Understanding Suicidal Ideation

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“Soak up the views. Take in the bad weather and the good weather. You are not the storm.” ~ Matt Haig

A recent report by Mental Health America (MHA) demonstrated that Suicidal ideation among adults is increasing. An additional 460,000 people reported experiencing serious thoughts of suicide, which is an increase of 0.15%.  [1]

This report also demonstrates how the COVID-19 pandemic has significantly affected American adults’ this issue, as over 178,000 people have reported frequent suicidal ideation since March 2020. 37% of these people reported having thoughts of suicide nearly every day.[2]

What is Suicidal Ideation?

Suicidal ideation is where an individual thinks about suicide or wants to take their own life. There are two types of suicidal ideation to be considered:

  • Passive  – This is where a person wishes they were dead or fantasizes about committing suicide but does not have plans to do so.[3]
  • Active  –  This is where the individual intends to take their own life and is in the process of putting together a plan or has already made one. [4]

There is also some key terminology around suicidal ideation which helps understand the specific circumstances and unique nature of each individual case:[5]

  • Suicide threat – This is where a person threatens to take their own life, despite potentially having no intention to follow through.  For example, they may threaten a romantic partner by saying, “If you leave me, I will kill myself.” While this does not minimize their distress or suicidal thoughts, the term describes the verbalization and persuasion of others to believe the threat.
  • Suicide gesture – This involves self-injurious behavior that is an outward expression of pain and is done to convince others they wish to die, even if they actually wish to live.
  • Non-suicidal self-injury or self-injurious thoughts – This is self-harming behavior or thoughts characterized by deliberate harm to the body without intending to die.  

It is key to note that Passive Suicidal Ideation is not necessarily any less serious than Active Suicidal Ideation. Additionally, self-injurious thoughts or behaviors could become active if left unaddressed. 

A 2019 report demonstrated that by trivializing those who fantasize about or threaten suicide, rates of death by suicide in America will continue to escalate. It is essential, therefore, that Suicide Ideation is understood and appropriate intervention and treatment is provided for those who are thinking about taking their lives.[6]

Understanding the Risk Factors

Nearly 45,000 people in the United States and more than 800,000 worldwide die by suicide each year.[7]  Though many suicide victims were being seen by psychiatrists or family physicians, the symptoms of Active Suicide Ideation are often either missed or minimized. Being able to spot the symptoms and offer intervention, especially in conjunction with major depression or substance abuse disorders, is essential in order to save lives.[8]

Some common symptoms of suicidal ideation are:[9]

  • Talking about or threatening death or suicide
  • Engaging in destructive and risk-taking behaviors such as alcohol or substance abuse or having unprotected sex
  • Isolation from loved ones
  • Increased depression or anxiety
  • Feeling hopeless or trapped
  • Increased mood swings
  • Giving away possessions or acting as if they are saying goodbye
  • Accessing the means to carry out suicide, such as acquiring a firearm or medications

Suicidal ideation is one of the symptoms of major depression and bipolar disorder, but it can occur in people suffering from anxiety, chronic stress, eating disorders, or PTSD or who have no mental health issues at all.[10]

Research has shown that those who are most at risk of Suicidal Ideation are not only those who suffer from the aforementioned mental health disorders but also those who face life stress or perceived life difficulties such as debt, relationship difficulties, loss of a job, legal stress, and chronic physical health conditions. These situations are thought to increase feelings of diminished self-worth and low self-mastery which can lead to hopelessness and despair.[11]

Warning signs are not always obvious, and an individual may be secretive about their suicidal thoughts. It is essential that the underlying causes of these suicidal thoughts are explored with a therapist alongside building a support network of loved ones. 

The key message to those who are suffering from Suicidal Ideation is that the feelings are temporary, and there is always another solution.

If you are concerned about any issues discussed in this blog, please contact Heather R. Hayes & Associates.  Call 800-335-0316 or email info@heatherhayes.com today.


[1] “The State of Mental Health in America”. Mental Health America, 2021, https://mhanational.org/issues/state-mental-health-america.

[2] “The State of Mental Health in America”. Mental Health America, 2021, https://mhanational.org/issues/state-mental-health-america.

[3] Baca-Garcia, Enrique et al. “Estimating Risk for Suicide Attempt: Are We Asking the Right Questions?”. Journal of Affective Disorders, vol 134, no. 1-3, 2011, pp. 327-332. Elsevier BV, doi:10.1016/j.jad.2011.06.026. Accessed 12 May 2021.

[4] Gliatto, Michael, and Anil Rai. “Evaluation and Treatment of Patients with Suicidal Ideation”. Aafp.Org, 2021, https://www.aafp.org/afp/1999/0315/p1500.html.

[5] Schrieber MD, Jennifer. “Suicidal Ideation and Behavior In Adults”. Uptodate.Com, 2021, https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-adults.

[6] Jobes, David A., and Thomas E. Joiner. “Reflections on Suicidal Ideation”. Crisis, vol 40, no. 4, 2019, pp. 227-230. Hogrefe Publishing Group, doi:10.1027/0227-5910/a000615. Accessed 12 May 2021.

[7] Schrieber MD, Jennifer. “Suicidal Ideation and Behavior In Adults”. Uptodate.Com, 2021, https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-adults.

[8] Gliatto, Michael, and Anil Rai. “Evaluation and Treatment of Patients with Suicidal Ideation”. Aafp.Org, 2021, https://www.aafp.org/afp/1999/0315/p1500.html.

[9] “What Is Suicidal Ideation?”. Verywell Mind, 2021, https://www.verywellmind.com/suicidal-ideation-380609.

[10] https://www.verywellmind.com/suicidal-ideation-380609

[11] Vilhjalmsson, R. et al. “Factors Associated With Suicide Ideation In Adults”. Social Psychiatry And Psychiatric Epidemiology, vol 33, no. 3, 1998, pp. 97-103. Springer Science And Business Media LLC, doi:10.1007/s001270050028. Accessed 12 May 2021.

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