Content warning
Pondering Self-Destruction: Recognizing Indicators, Root Causes, Countermeasures, and Helpful Resources
This section comprises information that might be distressing for certain readers. kindly proceed with caution.
There's no universal consensus regarding the definition of "suicidal ideation". For some individuals, it implies an individual is actively considering suicide, while for others, it encompasses thoughts of suicide as well.
Individuals experiencing suicidal thoughts may not necessarily intend to act upon them, and thus, some separated the two concepts by distinguishing between mere contemplation and the creation of ideas or plans. On the other hand, for others, "suicidal ideation" incorporates both.
Suicidal ideation is quite prevalent. As per data from the Centers for Disease Control and Prevention (CDC) in the United States, an estimated 4.6 million adults in 2022 seriously considered suicide. Over the span of 2000–2022, suicide rates have escalated by 36%.
This article aims to delve into the topic of suicidal ideation, touching upon its symptoms, causes, prevention, diagnosis, and treatment. We also provide information on available resources for help.
Help is within reach
If you or someone you know is facing a crisis, contemplating suicide or self-harm, please seek assistance:
- Dial or text the 988 Lifeline at 988 or visit 988lifeline.org to converse with empathetic counselors offering free and confidential support round the clock.
- Text 'HOME' to the Crisis Text Line at 741741 to engage with a volunteer crisis counselor providing unlimited and confidential support 24/7.
- If you're not based in the US, explore resources in your nation via Befrienders Worldwide.
- In an emergency, phone 911 or your local emergency number should you feel secure to do so.
If you're reaching out on behalf of another individual, stay with them until help arrives. In case you can, remove unsafe items such as weapons or toxic substances.
If you're not staying in the same household, persist on the phone until assistance is rendered.
What constitutes suicidal ideation?
Suicidal ideation entails an individual contemplating suicide or envisaging a strategy to accomplish it. It encompasses a spectrum of thoughts and behaviors, such as:
- passive contemplation
- active planning
- suicidal conduct, like self-harm or suicide attempts
However, some may only use the term "suicidal ideation" to refer to the active planning stage.
Not everyone who ponders suicide devises a plan. In 2022, 4.6 million adults in the United States acknowledged thoughts of suicide, according to the CDC. Among those, 3.8 million contemplated suicide, and 1.6 million attempted it.
In the presence of support and treatment, suicide can be prevented.
Symptoms of suicidal ideation
A person grappling with suicidal thoughts may exhibit alterations in speech, feelings, and behavior. They may discuss:
- a desire to die
- a sense of emptiness, hopelessness, or entrapment
- feeling like a burden to others
They may feel:
- unbearable emotional pain
- extreme anxiety or sadness
- uncontrollable rage or agitation
- guilt or shame
- a conviction there's no rationale for living
- significant swings in mood or mood fluctuations
Their behavior may also change. A person considering suicide might:
- withdraw from friends or family
- turn to alcohol or drugs more frequently
- sleep or eat excessively or barely at all
- engage in dangerous activities
- research methods of dying
- stockpile medications
- devise a suicide plan
- acquire a firearm
- draft a will
- distribute valuable possessions or money
- bid farewell
Not every individual with suicidal thoughts will display these warning signs. Sometimes, the signals may be subtle.
Gain more insights into suicide warning signs.
Factors contributing to suicidal ideation
Suicidal ideation typically does not stem from a single source but arises due to the conjunction of various life experiences, thoughts, and emotions.
That being said, two-thirds of individuals who take their lives also suffer from a mental health condition, often a mood disorder such as depression or bipolar disorder.
Other risk factors include:
- exposure to violence, including sexual or physical abuse
- suffering from a substance use disorder
- a family history of suicide, substance use, or mental disorders
- a personal history of suicide attempts
- chronic pain
- recent release from incarceration
- direct or indirect exposure to others' suicidal behavior
Suicide prevention strategies
Family members or friends may occasionally observe an individual displaying signs of suicidal ideation. In such instances, the American Foundation for Suicide Prevention advocates:
- engaging in a private conversation
- attentively listening to their story without judgment
- expressing your concern for them
- acknowledging their distress as genuine
- directly asking if they have suicidal thoughts
Avoid minimizing their problems or dispensing advice. If the person does have suicidal thoughts or plans:
- remove harmful objects, like firearms or drugs, from their reach if it is safe to do so
- seek help via 911 or the 988 Suicide and Crisis Lifeline
- remain with them until help arrives or escort them to the emergency room if possible
- follow up with them to assess their well-being at a later time
If the individual is exhibiting signs of suicidal ideation on social media, users can contact the platform's safety team for assistance.
Do not presume that someone else will intervene. Many individuals grappling with suicidal thoughts believe no one can help them, so they may not seek aid.
If an individual is grappling with suicidal inclinations and schedules a meeting with a doctor or specialist, the professional will engage in a dialogue to assess the severity of their symptoms and if they possess an intention to perpetrate suicide. This refers to whether they have an active tactic to end their life.
A plethora of suicide screening and risk evaluation tools are available to medical professionals. Nevertheless, these tools might not pinpoint an imminent risk of suicide. Consequently, a face-to-face conversation is essential.
A doctor or specialist might detect indications of suicidal inclinations in various circumstances, including routine appointments for chronic pain or melancholy. If an individual is gravely unwell or presents indications of potentially harming themselves, evaluation might occur in a mental health facility.
