Suicidal thoughts involve a person thinking about ending their own life. However, there is no universally accepted definition of the term “suicidal ideation” in the medical community.

Some people say that suicidal ideation involves actively planning suicide, whereas suicidal thoughts do not necessarily indicate a person has the intention to end their life.

However, others consider planning as a separate category and believe that suicidal thoughts and ideation are the same.

Suicidal ideation is common. In 2020, 12.2 million people in the United States reported seriously thinking about suicide. Of these, around 10% attempted suicide. With support and treatment, though, suicide is preventable.

This article discusses suicidal ideation, including the symptoms, causes, prevention, diagnosis, and treatment. It also explains where to get help.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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A person who is thinking about or planning suicide may show changes in their speech, feelings, and behavior. They may talk about:

  • their feelings of guilt or shame
  • being a burden to others
  • death

The person may feel:

  • unbearable emotional pain
  • extremely anxious and sad, full of rage, or agitated
  • trapped, hopeless, empty, or that there is no reason to live
  • severe fluctuations in mood or mood swings

Their behavior may also change. A person contemplating suicide may:

  • withdraw from friends or family
  • use alcohol or drugs more frequently
  • sleep or eat more or less
  • take dangerous risks
  • research ways to die
  • stockpile medications
  • make a plan for their suicide
  • purchase a gun
  • make a will
  • give away important possessions or money
  • say goodbye

Not everyone who is thinking about suicide shows these warning signs. Sometimes, the signs may be subtle.

Learn more about the warning signs of suicide.

Suicidal ideation often does not have a single cause but occurs due to a combination of different life events, thoughts, and feelings.

Risk factors include:

  • depression or other mental health conditions
  • a history of suicide attempts
  • a family history of suicide, substance misuse, or mental disorders
  • chronic pain
  • recent release from prison
  • exposure to family violence, including sexual or physical abuse
  • direct or indirect exposure to others’ suicidal behavior
  • the presence of guns in the home

Sometimes family members or friends may notice a person has signs of having suicidal thoughts. When this happens, the American Foundation for Suicide Prevention advises:

  • talking calmly with them in private and expressing care
  • taking what they say seriously and assuring them that their life matters
  • removing dangerous objects, such as guns and drugs, from their reach
  • calling for help and staying with them until help arrives
  • following up with them after the crisis is over

The diagnosis of suicidal thoughts or ideation can happen in a number of ways.

If a person is feeling suicidal and makes an appointment to speak with a doctor or therapist, they will have a conversation to determine how severe the symptoms are and whether the person has suicidal intent. This refers to whether a person has an active plan to take their own life.

An array of suicide screening and risk assessment tools are also available for doctors. However, these tools cannot always predict an imminent risk of suicide accurately. For this reason, a face-to-face interview is vital.

A doctor or therapist may also spot signs of suicidal thoughts in other situations, such as in a routine appointment for chronic pain or depression. If a person is seriously unwell or may be a danger to themselves, diagnosis may take place in a mental health center.

Treatment for suicidal thoughts and actions involves addressing the underlying cause or causes.

Safety planning

Safety planning is a short-term intervention that reduces the likelihood that a person will try to end their life. This approach limits a person’s access to lethal means of suicide by removing weapons, drugs, and poisonous substances from the home.

Safety planning also provides people with contacts and support resources they can use if they are in a crisis.


Psychotherapy, or talk therapy, helps people understand how their thoughts, feelings, and experiences impact their mental health. It then helps people work through their emotions and find ways to move forward.

There are many types of psychotherapy. Some popular options include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).

CBT teaches people to identify and, over time, replace unhelpful thoughts that negatively affect their mood with more balanced, realistic alternatives. DBT helps individuals to recognize negative thoughts and learn skills that boost coping methods in unsettling situations.

There are also some specialized versions of CBT for people who have experienced trauma or have other mental health conditions requiring special attention, such as eating disorders or addiction.

Learn about 14 different types of therapy.


Many people who think about suicide may have a mental health condition, such as anxiety, depression, or a substance use disorder. Medications may help treat the symptoms of these conditions and regulate a person’s mood.

There are different medications a doctor could prescribe, depending on the situation and a person’s circumstances.

However, it is also worth noting that some of these drugs can also cause suicidal ideation as a side effect, particularly in adults under the age of 25. A person should discuss any medications they already take with a doctor to determine whether adding another, or changing the dose, is likely to benefit them.

Ongoing support

People are less likely to take their own life if they receive ongoing support. This may involve easy access to effective mental health care, should a person need it again, as well as frequent follow-up calls from healthcare professionals.

A person’s family, friends, and community also play an important role in ensuring they stay connected with people.

It can help people to focus on the things that give their life meaning and purpose, such as:

  • looking after a pet, as they provide unconditional love
  • faith, as many religions promote the sanctity of life
  • things to look forward to, such as a wedding, graduation, or vacation
  • long-term plans or goals

If a person is having thoughts of suicide, it is critically important to get help as soon as possible. Below are helplines and support services where a person 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 people to a counselor 24/7.
  • Veterans Crisis Line: This 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 people who want 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 works with more than 250 national partners to promote suicide prevention.
  • Zero Suicide: This organization believes it is possible to prevent deaths from suicide in people who receive care from behavioral health systems. It presents a framework for safer suicide care.

Suicide was the cause of 45,979 deaths in the U.S. in 2020. This is one death every 11 minutes.

In the same year, approximately 12.2 million people in the country had suicidal thoughts, and 1.2 million attempted suicide.

Suicidal ideation is when a person is thinking of ending their own life. Some people use the term interchangeably with “suicidal thoughts,” while others view suicidal ideation as a distinct and more serious mental state.

Signs a person may be thinking about suicide include changes in their behavior, mood, or the things they talk about. They may appear to be making plans for their death, giving money or possessions away, or taking unusual risks.

However, suicide is preventable. Support from healthcare professionals and loved ones can keep a person from becoming isolated or gaining access to dangerous objects, such as guns. Treatment may involve a combination of safety planning, therapy, and medications.

If a loved one is experiencing suicidal ideation, taking them seriously and getting immediate help is vital.

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