Understanding Suicidal Ideation: Signs, Causes, And Mental Health Support Options
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-HELP (4357)
Suicidal ideation, or having suicidal thoughts, can be a painful experience that affects people of various ages and backgrounds. Although it can feel isolating, it may be more common than many realize. For people who experience suicidal ideation, suicidal thoughts are not a sign of weakness or failure but can be an indication of overwhelming stress, untreated mental health conditions, or emotional pain.
The first step to managing suicidal ideations may be to understand and acknowledge the signs, symptoms, and suicide risk factors. Building a support network and knowing where to go for help or mental health services can reduce suicidal thoughts and improve overall mental well-being. In this article, we will examine the signs and symptoms of suicidal ideation and explore strategies to treat or manage these thoughts.
What is suicidal ideation?
Suicidal ideation refers to thinking about, considering, or planning suicide. These thoughts can range from fleeting moments of wishing life were different to more persistent thoughts about ending a person’s own life. Not all suicidal thoughts lead to suicide attempts or suicidal behavior; however, it could be important to treat all suicidal ideation seriously.
Types of suicidal ideation
Suicidal ideation can generally be divided into two categories: passive suicidal ideation and active suicidal ideation. Passive suicidal ideation is when a person wishes they were no longer alive or feels that others would be better off without them. A person experiencing passive suicidal ideation does not actively plan to harm themselves. Active suicidal ideation occurs when a person has specific thoughts, intentions, or plans to end their life.
Prevalence of suicidal thoughts
Suicidal thoughts and ideation are relatively prevalent, with 5.0% of all adults reporting that they have had thoughts about suicide in 2023. Young adults may experience suicidal ideation more frequently, with 12.2% of adults between the ages of 18 and 25 reporting that they have had suicidal thoughts. It is also possible that these numbers underestimate the true prevalence of suicidal ideation due to societal stigma, shame, and fear of consequences.
Common signs and indicators
People experiencing suicidal ideation may hide or minimize their feelings and emotions, which can sometimes make it challenging to recognize suicidal thoughts. However, there are warning signs that may suggest someone is experiencing these thoughts. Being aware of the signs and indicators of suicidal ideation can make it easier to provide timely support and intervention.
Indicators may differ from person to person, but some common signs may include:
- Expressing hopelessness or helplessness–Talking about having no reason to live, feeling trapped, or believing things will never get better
- Withdrawal and social isolation–Pulling away from friends and family members or avoiding activities that once brought joy or connection
- Changes in mood or behavior–Noticeable shifts in mood, including irritability, extreme sadness, or reckless behaviors
- Talking or writing about death–Openly mentioning wanting to die, posting concerning messages on social media, or frequently bringing up themes of death in daily life can all be signs of suicidal ideation.
- Giving away belongings–A person experiencing suicidal ideation may take steps to prepare for death, such as giving away personal possessions or writing goodbye letters.
Potential causes and risk factors
Understanding underlying causes and risk factors can help predict suicidal ideation. Causes and risk factors may vary depending on the individual and their unique situation.
Mental health conditions
People living with a mental illness or mental health condition may be more likely to experience suicidal ideation. Conditions that can cause suicidal ideation may include the following:
- Depressive disorders–Major depressive disorder may be one of the strongest indicators of suicidal ideation. Persistent feelings of sadness and hopelessness may fuel these thoughts.
- Schizophrenia or schizoaffective disorder–Delusions, hallucinations, and loss of reality testing can lead to suicidal thoughts.
- Anxiety disorders–Anxiety disorders can cause persistent and ongoing distress, which can sometimes lead to suicidal ideation.
- Bipolar disorder–Both depressive episodes and the aftermath of manic episodes can involve increased suicide risk.
- Borderline personality disorder–Suicidal thoughts and self-harming behaviors may be common symptoms among those with borderline personality disorder, often related to intense emotional pain and fear of abandonment.
