Suicidal Thoughts, Suicidal Behavior & Suicide

No way out? Seeking an end to the emotional or physical pain? While suicide may seem like the answer, it isn’t. Whether you’re considering taking your own life or know someone expressing warning signs, the best thing to do is take action to prevent a suicide attempt. Read on to find out the signs and symptoms of suicidal behavior, risk factors, treatments for attempted suicides, and more.

Definition: What is Suicide?

Suicide is the intentional completion of ending one’s own life or, in other words, successfully killing oneself. Suicidal behavior is engaging in any deliberate action with potentially life-threatening consequences, such as taking an overdose of medication or drugs or deliberately jumping off a bridge.^[1,2,3]

Another form of suicidal behavior is non-suicidal self-injury, which is when a person may cause self-inflicted harm to his or her body that is unlikely to end his or her life. These acts might include cutting and burning oneself or inflicting bruises and broken bones, and can range from superficial wounds to permanent scars or disfigurement. A person may inflict non-suicidal self-injury as a cry for help.^[3,4]

Suicide Warning Signs: Suicidal Thoughts and Behaviors

Suicide warning signs or suicidal thoughts may be present or getting worse before a suicide attempt, which include:^[1,5,6]

Talking about suicide; for example, saying “I want to kill myself,” “I want to commit suicide,” “I wish I was dead” or “I wish I hadn’t been born”
Difficulty concentrating or thinking clearly
Obtaining the means to commit suicide, such as stockpiling pills or getting a gun
Withdrawing from social contact, avoiding friends, and wanting to be left alone
Loss of interest in activities that were previously enjoyable
Sudden difficulty in school or work performance
Having long-lasting sadness and mood swings, such as being emotionally high one day and deeply discouraged the next
Being preoccupied with death, dying or violence
Feeling trapped or hopeless about a situation
Performing self-destructive behaviors, such as drinking alcohol, using illegal drugs, or cutting
Changing normal routine, including eating or sleeping patterns
Changing one’s appearance or becoming less concerned about it
Doing risky or self-destructive things, such as using drugs or driving recklessly
Suddenly acting calm as if a decision has been made to kill oneself and feeling at peace with it
Giving away belongings or getting affairs in order when there is no other logical explanation for why this is being done
Saying goodbye to people as if they won’t be seen again
Developing personality changes or being severely anxious or agitated, particularly when experiencing some of the warning signs listed above

Causes of Suicide & Suicidal Behavior

Suicidal thoughts have numerous causes and almost always occur in people with depression, bipolar disorder, schizophrenia, and alcohol dependence. Most often, suicidal thoughts are the result of feeling like you can’t cope when faced with what seems to be an overwhelming life situation – a situation that seems impossible. If you don’t have hope for the future, you may mistakenly think suicide is a solution. You may experience a sort of tunnel vision, where in the middle of a crisis you believe suicide is the only way out. Those with suicidal tendencies may be seeking relief from:^[1,7,8]

Bad thoughts or feelings
Feelings of rejection, loss, or loneliness
Feeling like a victim
Feeling ashamed, guilty, or like a burden to others

Why do people commit suicide? Suicidal behaviors may be triggered by a situation or event that the person views as overwhelming, such as:

Death of a loved one
Unemployment or financial problems
Dependence on alcohol or other drug
Aging (the elderly have the highest rate of suicide)
Emotional trauma
Serious physical illness

There may also be a genetic link to suicide. People who complete suicide or who have suicidal thoughts or behavior are more likely to have a family history of suicide. While more research is needed to fully understand a possible genetic component, it’s thought that there may be a genetic link to impulsive behavior that could contribute to suicidal tendencies.

Suicide Warning Signs & Risk Factors

Around 75-percent of suicides are men and in almost all cultures, the suicide rate rises with age. People with a diagnosed mental health condition are at particular risk of suicide. Around 90-percent of suicide victims suffer from a psychiatric disorder at the time of their death. However, suicide attempts that do not result in death are much more common than completed suicides. Many of these suicide attempts are carried out in a way that makes rescue possible and may represent a desperate cry for help. Certain factors are known to be associated with increased risk of suicide, which include:^[1,8,9]

Drug and alcohol misuse
Access to firearms
Unemployment, financial or legal problems
Family member who committed suicide (almost always someone who shared a common mood disorder)
Social isolation
History of deliberate self-harm
Poverty
Living in communities where there have been recent outbreaks of suicide in young people
Poor social conditions
Imprisonment
Violence
Romantic breakup
Attempted suicide before
Bisexual, homosexual or transgender with an unsupportive family or in a hostile environment

Effects of Suicide

Suicidal thoughts and attempted suicide take an emotional toll, both for those who want to take their own life and for their loved ones. For instance, you may be so consumed by suicidal thoughts that you can’t function or find it extremely difficult to function in your daily life. And while many suicide attempts are impulsive acts during a moment of crisis, they can leave you with permanent serious or debilitating injuries, such as organ failure or brain damage.

