What Is Suicidal Ideation?

Suicidal ideation is when you think about killing yourself. The thoughts might or might not include a plan to die by suicide.

You may have heard suicidal ideation referred to as "suicidal thoughts." Not everyone with suicidal ideation acts on it. But if you or a loved one has it, you should get help right away.

You could reach out to a:

  • Family member or friend
  • Crisis counselor
  • Doctor or therapist
  • Spiritual leader
  • Online support group

You could also call the help line of the National Alliance on Mental Illness at 800-950-NAMI (6264) or the National Suicide Prevention Lifeline at 800-273-8255 (or text HOME to 741741).

Who Has Suicidal Ideation?

Things that can make you more likely to have suicidal ideation include:

What to Watch For

Some people with suicidal ideation say they feel:

  • Empty or hopeless
  • Guilty or shamed
  • Trapped or out of options
  • In severe mental or physical pain
  • Like a burden to loved ones

They might show outward signs of mental distress. For example, they could:

  • Use more alcohol or drugs
  • Act aggressively
  • Retreat from family and friends
  • Have severe mood swings
  • Behave recklessly or impulsively

Someone with severe suicidal ideation may also:

  • Buy a weapon
  • Collect or save pills
  • Give away their valuables
  • Tell friends and family goodbye
  • Search online for ways to kill themselves
  • Take dangerous risks, like driving far too fast
  • Make out a will or set other affairs in order

Treatment

Doctors and mental health professionals have a number of ways to help you feel better. The right treatment plan for you depends on things like:

  • How severe your suicidal thoughts are
  • How often you have them and how long they last
  • How detailed or extensive they are

Your treatment plan could include:

A safety plan. Your doctor or therapist will help you come up with one specific to you. It could include lists to help you:

  • Spot things that trigger negative or suicidal thoughts, like certain images, situations, or moods
  • Come up with healthy ways to de-stress, like relaxation techniques or exercise
  • Identify loved ones and professionals you can reach out to for support
  • Make your home safer to make suicidal actions less likely

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Talk therapy. A mental health professional can teach you ways to take charge of negative or suicidal thoughts. They can also help you treat an underlying mental health condition or substance abuse problem that might trigger suicidal ideation.

Medication. If a doctor or therapist recommends this, it may take a few tries to find the right medicine and dose for you. Don’t stop taking any medication without talking to your doctor first.

Hospital care. Your team might recommend this if you think about suicide often and if the thoughts last a long time or include a plan to die by suicide.

What if You’re Worried About a Loved One?

If you’re concerned that someone you care about might have suicidal ideation:

Have a candid talk. Ask them: “Are you thinking about killing yourself?” As hard as it is to ask this, experts say doing so won’t make your loved one think about suicide more.

Show support. Research says talking about it and acknowledging it may help your friend think about suicide less often.

Help them stay safe. If you can, get rid of any items from their home that the person close to you could use to make suicidal actions. And keep your loved one away from places that could pose a danger to them, too.

Find support. Add the National Suicide Prevention Lifeline -- 800-273-TALK (8255) -- and the Crisis Text Line’s number (741741) to your phone contacts. Share these numbers with your loved one, too. You could also connect them with someone else they trust, like:

  • A mental health professional
  • Another family member or friend
  • A spiritual advisor

Stay in touch. Check in with them often after you talk. Let them know you’re there for them when they need you.

WebMD Medical Reference Reviewed by Michael W. Smith, MD on March 08, 2021

Sources

SOURCES:

National Alliance on Mental Illness: “Risk of Suicide.”

Up to Date: “Suicidal ideation and behavior in adults.”

American Counseling Association: “Professional Counseling Digest.”

National Institute on Mental Health: “Suicide Prevention.”

Suicide Awareness Voices of Education: “I’m Having Thoughts of Suicide.”

Suicide Prevention Resource Center: “Patient Safety Plan Template.”

Mayo Clinic: “Are you thinking about suicide? How to stay safe and find treatment.”

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