Added risk from life stressors
In addition to mental health conditions, there may be an added risk of suicidal thoughts during periods of stress. Stressful life events, such as ending a marriage, academic or work-related pressure, or major life transitions, can feel overwhelming. These events can create feelings of hopelessness, shame, or feeling trapped, which may be linked to suicidal thoughts.
Trauma and loss
Trauma can make it challenging to cope with daily life and, when left unaddressed, may cause suicidal thoughts. Some common forms of trauma that may cause suicidal ideation include:
- Childhood trauma
- Domestic violence
- Sexual assault
- Surviving natural disasters or accidents
- Combat trauma
In addition to trauma, loss can also cause suicidal thoughts. This could include bereavement after the death of a loved one or the loss of a job, relationship, or general stability. Loss can lead to feelings of guilt or self-blame, sadness, and hopelessness, which may be linked to suicidal thoughts.
Coping strategies for individuals experiencing suicidal thoughts
It may be helpful to have some coping strategies to manage suicidal thoughts when they occur, especially if professional help is not available. One strategy may be to develop a safety plan. This plan can include warning signs that tell you a crisis is building alongside healthy distractions you can use to reduce suicidal thoughts. The plan may also list people or hotlines that you can call for support.
Another way to cope with and reduce suicidal thoughts is to practice grounding and mindfulness techniques. Grounding techniques, like naming five things you can see, four you feel, three you hear, two you smell, and one you taste, can center the mind in the present and help calm the body. Other mindfulness practices may include deep breathing or mindful observation, which can help focus attention and calm racing thoughts.
Developing a strong support network
Another strategy that can help reduce suicidal ideation may be to develop a strong support network. Human connection may provide comfort and a sense of belonging, which may reduce feelings of isolation and hopelessness. A support network does not need to be large, but it might help if it’s dependable and diverse.
To start developing a support network, you may identify trusted people in your life. These could include close friends, family members, faith leaders, mentors, and peers in support groups. During times of increased stress or anxiety, you can reach out to these people and communicate how they can support you.
Suicide prevention strategies for loved ones
It may be important to note that not all people experiencing suicidal thoughts have attempted suicide or will in the future; however, it may be best to take all warning signs seriously and provide support for suicide prevention. Supporting a loved one who may be experiencing suicidal thoughts can feel overwhelming, and having a plan can help.
Recognizing warning signs early on
Loved ones may want to be alert to changes in behavior, mood, or habits that may signal increased risk, such as:
- Talking about being a burden or wanting to die
- Withdrawing from friends and family
- Giving away possessions
- Changes in sleep or appetite
- Increased use of alcohol or drugs
Encouraging professional support
Loved ones do not have to carry the responsibility of support alone. Encouraging your loved one to seek professional support through a therapist, support group, or crisis hotline can be a good way to connect them to the help they need. Offering to help with practical steps like setting an appointment, giving them a ride, or sitting with them during a call can reduce stress and anxiety and may increase accountability.
Treatment and support options from a mental health professional
Connecting with a mental health professional can be an important part of treating suicidal ideation. Therapists and counselors may have specific training in reducing and managing suicidal thoughts. A professional may incorporate a variety of strategies and techniques, including therapeutic approaches, medication, and mindfulness techniques.
Therapy approaches
A therapist can evaluate, treat, and provide ongoing support for people experiencing suicidal thoughts. One common technique for reducing suicidal ideation is cognitive behavioral therapy (CBT). With CBT, a therapist can help a person identify and restructure negative thought patterns associated with suicidal ideation. Therapists may also use mindfulness and emotional regulation techniques to calm the mind and body.
Medication
In some cases, doctors may prescribe medication to reduce symptoms of mental health conditions that may contribute to suicidal thoughts. These can include antidepressant and anti-anxiety medications that can reduce depression and anxiety.
Crisis and suicide prevention support
A mental health professional can help those experiencing suicidal thoughts and provide suicide prevention support. During times of crisis, a therapist can conduct an immediate risk assessment and provide a non-judgmental space to talk about feelings. They may also connect individuals with emergency support and care options.
