Suicidal thoughts, or suicide ideation, refers to thinking about or planning suicide. Thoughts can range from creating a detailed plan to having a fleeting consideration. It does not include the final act of suicide.

Many people experience suicidal thoughts, especially during times of stress or when they are facing mental or physical health challenges.

Suicidal thoughts are a symptom of an underlying problem. Treatment is effective in many cases, but the first step is to ask for help.

If a loved one is having these thoughts or talking about suicide, it is essential to take action to help and protect them.

See the last section of this article for information on how to get help for someone who is experiencing suicidal thoughts.

Symptoms

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If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24/7 at 800-273-8255. People who are hard of hearing can call 800-799-4889.

A person who experiences or could experience suicidal thoughts may show the following signs or symptoms:

  • feeling or appearing to feel trapped or hopeless
  • feeling intolerable emotional pain
  • being preoccupied with violence, dying, or death
  • having mood shifts, either happy or sad
  • talking about revenge, guilt, or shame
  • experiencing agitation or a heightened state of anxiety
  • experiencing changes in personality, routine, or sleep patterns
  • increasing the use of drugs or alcohol
  • engaging in risky behavior, such as driving carelessly or taking drugs
  • getting their affairs in order and giving things away
  • getting hold of a gun or substances that could end a life
  • experiencing depression, panic attacks, or impaired concentration
  • isolating themselves
  • talking about being a burden to others
  • experiencing psychomotor agitation, such as pacing or wringing the hands
  • saying goodbye to others as though it were the last time
  • experiencing a loss of enjoyment in previously pleasurable activities, such as eating, exercise, social interaction, or sex
  • expressing severe remorse and self-criticism
  • talking about suicide or dying
  • expressing regret about being alive or ever having been born

A significant number of people with suicide ideation keep their thoughts and feelings a secret and show no sign that anything is wrong.

Learn more about the warning signs of suicide here.

Causes

Suicide ideation can occur when a person feels that they are no longer able to cope with an overwhelming situation. This could stem from financial problems, the death of a loved one, the end of a relationship, or a debilitating illness or health condition.

Some other common situations or life events that might cause suicidal thoughts include grief, sexual abuse, financial problems, remorse, rejection, and unemployment.

The following risk factors may increase the chance of suicide ideation:

  • a family history of violence or suicide
  • a family history of child abuse, neglect, or trauma
  • a history of mental health issues
  • a feeling of hopelessness
  • knowing, identifying, or being associated with someone who has completed suicide
  • engaging in reckless or impulsive behavior
  • a feeling of seclusion or loneliness
  • identifying as LGBTQIA+ with no family or home support
  • not being able to access care for mental health issues
  • a loss of work, friends, finances, or a loved one
  • having a physical illness or health condition
  • possessing a gun or other lethal methods
  • not seeking help due to fear or stigma
  • stress due to discrimination and prejudice
  • historical trauma, such as the destruction of communities and cultures
  • having attempted suicide before
  • experiencing bullying or trauma
  • exposure to graphic or sensationalized accounts of suicide
  • exposure to suicidal behavior in others
  • experiencing legal problems or debt
  • being under the influence of drugs or alcohol

Conditions that researchers have linked to a higher risk of suicide ideation include:

How does anxiety affect Black communities? Learn more here.

Prevention

Family and friends may notice through a person’s speech or behavior that they could be at risk of experiencing suicide ideation.

They can help by talking to the person and by seeking appropriate support.

The National Institute for Mental Health suggest the following tips for helping someone who may be going through a crisis:

  • Ask them if they are thinking about suicide. Studies show that asking does not increase the risk.
  • Keep them safe by staying around and removing any means of committing suicide, such as knives, where possible.
  • Listen to them and be there for them.
  • Encourage them to call a helpline or contact someone they might turn to for support, such as a friend, family member, or spiritual mentor.
  • Follow up with them after the crisis has passed, as this appears to reduce the risk of a recurrence.

Other tips include keeping some emergency phone numbers at hand. These may be for a trusted friend, a helpline, or the person’s doctor.

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 you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Click here for more links and local resources.

Treatment

Suicide ideation is a symptom of an underlying problem. Medications and talking therapies, such as cognitive behavior therapy or counseling, can often help.

Anyone who is experiencing mental health problems should try to seek treatment as soon as possible.

Once treatment starts, it is important to follow the treatment plan, attend follow-up appointments, and take any medications as a healthcare professional directs.

Reducing the risk

Supporting a person by listening to them and helping them engage with healthcare professionals can make a big difference.

According to the Centers for Disease Control and Prevention (CDC), people may have a lower risk of suicidal thoughts if they have:

  • access to healthcare, including help for substance use disorders
  • access to overall support for health and well-being
  • family and community links
  • skills for solving problems and dealing with disputes
  • beliefs that discourage suicide and encourage self-preservation
  • a sense of self-esteem and purpose in life

For people experiencing suicide ideation, the following may help:

  • talking to family, friends, or a support worker about their feelings
  • asking a loved one to meet their health provider and possibly attend sessions with them
  • avoiding or limiting the use of alcohol and recreational drugs
  • staying connected with others, as much as possible
  • getting regular exercise
  • eating a balanced diet
  • sleeping for at least 7–8 hours per day
  • not keeping guns, knives, or potentially harmful substances within easy reach
  • seeking things that provide pleasure, such as music or time spent outdoors
  • seeking and adhering to treatment
  • following a doctor’s recommendations about prescription drug use and monitoring for adverse effects

Many people experience suicidal thoughts at some time in their life. Sharing the problem with a healthcare provider, a loved one, or a support worker can often help.

Where to get help

If you or someone you know is having thoughts of suicide, it is vital to get help as soon as possible.

Here are some hotlines that offer support:

  • National Suicide Prevention Lifeline: This resource is available for a confidential chat 24 hours per day, 7 days per week.
    • The toll-free number is 800-273-8255.
  • Befrienders Worldwide: This resource offers contact numbers and support information for different countries and different languages.
  • Childhelp: All calls to the National Child Abuse Hotline are anonymous and confidential.
    • For the United States, call 800-422-4453.
  • Veterans Crisis Line: This is a confidential support line for veterans and those who are concerned about a veteran.
    • To contact, call 800-273-8255 and press 1.
    • Alternatively, send a text to 838255.
  • LGBTQ+: This resource offers options in Spanish and for those with hearing difficulties.
    • To contact, call 800-273-8255.
  • The Trevor Project: This is a crisis line for young people who identify as LGBTQ+.
    • To contact, call 866-488-7386.
    • Alternatively, use the chatline.

These services offer confidential help.

Statistics

In the U.S., suicide is the 10th leading cause of death. According to the American Foundation for Suicide Prevention, it was responsible for over 48,000 fatalities in 2018.

In 2017, it was the second leading cause in people aged 10–34 years. The number of suicides was double the number of homicides.