Understanding Suicidal Thoughts and Ideation: How to Cope

DISCLAIMER: This article deals with suicide, suicidal ideation, suicidal thoughts and self-harm. Information present in this article may be difficult or triggering to some people. If you also have suicidal thoughts or know someone with suicidal thoughts, please call the National Suicide Prevention Hotline at 988 to speak with a trained professional and counselor. If you or a loved one is in immediate danger, call 911. 

Suicide is a major public health concern. Suicide is one of the leading causes of death in the United States and has been on the rise in recent years. Understanding the issues concerning suicide and mental health is an important way to take part in suicide prevention, help others in crisis, and change the conversation around suicide. Here’s a list of FAQs we put together about suicide to help you keep informed.

What causes people to want to harm or have suicidal thoughts?

First and foremost, we should define the different types of self-harm. 

Suicide is a completed death inflicted by the self, where the person intentionally ends their own life. Suicide is second leading cause in adolescents, and young adults between ages 15-24.  

A suicide attempt is when a person actively tries to kill themselves but they survive the effort. Over 90% of those who attempt suicide are struggling with a significant mental health disorder such as major depression.

A suicidal gesture, otherwise known as a parasuicide, is where a person goes through the motions of a suicide but does not have the intent to go through with it. Instead, they are giving the appearance of a suicide to communicate with those around them. 

Suicidal ideation is thinking about death, contemplation of suicide, and having the desire to die. 

All of these are grave matters and require the help of a trusted counselor or professional. At the foundation of all suicide attempts, suicidal gestures, and suicidal ideation is an overwhelming sense of hopelessness and worthlessness. A recent study suggests that at least 64% of attempted suicides are impulsive acts –– which is a very alarming and dangerous statistic.* Likely more than half the deaths by suicide were done impulsively, driven by overwhelming emotions of despondency, hopelessness, and worthlessness. 

This statistic is not surprising. Adolescents and young adults in their early 20s are still developing and they are inclined to act impulsively. The prefrontal cortex in their brain, which is responsible for decision making and assessing all possible consequences, is not fully developed yet. Therefore, it is absolutely crucial to find help for any child, teenager, or young adult who is suffering. 

What are the risk factors associated with suicide, suicidal attempts, and suicidal ideation?

There are several factors that increase the risk of suicide:

– family history of suicide or suicidal attempts
– exposure to a negative and toxic environment such as constant bullying at school, abuse at home by a parent or caretaker as some examples
– romantic rejection
– loss of a loved one or loved ones
– mental illness, particularly major depression
– stigma against seeking help for depression in the community
– isolation from community or loved ones 
– alcohol and substance abuse

What can we do to help if we hear someone talk about suicide or harming themselves?

When someone you know comes to you to talk to you about taking their own life, it can be very shocking and upsetting. No matter what their intentions are, it is a cry for help and they need someone to talk to. Here is what you can do for the person:

First and foremost, do not be afraid to talk to them and listen to them. They really need you to be there for them. You can first start by providing assurance that you are here for them and that they can trust you. You can also begin asking questions that are direct but also sensitive to how they are feeling:
– ”Are you feeling so sad that you do not want to live anymore?”
– ”Are you feeling so sad that you want to just give up?”
– ”Have you ever thought about suicide before?” 
– ”Have you tried to harm yourself before?”
– “How long have you been feeling this way?”
– “Did something happen to make you feel this way?” 

Even though you may be feeling very anxious for the person who is talking about suicide, do your best to avoid appearing alarmed. However, we want to help validate and normalize their feelings of despondency – we want to help them understand that these feelings come and go. 

Asking to go further into detail about their suicidal thoughts and feelings will not convince them to go through with it. Instead, it actually will help the person as they desperately need to talk about it and may even reduce the risk of acting upon these thoughts.

How do we know when someone is serious about their suicidal thoughts?

We must take seriously anyone who talks about suicide or harming themselves, even if they may not have an intent to go through with it. Any comments about wanting to die by suicide, even if it is for attention-seeking purposes, is not normal. 

If it is for attention-seeking purposes, it really means that they need your attention. They talk about suicide because they haven’t been able to get it any other way. It is a serious cry for help and it is important to take it seriously. 

Any discussion of suicide, suicidal ideation, and suicidal attempts are related to a mental health condition such as major depression or anxiety. We must find out the underlying psychological reason. Perhaps there is not an official diagnosis yet, so we must try and get a full picture of what is happening in their life and environment that is causing them to feel so hopeless that they feel the only relief is death. 

What are typical treatments for those who speak about suicide and have suicidal thoughts?

We urgently recommend that they see a psychotherapist to get to the root of this preoccupation with self-harm and death. A psychotherapist can help discover whether the root of this overwhelming sadness comes from something in their past, or from a major recent loss, or from their current environment. A psychotherapist will also be able to identify other underlying disorders such as borderline personality disorder or bipolar disorder and tailor the treatment to the individual.

If someone has a major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, and others, some of these may need medication to stabilize neurological chemistry which may cause someone to be more inclined to have suicidal thoughts. 

Lastly, we cannot forget the spiritual aspect of healing. Ongoing, constant, teaching of the person’s identity as a child of God will help them understand that they have meaning and purpose on this earth. Helping them meditate on the good news of the Gospel and the love of God will help instill hope and help them see the value of their life. 

You can watch the accompanying Anchor of Hope video here.

*Physicians Postgraduate Press, Inc. Lifelong Learning for Clinicians

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