Signs and Symptoms of Suicidal Ideation

Pacific Grove Hospital is a nationally recognized 68-bed acute psychiatric and chemical dependency treatment center offering inpatient & outpatient services for psychiatric illnesses, addictions & co-occurring disorders.

Understanding Suicidal Ideation

Learn about suicidal ideation

Suicidal ideation is the term used for thoughts about or an unusual preoccupation with ending one’s own life. The range of suicidal ideation can widely vary from a fleeting thought to a laid out, detailed plan which may or may not be deliberately designed to fail. However, in some instances these thoughts and plans are indeed intended to result in death.

Suicidal ideations may be the result of loss, anxiety disorders, depression, substance abuse, and problems in other areas of a person’s life that feel so overwhelming suicide seems like the only way to cope. The fact of the matter is that suicide is a long-term solution to a short-term problem. People who are feeling like harming themselves see no other option to end the deep emotional pain they are facing. This emotional pain can distort thinking so much so that it’s hard to consider that there may be other alternatives to dealing with their problems. Those who are contemplating or who have previously attempted suicide should seek treatment right away. 

It is vital to remember that many suicide attempts are a way of expressing deep distress and may not actually be a desire to die. Any person who appears to be suicidal should not be left alone – this is a medical emergency. Call 911 immediately, remove all possible methods of suicide, and stay with the person until help arrives.


Suicidal ideation statistics

Suicide remains one of the top ten causes for death in the United States. It’s been estimated that 11 people attempt suicide for every completed suicide. In 2007, suicide was named the tenth leading cause of death in the US, accounting for nearly 35,000 lives lost. Suicide was the seventh leading cause for death in males, fifteenth for females, and a shocking third leading cause for death among people ages 15 to 24.

Causes and Risk Factors

Causes and risk factors for suicidal ideation

The causes for suicide are not thought to be the result of a single factor, but rather the interplay of genetic, physical, and environmental risk factors. The most commonly cited causes for suicidal ideation and death by suicide include:

Genetic: People who are born into families in which a first-degree relative, such as a parent or sibling, attempted or completed suicide are at a higher risk for suicidal ideation. Additionally, those who have a family history of mental illness or substance abuse are at higher risk for suicidal ideation and behaviors.

Physical: Research indicates that the risk for suicide is associated with changes in the neurotransmitters in the brain. In individuals who have attempted suicide, there is a notable decrease in the levels of the neurotransmitter serotonin.

Environmental: Growing up or living in a home in which violence was present increases the risk for suicidal ideation. Additionally, exposure to suicidal behavior of friends, peers, and family can increase the risks for suicidal behaviors.

Risk Factors:

  • Having firearms in the home
  • Past history of suicide attempts
  • Impulse control disorders
  • Physical or sexual abuse in childhood
  • Incarceration
  • Being male
  • Being between the ages of 15-24
  • Teen pregnancy
  • Sexually transmitted infections
  • Conflicts between family members and loved ones

Signs and Symptoms

Signs and symptoms of suicidal ideation

One of the best ways to prevent death by suicide is to recognize and understand the warning signs of suicide. Most people who attempt suicide will show some sort of indication of their intentions and an intervention may stop a suicide from occurring. If anyone talks about suicide, it should always be taken very seriously. Symptoms of suicidal ideation may include the following:

Behavioral Symptoms:

  • Increased substance abuse
  • Saying goodbye to loved ones
  • Talking about suicide
  • Saying things like “I’m going to kill myself,” or “I wish I were dead”
  • Decline in work or academic performance
  • Withdrawing from once-pleasurable activities
  • Increasing amount of time spent alone
  • Violent, rebellious, reckless behaviors
  • Talking about having no reason to live
  • Running away from home
  • Sudden changes in personality
  • Seeking out lethal means to end their life
  • Getting affairs in order – making a will, giving away treasured possessions
  • Forming a plan for the suicide attempt

Physical Symptoms:

  • Insomnia
  • Changes in eating patterns
  • Weight loss or gain
  • Vague somatic physical symptoms
  • Neglecting personal appearance
  • Worsening of physical health
  • Psychomotor agitation

Cognitive Symptoms:

  • Difficulty concentrating
  • Problems with short-term memory
  • Preoccupation with death, dying, or violence

Psychosocial Symptoms:

  • Hopelessness
  • Depression
  • Depression followed by a period of intense happiness and relief
  • Despair
  • Paranoia
  • Delusions
  • Psychosis
  • Hallucinations
  • No hope for the future
  • Belief that nothing will get better
  • Anger
  • Panic attacks
  • Angst
  • Extreme remorse
  • Anxiety
  • Anhedonia
  • Sudden sense of calm


Effects of suicide

Suicide attempts and behaviors can leave behind a number of devastating effects not only for the individual, but for those around them as well. If you’re feeling hopeless about the future and believe suicide is the only way to end your pain, call 911 immediately. Effects of suicide may include:

  • Shame
  • Guilt
  • Anger
  • Self-loathing
  • Damage to vital organs
  • Brain death
  • Coma
  • Seizures
  • Death

Effects on Survivors

Effects on suicide survivors

There are currently about 35,000 suicides annually in the United States. It’s estimated that for every suicide there are at least 6 suicide survivors. Suicide survivors are those who are left behind after a loved one has ended their life. Experiencing the loss of a loved one to suicide can be shocking, painful, and unexpected, and can severely impact the grieving process. Common effects suicide survivors experience include:

  • Shame
  • Feeling responsible for not preventing the suicide
  • Feeling rejected or abandoned by their loved ones
  • Fear
  • Depression
  • Relief (if loved one was suffering)
  • Anger
  • Numbness
  • Profound sadness
  • Emotional shock
  • Grief (physical, mental, emotional, and spiritual)
  • Denial
  • Helplessness
  • Guilt
  • Self-blame
  • Post-traumatic stress disorder

Co-Occurring Disorders

Suicidal ideation and co-occurring disorders

Many adults who experience suicidal thoughts are also struggling with a co-occurring, comorbid mental health condition. According to the United States Department of Health and Human Services, over 90% of people who die by suicide have a co-occurring mental illness. The most common co-occurring disorders include:

  • Depressive disorders
  • Paranoia
  • Dysthymia
  • Personality disorders
  • Anxiety disorders
  • Post-traumatic stress disorder (PTSD)
  • Bipolar disorder
  • Schizophrenia
  • Borderline personality disorder
  • Substance abuse disorders
  • Alcoholism
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