Suicidal Ideation—Adult
(Suicidal Thinking)
Definition
Thinking about or planning to commit suicide is known as suicidal ideation.
Causes
The causes are not the same in each person. A person may be having problems coping with stress. They may also feel overwhelmed and hopeless. Or they may have a substance use problem or a mental illness.
Risk Factors
Things that may raise the risk are mental health problems, such as:
- Anxiety disorders
- Depression
- Substance use disorders
- Posttraumatic stress disorder (PTSD)
- Schizophrenia
- Bipolar disorder
- Borderline personality disorder
Other things that may raise the risk are:
- Being within reach of items that could be used for self-harm, such as guns
- Lack of a support system
- Poor coping skills
- A stressful life event, such as job loss
- Prior suicide attempts
- Prior trauma
- History of acting without thinking or of being violent
- Having family members or friends who have died by suicide
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Symptoms
A person may:
- Talk about wanting to die or kill oneself
- Talk about feelings of despair
- Prepare for death, such as giving away items
- Pull away from family and friends
Other problems may be:
- Mood swings
- Lack of focus
- No longer wanting to do daily activities, such as work and hobbies
- Eating more or less
- Sleeping too little or too much
- Changes in the way a person looks, such as not brushing one's hair or teeth
- Using more alcohol or drugs
- Acting worried or restless or making choices quickly
- Talking about feeling trapped or being in pain
Diagnosis
The doctor will ask about your symptoms. You will also be asked about your physical and mental health history. The doctor may also ask your family questions. A mental health exam may be done to look for any other issues.
Treatment
Treatment will be needed right away. A person may need to stay in a care center. Individual, family, or group therapy may be used to help manage unhelpful thinking.
The goals of treatment are to:
- Care for any mental, physical, and substance use disorders
- Teach family and friends how to offer support
- Learn how to better solve problems and resolve conflict
Prevention
To lower the risk of this problem:
- Follow care plans for mental or physical health problems.
- Get treated for any substance or alcohol use disorder.
- Talk about problems with family members, friends, or a therapist.
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:
Klonsky ED, Qiu T, et al. Recent advances in differentiating suicide attempters from suicide ideators. Curr Opin Psychiatry. 2017 Jan;30(1):15-20 .
Major depressive disorder (MDD). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/major-depressive-disorder-mdd. Updated January 19, 2018. Accessed April 18, 2018.
Risk of suicide. National Alliance on Mental Illness. Available at: https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Suicide. Accessed September 4, 2020.
Suicidal ideation and behavior. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/suicidal-ideation-and-behavior. Accessed September 4, 2020.
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 September 4, 2020.
Warning signs of suicide. Suicide Awareness Voices of Education site. Available at: https://save.org/about-suicide/warning-signs-risk-factors-protective-factors. Accessed September 4, 2020.
We can all prevent suicide. National Suicide Prevention Lifeline website. Available at: https://suicidepreventionlifeline.org/how-we-can-all-prevent-suicide. Accessed September 4, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board Adrian Preda, MD Last Updated: 2/19/2021