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:

• Depression
• Substance use disorders
• Posttraumatic stress disorder (PTSD)
• Anxiety disorders
• Schizophrenia
• Bipolar disorder
• Borderline personality disorder

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.