Suicidal ideation, or suicidal thoughts, is the

thought process In their most common sense, the terms thought and thinking refer to cognitive processes that can happen independently of sensory stimulation. Their most paradigmatic forms are judging, reasoning, concept formation, problem solving, and delibe ...

of having ideas or ruminations about the possibility of dying by

suicide Suicide is the act of intentionally causing one's own death. Risk factors for suicide include mental disorders, physical disorders, and substance abuse. Some suicides are impulsive acts driven by stress (such as from financial or ac ...

.World Health Organization, ''ICD-11 for Mortality and Morbidity Statistics'', ver. 09/2020
MB26.A Suicidal ideation
/ref> It is not a diagnosis but is a symptom of some

mental disorder A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...

s, use of certain

psychoactive drug A psychoactive drug, psychopharmaceutical, mind-altering drug, consciousness-altering drug, psychoactive substance, or psychotropic substance is a chemical substance that alters psychological functioning by modulating central nervous system acti ...

s, and can also occur in response to adverse life circumstances without the presence of a mental disorder.Barry, Lisa C. Passive Suicidal Ideation in Older Adults: Implications for Suicide Prevention, ''American Journal of Geriatric Psychiatry'' 27, no. 12 (December 2019): 1411 ("... growing evidence points toward a subgroup of individuals who endorse passive SI uicidal ideationin later life outside the context of clinical depression.") On suicide risk scales, the range of suicidal ideation varies from fleeting thoughts to detailed planning. Passive suicidal ideation is thinking about not wanting to live or imagining being dead. Active suicidal ideation involves preparation to kill oneself or forming a plan to do so. Most people who have suicidal thoughts do not go on to make suicide attempts, but suicidal thoughts are considered a risk factor. During 2008–09, an estimated 8.3 million adults aged 18 and over in the United States, or 3.7% of the adult U.S. population, reported having suicidal thoughts in the previous year, while an estimated 2.2 million reported having made suicide plans in the previous year. In 2019, 12 million U.S. adults seriously thought about suicide, 3.5 million planned a suicide attempt, 1.4 million attempted suicide, and more than 47,500 died by suicide. Suicidal thoughts are also common among teenagers. Suicidal ideation is associated with depression and other

mood disorder A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where the main underlying characteristic is a disturbance in the person's mood. The classification is in the ''Diagnostic ...

s; however, many other

mental disorders A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...

, life events and family events can increase the risk of suicidal ideation.

Mental health Mental health is often mistakenly equated with the absence of mental illness. However, mental health refers to a person's overall emotional, psychological, and social well-being. It influences how individuals think, feel, and behave, and how t ...

researchers indicate that healthcare systems should provide treatment for individuals with suicidal ideation, regardless of diagnosis, because of the risk for suicidal acts and repeated problems associated with suicidal thoughts. There are a number of treatment options for people who experience suicidal ideation.

Definitions

The

ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...

describes suicidal ideation as "thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans". The

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...

defines it as "thoughts about

self-harm Self-harm refers to intentional behaviors that cause harm to oneself. This is most commonly regarded as direct injury of one's own skin tissues, usually without suicidal intention. Other terms such as cutting, self-abuse, self-injury, and s ...

, with deliberate consideration or planning of possible techniques of causing one's own death". The U.S.

Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...

defines suicidal ideation "as thinking about, considering, or planning suicide".

Terminology

Another term for suicidal ideation is ''suicidal thoughts''. When someone who has not shown a history of suicidal ideation experiences a sudden and pronounced thought of performing an act which would necessarily lead to their own death, psychologists call this an

intrusive thought An intrusive thought is an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate. When such thoughts are paired with obsessive–compulsi ...

. A commonly experienced example of this is the ''high place phenomenon'', also referred to as ''the call of the void'', which is a sudden urge to jump when in a high place. A euphemism for suicidal ideation is ''internal struggle'', while ''voluntary death'' and ''eating one's gun'' are a synonym and a euphemism respectively, for suicide itself.

