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Contemplating Self-Destruction: Symptoms, Triggers, Mitigation Strategies, and Support Services
This article contains information that some readers might find disturbing. Proceed at your own discretion.
The phrase "suicidal ideation" doesn't have a universally accepted meaning. For some, it means an individual is actively planning suicide, whereas for others, it encompasses suicidal thoughts and intentions.
Not all individuals with suicidal thoughts intend to carry them out, which is why some people categorize only thinking about suicide as separate from developing ideas or planning. However, others consider both as components of "suicidal ideation."
Suicidal ideation is relatively common. In the United States, the CDC reported that 12.2 million individuals had serious suicidal thoughts in 2022. The suicide rate has increased by 36% between 2000 and 2022.
This article delves into suicidal ideation, discussing its symptoms, causes, prevention, diagnosis, and treatment, as well as resources for help.
Help is available
In case of an emergency and if you or someone else is considering suicide or self-harm, seek assistance:
- Contact or message the 988 Lifeline at 988 or visit 988lifeline.org to talk to caring counselors offering free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not based in the US? Find a helpline in your country through Befrienders Worldwide.
- Dial 911 or your local emergency services number if you feel safe doing so.
If calling for someone else, stay with them until help arrives, and if possible, remove items that could cause harm.
If you're not physically present, remain on the phone until help arrives.
What is suicidal ideation?
"Suicidal ideation" refers to a person contemplating death by suicide or devising a strategy to do so. The term encompasses various thoughts and actions, such as:
- passive thinking
- active planning
- suicidal behavior, including self-harm and suicide attempts
Certain people only use the term "suicidal ideation" to describe the planning phase.
Not all individuals who think about suicide progress to planning suicide. In 2022, 12.2 million Americans reported having suicidal thoughts, according to CDC data. Of those, 3.8 million planned suicide, and 1.6 million attempted suicide.
With support and treatment, suicide can be prevented.
Suicidal ideation symptoms
A person experiencing suicidal ideation may exhibit changes in speech, feelings, and behavior. They may talk about:
- wanting to die
- feeling drained, hopeless, or trapped
- being a burden to others
They may experience:
- intense emotional pain
- extreme anxiety or sadness
- intense rage or restlessness
- guilt or embarrassment
- believing there's no reason to live
- severe fluctuations in mood or mood changes
Their behavior may also change. A person contemplating suicide might:
- retreat from friends and family
- use alcohol or drugs more frequently
- sleep more or less
- engage in risky activities
- research ways to end their life
- stockpile medications
- develop a suicide plan
- acquire a firearm
- create a will
- give away important possessions or money
- say goodbye
Not all individuals who consider suicide display these warning signs. Sometimes, the signs can be subtle.
Learn more about the warning signs of suicide.
Suicidal ideation causes
Suicidal ideation rarely has a single cause. Instead, it stems from different life events, thoughts, and feelings.
It's worth noting that many individuals who die by suicide have a mental health condition, typically a mood disorder such as depression or bipolar disorder.
Additional risk factors include:
- exposure to violence, including physical or sexual abuse
- substance use disorder
- a family history of suicide, substance use, or mental disorders
- personal history of suicide attempts
- chronic pain
- recent prison release
- direct or indirect exposure to others' suicidal behavior
Suicide prevention
In cases where individuals display signs of suicidal ideation, family members or friends can follow advice from the American Foundation for Suicide Prevention:
- Speak with them privately
- Listen to their story without judgment
- Express your concern for them
- Take what they say seriously
- Ask directly if they have suicidal thoughts or plans
Try to avoid minimizing their problems or providing unsolicited advice. If the person does have suicidal thoughts or plans:
- Remove harmful objects, like weapons and drugs, from their reach if it's safe to do so
- Contact help services via 911 or the 988 Suicide and Crisis Lifeline
- Stay with them until help arrives or accompany them to the emergency room
- Follow up with them later to check on their well-being
Alternatively, if the person is exhibiting signs of suicidal ideation on social media, you can contact that company's safety team for assistance.
Do not underestimate the power of reaching out. Many individuals who struggle with suicidal thoughts believe there's nothing anyone can do to help them, so they might not seek help.
If someone is pondering self-harm and schedules a consultation with a medical professional or psychologist, the expert will engage in a discussion to assess the seriousness of their symptoms and whether they harbor intentions to carry out self-harm. This pertains to whether they have a current plan for self-destruction.
Various suicide assessment and prevention instruments are available to medical professionals. However, these tools may not always detect an immediate risk of self-harm. Consequently, a face-to-face meeting is indispensable.
