Sometimes, some of us, carry around a lot of pain. This pain is heavy and tiring and feels overwhelming. Pain is a normal part of life but it can also feel abnormal. This abnormality can make it feel like you are alone and that you are trapped. You are not alone. There are people and things that can help. 

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Suicidal ideation, in a strictly clinical sense, is wanting to take your own life or thinking about suicide. There are two types of suicidal ideation: passive and active. Passive suicidal ideation happens when you wish you were dead or that you could die, but you don't have any plans to commit suicide. Active suicidal ideation is not only thinking about dying but having the intent to commit suicide, including planning how to do it.

Suicidal ideation is one of the symptoms of both major depression and the depression found in bipolar disorder, schizophrenia, schizoaffective, and other mental illnesses.


While there can be no apparent symptoms someone is thinking about suicide, there are some indicators to pay attention to if you or a loved one are thinking about or contemplating suicide:

  • Isolating yourself from your loved ones
  • Feeling hopeless or trapped
  • Talking about death or suicide
  • Giving away possessions
  • An increase in substance use or misuse
  • Increased mood swings, anger, rage, and/or irritability
  • Engaging in risk-taking behavior like using drugs or having unprotected sex
  • Accessing the means to kill yourself, such as medication, drugs, or a firearm
  • Acting as if you're saying goodbye to people
  • Feeling extremely anxious

If you think a loved one is thinking about or planning suicide, ask. It's a myth that you'll give another person the idea to kill him or herself. Asking shows that you're concerned and that you care about the person.

The Cause

There is not one singular event that leads to suicidal ideation. Often thoughts appear when we are feeling hopeless, out of control, and like our lives have no meaning or purpose. These thoughts can be the result of relationship problems, trauma, substance abuse, a crisis of some sort, pressure at work, physical health issues, or financial difficulties. Having any mental health disorder such as depression, bipolar disorder, or PTSD, can also contribute.

There are a variety of risk factors for suicidal ideation and suicide, including

  • Having attempted suicide in the past
  • Having a mental health disorder
  • Feeling hopeless, isolated, and/or lonely
  • Not being married
  • Being gay, lesbian, bisexual, or transgender
  • Having served in the military
  • Having a chronic physical illness like cancer or a terminal disease
  • Having chronic pain
  • Having a traumatic brain injury
  • Having a family history of suicide
  • Having a drug or alcohol use disorder
  • Having experienced childhood abuse or trauma
  • Living in a rural area
  • Having access to firearms


Treatment for Suicidal Ideation

If you have suicidal thoughts but there is no crisis, your doctor or therapist may recommend psychotherapy, medications, and lifestyle changes that can help reduce the risk of suicide.

  • Psychotherapy, or talk therapy, during which you work with a therapist to explore why you’re feeling suicidal and how to cope.
  • Family therapy and education. Involving loved ones in treatment can help them better understand what you're going through, learn the warning signs, and improve family dynamics.
  • Substance use disorder treatment, if you are also experiencing an increase in alcohol or drug use.
  • Lifestyle changes, including managing stress, improving sleep, eating, and exercise habits, building a solid support network, and making time for hobbies and interests.
  • Medications to treat any underlying depression causing your suicidal ideation. This may include antidepressants, antipsychotic medications, or anti-anxiety medications.