Suicidal ideation is best defined as thoughts of wanting to take your own life or thinking about suicide. Two types of ideations can exist for an individual: active and passive. Experiencing active suicidal ideation are not only the thoughts, but also having the intent to commit suicide with a plan included for oneself. Passive suicidal ideation occurs for an individual when you wish you were dead or having thoughts of not wanting to live with an intent or plan not involved. Suicidal ideation can be critical criteria for both major depression and depression that is found in bipolar disorder. Individuals who suffer from serious mental illness are commonly linked to suicidal ideation, yet suicidal ideation can still occur in people without a diagnosis.
Prevalence and Statistics
According to the National Institute of Mental Health the public health concern for rising suicide rates is high. Naming the act of completion as one of the leading causes of death in America. The Center for Disease Control and Prevention (CDC) completed a report in 2019 that presented alarming results. In the United States, suicide is the 10th leading cause of death and the second leading cause of death among 10–34-year-olds. As for differences in men and women, attempting suicide is more often in women but men are three to four times successful in completing suicide. Statistics for men suicide methods are often more violent, making them more likely to be completed before anyone can intervene.
Symptoms
Different warning signs can be present that can signal you or others that they are thinking out or contemplating suicide. Please review the following:
- Isolation and withdrawal from others
- Feelings of hopelessness or helplessness
- Conversations about death or suicide
- High anxiety
- Giving away possessions
- Substance abuse or an increase in misuse
- Irritability
- Having access to means such as medication, firearms, or drugs
If you are concerned that a loved one is thinking about or planning suicide it is okay to ask. Directly asking the individual displays care and concernment about their mental health. Remembering to know the difference between passive and active suicidal ideation is also key. Although one might be experiencing passive suicidal ideation like wishing they could die in a tragic car accident, do not think it cannot quickly escalate to active suicidal thoughts.
Causes
Unfortunately, there is not one main factor that contributes to suicidal ideas. There can be a variety of elements that contribute to an individual experiencing such intrusive thoughts. Oftentimes when feelings of hopelessness and helplessness are present it can be difficult to feel in control of your life. Creating meaning and purpose for oneself can feel daunting and “not worth living for anymore.”
Different circumstances can add to the negative heightened feelings one is experiences due to a crisis occurring, relationship problems, current or past trauma, substance use, financial problems, or medical concerns. An individual who has a severe mental health disorder such as major depression, PTSD, or anxiety can also contribute to these emotions.
Some risk factors for suicidal ideation are listed below but are not limited to:
- Past suicide attempt
- Family history of past suicide attempts
- Mental health diagnosis
- Isolation
- Feelings of loneliness
- Identifying with a marginalized group of people
- Military veterans
- Having chronic illness, disease, or pain
- Having a traumatic brain injury
- Substance abuse
- Past or current trauma
- Having access to firearms
Diagnosis
If symptoms of depression and suicidal thoughts are occurring for you or a loved one, it is encouraged for you to consult your medical provider or mental health professional. Different questions that may be given to you during this process can include the following:
- How long have you been experiencing thoughts of suicide?
- Have you created a suicide plan with an intent to follow through with it?
- Do you have a history of depression or mental illness?
- Are you taking any medication—and, if so, what kind?
- How often do you use alcohol or drugs?
Treatment
If you have suicidal thoughts but there is no crisis, a collaborative approach to working with psychotherapy and possibly medications can help reduce the risk of completing suicide. Lifestyle changes can also target the ability to create balance in the individual’s life overall.
- Psychotherapy which is also known as talk therapy is a form where the person can explore ways to cope and identify feelings and emotions.
- Family therapy and psychoeducation involves the individual’s support system learning how they can better understand what you’re going through, learn various warning signs, and improve family dynamics overall.
- Medications can be integrated in a person’s treatment at the discretion of a professional psychiatrist that can evaluate the severity of mental health symptoms. Different medications that could be offered if applicable can include antidepressants, anti-anxiety meds, and antipsychotic medications.
- Lifestyle changes can help manage one’s stress, create healthy sleep hygiene, eating, exercise habits, creating a sense of community, and carving out time for self-care and hobbies/interests.
Coping Skills
Here are some ways to help reduce suicidal thoughts and get the help you need to get back on track, whether you or a loved one are experiencing suicidal ideation:
- Identify triggers
- Feelings are temporary and will pass
- Self-care
- Build of sense of community and support
- Get active
If you or a loved one are in a crisis, please call the National Suicide Prevention Lifeline at 1-800-273-8255 (All calls are confidential and free) or visit http://www.suicidepreventionlifeline.org