** If you feel you or someone you know may be at risk for suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or go to your local emergency room immediately. **

Suicidal ideation is a common medical term for thoughts about suicide, which may be as detailed as a formulated plan or as basic as just a few fleeting suicidal thoughts without the suicidal act itself. Many people faced with suicidal ideation do not commit suicide but may have suicidal behavior or make suicide attempts. The range of suicidal ideation varies immensely from fleeting to detailed planning, unsuccessful attempts or role playing, which may be constructed to fail or be discovered or be intended to succeed. People who face issues with suicidal thoughts and behaviors may have symptoms of depression, hopelessness, severe anxiety, insomnia, or panic attacks. It is important to note that not all people who are diagnosed with a medical or mental health condition experience suicidal ideation and that all suicidal ideation and behavior should be taken seriously.

Common Variables Used to Assess Suicide Risk and Behavior.

If you see these behaviors in yourself or someone else, get help now: 

• Threatening to hurt oneself 
• Threats to kill oneself
• Attempts to access means to kill oneself, such as weapons or medications
• Talking and writing about own death
• Revenge seeking behavior
• Talking about feeling trapped in an unhappy situation, and not seeing anyway out
• Feeling no reason to live, and no purpose in life
• Withdrawing from friends, school, work, family, and all other important relationships
• Engaging in risky behavior without caution 

Statistics about Suicide*:

• The national average of suicide is 11.3 suicides per 100,000 people.
• Suicide accounts for 1% of deaths in America.
• An estimated 11 suicide attempts occur per every suicide death.
• Suicide takes away more total years of life than any cause other than heart disease and cancer.
• In 2007, suicide was the seventh most common cause of death for males and the fifteenth most common cause of death for women.
• Nearly four times as many males die from suicide as females.
• The age group with the highest suicide rate is those 65 and older, at 14.3 suicides per 100,000 people. 
• American Indian and Alaska Natives have the highest suicide rates of any racial group, at 14.3 suicides per 100,000 people.
• Non-Hispanic blacks have the lowest suicide rate of any racial group, at 5.2 suicides per 100,000 people.

 *Statistics from the National Institute of Mental Health's Suicide Statistics and Prevention.

Common Causes for Suicidal Ideation and Behavior May Include:

Life Events

• Failed or failing relationship(s)

• Grief

• Medical illness

• Rejection

• Sexual abuse, emotional abuse and/or physical abuse

• Unemployment

Past History

• Family history of parasuicide (self-harm, attempts or gestures with no intent to die)

• History of previous suicide attempt(s)

Prescription Medication Side Effects

• Suicidal ideation and behavior may be a side effect of various prescription drugs

Psychological Issues

• Eating & Food Issues

• Bipolar

• Body Image

• Dissociation

• Gender Identity Issues

• Depression

• Panic

• Post-traumatic stress/trauma

• Schizophrenia

• Social anxiety

Suicidal ideation and behavior have been found to be most prevalent in people faced with mood issues such as bipolar coupled with substance or alcohol abuse. People diagnosed with schizophrenia have a higher rate of suicidal ideation during periods of remission. People diagnosed with serious medical illnesses such as AIDS or cancer are more likely to experience suicidal ideation if they also have a psychiatric disorder. 

Psychotherapy for Suicidal Ideation

Psychotherapy can be beneficial for people who struggle with chronic suicidal ideation and behavior. However, when an individual is at risk of suicide it's very important to receive a higher level of care, such as hospitalization, intense in-patient or out-patient treatment. Weekly psychotherapy is simply insufficient to manage and protect suicidal individuals. The psychotherapy model views "hopelessness" as strongest contributing factor to suicidal ideation. A large part of crisis intervention and post crisis counseling aims to restore hope. Psychotherapy may be used to curb urges to self-harm and will likely attempt to resolve the underlying cause of suicidal ideation.

Medical Attention to Suicidal Ideation

Diagnoses of medical illness and psychiatric disorders allow the medical community with options for treatment. Suicidal ideation may be a result of or cause of a host of psychiatric problems which may need to be treated with medication. In severe cases of suicidal ideation and behavior, hospitalization or intense in-patient or out-patient treatment may be necessary. Suicidal ideation may lead to deteriorating physical health, which may require medical attention.

Psychiatric Disorders Associated with Suicidal Ideation

The DSM covers many psychiatric disorders which may cause or are a result of suicidal ideation and behavior. They include:

• Adjustment disorder - psychological response to identifiable stressor(s) that cause(s) significant behavioral or emotional symptoms

• Anorexia - eating disorder detailed by refusal to maintain a healthy body weight with an obsessive fear of gaining weight due to a distorted self-image

• Bipolar - mood disorder defined by one or more episodes of abnormally elevated energy levels with or without one or more depressive episodes

• Body dysmorphic disorder - psychological disorder described by excessive concern about and preoccupied by a perceived defect in physical features

• Borderline personality disorder - personality disorder characterized by a prolonged disturbance of personality function in a person, defined by depth and variability of moods

• Dissociative identity disorder - psychological disorder in which multiple and distinct personalities are present

• Gender dysphoria - formal diagnosis for someone who is discontent with the biological gender with which they were born

• Major depressive disorder - mental disorder characterized by an all-encompassing low mood with low self-esteem and social isolation

• Panic disorder - anxiety disorder described by severe and recurring panic attacks

• Post-traumatic stress disorder - anxiety disorder that may develop after exposure to an event that results in psychological trauma

• Schizophrenia - mental disorder characterized by disintegrating thinking process and diminishing emotional responsiveness

• Social anxiety - anxiety disorder detailed by intense fear in social situations which may cause a large amount distress and impaired ability to function 

Resources Related to Suicide:

NIMH Suicide Prevention

Suicide Awareness Voices of Education (SAVE)

American Foundation for Suicide Prevention

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Last updated: 05-14-2013