Carl R. Darnall Army Medical Center - Health Library

Suicidal Ideation—Adult

(Suicidal Thinking)

Definition

Thinking about, considering, or planning to commit suicide is known as suicidal ideation.

Causes  ^

Suicide is often the result of many factors which can vary from person to person. Many people thinking about suicide are having difficulty coping with stressful factors and feel very overwhelmed and hopeless.

The majority of people who consider suicide also have a mental illness like depression or substance abuse. These conditions may cause suicidal thoughts alone or simply make stressful situations worse.

Risk Factors  ^

Factors that may increase the risk of suicidal ideation include mental health disorders such as:

Other factors that may increase the risk of suicidal ideation include:

  • Lack of a support system
  • Poor coping skills
  • Current traumatic or stressful life event, such as a job or financial loss or the loss of a relationship
  • History of trauma or abuse
  • History of hasty or violent behaviors
  • Family history of suicide
  • Exposure to others who have died by suicide
  • Prior suicide attempts
  • Easy access to items that could be used for self-harm such as guns

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Symptoms  ^

People who are thinking about suicide may:

  • Talk about wanting to die or commit suicide
  • Talk about feelings of despair
  • Plan for death, such as giving away favorite items
  • Withdraw from family and friends

Other symptoms may include:

  • Irritability
  • Indifference
  • Difficulty focusing
  • Loss of interest in daily activities such as work and hobbies
  • Loss or gain in appetite
  • Sleeping too little or too much
  • Changes in appearance such as lack of personal hygiene
  • Increased use of alcohol or drugs
  • Mood swings that range from irritability to a sudden sense of calm
  • Acting anxious or restless, or behaving hastily
  • Talking about feeling trapped or in unbearable pain

These symptoms can occur without suicidal ideation. However if someone you know has these signs, try to talk to them to better learn what is happening. Asking about suicidal feelings will not encourage someone to commit suicide but may actually help prevent suicide.

If you or someone you know has thoughts of suicide or harming oneself, it is important to seek professional help right away. There are many suicide hotlines to help those considering suicide or to provide information for friends and family of someone considering suicide.

If the risk of suicide is severe, go to an emergency room or call for emergency services. Risk is considered severe if the person has a well thought out plan to commit suicide and has access to items that can cause harm.

Diagnosis  ^

The doctor will ask about symptoms and medical and psychiatric history. Family members may also be interviewed.

A mental health specialist may complete a psychological assessment to look for any underlying issues.

Treatment  ^

Immediate hospitalization may be needed if there is a severe threat of suicide.

Individual, family, and/or group therapy will be used to help manage suicidal thoughts.

Overall treatment goals include:

  • Care for underlying mental, physical, and substance use disorders
  • Limiting access to items that may be used for self-harm
  • Developing a support system that includes family members and friends
  • Developing skills in problem solving, conflict resolution, and handling problems through nonviolent means

Prevention  ^

To help reduce the chances of suicidal ideation:

  • Follow treatment plans for mental or physical health disorders that you may have.
  • Avoid drugs and alcohol. Talk to your doctor if you have a substance or alcohol use disorder.
  • If you have difficulty coping with a stressor, talk to someone you trust, such as a family member, friend, or therapist.
  • Limit access to items that may be used for self-harm.
RESOURCES:

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org

National Alliance on Mental Illness
https://www.nami.org

CANADIAN RESOURCES:

Canadian Mental Health Association
https://cmha.ca

Health Canada
https://www.canada.ca

REFERENCES:

Depression in children and adolescents. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T906140/Depression-in-children-and-adolescents. Updated February 20, 2018. Accessed April 18, 2018.

Major depressive disorder (MDD). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116638/Major-depressive-disorder-MDD. Updated January 19, 2018. Accessed April 18, 2018.

Norris D, Clark MS. Evaluation and treatment of the suicidal patient. Am Fam Physician. 2012;85(6):602-605.

Risk of suicide. National Alliance on Mental Illness. Available at: https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Suicide. Accessed April 18, 2018.

Suicidal thoughts. American Association for Marriage and Family Therapy website. Available at: http://www.aamft.org/iMIS15/AAMFT/Content/Consumer_Updates/Suicidal_Thoughts.aspx. Accessed April 18, 2018.

Suicide in children and teens. American Academy of Child & Adolescent Psychiatry website. Available at: https://www.aacap.org/AACAP/Families_and_youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.aspx. Updated October 2017. Accessed April 18, 2018.

Warning signs of suicide. Suicide Awareness Voices of Education site. Available at: https://save.org/about-suicide/warning-signs-risk-factors-protective-factors. Accessed April 8, 2018.

We can all prevent suicide. National Suicide Prevention Lifeline website. Available at: https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide. Accessed April 18, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Adrian Preda, MD  Last Updated: 3/8/2016