Suicidal Ideation

What is suicidal ideation?

Suicidal ideation involves thinking about, imagining, or planning suicide. Suicidal thoughts can range from a detailed suicide plan (active suicidal ideation) to fleeting considerations of suicide (passive suicidal ideation). Suicidal ideation does not include the final act of suicide.

Suicidal ideation is common, and many people experience suicidal thoughts combined with stress, depression, or other mental health problems. In most cases, suicidal thoughts are temporary and can be treated, but sometimes, they place an individual at risk for attempting or completing suicide.

How common is suicidal ideation?

According to the CDC, suicide rates have increased by 30% since 1999, with nearly 45,000 lives lost to suicide in 2016. In an international survey by the World Health Organization, about 2% of people surveyed experienced suicidal thoughts at least once in the past year. In a United States national survey, about 4.3% of adults reported having suicidal thoughts.

A longitudinal study found that rates of suicide and the prevalence of suicidal ideation were higher among women, young people, people with low levels of education, and people diagnosed with a mental health condition.

What causes suicidal ideation?

Suicidal ideation can happen in a wide range of situations, and it does not have a clear cause. Instead, suicidal ideation usually arises from a combination of different mental health stresses and risk factors.

According to the American Psychiatric Association, common risk factors for suicidal ideation include:

• Family history of suicide, substance abuse, or psychiatric disorders
• Alcohol use, drug use, or other substance use
• Previous suicide attempts
• Childhood or adolescent experiences of abuse
• Feelings of loneliness or isolation
• Prolonged stress, such as high school bullying, unemployment, or financial issues
• Stressful life events, such as the death of a family member
• Serving in the military
• LGBTQ+ identity

Also, individuals with the following mental health conditions face a higher risk of suicidal ideation:

• Mood disorders, such as major depression and bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Anxiety disorder
• Borderline personality disorder
• Substance use disorder
• Schizophrenia

What are the warning signs of suicidal ideation?

Someone who is experiencing suicidal ideation may show the following signs or symptoms:

• Mood swings or sudden improvement in mood
• Preoccupations with violence, dying, or death
• Experiencing depression, anxiety, or impaired concentration
• Changes in personality, routine, or eating/sleeping patterns

According to the National Alliance on Mental Illness (NAMI), suicidal behaviors are a psychiatric emergency and indicate a high risk of suicide. If your loved one takes any of the following steps, seek help from a medical professional or call 911:

• Engaging in risky behavior, such as substance use or reckless driving
• Getting affairs in order and giving things away
• Searching for a means of suicide, such as a gun or drugs

Individuals struggling with suicidal ideation often keep their suicidal thoughts and feelings a secret. They show no indication that anything is wrong, making it difficult to assess an individual’s risk of suicide accurately. According to an emergency room report, patients who attempt suicide often fail to report suicidal ideation due to stigma and fear of judgment.

If you believe a loved one is experiencing thoughts of suicide, the following suicide prevention tips can help someone going through a mental health crisis.

• Ask them if they’re thinking about suicide.
• Keep them safe by removing means of dying by suicide and staying nearby.
• Listen to them and be there for them.
• Encourage them to call a helpline or contact a mental health professional.
• Follow up with them after the mental health crisis has passed to reduce the risk of a recurrence.

What should you do if you’re having thoughts of suicide?

If you or a loved one is having thoughts of suicide, seeking help is critical. If you’re in a life-threatening situation or experiencing a mental health crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255, the NAMI Helpline at 1-800-950-NAMI (6264), or 911.

If you’re experiencing passive suicidal ideation and do not plan to follow through with your suicidal thoughts, the following resources can help.

• Therapy: Suicidal ideation can be a symptom of a wide range of mental disorders, such as major depression or bipolar disorder. If you’re not sure where to start, visiting your general practitioner, psychiatrist, or therapist can help you create a treatment plan. Your doctor can prescribe medication such as tricyclic antidepressants to treat underlying mental health problems.

• Reach out for support: Expressing your feelings with family members and friends can help you build a powerful support system. If you don’t think your friends and family will understand, joining a support group like NAMI Homefront, NAMI Peer-to-Peer, or NAMI Connection can allow you to share your experience and gain support.

• Make a safety plan: Whether alone, with your therapist, or with loved ones, creating a safety plan or no-harm contract can help you keep yourself safe. Your safety plan should identify triggers, list coping strategies, and make note of people you can reach out to during a mental health crisis.

• Focus on self-care: Taking care of your physical health and mental health can help reduce suicidal ideation. Aim to prioritize daily habits like healthy eating, physical activity, and getting enough sleep. Try making a plan with a friend or family member to foster healthy behaviors together.

• Practice mindfulness techniques: Meditation and mindfulness practices can help you relax and manage negative emotions like stress and anxiety. The NAMI Hearts and Minds educational program promotes sound mind and body practices among individuals with mental illnesses.

What should you look for in a therapist?

If you’re experiencing suicidal ideation, the most important thing is to seek treatment immediately from a clinician or mental health professional. Suicidal ideation can be dangerous, and getting the support you need can significantly improve your mental health.

It’s important to work with a mental health professional that you feel comfortable with and who supports your mental health needs moving forward. Suicidal ideation can not only reduce your quality of life, but it can also increase your suicide risk, especially when it’s the symptom of a mental health disorder.

If you’re struggling with suicidal thoughts, consider using WithTherapy to find a therapist. WithTherapy connects each patient to a personalized shortlist of mental health professionals and uses science and research to match your personal preferences.

We’ll connect you with a therapist you feel comfortable with, regardless of your preferences and requirements. Working with a mental health expert can help you manage negative emotions, develop coping strategies, and improve your overall mental health.

Find a Therapist to Help With Suicidal Ideation