Treatment for suicidal notions
Addressing suicidal inclinations and actions necessitates addressing the underlying factors.
Safety planning
Safety planning is an approach designed to reduce the likelihood of an individual attempting suicide. This strategy limits an individual's access to lethal means of suicide by removing weapons, medications, and harmful substances from the home.
Safety planning also supplies individuals with contacts and supportive resources they can utilize during a crisis.
Psychotherapy
Psychotherapy, often referred to as "talk therapy," aids individuals in comprehending how their thoughts, feelings, and experiences impact their psychological health. It then helps people navigate their emotions and discover methods to advance.
There are various forms of psychotherapy. Some of the most frequently employed methods include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).
CBT helps individuals identify and, over time, substitute detrimental thoughts that negatively affect their mood with more balanced, realistic alternatives. DBT assists individuals in recognizing negative thoughts and acquiring skills to enhance coping mechanisms in challenging circumstances.
There are also specialized versions of CBT designed to aid individuals who have experienced trauma or who have other mental health conditions requiring particular attention, such as eating disorders or addiction.
Explore the different types of therapy.
Medication
Many individuals who entertain suicidal thoughts might have a mental health condition, such as anxiety, depression, or a substance use disorder. Medications may aid in treating the symptoms of these conditions and regulating an individual's mood.
However, some of these medications can also induce suicidal thoughts as a side effect, particularly in children, adolescents, and young adults. Experts emphasize the importance of discoursing with a doctor or another healthcare professional about any medications an individual is currently taking to determine whether adding another drug or adjusting the dosage is likely to benefit them.
Ongoing assistance
Individuals are less likely to die by suicide if they receive ongoing support. This may involve easy access to effective mental healthcare should an individual need it again, as well as frequent follow-up calls from healthcare professionals.
A person's family, friends, and community also play a significant role in ensuring they remain connected with others.
It is essential for individuals to focus on the aspects of life that give their existence significance and purpose, such as:
- caring for a pet, as they offer unconditional love
- leaning into their faith, as many religions uphold the sanctity of life
- having events to look forward to, such as a wedding, graduation, or vacation
- making long-term plans or goals
Where to obtain assistance
If an individual is grappling with thoughts of suicide, it is of the utmost importance to seek help as soon as possible. Below are helplines and support services where an individual can speak with a counselor or healthcare professional confidentially:
- *988 Suicide & Crisis Lifeline*: An individual may receive 24/7 phone support by calling 988. Alternatively, the older number 800-273-TALK (8255) is still available.
- *Crisis Text Line*: Texting “HOME” to 741741 connects individuals to a counselor 24/7.
- *Veterans Crisis Line*: This hotline provides a 24/7 online chat service for veterans, even if they do not receive benefits from the Veterans Administration. To contact, call 988 and press 1, or text 838255.
- *The Trevor Project*: This is a crisis line for teenagers and young adults who identify as LGBTQIA+. To contact, call 866-488-7386 or text “START” to 678678.
The following websites offer information for individuals who wish to learn more about suicide and its prevention:
- *Suicide Prevention Resource Center*: The Substance Abuse and Mental Health Services Administration offers information about programs, toolkits, and effective strategies.
- *National Action Alliance for Suicide Prevention*: This organization collaborates with more than 250 national partners to promote suicide prevention.
- *Zero Suicide*: This organization believes it is possible to prevent deaths from suicide in individuals who receive care from behavioral health systems. It presents a framework for safer suicide care.
Conclusion
Suicidal notions refer to an individual thinking about or planning suicide. Some individuals use the term interchangeably with "suicidal thoughts," while others view suicidal notions as a more serious mental state.
Signs an individual may be contemplating suicide include changes in their behavior, mood, or the subjects they discuss. They may appear to be making plans for their death, offering money or possessions away, or engaging in unusual risks.
However, suicide is preventable. Support from healthcare professionals and loved ones can help keep an individual from becoming isolated or acquiring access to harmful objects, such as guns. Treatment may involve a combination of safety planning, therapy, and medications.
If a loved one is experiencing suicidal notions, taking them seriously, being present for them, and obtaining immediate help is vital.
Read this article in Portuguese.
Individuals with Crohn's disease might be at a higher risk of developing suicidal ideation due to the disease's impact on their mental health and quality of life. A study published in the journal Inflammatory Bowel Diseases found that people with Crohn's disease were nearly twice as likely to report thoughts of suicide compared to the general population.
Furthermore, the use of certain medications for Crohn's disease, such as antidepressants and mood stabilizers, may contribute to the risk of suicidal ideation, especially in young adults. It is essential for healthcare providers attending to patients with Crohn's disease to be aware of this risk and monitor their patients' mental health closely.
As part of a predictive model for suicide risk in individuals with Crohn's disease, factors such as depression, anxiety, insomnia, and other mental health conditions may be indicative of a higher risk. Therefore, regular mental health assessments and close collaboration between gastroenterologists and mental health specialists can significantly contribute to improving patient outcomes and reducing the risk of suicide.
AQ (Autism Quotient) tests have shown that children and adolescents with Crohn's disease often have higher scores, suggesting that people with Crohn's disease are more likely to have autism spectrum disorder (ASD) or related conditions. This raises the importance of considering mental health concerns, including the risk of suicidal ideation, in the overall care of individuals with Crohn's disease, especially those with ASD or related conditions.