Risk factors

The risk factors for suicidal ideation can be divided into three categories: psychiatric disorders, life events, and family history.

Mental disorders

Suicidal ideation is a symptom of many mental disorders and can occur in response to adverse life events without the presence of a mental disorder. There are several psychiatric disorders that appear to be

comorbid In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sicknes ...

with suicidal ideation or considerably increase the risk of suicidal ideation. For example, many individuals with

borderline personality disorder Borderline personality disorder (BPD) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, an acute fear of Abandonment (emotional), abandonment, and intense emotiona ...

exhibit recurrent suicidal behavior and suicidal thoughts. One study found that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts. The following list includes the disorders that have been shown to be the strongest predictors of suicidal ideation. These are not the only disorders that can increase the risk of suicidal ideation. The disorders in which risk is increased the greatest include: *

Major Depressive Disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive depression (mood), low mood, low self-esteem, and anhedonia, loss of interest or pleasure in normally ...

Anxiety disorders Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause phys ...

Autism spectrum disorder Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental disorder characterized by differences or difficulties in social communication and interaction, a preference for predictability and routine, sensory processing di ...

Dysthymia Dysthymia ( ), known as persistent depressive disorder (PDD) in the DSM-5-TR and dysthymic disorder in ICD-11, is a psychiatric condition marked by symptoms that are similar to those of major depressive disorder, but which persist for at leas ...

Bipolar disorder Bipolar disorder (BD), previously known as manic depression, is a mental disorder characterized by periods of Depression (mood), depression and periods of abnormally elevated Mood (psychology), mood that each last from days to weeks, and in ...

Attention deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, impulsivity, and emotional dysregulation that are excessive and pervasive, impairing in multiple con ...

(ADHD) *

Premenstrual dysphoric disorder Premenstrual dysphoric disorder (PMDD) is a mood disorder characterized by emotional, cognitive, and physical symptoms. PMDD causes significant distress or impairment in menstruating women during the luteal phase of the menstrual cycle. The symp ...

(PMDD) *

Post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental disorder that develops from experiencing a Psychological trauma, traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster ...

(PTSD) and

complex post-traumatic stress disorder Complex post-traumatic stress disorder (CPTSD, cPTSD, or hyphenated C-PTSD) is a stress-related mental disorder generally occurring in response to complex traumas (i.e., commonly prolonged (or repetitive) exposure to a traumatic event (or trau ...

(C-PTSD) *

Personality disorders Personality disorders (PD) are a class of mental health conditions characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the culture. T ...

Psychosis In psychopathology, psychosis is a condition in which a person is unable to distinguish, in their experience of life, between what is and is not real. Examples of psychotic symptoms are delusions, hallucinations, and disorganized or inco ...

(detachment from reality) *

Paranoia Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of co ...

Schizophrenia Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...

Substance use disorders Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences to self and others. Related terms include ''substance use problems'' and ''problematic drug or alcohol use''. Along with substance-ind ...

, *

Nightmare disorder Nightmare disorder is a sleep disorder characterized by repeated intense nightmares that most often center on threats to physical safety and security. The nightmares usually occur during the REM stage of sleep, and the person who experiences th ...

Gender dysphoria Gender dysphoria (GD) is the distress a person experiences due to inconsistency between their gender identitytheir personal sense of their own genderand their sex assigned at birth. The term replaced the previous diagnostic label of gender i ...

Conduct disorder Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior that includes theft, lies, physical violence that may lead to destruction, and reck ...

Specific learning disorder Learning disability, learning disorder, or learning difficulty (British English) is a condition in the brain that causes difficulties comprehending or processing information and can be caused by several different factors. Given the "difficulty ...

Obsessive compulsive disorder Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Obsession (psychology), a persistent attachment to an object or idea * Fixation (psychology), persi ...

Eating disorders An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's health, physical or mental health, mental health. These behaviors may include eating too much food or too little food. Types of eatin ...

