How to Respond to Suicidal Thoughts

by

Reviewed by Jodi Jaspan, MS, LPC

The following information may be triggering. If you are experiencing suicidal thoughts, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Suicidal thoughts are one of the most severe mental health symptoms someone may face. If you find yourself having these types of thoughts, or if a loved one expresses suicidal intent, it is a serious and often frightening situation.

Here’s what you need to know about suicidal thoughts and what you can do to address them.

Signs of Suicidal Ideation

People experiencing suicidal thoughts may have trouble reaching out for help. They may fear that they will be judged or will feel shame due to stigma or moral beliefs. Therefore, it’s important to know the signs of suicidal ideation and reach out to someone who is struggling. Signs that someone is having suicidal thoughts include:

  • Persistent sadness or mood swings
  • Feeling hopeless or helpless, belief that things will never get better or that it is impossible to improve one’s circumstances
  • Changes in sleep patterns, sleeping too much or too little
  • Withdrawing from family and friends
  • Loss of interest in activities they once enjoyed
  • Changes in personality, uncharacteristic attitudes or behaviors
  • Neglecting personal appearance/hygiene
  • Dangerous behaviors such as drug and alcohol abuse or reckless driving
  • Making preparations such as giving away possessions, paying off debts, writing a will, or saying goodbye to friends and family
  • Sudden calmness or happiness after a period of low mood; this could indicate that the person has decided to commit suicide
  • Researching or obtaining the means to commit suicide, for example, purchasing a firearm or drugs
  • Expressing a wish to die or threatening suicide

Even if someone does not explicitly talk about suicide, they may hint at suicidal intent with statements such as:

  • I don’t want to be a burden to anyone
  • I feel trapped
  • My pain is unbearable
  • I feel like I have no reason to live
  • No one will miss me when I’m gone
  • The world would be better off without me
  • I wonder how they would feel if I was dead
  • They would regret how they treated me if I was dead

Assessing a Crisis Situation

If you or someone you know is having suicidal thoughts, assess suicide risk by asking these questions:

  • Do you have a plan to kill yourself?
  • Do you have a specific timeline of when you would do it?
  • Do you have the means to carry out your plan?
  • Do you intend to kill yourself?

If the answer to any of these questions is “yes,” then this is an emergency situation that requires immediate help. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255), or go to the nearest emergency room. If you are with someone who is suicidal, do not leave them alone. Remove firearms, sharp objects, medications, and anything else that could be used to commit suicide.

If you are feeling suicidal and are alone, reach out for help immediately. You can reach out to a family member, friend, therapist, spiritual director, or anyone else you feel comfortable talking to. If there is no one available to be with you, call 911 or a suicide prevention line.

What Causes Suicidal Thoughts?

Suicidal thoughts can be caused by a variety of factors, including:

  • A mental health condition
  • Traumatic events like an assault or accident
  • Past physical or sexual abuse
  • Chronic pain or illness
  • Loneliness or social isolation
  • Stressful life events such as divorce, death of a loved one, or job loss
  • Drug or alcohol use
  • Exposure to suicide through the media, peers, or family members

These are just some of the risk factors identified by the National Institute of Mental Health (NIMH) and the Centers for Disease Control and Prevention (CDC). Any situation or pattern of events that makes someone feel hopeless or helpless may lead to suicidal thoughts. There are also certain periods of life, such as pregnancy or adolescence, that may trigger these thoughts.

Suicidal Thoughts During Pregnancy

For many women, pregnancy can trigger mental health concerns. Postpartum depression is a well-known condition, but anxiety and suicidal thoughts are also common. A Canadian study found that five percent of deaths during pregnancy or in the first year after birth were caused by suicide.

If you experience any mental health concerns during or after pregnancy, don’t hesitate to reach out to your doctor for help. Suicidal thoughts during pregnancy can be caused by a number of different factors, from changes in hormones to the additional responsibilities of being a new parent.

Suicidal Thoughts in Children and Teens

Teens are especially vulnerable to suicidal ideation. Adolescence is a difficult time filled with stressors such as puberty, social conflicts, and academic pressure. Also keep in mind that the average age of onset for many mental health disorders is in the mid-teen years.

