Suicidal Ideation—Adult

(Suicidal Thinking)

Soo-uh-sid-ul I-de-a-shun

Definition

Definition

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

Causes

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

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 attempt
  • Easy access to items that could be used for self-harm, such as guns

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Symptoms

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; behaving hastily
  • Talking about feeling trapped or in unbearable pain

These symptoms can occur without suicidal ideations. 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 a 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

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

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 abuse 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

Prevention

To help reduce your risk of suicidal ideation, take these steps:

  • Follow treatment plans for mental or physical health disorders that you may have.
  • Avoid drugs and alcohol.
  • 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 http://www.familydoctor.org

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

CANADIAN RESOURCES:

Canadian Mental Health Association http://www.cmha.ca

Health Canada http://www.hc-sc.gc.ca

References:

Gliatto M, Rai A. Evaluation and treatment of patients with suicidal ideation. Am Fam Physician. 1999 Mar 15;59(6):1500-1506.

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 January 29, 2015.

Suicide. National Alliance on Mental Illness. Available at:
http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=23041
Accessed January 29, 2015.

Suicide—causes. NHS Choices website. Available at:
http://www.nhs.uk/Conditions/Suicide/Pages/Causes.aspx
Updated November 15, 2012. Accessed January 29, 2015.

Suicide risk factors. National Suicide Prevention Lifeline website. Available at:
http://www.suicidepreventionlifeline.org/learn/riskfactors.aspx
Accessed January 29, 2015.

Symptoms and danger signs. Suicide Awareness Voices of Education site. Available at:
http://www.save.org/index.cfm?fuseaction=home.viewpage&page_id=705f4071-99a7-f3f5-e2a64a5a8beaadd8
Accessed January 29, 2015.

Teenage suicide. National Alliance on Mental Illness website. Available at:
http://www.nami.org/Content/ContentGroups/Helpline1/Teenage_Suicide.htm
Accessed January 29, 2015.

Last reviewed February 2015 by Michael Woods, MD
Last Updated: 4/7/2015

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