, such as

Anorexia Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. Individuals wit ...

Binge eating disorder Binge eating disorder (BED) is an eating disorder characterized by frequent and recurrent binge eating episodes with associated negative psychological and social problems, but without the compensatory behaviors common to bulimia nervosa, OSFE ...

, and

Bulimia Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating (eating large quantities of food in a short period of time, often feeling out of control) followed by compensatory behaviors, such as self-induc ...

Medication side effects

Antidepressant medications are commonly used to decrease the symptoms in patients with moderate to severe

clinical depression Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Intro ...

, and some studies indicate a connection between suicidal thoughts and tendencies and taking antidepressants, increasing the risk of suicidal thoughts in some patients. Some medications, such as

selective serotonin reuptake inhibitor Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions. SSRIs primarily work by blo ...

s (SSRIs), can have suicidal ideation as a side effect but can also be effective as antidepressants. Monitoring is advised for those who take SSRIs. In 2003, the

U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...

(FDA) issued the agency's strictest warning for manufacturers of all antidepressants (including

tricyclic antidepressants Tricyclic antidepressants (TCAs) are a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade. They are named after their chemical structure, which contains ...

CAsand

monoamine oxidase inhibitors Monoamine oxidase inhibitors (MAOIs) are a class of drugs that inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B). They are best known as effective antidepressants, espe ...

) due to their association with suicidal thoughts and behaviors. Further studies disagree with the warning, especially when prescribed for adults, claiming more recent studies are inconclusive in the connection between the drugs and suicidal ideation. Individuals with anxiety disorders who self-medicate with drugs or alcohol may also have an increased likelihood of suicidal ideation. Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide, with alcoholism present in between 15% and 61% of cases. Use of prescribed

benzodiazepine Benzodiazepines (BZD, BDZ, BZs), colloquially known as "benzos", are a class of central nervous system (CNS) depressant, depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed t ...

s is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects, such as

disinhibition Disinhibition, also referred to as behavioral disinhibition, is medically recognized as an orientation towards immediate gratification, leading to impulsive behaviour driven by current thoughts, feelings, and external stimuli, without regard for ...

, or withdrawal symptoms.

Life events

Life events are strong predictors of increased risk for suicidal ideation. Furthermore, life events can also lead to or be comorbid with the previously listed psychiatric disorders and predict suicidal ideation through those means. Life events that adults and children face can be dissimilar and for this reason, the list of events that increase risk can vary in adults and children. The life events that have been shown to increase risk most significantly are: *

Alcohol use disorder Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records. The World Hea ...

** Studies have shown that individuals who binge drink, rather than drink socially, tend to have higher rates of suicidal ideation **Certain studies associate those who experience suicidal ideation with higher alcohol consumption **Not only do some studies show that solitary binge drinking can increase suicidal ideation, but there is a positive feedback relationship causing those who have more suicidal ideation to have more drinks per day in a solitary environment *Minoritized

gender expression Gender expression (or gender presentation) is a person's behavior, mannerisms, interests, and appearance that are associated with gender in a particular cultural context, typically understood in terms of masculinity and femininity. Gender expr ...

and/or

sexuality Human sexuality is the way people experience and express themselves sexually. This involves biological, psychological, physical, erotic, emotional, social, or spiritual feelings and behaviors. Because it is a broad term, which has varied ...

or being a

minority Minority may refer to: Politics * Minority government, formed when a political party does not have a majority of overall seats in parliament * Minority leader, in American politics, the floor leader of the second largest caucus in a legislative b ...

group of any kind. *

Unemployment Unemployment, according to the OECD (Organisation for Economic Co-operation and Development), is the proportion of people above a specified age (usually 15) not being in paid employment or self-employment but currently available for work du ...

