Suicidal ideation, often called suicidal thoughts or ideas, is a broad term that describes a range of thoughts, wishes and preoccupations with death and suicide. Suicidal ideation can be persistent, fluctuate depending on life situations and events or change on a day-to-day basis.

According to the Centers for Disease Control:

• In 2016–2020, the annual average emergency department (ED) visit rate for patients with suicidal ideation was 40 visits per 10,000 people
• The ED visit rate for suicidal ideation was higher among males (46 per 10,000 males) than females (34 per 10,000 females)
• The male visit rate for suicidal ideation was highest for the 35–44 age group (97 per 10,000 people)
• The female visit rate was highest for the 14–18 age group (128 per 10,000)
• Non-Hispanic Black patients had the highest ED visit rate for patients with suicidal ideation
• An estimated 4% to 4.8% of adults aged 18+ have suicidal ideation each year

Suicidal ideation can be passive or active. Passive suicidal ideation is when someone has recurrent thoughts or wishes to be dead without forming a plan to die by suicide. Active suicidal ideation is the intent to die by suicide and a plan is formed.

Signs of suicidal ideation:

• Feeling hopeless, worthless or without purpose
• Isolating from loved ones
• Giving away possessions
• Talking about death
• Changes in eating and sleeping patterns
• An increase in substance use
• Unpredictable moods or Increased mood swings
• Engaging in risk-taking behavior
• Accessing the means to die by suicide, such as medication, firearms or drugs
• Saying goodbye to people and loved ones

Treatment for Suicidal Ideation

There are several causes for suicidal ideation, ranging from difficult life changes and unsupportive environments to genetics and brain chemistry. The most effective interventions will be individualized for each person and often include more than one approach.

The common treatment modalities for suicidal ideation include:

• Psychotherapy: Psychotherapy involves talking with a mental health professional and can include individual, group and/or family therapy. This process helps identify and change emotions, thoughts and behaviors that may contribute to suicidal ideation. There are many psychotherapy modalities, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and more.
• Medication: Medications may be effective in treating any underlying mental health disorders, such as depression, bipolar disorder, anxiety or others and are often used in conjunction with psychotherapy. There are several different types of antidepressants, and it may take time to figure out which one is most effective. Some antidepressants have side effects, which often improve with time. If they don’t, talk to your healthcare provider about trying a different medication or pursuing a different treatment option.
• Holistic therapies: Holistic therapies and complementary medicine include yoga, mindfulness and meditation practices, equine therapy, massage and more. These can be used in tandem with any other treatment methods.

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