The role of online therapy
Online therapy can be an effective way to reduce suicidal ideation and manage suicidal thoughts. In a virtual environment, therapists can implement strategies like CBT and mindfulness practices to reduce anxiety, stress, and depression, which may be linked to suicidal thoughts. Through online therapy, a person may learn coping strategies and techniques to manage these feelings as they occur.
It can be challenging for people who are experiencing suicidal thoughts to attend in-person therapy at a traditional brick-and-mortar office. Online therapy sessions can occur from anywhere with a personal device and an internet connection; however, BetterHelp isn't meant for crisis situations. This means that patients can get the care that they need from a place where they are comfortable.
Takeaway
What are five signs that a person may be depressed and suicidal?
Someone may be depressed and experiencing suicide ideation if they:
- Talk about wanting to die and being a burden to others
- Believe they have no reason to live
- Experience unbearable physical or emotional pain
- Make a suicide plan
- Withdraw from and/or say goodbye to friends
Not everyone who develops suicidal ideation lives with a mental disorder, but many do live with depression or another underlying condition.
What assessments are used for suicidal ideation?
Common assessments that look for suicidal ideation include the Ask Suicide-Screening Questions tool and the Columbia-Suicide Severity Rating Scale. A suicidal ideation scale called the Suicidal Ideation Attribute Scale is sometimes used as well.
What can I do if I have suicidal thoughts?
If you’re having suicidal thoughts, you can call or text the 988 Suicide and Crisis Lifeline for support. It may also be helpful to talk to a loved one or reach out to a therapist if you’re feeling suicidal. The Substance Abuse and Mental Health Services Administration (SAMHSA) has helpful resources as well. Choosing to seek treatment can reduce suicide risk and help you manage any underlying mental disorders.
What are the main causes of suicidal thoughts?
While there isn’t necessarily a leading cause of suicide, the main risk factors for suicidal thoughts include the following:
- Depression, substance use disorder, or another psychiatric disorder
- A history of suicide attempts
- Chronic pain
- A family history of suicide or mental illness
- Exposure to family violence
- Presence of firearms in the home or access to lethal means
- A recent release from jail or prison
While these factors may indicate increased suicide risk, not everyone with these risk factors will go on to attempt suicide. Around half of people who attempt suicide have been diagnosed with a mental disorder, according to psychiatric epidemiology data. In addition, there is a higher prevalence of suicide among men compared to women when looking at suicide rates.
How do you know when you're having suicidal thoughts?
Suicidal thoughts generally refer to thoughts about wishing to die or taking one’s own life. These may be fleeting thoughts, or they may be persistent, intrusive thoughts. Consider reaching out for help from a loved one or a mental health professional if you’re having suicidal thoughts.
How do therapists deal with suicidal ideation?
Different therapists may use different approaches. Some may recommend visiting the emergency room to be admitted into inpatient care. Others may use dialectical behavior therapy (DBT) techniques or recommend working with a psychiatrist to see if taking antidepressants or another form of medication could be helpful.
What questions should I ask someone with suicidal ideation?
The questions you should ask someone experiencing suicidal ideation may vary depending on whether you are a loved one or a mental health professional. Mental health professionals may ask if the individual has a suicide plan, while loved ones may express how much they care about the person and ask how they can be there for them.
Is CBT used for suicidal ideation?
There is a specific type of CBT called cognitive behavioral therapy for suicide prevention (CBT-SP). It can help people develop safety plans and effective coping skills. While it may not always be possible to prevent suicidal ideation, CBT can help individuals manage difficult thoughts and emotions.
How do counselors assess for suicidal ideation?
Counselors may use various suicide risk screening tools to check for suicidal ideation. Questions about suicidal ideation may also be part of assessments for different mental disorders, such as depression.
What is DBT for suicidal ideation?
Dialectical behavior therapy (DBT) can help people manage intense emotions, such as those that often accompany suicidal ideation. DBT centers on four modules: mindfulness, emotional regulation, interpersonal effectiveness, and distress tolerance.
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