Chronic illness A chronic condition (also known as chronic disease or chronic illness) is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term ''chronic'' is often applied when the ...

or pain * Death of family members or friends * End of a relationship or being

rejected ''Rejected'' is an animated surrealist short comedy film directed by Don Hertzfeldt that was released in 2000. It was nominated for an Academy Award for Best Animated Short Film the following year at the 73rd Academy Awards, and received 27 a ...

by a romantic interest *Major change in life standard (e.g. relocation abroad) * Other studies have found that

tobacco use Tobacco is the common name of several plants in the genus ''Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the chi ...

is correlated with depression and suicidal ideation *

Social isolation Social isolation is a state of complete or near-complete lack of contact between an individual and society. It differs from loneliness, which reflects temporary and involuntary lack of contact with other humans in the world. Social isolation c ...

Unplanned pregnancy Unintended pregnancies are pregnancies that are mistimed or unwanted at the time of conception, also known as unplanned pregnancies. Sexual activity without the use of effective contraception through choice or coercion is the predominant cause o ...

Bullying Bullying is the use of force, coercion, Suffering, hurtful teasing, comments, or threats, in order to abuse, aggression, aggressively wikt:domination, dominate, or intimidate one or more others. The behavior is often repeated and habitual. On ...

, including

cyberbullying Cyberbullying (cyberharassment or online bullying) is a form of bullying or harassment using electronic means. Since the 2000s, it has become increasingly common, especially among teenagers and adolescents, due to young people's increased u ...

and

workplace bullying Workplace bullying is a persistent pattern of mistreatment from others in the workplace that causes physical and/or emotional harm. It includes verbal, nonverbal Nonverbal communication is the transmission of messages or signals through a non ...

* Previous suicide attempts ** Having previously attempted suicide is one of the strongest indicators of future suicidal ideation or suicide attempts * Military experience ** Military personnel who show symptoms of PTSD, major depressive disorder, alcohol use disorder, and generalized anxiety disorder show higher levels of suicidal ideation * Community violence * Undesired changes in body weight ** Women: increased BMI increases chance of suicidal ideation ** Men: severe decrease in BMI increases chance of suicidal ideation *** In general, the obese population has increased odds of suicidal ideation in relation to individuals that are of average-weight * Exposure and attention to suicide related images or words

Family history

* Parents with a history of depression ** Valenstein et al. studied 340 adults whose parents had experienced depression. They found that 7% of the offspring had suicidal ideation in the previous month alone * Abuse ** Childhood: physical, emotional and sexual abuse ** Adolescence: physical, emotional and sexual abuse * Family violence * Childhood residential instability **Certain studies associate those who experience suicidal ideation with

family disruption Family (from ) is a group of people related either by consanguinity (by recognized birth) or affinity (by marriage or other relationship). It forms the basis for social order. Ideally, families offer predictability, structure, and safety as m ...

Relationships with parents

According to a study conducted by Ruth X. Liu of

San Diego State University San Diego State University (SDSU) is a Public university, public research university in San Diego, California, United States. Founded in 1897, it is the third-oldest university and southernmost in the 23-member California State University (CS ...

, a significant connection was found between the parent–child relationships of adolescents in early, middle and late

adolescence Adolescence () is a transitional stage of human Developmental biology, physical and psychological Human development (biology), development that generally occurs during the period from puberty to adulthood (typically corresponding to the age o ...

and their likelihood of suicidal ideation. The study consisted of measuring relationships between mothers and daughters, fathers and sons, mothers and sons, and fathers and daughters. The relationships between fathers and sons during early and middle adolescence show an inverse relationship to suicidal ideation. Closeness with the father in late adolescence is "significantly related to suicidal ideation". Liu goes on to explain the relationship found between closeness with the opposite sex parent and the child's risk of suicidal thoughts. It was found that boys are better protected from suicidal ideation if they are close to their mothers through early and late adolescence; whereas girls are better protected by having a close relationship with their father during middle adolescence. An article published in 2010 by Zappulla and Pace found that suicidal ideation in adolescent boys is exacerbated by detachment from the parents when depression is already present in the child. Lifetime prevalence estimates of suicidal ideation among nonclinical populations of adolescents generally range from 60% to 75% and in many cases its severity increases the risk of suicide. Parents who are unaccepting of their child's expressed LGBT sexuality create a hotbed for suicidal ideation (see under LGBT youth below).

