Suicidal thoughts, also known as suicidal ideation, are thoughts about how to kill oneself, which can range from a detailed plan to a fleeting consideration and does not include the final act of killing oneself.
The majority of people who experience suicidal ideation do not carry it through. Some may, however, make suicide attempts. Some suicidal ideations can be deliberately planned to fail or be discovered, while others might be carefully planned to succeed.
According to a Finnish study, over one fifth of people who actually died by suicide had discussed their aim with a doctor or other health care professional during their last session.
Here are some key points about suicidal thoughts. More detail and supporting information is in the main article.
- The vast majority of people with suicidal thoughts do not carry them out to their conclusion
- There are about 30,000 suicides each year in America
- Roughly 4 in 5 American suicide victims are male
- Nearly all completed suicides are among individuals with mental illness
- Causes of suicidal thoughts can include depression, anorexia and substance abuse
- People with a family history of mental illness are more likely to have suicidal thoughts
- People who own guns are more likely to complete suicide
- In America, suicides outnumber homicides by almost 2 to 1
- Suicidal thoughts are preventable and there is plenty of help available - see the last section of this article for more information.
How common is suicide?
Around 4% of people with schizophrenia commit suicide.
USA - according to the FDA (Food and Drug Administration), there are about 30,000 completed suicides in America each year, an annual incidence of 0.01%. 80% of suicides are among males.
Suicide is the third leading cause of death among 15 to 24 year olds. Twenty per cent of all suicides are among this age group.
United Kingdom - according to the NHS (National Health Service), during the last 20 years suicide rates in the UK have been steadily dropping. In 2006, there were 5,554 completed suicides among people aged at least 15 years.
Roughly 140,000 people are hospitalized annually in England and Wales after suicide attempts. Three-quarters of all UK suicides are in males, with the highest risk among those aged 25 to 34 years, followed by 35 to 44 years. After accidental death, suicide is the second most common cause of death in males aged 15 to 44.
The NHS adds that according to its research, nearly all completed suicides are among individuals with a mental illness, for example, depression. Approximately ten to fifteen per cent of patients with bipolar disorder die prematurely due to suicide. About 4% of individuals with schizophrenia die by suicide, usually not long after the onset of symptoms.
Symptoms of suicidal thoughts
There are a number of signs and symptoms of suicidal thoughts; the list below contains some of the most common.
Common symptoms of suicidal thoughts include:
- Appearing to feel trapped or hopeless
- Appearing to have an abnormal preoccupation with violence, dying and/or death
- Being in a heightened state of anxiety
- Being very moody
- Changing personality
- Changing routine
- Changing sleeping patterns
- Consuming (more) drugs
- Consuming more alcohol
- Engaging in risky behavior, such as driving carelessly or taking drugs
- Getting affairs in order
- Getting hold of a gun, medications, or substances that could end a life
- Giving stuff away
- Having depression
- Having panic attacks
- Impaired concentration
- Increased self-criticism
- Isolating oneself
- Psychomotor agitation - such as pacing around a room, wringing one's hands, taking off clothing and putting it back on, and other such actions
- Saying goodbye to others as if it were the last time
- Seeming to be unable to experience pleasurable emotions from normally pleasurable life events such as eating, exercise, social interaction or sex
- Seeming to have severe remorse
- Talking about killing oneself, expressing regret about being alive or ever having been born.
A significant number of people with suicidal ideation keep their thoughts and feelings a secret and appear to show no apparent signs.
According to Medilexicon's medical dictionary, suicide means:
- The act of taking one's own life
- A person who commits such an act.
Causes of suicidal thoughts
Scientists believe that there may be a genetic component to suicidal thoughts.
Suicidal ideation is a feeling people may have when they are no longer able to cope with an overwhelming situation, which could be financial, the death of somebody they love, breaking up, or a devastating/debilitating illness.
There may be a feeling of bleakness and an erroneous assumption that taking their own life might be the answer. If the individual's mental state is heightened enough, suicide may seem to be the only exit.
Experts believe there may be a genetic factor associated with a higher risk of suicide. Individuals with suicidal thoughts, or those who have taken their own lives tend to have a family history of suicide or suicidal thoughts.
