Signs & Symptoms of Suicidal Ideation

Understanding Suicidal Ideation

Learn About Suicidal Ideation

Suicide, or the act of taking one’s own life, is an all-too-common and tragic public health crisis, often done in response to overwhelming, unbearable emotional pain. Suicide is especially tragic as it is a preventable death and leaves behind many loved ones and family members, also called “suicide survivors,” who must grieve this terrible loss.  Suicidal ideation, or suicidal thoughts are a lot more common than most people let on – in fact, most people have thought about suicide at one point or another. These thoughts are quite troubling, especially as they’re usually accompanied by a mental illness such as depression or bipolar disorder. Suicidal ideation is broken down into two forms: active and passive. Active suicidal ideation involves an existing wish to die accompanied by a plan for how to carry out the death. Passive suicidal ideation involves a desire to die, but without a specific plan for carrying out the death. Anyone who has or knows someone who has active suicidal ideation should call 911 or go to the nearest emergency room immediately. This is a medical emergency.

A person with suicidal ideation may not ask for help. However, that does not mean help is not needed or wanted. Many people who die by suicide do not actually wish for death – they only want the pain to go away. Prevention of suicide begins with recognizing  the warning signs of suicidal behaviors and taking action.


Suicidal Ideation Statistics

Nearly 40,000 people in the United States die by suicide each year; more than those who die by homicide. Men are more likely than women to die by suicide, as they tend to use more lethal means to complete the suicide.. Suicide is a major preventable public health crisis in the U.S. and worldwide. In 2007, suicide was the tenth leading cause of death in the United States at an overall rate of 11.3 suicide deaths per 100,000 people. It’s estimated that 11 suicide attempts occur for every death by suicide.

Causes and Risk Factors

Causes and Risk Factors for Suicidal Ideation

It’s believed that the causes and risk factors for suicidal ideation are a combination of genetic, physical, and environmental risk factors that work together. Common causes and risk factors for suicidal ideation include:

Genetic: People that are born into families with a history of mental illness or suicidal thoughts are at a higher risk for developing suicidal thoughts or mental illness themselves. However, while there is a genetic component to suicidal ideation and mental illness, not everyone who has a family history will develop suicidal ideations, nor do all those who have suicidal ideation have a family history of the disorder.

Physical: It’s thought that abnormally low levels of the neurotransmitters dopamine and serotonin, in addition to changes to the structure and function of the brain, can increase the risk for many mental illnesses, including those that cause suicidal thoughts and behaviors.

Environmental: Those who are bombarded with repeated, negative life events and experience constant levels of major stress that overwhelm their ability to cope are at higher risk for suicide. Additionally, those exposed to others who die by suicide are at greater risk for developing suicidal ideation themselves.

Risk Factors:

  • Untreated mental disorders
  • Prior history of suicide attempt
  • Family history of suicide or mental disorders
  • Family and domestic violence
  • Having guns in the home
  • Incarceration
  • Being male

Signs and Symptoms

Signs and Symptoms of Suicidal Ideation

Most people who are experiencing suicidal ideations do give off warning signs that they’re intending to die by suicide. The best way to prevent this tragedy is to recognize and act upon any warning signs that a loved one or family member is considering death by suicide. The most common warning symptoms and signs of suicidal thoughts and behaviors include:

Behavioral Symptoms:

  • Giving away prized possessions
  • Talking about death, dying
  • Using phrases such as “when I’m gone…” or “I’m going to kill myself”
  • Getting affairs in order
  • Saying goodbye to loved ones
  • Obtaining items needed for suicide attempt
  • Decreased social contact
  • Increasing drug and alcohol usage
  • Withdrawing from once-pleasurable activities
  • Increased risky behaviors

Physical Symptoms:

  • Scars or injuries from past suicide attempts
  • Changes in eating or sleeping habits
  • Chronic and/or terminal illness

Cognitive Symptoms:

  • Preoccupation with death and dying
  • Belief that dying by suicide is the only way to end emotional pain

Psychosocial Symptoms:

  • Feeling helpless; trapped by emotional pain
  • Psychosis
  • Self-loathing
  • Hopelessness
  • Paranoia
  • Intense emotional pain
  • Feeing hopeless about a situation
  • Mood swings
  • Sudden changes in personality
  • Severe anxiety and agitation


Effects of Suicidal Ideation

The long-term effects of suicidal thoughts and behaviors are tremendously challenging, often devastating, and may include:

  • Severe injury
  • Damage to all organ systems
  • Brain damage
  • Brain death
  • Seizures
  • Coma
  • Death

Effects upon Suicide Survivors:

For every completed suicide, 6 to 8 people are left behind to grieve the major loss. These suicide survivors must face grief complicated by the stigma of dying by suicide. Effects of suicide on suicide survivors can include:

  • Extreme guilt
  • Going over and over the last moments with the loved one, trying to figure out how they could have prevented the suicide
  • Complicated grieving
  • Shame
  • Anger
  • Feelings that they are unable to properly grieve in a public way due to the stigma of suicide
  • Deep depression

Co-Occurring Disorders

Suicidal Ideation and Co-Occurring Disorders

Suicidal ideations are often a symptom or result of undiagnosed or untreated mental health disorders. The most common co-occurring, comorbid mental health disorders include:

  • Depressive disorders
  • Bipolar disorder
  • Borderline personality disorder
  • Anxiety disorders
  • Substance abuse and addiction
  • Alcoholism
  • Schizophrenia
  • Obsessive-compulsive disorder
  • Psychosis
  • Paranoia
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