Prevention

Early detection and treatment are the best ways to prevent suicidal ideation and suicide attempts. If signs, symptoms, or risk factors are detected early then the individual might seek treatment and help before attempting to take their own life. In a study of individuals who did die by suicide, 91% of them likely had one or more mental illnesses. However, only 35% of those individuals were treated or being treated for a mental illness. This emphasizes the importance of early detection; if a mental illness is detected, it can be treated and controlled to help prevent suicide attempts. Another study investigated strictly suicidal ideation in adolescents. This study found that depression symptoms in adolescents as early as 9th grade is a predictor of suicidal ideation. Most people with long-term suicidal ideation do not seek professional help. The previously mentioned studies point out the difficulty that mental health professionals have in motivating individuals to seek and continue treatment. Ways to increase the number of individuals who seek treatment may include: * Increasing the availability of therapy treatment in early stage * Increasing the public's knowledge of when psychiatric help may be beneficial to them ** Those who have adverse life conditions seem to have just as much risk of suicide as those with mental illness A study conducted by researchers in Australia set out to determine a course of early detection for suicidal ideation in teens stating that "risks associated with suicidality require an immediate focus on diminishing self-harming cognitions so as to ensure safety before attending to the underlying etiology of the behavior". A Psychological Distress scale known as the K10 was administered monthly to a random sample of individuals. According to the results among the 9.9% of individuals who reported "psychological distress (all categories)" 5.1% of the same participants reported suicidal ideation. Participants who scored "very high" on the Psychological Distress scale "were 77 times more likely to report suicidal ideation than those in the low category". In a one-year study conducted in Finland, 41% of the patients who later died by suicide saw a healthcare professional, most seeing a psychiatrist. Of those, only 22% discussed suicidal intent on their last office visit. In most of the cases, the office visit took place within a week of the suicide, and most of the victims had a diagnosed depressive disorder. There are many centers where one can receive aid in the fight against suicidal ideation and suicide. Hemelrijk et al. (2012) found evidence that assisting people with suicidal ideation via the internet versus more direct forms such as phone conversations has a greater effect. In a 2021 research study, Nguyen et al. (2021) propose that maybe the premise that suicidal ideation is a kind of illness has been an obstacle to dealing with suicidal ideation. They use a Bayesian statistical investigation, in conjunction with the mindsponge theory, to explore the processes where mental disorders have played a very minor role and conclude that there are many cases where the suicidal ideation represents a type of cost-benefit analysis for a life/death consideration, and these people may not be called "patients".

Assessment

Assessment seeks to understand an individual by integrating information from multiple sources such as clinical interviews; medical exams and physiological measures; standardized psychometric tests and questionnaires; structured diagnostic interviews; review of records; and collateral interviews.

Interviews

Psychologists, psychiatrists, and other mental health professionals conduct clinical interviews to ascertain the nature of a patient or client's difficulties, including any signs or symptoms of illness the person might exhibit. Clinical interviews are "unstructured" in the sense that each clinician develops a particular approach to asking questions, without necessarily following a predefined format. Structured (or semi-structured) interviews prescribe the questions, their order of presentation, "probes" (queries) if a patient's response is not clear or specific enough, and a method to rate the frequency and intensity of symptoms.

Standardized psychometric measures

* Beck Scale for Suicide Ideation * Nurses' Global Assessment of Suicide Risk * Suicidal Affect–Behavior–Cognition Scale (SABCS) * Columbia Suicide Severity Rating Scale

Management

Treatment of suicidal ideation can be problematic due to the fact that several medications have actually been linked to increasing or causing suicidal ideation in patients. Therefore, several alternative means of treating suicidal ideation are often used. The main treatments include: therapy, hospitalization, outpatient treatment, and medication or other modalities.

Diet

There are no specific diets that can treat suicidal ideation.

