What Is Suicidal Ideation?

Suicidal ideation is a term used to describe someone having thoughts about killing themselves. These thoughts might be passive, like thinking, “I hope I don’t wake up tomorrow.” They can also be active. This means they may be thinking about how to end their life. The thoughts may be frequent or come and go.

Suicidal thoughts and plans should always be taken seriously, regardless of their severity or how often they occur. We’ll learn more below. But if you or someone you know is currently thinking about suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255, or contact local emergency services. 

Why do people sometimes have suicidal thoughts? 

Millions of people experience suicidal thoughts. In a recent study, nearly 5% of adults reported having had suicidal ideation. Adults under age 25 were most likely to report suicidal ideation. The rate is even higher for teenagers. Around 18% of high schoolers also say they’ve seriously thought about suicide. 

So what causes so many people to think about dying? Each person is different, and the causes of suicidal ideation can vary. Someone who thinks about or attempts suicide may be dealing with any of the following: 

• Mental health conditions

• Substance or alcohol use

• A history of trauma or abuse

• Loss of a relationship

• Loss of a job

• Feelings of isolation

• Lack of social support

• Easy access to lethal methods of killing oneself

While these and other difficult situations do not usually lead to suicide attempts, they can put people at higher risk. Suicide is also complicated. Often, it’s a combination of factors that may lead to thoughts about suicide.

How serious is suicidal ideation?

Suicidal ideation should always be taken seriously. Regardless of the type of suicidal thoughts someone may have, it’s important to talk about it. You can reach out to someone you love, a school counselor, a healthcare provider, or a crisis hotline 

A healthcare professional should also assess the risk that someone may attempt suicide. They may ask about your current thoughts or plans about suicide. They may also recommend further care, such as meeting with a mental health professional for an assessment or ongoing support. 

What are warning signs of suicidal thoughts? 

There is not always a clear warning when someone is having suicidal thoughts. However, there are common behaviors that many people have when they’re thinking about suicide. The signs may include: 

• Having sudden changes in behavior

• Experiencing extreme physical or emotional pain

• Showing increased sadness, hopelessness, or shame

• Feeling trapped

• Feeling like there’s no reason to live

• Talking about suicide or saying they’re a burden to others

• Experiencing rage or increased anger

• Isolating from friends

• Saying goodbye to loved ones

• Giving away important possessions

• Having extreme mood swings

• Increasing use of drugs or alcohol

• Showing risky behaviors, such as driving recklessly

What should you do if you have suicidal ideation?

It can be frightening to have thoughts about suicide and wanting to die. Sometimes, people keep their thoughts to themselves. But know that talking about it can keep you safe and help you get the support you need.

You might compare thinking about suicide to having another serious health condition, such as signs of a stroke. It’s not your fault that you’re experiencing it, but you do need support.  

Even if you feel alone, there are people you can reach out to. Here are some ideas of people you might talk to: 

• Your primary healthcare provider

• A friend you trust

• A supportive family member

• A therapist or other mental health professional

• Mentors in your church or religious center

• A school counselor or teacher

• A crisis call center or text line

Another resource is the National Alliance on Mental Illness (NAMI). The organization is a peer-based support group that can offer ongoing help. You can also contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 to be connected with resources. 

The Trevor Project is an organization that supports LGBTQIA+ youth. For support, you can text START to 678-678, call 1-866-488-7386, or visit them online. 

If you don’t get the support you need, continue reaching out until you do. If you’re currently at high risk of harming yourself, call 911 or go to your local emergency room. 

How do you talk to someone about suicidal ideation?

What if someone talks to you about suicidal thoughts? Or are you are worried that someone you care about may be thinking of suicide? It’s normal to be unsure of how to help. However, there are many ways you can provide support. 

First, be open and accepting of your loved one. Talk directly about the topic. It’s OK to ask them if they’re having suicidal thoughts. Asking directly won’t plant the idea in their head. It’s actually a signal to your loved one that you’re open to hearing about their experience. 

If you can, work with your loved one to remove any means that they might have to harm themselves. This makes it harder for someone to harm themselves impulsively. 

Also, help your loved one seek professional support. You might help them contact a crisis mental health service, schedule an appointment with a healthcare provider or therapist, or locate additional resources for support. 

Don’t agree to secrecy or keep the concern to yourself. Instead, you can say something like, “I love you and want to keep you safe. If I’m worried you plan to end your life, I need to get help.” And if you are worried about the imminent safety of your loved one, call 911.

It can take an emotional toll when a loved one is considering suicide. It is OK for you to get help in dealing with your emotions as well. Consider reaching out to get counseling or other support for yourself too. 

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Written by:

Jennie Bedsworth, LCSW

Jennie Bedsworth, MSW, LCSW, is a licensed clinical social worker and therapist with 20 years of experience in journalism, teaching, and mental health. Prior to completing her master's degree, she wrote for The Furrow magazine and was editor of Missouri Ruralist magazine.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

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