For those left behind after a suicide – people known as survivors of suicide – grief, anger, depression and guilt are common. Relatives of people who seriously attempt or complete suicide often blame themselves or become extremely angry, seeing the attempt or act as selfish. However, when people are suicidal, they often mistakenly believe that they are doing their friends and relatives a favor by taking themselves out of the world. These irrational beliefs often drive their behavior.^[1,10]

Suicide Prevention

Feeling suicidal is often a temporary state of mind. If appropriate and timely help and emotional support is offered to people who are experiencing deep unhappiness and distress, this can reduce the risk of them committing suicide. Sometimes, simply talking to a sympathetic, nonjudgmental listener is enough to prevent the person from attempting suicide, as many people who attempt suicide talk about it beforehand. For this reason suicide prevention centers have telephone “hotline” services. Do not ignore a suicide threat or attempted suicide.^[1,8]

Further, avoiding alcohol, narcotics, sedatives that have not been prescribed, and illegal drugs can help prevent suicide. These substances affect the brain and can make the depression worse over time. In homes with adolescents:

Secure all prescription medicines
Do not keep alcohol in the home, or keep it locked up
Securely lock all guns and keep the ammunition separate

Treatments for Suicidal Behavior

Treatment of suicidal thoughts and behavior depends on the specific situation, including the level of suicide risk and what underlying problems may be causing the suicidal thoughts or behavior.^[1,11,12]

Non-emergency Situations

If you have suicidal thoughts, but aren’t in a crisis situation, you may need outpatient treatment. This treatment may include:

Psychotherapy: In psychotherapy, also called counseling or talk therapy, you explore the issues that make you feel suicidal. You and your therapist can work together to develop treatment plans and goals.
Medications: Antidepressants, antipsychotic medications, anti-anxiety medications and other medications for mental illness can help reduce symptoms, which can help you feel less suicidal.
Addiction treatment: Treatment for drug or alcohol addiction can include detoxification, addiction treatment programs and self-help group meetings.
Family support and education: Your loved ones can be both a source of support and conflict. Involving them in treatment can help them understand what you’re going through, give them better coping skills, and improve family communication and relationships.

Emergency Situations

A person may need emergency measures after attempting suicide. First aid, CPR, or mouth-to-mouth resuscitation may be needed. Hospitalization is often needed to treat a suicide attempt and to prevent future attempts and mental health intervention is one of the most important aspects of treatment. After suicidal behavior is addressed, any underlying disorders should be treated, such as major depression, bipolar disorder, or alcohol dependence.

There are suicide hotline numbers to call from anywhere in the United States, 24 hours a day, 7 days a week: 1-800-SUICIDE or 1-800-999-9999.

If a friend or family member talks or behaves in a way that makes you believe he or she might commit suicide, don’t try to handle the situation without help – get help from a trained professional as quickly as possible. The person may need to be hospitalized until the suicidal crisis has passed. If you believe someone is in danger of committing suicide or has made a suicide attempt:

Don’t leave the person alone.
Call 911 or your local emergency number right away. Or, if you think you can do so safely, take the person to the nearest hospital emergency room yourself.
Try to find out if he or she is under the influence of alcohol or drugs or may have taken an overdose.
Tell a family member or friend right away what’s going on.

If you’ve made a suicide attempt and you’re injured:

Call 911 or your local emergency number
Have someone else call if you’re not alone

If you’re not injured, but you’re at immediate risk of harming yourself; that is, if you find yourself thinking ‘I want to commit suicide’ or if you find yourself feeling suicidal:

Call 911 or your local emergency number
Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.

At the emergency room, you’ll be treated for any injuries and may be given medications to calm or ease symptoms of an underlying mental illness, such as depression. The doctor may want you to stay in the hospital long enough to make sure any treatments are working, that you’ll be safe when you leave and that you’ll get the follow-up treatment you need.

References

Scripps. Suicide and Suicidal Behavior. Retrieved June 9, 2013, from http://www.scripps.org/articles/1841-suicide-and-suicidal-behavior.
Mayo Clinic. Suicide and Suicidal Thoughts. Definition. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/DS01062.
The Merck Manual. Suicidal Behavior. Retrieved June 30, 2013, from http://www.merckmanuals.com/home/mental_health_disorders/suicidal_behavior/suicidal_behavior.html.
International Society for the Study of Self-Injury. About Self-Injury. Retrieved June 30, 2013, from http://www.isssweb.org/aboutnssi.php.
Cleveland Clinic. Diseases & Conditions. Recognizing Suicidal Behavior. Retrieved June 30, 2013, from http://my.clevelandclinic.org/disorders/mental_illness/hic-recognizing-suicidal-behavior.aspx.
Mayo Clinic. Suicide and Suicidal Thoughts. Symptoms. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/DS01062/DSECTION=symptoms.
Mayo Clinic. Suicide and Suicidal Thoughts. Causes. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/DS01062/DSECTION=causes.
Mental Health Foundation. Suicide. Retrieved June 9, 2013, from http://www.mentalhealth.org.uk/help-information/mental-health-a-z/S/suicide/.
Mayo Clinic. Suicide and Suicidal Thoughts. Risk Factors. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/DS01062/DSECTION=risk-factors.
Mayo Clinic. Suicide and Suicidal Thoughts. Complications. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/DS01062/DSECTION=complications.
Mayo Clinic. Suicide and Suicidal Thoughts. Treatments and Drugs. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/DS01062/DSECTION=treatments-and-drugs.
Mayo Clinic. Suicide and Suicidal Thoughts. In-Depth. Retrieved June 9, 2013, from http://www.mayoclinic.com/health/suicide/MH00058.

By C. J. Newton, MA, Therapists.com Editor