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Managing Suicidal Ideation

Overview

If your doctor diagnoses you with suicidal ideation, it means that you’re preoccupied with the idea of suicide. You may regularly think about the way you would commit suicide or think about what life would be like if you weren’t around. You may also replay the suicidal act out in your mind.

It’s important to know what warning signs to look for if you or someone you know is dealing with suicidal ideation. The sooner you recognize the signs, the sooner you can find the help you need.

Symptoms

Signs that you or someone is having serious thoughts of suicide include:

  • vocalizing that you wish you weren’t alive, had not been born, or that your friends or family would be better off without you
  • avoiding social contact and wanting to stay away from others
  • preparing for suicide, such as acquiring a weapon or researching methods of suicide
  • being especially risky in all areas of your life, including using excessive amounts of alcohol or drugs
  • showing signs of anxiety or getting upset over minor things
  • wanting to give away your possessions or treating people as if you might not see them again
suicide warning signs

If you’re having thoughts of suicide or if you suspect someone you know is having thoughts of suicide, call 911.

Read more: Suicide and suicidal behavior »

Risk factors

Depression and suicidal ideation
Depression is often a trigger for thoughts of suicide. Over 15 million adults in the United States are diagnosed with a major depressive disorder each year.

Suicide can run in families. You may be more likely to try to take your own life if someone in your family has already done so.

You may also be at risk for suicidal ideation if you’re experiencing:

  • grief
  • a traumatic situation
  • a difficult struggle or challenge
  • depression

Seeking help early can help you reduce your risk for suicidal ideation and suicide.

Your risk of suicide might increase if you have:

  • a drug or alcohol abuse problem
  • a mental disorder or stress condition
  • chronic pain, terminal illness, or another medical situation in which you might feel hopeless
  • attempted suicide before

Being under the influence of drugs or alcohol can increase your risk for suicidal ideation and provide an added urge to go through with the act.

Passive suicidal ideation

Passive suicidal ideation is when a person desires death but has no specific plan to commit suicide.

If you’re experiencing passive suicidal ideation, your fantasies may involve dying in your sleep or having a fatal accident. You may believe that the world would be better off without you.

Passive doesn’t mean harmless. This train of thought has the potential to make you more likely to put yourself in harm’s way.

Even if passive suicidal ideation appears to be fleeting, the risk of a suicide attempt is very real. The line between passive and active suicidal ideation is blurry. The transition from one to the other can happen slowly or suddenly, and it’s not always obvious to the casual observer.

While someone might admit to wishing to die, they may deny making plans to do so. Warning signs that suicidal ideation has become active include giving away possessions, getting affairs in order, and saying goodbye to loved ones.

No one could ever predict with 100 percent certainty if someone will or will not take their own life. Even trained medical professionals can’t predict who will commit suicide. This is why you need to take threats or thoughts of suicide seriously.

An underlying condition such as substance abuse, major depression, or other mood disorders may lead to a preoccupation with dying. Added stressors such as the death of a loved one, divorce, or a job loss can trigger thoughts of hopelessness or worthlessness.

You shouldn’t take passive suicidal ideation lightly. It’s impossible to predict who’s likely to act on these thoughts. That’s why anyone who expresses passive suicidal ideation should be considered at risk for suicide.

See your doctor or psychiatrist for a careful evaluation and to get appropriate treatment.

Medications and suicidal ideation

Researchers have linked some medications with an increase in suicidal thoughts. Antidepressants have been linked to this behavior. This is particularly the case in the first weeks of taking the medication or after a change in dosage. Children and adolescents are at increased risk of this. Researchers in recent studies are disputing this relationship.

If you begin having thoughts of suicide while taking an antidepressant, contact your doctor immediately. They can work with you to safely adjust your treatment plan.

How is suicidal ideation diagnosed?

If you have depression and are having thoughts of suicide, seek immediate medical help.

When you see your doctor, they’ll ask you many questions so they can assess the severity of your situation. Some questions your doctor may ask include:

  • How long have you had thoughts of suicide?
  • Do you have a history of depression?
  • How far have your thoughts of suicide gone? Have you come up with a plan?
  • Are you taking any medications? If so, what are they?
  • Do you use alcohol or drugs? If so, how often?

You should also expect your doctor to ask you to take a questionnaire. Your answers will help your doctor evaluate your mental health and develop a course of treatment.

How is suicidal ideation treated?

Your doctor will treat your depression according to the severity of your condition.

You doctor may prescribe antidepressants or anti-anxiety medication. These can help you manage your symptoms. You should also expect your treatment plan to include talking to a psychologist or counselor.

Ask your doctor or psychologist about ways to find additional support. They can recommend a support group. They may also have recommendations for how to get help if you use alcohol or drugs that may be contributing to your challenges.

If your risk of suicide is high, you may need to stay in an inpatient treatment facility. This is for your safety. You can receive your treatment at the facility and you won’t have access to items you may use to commit suicide.

What is the outlook?

Your outlook for depression or suicidal thoughts will improve with a strong network of friends and family. Talking with others about the challenges you’re facing may help. Getting outside and exercising can also help reduce depression, whether for the change of scenery or the good-feeling chemicals, or endorphins, that you experience during physical activity.

Treatment for suicidal ideation is available and can be successful. Ask for help if you need it.

How can you prevent suicidal ideation?

Knowing your triggers for depression and suicidal ideation can help you avoid or better manage these triggers in the future.

  • Keep track of situations you find stressful and how you handle them.
  • Keep a journal to help you understand and manage your feelings.
  • Find ways to relieve stress, such as physical activity or talking with a friend.
  • Seek help at the first signs of depression.
  • Call 911 if you’re having thoughts of suicide.

Remember that you’re not alone and resources are available to help you. Call a crisis line or prevention hotline to speak to someone who can help you find the support you need. The National Suicide Prevention Lifeline is 800-273-TALK.

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