A medical professional or psychologist might also detect indications of self-harm inclinations during different situations, such as during a regular visit for chronic pain or depression. If an individual is severely unwell or shows signs of being a threat to themselves, evaluation may take place in a mental health facility.
Addressing Self-Harm Thoughts
Addressing thoughts of self-harm and actions involves dealing with the underlying causes.
Safety Measures
Safety planning is a strategy that can decrease the likelihood of a person attempting self-harm. This strategy involves limiting a person's access to lethal means of self-harm by removing weapons, drugs, and harmful substances from the home.
Safety planning also provides people with emergency contacts and supportive resources they can utilize during a crisis.
Psychotherapy
Psychotherapy, or talk therapy, assists individuals in understanding how their thoughts, emotions, and experiences impact their mental health. It then helps them navigate their emotions and discover ways to progress.
There are numerous types of psychotherapy. Some of the most popular options include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).
CBT helps individuals identify and, over time, replace detrimental thoughts that impact their mood with more balanced, realistic alternatives. DBT aids individuals in recognizing negative thoughts and learning abilities that enhance coping mechanisms in challenging situations.
Additionally, there are some specialized variations of CBT designed to assist individuals who have experienced trauma or who have other mental health conditions requiring specialized attention, such as eating disorders or addiction.
Explore the different types of therapy.
Medication
Many individuals who contemplate self-harm may have a mental health condition, such as anxiety, depression, or a substance use disorder. Medications may aid in addressing the symptoms of these conditions and regulating a person’s mood.
However, some of these meds can also cause thoughts of self-harm as a side effect, particularly in younger adults. Experts stress the importance of discussing any medications an individual currently takes with a doctor or another healthcare professional to determine whether adding another drug, or altering the dosage, would benefit them.
Ongoing Support
Individuals are less likely to self-harm if they receive ongoing support. This may involve easy access to effective mental health care, should an individual require it again, as well as frequent follow-up calls from healthcare professionals.
A person's family, friends, and community also play a significant role in ensuring they remain connected with others.
It is essential for individuals to focus on the things that give their life meaning and purpose, such as:
- caring for a pet, as they provide unconditional love
- leaning into their faith, as many religions promote the sanctity of life
- having things to look forward to, such as a wedding, graduation, or vacation
- making long-term plans or goals
Seeking Help
If an individual is experiencing thoughts of self-harm, it is critically important to seek help immediately. Below are helplines and support services where an individual can discuss issues with a counselor or healthcare professional confidentially:
- *988 Suicide & Crisis Lifeline*: An individual may receive 24/7 phone support by dialing 988. Alternatively, the older number 800-273-TALK (8255) is still available.
- *Crisis Text Line*: Texting “HOME” to 741741 connects individuals to a counselor 24/7.
- *Veterans Crisis Line*: This hotline provides a 24/7 online chat service for veterans, even if they do not receive benefits from the Veterans Administration. To contact, call 988 and press 1, or text 838255.
- *The Trevor Project*: This is a crisis line for teenagers and young adults who identify as LGBTQIA+. To contact, call 866-488-7386 or text “START” to 678678.
The following websites offer information for individuals who want to learn more about self-harm and its prevention:
- *Suicide Prevention Resource Center*: The Substance Abuse and Mental Health Services Administration offers information about programs, toolkits, and effective strategies.
- *National Action Alliance for Suicide Prevention*: This organization works with over 250 national partners to promote self-harm prevention.
- *Zero Suicide*: This organization believes it is possible to prevent deaths from self-harm in individuals who receive care from behavioral health systems. It presents a framework for safer self-harm care.
Conclusion
Self-harm thoughts, also referred to as suicidal ideation, occur when a person contemplates or plans self-harm. Some use the term interchangeably with “suicidal thoughts,” whereas others view self-harm thoughts as a more severe mental state.
Indications that a person might be considering self-harm include changes in their behavior, mood, or the topics they discuss. They may appear to be planning for their death, giving money or possessions away, or taking unnecessary risks.
However, self-harm is preventable. Support from healthcare professionals and loved ones can help prevent a person from feeling isolated or gaining access to dangerous objects, such as guns. Treatment may involve a combination of safety planning, therapy, and medications.
If a loved one is experiencing self-harm thoughts, taking them seriously, being there for them, and seeking immediate help is essential.
Read this article in French.
In the context of discussing the warning signs and prevention of suicidal ideation, here are two sentences that contain the given words:
- It's crucial to remove harmful objects, such as weapons and drugs, from the reach of individuals who are exhibiting signs of suicidal ideation if it's safe to do so, as mentioned by the American Foundation for Suicide Prevention.
- Certain medical conditions, like Crohn's disease, can increase the risk of suicidal ideation and require careful monitoring and treatment to manage related symptoms and emotions.