The most common situations or life events that might cause suicidal thoughts are grief, sexual abuse, financial problems, remorse, rejection, relationship breakup and unemployment.
Psychiatric factors linked to a higher risk of suicidal ideation include:
- Adjustment disorder
- Anorexia nervosa
- Bipolar disorder
- Body dysmorphic disorder
- Borderline personality disorder
- Dissociative identity disorder
- Gender dysphoria (Gender identity disorder)
- Major depressive disorder
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
- Substance abuse.
The following risk factors may have an impact on suicidal ideation probability:
- A family history of mental illness/problems
- A family history of substance abuse
- A family history of violence
- A family history of suicide
- A feeling of hopelessness
- A feeling of seclusion or loneliness
- Being homosexual with no family/home support
- Being in trouble with the law
- Being under the influence of alcohol or drugs
- For children, having disciplinary, social or school problems
- Having a problem with substance abuse
- Having a psychiatric disorder or mental illness
- Having attempted suicide before
- Reckless or impulsive behavior
- The possession of guns
- Sleep deprivation.
Suicidal thoughts triggered by other people's suicide
Researchers reported in CMAJ (Canadian Medical Association Journal) that suicide can be contagious, and more so among adolescents.
Dr. Ian Colman, from the Department of Epidemiology and Community Medicine and Canada Research Chair in Mental Health Epidemiology, explained that one person's suicide can have an impact on another's suicidal thoughts or behavior, especially among teenagers.
He adds that the teenagers do not necessarily have to be associated with the person who died by suicide to start having suicidal thoughts or attempting to end his/her own life.
Dr. Coleman wrote:
"When someone dies, particularly a young person, the deceased is described by their loved ones in the media and in social media in glowing, romantic terms, often mentioning how beautiful the child was.
Talk like this is common when any child dies, but it can be dangerous when talking about suicide. When other vulnerable youth are reading or hearing about this, they see the reports about how wonderful the person was and they want their loved ones to feel the same way about them."
Prevention of suicidal thoughts
Exercise has been shown to lift general mood and stave off suicidal thoughts.
Mental illness is the most common cause of suicidal ideation and completed suicide. A significant number of mental problems, such as depression, can be successfully treated with medications and talking therapies, such as CBT (cognitive behavioral therapy) or counseling.
Individuals with a mental illness/problem should see their doctor and get treatment.
The following may help lower the risk of suicidal ideation and suicide attempts:
- Adherence (compliance) - this means following your treatment plan, going to follow-up appointments, taking medications as instructed, etc.
- Alcohol and illegal drugs - avoid them
- Avoid isolation - try to stay connected to the outside world
- Do exercise
- Eat a well-balanced, healthy diet
- Family - involve your family in treatment, get their support. Ask them to come along to your sessions, health care professionals can help them acquire better coping and supportive skills
- Focus on the good things in life (talking therapies may help you achieve this)
- Get at least 7-8 hours continuous sleep every 24-hour period
- Get treatment for a mental illness
- Means of ending one's life - get rid of guns, knives and dangerous drugs.
- Seek out things that give you pleasure, such as being with friends/family you like
- Self help groups - sharing the anguish and anxieties that drive you towards suicidal ideation can be relieving and comforting. You will see how others got through it. If you can support other people you may feel better about yourself and those around you.
If you are feeling suicidal, it is important to get help.
The following is a small selection of information that may help:
- Befrienders Worldwide - find contact numbers and support information for your country to allow you to talk to someone right now.
- USA: Childhelp - National Child Abuse Hotline 1-800-4-A-CHILD (1-800-422-4453). All calls are anonymous and confidential.
- UK: ChildLine - Dial 0800 1111 to speak to a counselor. Calls are free and confidential.
- If you are thinking about suicide... read this first
- How to cope with suicidal feelings
- Depression: Causes, Symptoms and Treatment
- PTSD (Post-Traumatic Stress Disorder)
If you are considering self-harm, it is also important to get help and these sites may help you:
These are just a small selection of the options available to you - your doctor should be able to help. Please do not give up, you will feel better again.
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Results of a 2-year study on health and resilience in US veterans show that nearly 14% report having suicidal thoughts in one or both waves of the research.