• Suicidal Ideation—Adult

    (Suicidal Thinking)

    Definition

    Thinking about, considering, or planning to commit suicide is known as suicidal ideation.

    Causes

    Suicide is often the result of many factors which can vary from person to person. Many people thinking about suicide are having difficulty coping with stressful factors and feel very overwhelmed and hopeless.
    The majority of people who consider suicide also have a mental illness like depression or substance abuse. These conditions may cause suicidal thoughts alone or simply make stressful situations worse.

    Risk Factors

    Factors that may increase the risk of suicidal ideation include mental health disorders such as:
    Other factors that may increase the risk of suicidal ideation include:
    • Lack of a support system
    • Poor coping skills
    • Current traumatic or stressful life event, such as a job or financial loss or the loss of a relationship
    • History of trauma or abuse
    • History of hasty or violent behaviors
    • Family history of suicide
    • Exposure to others who have died by suicide
    • Prior suicide attempt
    • Easy access to items that could be used for self-harm, such as guns
    The Brain
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Symptoms

    People who are thinking about suicide may:
    • Talk about wanting to die or commit suicide
    • Talk about feelings of despair
    • Plan for death, such as giving away favorite items
    • Withdraw from family and friends
    Other symptoms may include:
    • Irritability
    • Indifference
    • Difficulty focusing
    • Loss of interest in daily activities, such as work and hobbies
    • Loss or gain in appetite
    • Sleeping too little or too much
    • Changes in appearance, such as lack of personal hygiene
    • Increased use of alcohol or drugs
    • Mood swings that range from irritability to a sudden sense of calm
    • Acting anxious or restless; behaving hastily
    • Talking about feeling trapped or in unbearable pain
    These symptoms can occur without suicidal ideation. However, if someone you know has these signs, try to talk to them to better learn what is happening. Asking about suicidal feelings will not encourage someone to commit suicide but may actually help prevent suicide.
    If you or someone you know has thoughts of suicide or harming oneself, it is important to seek professional help right away. There are many suicide hotlines to help those considering suicide or to provide information for friends and family of someone considering suicide.
    If the risk of suicide is severe, go to an emergency room or call for emergency services. Risk is considered severe if the person has a well thought out plan to commit suicide and has access to items that can cause harm.

    Diagnosis

    The doctor will ask about symptoms and medical and psychiatric history. Family members may also be interviewed.
    A mental health specialist may complete a psychological assessment to look for any underlying issues.

    Treatment

    Immediate hospitalization may be needed if there is a severe threat of suicide.
    Individual, family, and/or group therapy will be used to help manage suicidal thoughts.
    Overall treatment goals include:
    • Care for underlying mental, physical, and substance abuse disorders
    • Limiting access to items that may be used for self-harm
    • Developing a support system that includes family members and friends
    • Developing skills in problem solving, conflict resolution, and handling problems through nonviolent means

    Prevention

    To help reduce your risk of suicidal ideation:
    • Follow treatment plans for mental or physical health disorders that you may have.
    • Avoid drugs and alcohol. If you have problems with substance abuse, talk to your doctor.
    • If you have difficulty coping with a stressor, talk to someone you trust, such as a family member, friend, or therapist.
    • Limit access to items that may be used for self-harm.

    RESOURCES

    Family Doctor—American Academy of Family Physicians http://www.familydoctor.org

    National Alliance on Mental Illness http://www.nami.org

    CANADIAN RESOURCES

    Canadian Mental Health Association http://www.cmha.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Gliatto M, Rai A. Evaluation and treatment of patients with suicidal ideation. Am Fam Physician. 1999;59(6):1500-1506.

    Major depressive disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116638/Major-depressive-disorder-MDD. Updated September 20, 2016. Accessed October 3, 2016.

    Risk of suicide. National Alliance on Mental Illness. Available at: http://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Suicide. Accessed March 8, 2016.

    Suicidal thoughts. American Association for Marriage and Family Therapy website. Available at: http://www.aamft.org/iMIS15/AAMFT/Content/Consumer%5FUpdates/Suicidal%5FThoughts.aspx. Accessed March 8, 2016.

    Suicide—causes. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Suicide/Pages/Causes.aspx. Updated November 15, 2012. Accessed March 8, 2016.

    Suicide risk factors. National Suicide Prevention Lifeline website. Available at: http://www.suicidepreventionlifeline.org/learn/riskfactors.aspx. Accessed March 8, 2016.

    Symptoms and danger signs. Suicide Awareness Voices of Education site. Available at: http://www.save.org/index.cfm?fuseaction=home.viewpage&page%5Fid=705f4071-99a7-f3f5-e2a64a5a8beaadd8. Accessed March 8, 2016.

    Teenage suicide. American Academy of Child & Adolescent Psychiatry website. Available at: http://www.aacap.org/AACAP/Families%5Fand%5Fyouth/Facts%5Ffor%5FFamilies/FFF-Guide/Teen-Suicide-010.aspx. Updated October 2013. Accessed March 8, 2016.

    Revision Information

    • Reviewer: EBSCO Medical Review Board James Cornell, MD
    • Review Date: 03/2017
    • Update Date: 03/08/2016
  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.