Suicidal depression is a medical emergency that requires immediate treatment. Doctors may also refer to this condition as depression with suicidal ideation.

According to the National Institute of Mental Health, about 14.5 million – or 5.7% – adults in the United States experienced at least one major depressive episode that impaired their daily functioning in 2021. Suicide accounted for more than 48,000 deaths in the U.S. that year.

A person requires emergency treatment if they experience suicidal ideation, which refers to having suicidal thoughts, or if they make statements that suggest they may be considering suicide. Long-term treatment with medications, psychotherapy, and other therapies can often help reduce symptoms of depression.

This article explains suicidal depression, signs a person may be having suicidal thoughts, passive suicidal ideation, and more.

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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Suicidal depression is major depression with suicidal thoughts. Doctors may refer to these thoughts as “suicidal ideation.”

Major depressive disorder has several clinical diagnostic criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

A mental health professional may diagnose major depression if a person experiences certain symptoms for at least 2 weeks, such as:

A person with depression may experience thoughts of death or suicide. They may also attempt suicide.

In these cases, a healthcare or mental health professional may diagnose major depression with suicidal thoughts, also called suicidal depression.

Read more about suicidal ideation.

It can be challenging to know if someone is experiencing suicidal ideation. Signs and symptoms of this pattern of thinking can vary.

Things to know

Not everyone who experiences depression has suicidal thoughts.

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A person who is experiencing thoughts of suicide may talk about these thoughts or thoughts of death in general. They may also express feelings of:

  • being trapped
  • hopelessness or worthlessness
  • a lack of a sense of belonging or purpose
  • helplessness

They may show signs of:

A person might also:

  • withdraw from friends, family, work, school, activities, and hobbies
  • visit, call, or text loved ones to say goodbye, particularly after an absence of contact
  • begin making arrangements for their death, such as funeral arrangments
  • look for ways to die, such as through online searches
  • give away items they value

Help is available

If someone is at immediate risk of harming themself, contact 911 right away.

If a person is experiencing thoughts about suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day.

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Passive suicidal ideation is when a person has thoughts about death or suicide with no direct plans to engage in suicidal behavior.

The authors of a 2020 analysis note that researchers have not yet adequately studied passive suicidal ideation. For this reason, doctors do not fully understand its clinical importance.

The review suggests passive suicidal ideation often occurs with other mental health conditions or symptoms. The authors also found that active and passive ideation share several characteristics typically associated with suicide risk.

They suggest a strong association between passive suicidal ideation and suicide attempts and preliminary evidence of a comparably strong association with suicide deaths. This means people may take passive suicidal ideation as a potential sign of suicidality.

Several factors can contribute to the risk of a person experiencing suicidal thoughts.

Suicidal ideation and suicide attempts often occur with depression. Some risk factors for developing depression include:

  • Genetics: The condition often runs in families.
  • Biochemistry: Depression may result from altered levels of certain chemicals in the brain.
  • Environmental factors: Poverty, abuse, neglect, and other forms of trauma can cause depression.
  • Personality and lifestyle: A person may be more likely to develop depression if they have low self-esteem or are under extreme stress.

Risk factors for suicide can include:

  • Personal factors and life events: Experiencing the following may make a person more likely to die by suicide:
    • trauma
    • legal issues
    • substance misuse
    • job loss
    • serious illness
    • previous suicide attempts
  • Relationships: Relational factors that may contribute to suicidality include:
    • experiencing trauma or abuse
    • the loss of a significant relationship
    • a family history of mental health issues
    • bullying and social isolation
  • Societal factors: Exposure to the following may make suicide more likely:
    • unhealthy media presentations
    • easy access to the means to take one’s own life
    • stigma associated with mental health issues and seeking help
  • Community factors: Within the community, the following circumstances may contribute to suicidality:
    • discrimination
    • a lack of access to healthcare
    • suicide occurring among others in the community

Read more about warning signs and risk factors for suicide.

Things to know

Some people may try to hide signs that they are experiencing depression from others or may not even realize that they have the condition. Learn more about the hidden signs of depression.

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Up to 80–90% of people with depression respond well to treatment of some kind.

Treatment for depression with suicidal thoughts often includes a combination of medication and psychotherapy.


Common medications doctors recommend to help treat depression include:


Psychotherapy can take different forms. Some examples include:

These types of therapy may also help a person address suicidal thoughts.

People who do not respond to other treatments may benefit from electroconvulsive therapy. This involves using electrical pulses to stimulate the brain.

Read more about antidepressants.

Preventing suicidal depression may be challenging.

According to a 2018 article on depression prevention, the belief that it is impossible to prevent the development of depression dates back to a 1984 publication by the National Institute of Mental Health.

The authors of the 2018 article state that although more recent research has shown this assumption to be untrue, few studies have looked into practical means to help prevent depression.

The authors of the article suggest future research should look at the following:

  • predictive variables that can help show how different treatments affect outcomes in general
  • specific risk factors associated with depression development
  • protective factors that may reduce the effects of risk factors

In the future, researchers may develop a better understanding of how to prevent depression.

For now, a person can try taking steps to reduce risk factors as much as possible, such as managing stress.

Since depression is a risk factor for suicide, following a treatment plan for depression may help with preventing suicidal thoughts.

The following section provides answers to common questions about suicidal thoughts and depression.

Are suicidal thoughts a sign of depression?

Suicidal thoughts are a symptom of depression.

However, these thoughts can also be a symptom of other mental health conditions, such as:

What constitutes a suicidal thought?

Suicidal thoughts include active and passive thoughts. Active thoughts involve a person making plans to take their own life. Passive thoughts of suicide involve thinking about the prospect with no active plan.

Mental health resources and support

Visit our dedicated hub for more research-backed information and resources on mental health and well-being.

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Having suicidal thoughts is a symptom of depression. With a diagnosis of suicidal depression, a person experiences these thoughts and other depression symptoms.

A person who is experiencing thoughts of suicide can find help through the Suicide and Crisis Lifeline by calling or texting 988.

If someone is in immediate danger of harming themselves, they or another person should call 911.