Younger children can also think about suicide. The challenge with suicidal thoughts in children is that they are less likely to talk about them. Pay close attention to your child’s behavior and watch for signs that they are preoccupied with death. This may be evident in the shows they watch on TV, the websites they visit, or how they write. Or they may say vague things such as, “Everyone would be happier without me around.”

Suicidal Thoughts vs. Intent

There are different degrees of suicidal thoughts. Some people may experience passive suicidal ideation, which means they want to die but do not have a plan or the intent to commit suicide. They may think about being killed by an outside force such as a car accident, or may think more general thoughts like “my family would be happier without me.”

Active suicidal ideation involves explicit thoughts of killing oneself, including how they would do it and when. People experiencing active suicidal ideation may even take steps like giving away their possessions or saying goodbye to friends.

While both passive and active ideation can be life-threatening, not everyone who thinks about suicide will end up acting on these thoughts. Suicidal intent is a complex area of mental health. It can rapidly fluctuate within a matter of weeks, days, or even hours. This is why it’s important to get help from a mental health professional.

Harm OCD

There is a type of Obsessive Compulsive Disorder (OCD) that features intrusive thoughts about harming oneself or others. This is known as Harm OCD, and it is different than suicidal ideation. Most people with Harm OCD do not want to commit suicide. They fear that they will lose control and hurt themselves.

There are effective therapies to treat Harm OCD. You should seek help from a mental health professional if you are experiencing involuntary thoughts about harming yourself or others.

Treatment for Suicidal Thoughts

There are many effective treatments for suicidal thoughts, including therapy and medication. An effective treatment plan will focus on identifying the root of the ideation and developing coping methods. 

Therapy

A therapist or psychologist can teach you proven techniques to cope with suicidal thoughts and the issues that may be causing them. Cognitive behavioral therapy and dialectical behavior therapy are especially helpful for treating suicidality. Your treatment provider will choose the best type of therapy to address the suicidal thoughts as well as any other factors that are contributing to them.

In some cases, outpatient therapy sessions cannot effectively treat suicidal thoughts. Some individuals may require 24-hour care in a hospital setting. Others may need a more structured treatment plan than talking to a therapist. In these cases, an intermediate level of care like intensive outpatient treatment or partial hospitalization might be the right fit.

The Light Program treats suicidal thoughts in adults and adolescents. Our programming includes intensive outpatient and partial hospitalization.

Learn More

Medication

Your doctor or psychiatrist may prescribe drugs to help reduce suicidal thoughts. Medication is most often recommended when you have an underlying mental health condition that is causing suicidal ideation. Types of medications that might help include antidepressants, antipsychotic medications, and anti-anxiety medications.

Can Antidepressants Cause Suicidal Thoughts?

There have been concerns over whether antidepressants can actually cause suicidal thoughts. Overall, research has found that antidepressants may increase suicidal thoughts and behaviors in individuals up to age 24. For people ages 25 to 30, there was no increase in these thoughts, and the risk of suicidal thoughts actually decreased for older adults.

The Food and Drug Administration (FDA) issued a black box warning for antidepressants in October 2004. The warning stated that these drugs may increase the risk of suicidal thoughts and behaviors in children and adolescents. In May 2007, the FDA updated the black box warning to expand the risk to young adults. It also included information about the risk of suicide in patients with untreated depression.

Keep in mind that leaving a mental health disorder untreated is more likely to lead to suicide than taking an antidepressant that may increase suicidal thoughts. Most of the time, the increase in suicidal thoughts is temporary and only experienced when starting a new medication or adjusting the dosage. Reach out to your primary care provider immediately if you experience suicidal thoughts while taking an antidepressant.

How to Stop Suicidal Thoughts

Suicidal thoughts can be dangerous, scary, and overwhelming. You may fear that the thoughts will never end or that you might act on them. The best way to stop suicidal thoughts is to reach out for help from a doctor or mental health professional. If that feels overwhelming, start by reaching out to a trusted friend, family member, or another person you feel safe talking to.

If you feel ready to take the first step toward managing suicidal thoughts, reach out to The Light Program. Our trained counselors and caring staff will listen to you, make you feel validated, and help you find a way to cope with suicidal thoughts. If you are a parent concerned about your child, we have a variety of adolescent programs to help.

Call (610) 644-6464