Therapy

psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of Psychology, psychological methods, particularly when based on regular Conversation, personal interaction, to help a person change behavior, increase hap ...

a person explores the issues that make them feel suicidal and learns skills to help manage emotions more effectively.

Hospitalization

Hospitalization allows the patient to be in a secure, supervised environment to prevent suicidal ideation from turning into suicide attempts. In most cases, individuals have the freedom to choose which treatment they see fit for themselves. However, there are several circumstances in which individuals can be hospitalized involuntarily. These circumstances are: * If an individual poses a danger to self or others * If an individual is unable to care for oneself Hospitalization may also be a treatment option if an individual: * Does not have social support or people to supervise them * Has a suicide plan * Has symptoms of a psychiatric disorder (e.g.,

psychosis In psychopathology, psychosis is a condition in which a person is unable to distinguish, in their experience of life, between what is and is not real. Examples of psychotic symptoms are delusions, hallucinations, and disorganized or inco ...

mania Mania, also known as manic syndrome, is a Psychiatry, psychiatric Abnormality (behavior), behavioral syndrome defined as a state of Abnormality (behavior), abnormally elevated arousal, affect (psychology), affect, and energy level. During a mani ...

, etc.)

Outpatient treatment

Outpatient treatment allows individuals to remain at their place of residence and receive treatment when needed or on a scheduled basis. Being at home may improve quality of life for some patients, because they will have access to their personal belongings, and be able to come and go freely. Before allowing patients the freedom that comes with outpatient treatment, physicians evaluate several factors of the patient. These factors include the patient's level of social support,

impulse control Inhibitory control, also known as response inhibition, is a cognitive process Cognition is the "mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of ...

and quality of judgment. After the patient passes the evaluation, they are often asked to consent to a "no-harm contract". This is a contract formulated by the physician and the family of the patient. Within the contract, the patient agrees not to harm themself, to continue their visits with the physician, and to contact the physician in times of need. There is some debate as to whether "no-harm" contracts are effective. These patients are then checked on routinely to assure they are maintaining their contract and avoiding dangerous activities (drinking alcohol, driving fast and not wearing a seat belt, etc.).

Medication

Prescribing medication to treat suicidal ideation can be difficult. One reason for this is that many medications lift patients' energy levels before lifting their moods. This puts them at greater risk of following through with attempting suicide. Additionally, if a person has a comorbid psychiatric disorder, it may be difficult to find a medication that addresses both the psychiatric disorder and suicidal ideation. Antidepressants may be effective. Often,

SSRIs Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions. SSRIs primarily work by blo ...

are used instead of

TCAs A traffic alert and collision avoidance system (TCAS), pronounced ), also known as an Airborne Collision Avoidance System (ACAS), is an aircraft collision avoidance system designed to reduce the incidence of mid-air collision (MAC) between aircraf ...

as the latter typically have greater harm in overdose. Antidepressants have been shown to be a very effective means of treating suicidal ideation. One correlational study compared mortality rates due to suicide to the use of SSRI antidepressants in certain counties. The counties which had higher SSRI use had a significantly lower number of deaths caused by suicide. Additionally, an experimental study followed depressed patients for one year. During the first six months of that year, the patients were examined for suicidal behavior including suicidal ideation. The patients were then prescribed antidepressants for the six months following the first six observatory months. During the six months of treatment, experimenters found suicidal ideation reduced from 47% of patients down to 14% of patients. Thus, it appears from current research that antidepressants have a helpful effect on the reduction of suicidal ideation. Although research is largely in favor of the use of antidepressants for the treatment of suicidal ideation, in some cases antidepressants are claimed to be the cause of suicidal ideation. Upon the start of using antidepressants, many clinicians will note that sometimes the sudden onset of suicidal ideation may accompany treatment. This has caused the Food and Drug Administration (FDA) to issue a warning stating that sometimes the use of antidepressants may actually increase suicidal ideation. Medical studies have found antidepressants help treat cases of suicidal ideation and work especially well with psychological therapy.

