Suicidal Thoughts

A lot of people think about suicide or say things like, “I wish I was dead” at times of great stress. For most people these thoughts are a way to express anger, frustration, and other strong emotions. They may not, in and of themselves be a sign of a problem. Suicidal thoughts could be a signal for help, though, if they:

• Don’t go away or occur often
• Lead to suicidal threats, gestures, or attempts
• Are a symptom of a medical illness or mental health condition such as:
  • Depression (see page 186). Up to 70% of persons who commit suicide are known to have suffered from depression right before their deaths.
  • Bipolar disorder (manic depression) – a mood disorder characterized by mood swings from elation and/or euphoria to severe depression. Suicide can take place during either the manic or depressive episodes.
  • Schizophrenia – a group of mental disorders in which there are severe disturbances in thinking, mood, and behavior. The sufferer experiences delusions, hallucinations, disordered thinking, and/or inappropriate emotions.
  • Grief/Bereavement (see page 198). The loss of a loved one may provoke thoughts of suicide. A person may find it hard to goon living without their loved one or may want to be with him or her in death.

Suicide:

• Is more common in men than women. Men commit 4 times as many suicides as women.
• Is attempted 3 times more often by women than men. Young women attempt suicide 4 to 8 times more often than young men.
• Is committed more often by white men than by black men
• Has the highest rate in adults over age 65
• Is the third leading cause of death among 15-24 year olds behind accidents and homicide

Suicidal threats and attempts are a person’s way of letting others know that he or she is in need of attention or wants someone to help them. Suicide attempts and/or threats should never be taken lightly or taken only as a “bluff.” Most people who threaten and/or attempt suicide more than once usually succeed if they are not stopped.

Prevention and Treatment


Prevention and treatment include:

• Knowing the warning signs for suicide (see “Questions to Ask” on page 215)
• Taking courses that teach problem solving, coping skills, and suicide awareness in schools and in the community
• Addressing and treating the emotional and/or physical problems that lead to thoughts and attempts of suicide such as:
  • Medical treatment for physical and/or mental health conditions such as depression. This includes monitoring medicine, if used.
• Therapy such as individual and family counseling
• Keeping firearms, drugs, and other means to commit suicide away from potential victims
• Emergency care and hospitalization, if necessary, after an attempted suicide

Questions to Ask


{Note: In some suicides, no warning signs are shown or noticed.}

Are any of the following present? Suicide attempts Plans being made to commit suicide Repeated thoughts of suicide or death
With thoughts of suicide or death, are any of these conditions present? Depression Manic depression Schizophrenia Any other mental health or medical condition
Have thoughts of suicide come as a result of one of the following? Taking, stopping, or changing the dose of a prescribed medicine Using drugs and/or alcohol
Has there been a lot less interest or pleasure in almost all activities or a depressed mood most of the day, nearly every day for at least 2 weeks? Or, have you been in a depressed mood most of the day nearly every day and have you had any of the following for at least 2 weeks? Feeling slowed down or restless and unable to sit still Feeling worthless or guilty Changes in appetite or weight loss or gain Thoughts of death or suicide Problems concentrating, thinking, remembering, or making decisions Trouble sleeping or sleeping too much Loss of energy or feeling tired all the time Headaches Other aches and pains Digestive problems Sexual problems Feeling pessimistic or hopeless Being anxious or worried
Does the person thinking about suicide have other blood relatives who committed or attempted suicide?
Has the person recently done 1 or more of the following? Given away favorite things, cleaned the house, and gotten legal matters in order Purchased or gotten a weapon or pills that could be used for suicide Given repeated statements that indicate suicidal thoughts such as, “I want to be dead”, “I don’t want to live anymore,” or “How does a person leave their body to science?” Made suicidal gestures such as standing on the edge of a bridge, cutting their wrists with a dull instrument, or driving recklessly on purpose
Have suicidal thoughts come as a result of an upset in life such as? A separation A divorce The death of a loved one or other loss such as the loss of a job A rejection Being ridiculed

Self-Care Tips


If you are having thoughts of suicide:

• Let someone know. Talk to a trusted family member, friend, or teacher. If it is hard for you to talk directly to someone, write your thoughts down and let someone else read them.
• Call your local crisis intervention or suicide prevention hotline. Look in your local phone book or call directory assistance or the operator for the number. Follow up with a visit to your doctor or local mental health center, if instructed to do so.

{Note: For information on suicide see “Places to Get Information & Help” under “Suicide ” on page 377.}