempts in the USA.
Causes of Suicidal Ideation
There are many possible causes of suicidal ideation. Sometimes, there isn’t a single identifiable cause or there could be several things that contribute to suicidal thoughts.
Biological factors (genetics, brain development).
Demographics (like age, education, employment and socioeconomic status).
Interpersonal relationships.
Negative life events.
Sexual orientation and/or gender identity.
Stress.
Substance use disorder.
An underlying mental health condition, such as depression, anxiety or psychosis.
Symptoms of Suicidal ideation
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.
Signs of suicidal ideation
There are several warning signs that someone may be experiencing suicidal thoughts.
These include expressing feelings of hopelessness or being a burden to others, talking about wanting to die or hurt oneself, withdrawing from friends and activities, expressing unusual anger or rage, and giving away prized possessions.
If you are worried that someone you know is exhibiting signs of suicidal ideation or intent, it’s important to get them professional help immediately. Suicide is a preventable problem, but it requires intervention from trained professionals to ensure the safety of those at risk.
Diagnosis of suicidal ideation
A healthcare provider or mental health professional will diagnose suicidal ideation after asking you a series of questions to learn more about your thoughts of suicide.
While there are several types of suicidal ideation assessments and questionnaires, there isn’t a specific suicidal ideation test to predict whether you’re going to harm yourself. The goal of a diagnosis is to help your provider learn more about what’s going on, including the cause of the suicidal ideation, so they can help you treat it.
Suicidal ideation scale
There are several types of suicidal ideation scales available to help a healthcare provider learn more about how suicidal ideation affects you and its severity. To do this, your provider will ask you several “yes” or “no” questions.
For example, questions on the Columbia-Suicide Severity Rating Scale (C-SSRS)
Have you wished you were dead or wanted to go to sleep and not wake up?
Have you had any thoughts about killing yourself?
Do you have a plan in place to kill yourself?
Have you harmed yourself or done anything to fulfill the plan you created (like purchasing a weapon, giving away valuables, writing a note, etc.)?
If a provider asks you questions, it’s important that you answer honestly. They’re looking out for your health and safety, so your truthfulness can open doors to treatment.
Treatment for suicidal ideation
Treatment for suicidal ideation varies based on the severity and likely cause.
One goal of treatment is to keep you safe.
A healthcare provider might recommend one or a combination of the following as treatment for suicidal ideation:
A safety plan that includes coping skills and people to reach out to if suicidal ideation occurs.
Cognitive behavioral therapy or other therapies to strengthen coping skills.
Reach out for help by calling (or texting) emergency services or a crisis line if you’re in danger of acting on your suicidal thoughts.
Reach out to someone you trust. Meet with them or have a conversation. You don’t have to talk about suicide, it helps to be around others who care and listen.
Care can
Participate in an activity you enjoy (or used to enjoy). You may not feel up to participating fully, but activities, even taking a short walk or petting a dog, can offer a positive distraction.
Focus on the moment and getting through the day rather than the future.
Thinking too far ahead can be overwhelming and stressful.
Avoid using substances like alcohol or unprescribed drugs.
If you’re a caretaker for someone who has active suicidal ideation, make sure to remove any items or objects from their living space that could cause harm, including weapons or unprescribed medications.
If you’re on the receiving end of treatment, know that your caretakers are not taking away your property they are relocating items until you’re safe enough to have them in your possession.
Importance of professional help if someone you know exhibits either of these signs
Only 31% of those who complete suicide receive mental health services in the year prior to their suicide.
If someone you know is exhibiting signs of suicidal ideation or intent, it’s important to get them professional help immediately.
Suicide is a preventable problem, but it requires intervention from trained professionals to ensure the safety of those at risk.
Early intervention can make all the difference in helping prevent suicide.
If you or a loved one requires immediate support, please dial Specific help line to reach the nationwide Suicide Prevention Lifeline. Such as https://icallhelpline.org/
Healthcare provider (a primary care physician) and/or a mental health professional (a therapist, psychologist or psychiatrist) can treat suicidal ideation and its causes.
Support from your friends, family and community can help in the long term.
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A light on Practice of Medicine (The information provided is for informational and educational purposes only and should not be considered professional advice)
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