Lithium Lithium (from , , ) is a chemical element; it has chemical symbol, symbol Li and atomic number 3. It is a soft, silvery-white alkali metal. Under standard temperature and pressure, standard conditions, it is the least dense metal and the ...

reduces the risk of suicide in people with mood disorders. Tentative evidence finds

clozapine Clozapine, sold under the brand name Clozaril among others, is a psychiatric medication and was the first atypical antipsychotic to be discovered. It is used primarily to treat people with schizophrenia and schizoaffective disorder who have ...

in people with schizophrenia reduces the risk of suicide.

Others

Dialectical behavior therapy

Transcranial magnetic stimulation

Electroconvulsive therapy Electroconvulsive therapy (ECT) is a psychiatry, psychiatric treatment that causes a generalized seizure by passing electrical current through the brain. ECT is often used as an intervention for mental disorders when other treatments are inadequ ...

LGBT youth

Suicidal ideation rates among

lesbian A lesbian is a homosexual woman or girl. The word is also used for women in relation to their sexual identity or sexual behavior, regardless of sexual orientation, or as an adjective to characterize or associate nouns with female homosexu ...

gay ''Gay'' is a term that primarily refers to a homosexual person or the trait of being homosexual. The term originally meant 'carefree', 'cheerful', or 'bright and showy'. While scant usage referring to male homosexuality dates to the late ...

bisexual Bisexuality is romantic attraction, sexual attraction, or sexual behavior toward both males and females. It may also be defined as the attraction to more than one gender, to people of both the same and different gender, or the attraction t ...

transgender A transgender (often shortened to trans) person has a gender identity different from that typically associated with the sex they were sex assignment, assigned at birth. The opposite of ''transgender'' is ''cisgender'', which describes perso ...

(

LGBT LGBTQ people are individuals who are lesbian, gay, bisexual, transgender, queer, or questioning. Many variants of the initialism are used; LGBTQIA+ people incorporates intersex, asexual, aromantic, agender, and other individuals. The gro ...

)

youth Youth is the time of life when one is young. The word, youth, can also mean the time between childhood and adulthood (Maturity (psychological), maturity), but it can also refer to one's peak, in terms of health or the period of life known as bei ...

are significantly higher than among the general population. Suicidal ideation, which has a higher prevalence among LGBT teenagers compared to their cisgender and heterosexual peers, has been attributed to

minority stress Minority stress describes high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status; well understood causes of minority stress are ...

, bullying, and parental disapproval. Within the LGBTQ+ population, transgender youths face the highest rate of suicidal ideation. It is estimated that 82% of transgender people consider suicide with another estimated 40% actually attempting to kill themselves.

South Korea

South Korea South Korea, officially the Republic of Korea (ROK), is a country in East Asia. It constitutes the southern half of the Korea, Korean Peninsula and borders North Korea along the Korean Demilitarized Zone, with the Yellow Sea to the west and t ...

has the 4th highest rate of suicide in the world and the highest in the

OECD The Organisation for Economic Co-operation and Development (OECD; , OCDE) is an international organization, intergovernmental organization with 38 member countries, founded in 1961 to stimulate economic progress and international trade, wor ...

. Within these rates, suicide is the primary cause of

death Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...

for

, ages 10–19. While these rates are elevated, suicidal ideation additionally increases with the introduction of LGBT identity.

References

External links

Evaluation and Treatment of Patients with Suicidal Ideation

Suicidal Thought

National Suicide Prevention Lifeline: Warning signs
{{DEFAULTSORT:Suicidal Ideation Anxiety disorders Attention deficit hyperactivity disorder Autism spectrum disorders Bipolar disorder Borderline personality disorder Major depressive disorder Mental disorders Paranoia Personality disorders Post-traumatic stress disorder Psychosis Symptoms of schizophrenia Substance dependence Substance-related disorders Ideation Symptoms and signs of mental disorders Symptoms or signs involving content of thought