I’ve struggled most my life with suicidal behaviour and I’ve talked about some episodes that resulted in me trying or almost trying to take my life before in pervious articles. If you’ve been reading my blog for a while, then you’ll likely remember some details. For example, my article about how I became suicidal during my postgraduate degree, which you can find here. This time, I thought I’d talk about suicidal ideation to provide a better understanding of what it’s like to have suicidal thoughts. That way, you’ll be better able to support yourself or others that might be living with suicidal thoughts.
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Definition Of Suicidal Ideation
Suicidal behaviour comes on a spectrum, with completing suicide on one end and fleeting suicidal thoughts on the other (Gliatto and Rai, 1999). Suicidal ideation is the part of the spectrum that deals with suicidal thoughts, I.e. thoughts about killing yourself (You, Van Orden, and Conner, 2011). Thus, someone is suffering from suicidal ideation if they’re thinking about suicidal or feeling like they want to end their life.
Risk Factors For Suicidal Ideation
Hopelessness and anhedonia are two of the risk factors I talked about in my article, ‘Taking Antidepressants Isn’t A Big Deal, Here’s Why‘. These two, coupled with anergia (low energy), are three symptoms of depression that will probably require a pharmacology intervention, as they won’t respond to talking therapy on their own. So it’s not a surprise that two of these factors are also linked to suicidal ideation and suicide (Gliatto and Rai, 1999).
A study by You, Van Orden, and Conner (2011) conducted on 814 participants recruited from four residential substance dependency treatment services, examined the relationships between social connections and histories of suicidal ideation. They found that substance dependency came with an elevated risk of suicidal ideation and attempts because of interpersonal conflict, low belongingness, low perceived social support, and living alone (attempts only).
The reason for this is likely because of the behaviour of dependency, making it difficult to maintain relationships and maintain trust. It can be extremely difficult to support someone with substance dependency, as I found out when trying to help a friend (Domestic Abuse: Female Perpetrators, Male Victim). Thus, they can alienate everyone that had tried to help them.
Furthermore, a lot of people become substance dependent because they’ve been trying to use substances to manage trauma or to cause them to forget trauma. Unfortunately, it only makes things worse to use this poor coping strategy.
Mental health conditions
The presence of any mental disorder can increase someones risk of experiencing suicidal ideation (Nock et al., 2008). It’s not always just depression. It’s just that depression gets a lot of the attention because anyone can become depressed.
Before we get to talking about what it’s like living with suicidal ideation, let’s look at some statistics so you can see the scale of the problem. In the US in 2017, 10.6 million Americans (aged over 18) or 4.3% of the American population reported suffering from suicidal ideation (SAMHSA, 2018).
In Brazil, a first of its kind population-based study was conducted by Botega, Barros, Oliveira, Dalgalarrondo, and Marín-León (2005) to investigate suicidal behaviour in the country. They interviewed 515 participants, and found that for every 17 participants who had suicidal ideation, five had planned to kill themselves, three effectively attempted suicide, and of those three, one received medical support. In short, there was a 17.1% prevalence of suicidal ideation and 2.7% prevalence for suicide attempts, which are similar figures seen in other studies conducted in Europe, USA, and Australia. The study also found that suicidal ideation was consistently associated with factors related to mental disorders or distress. Hence why mental health is a risk factor for suicidal ideation.
A report by Nock et al. (2008) that looked into the prevalence and risk factors of suicidal behaviours across 17 countries. The report comprised 84,850 adult participants and found an estimated lifetime prevalence of suicidal ideation to be 9.2%. However, a more alarming figure comes from Evans, Hawton, Rodham, and Deeks (2005) systematic review of international literature. Their review found that a staggering 19% of adolescents experienced suicidal ideation.
Interesting, areas within the Arctic circle were studied to access the living conditions of the people who lived there. Broderstad, Eliassen, and Melhus (2011) conducted a population-based survey of 2,099 people living in Alaska, Greenland, Sweden, and Norway. Their study found that Greenland (17%), Alaska (14%), Norway (11%), and Sweden (6%) for the prevalence of suicidal ideation. Furthermore, suicidal ideation was most common in the youngest age group across each location. This could result from long periods of continued sunlight and then long periods of darkness, making for a more extreme verision of seasonal affective disorder (SAD).
The reason the figures about the high rate of suicidal ideation in adolescents is important is because of the impact it has later in life. This was highlighted in a study by Reinherz, Tanner, Berger, Beardslee, and Fitzmaurice (2006). In their study, they followed the developments of 346 participants from aged five to 30, with those who had suicidal ideation at age 15 being compared to those who didn’t at age 15. The study found a strong relationship between suicidal ideation at 15 having higher rates of suicidal ideation and behavior, psychopathology, problem behaviours, and poor functioning 15 years later at age 30.
Nock et al. (2008) study also highlighted another important statistic that we should all be aware of. Across all 17 countries in their study, they found that 60% of people transitioned from suicidal ideation to their first suicide attempt with the first year of the onset of their ideation. Most notably, the earlier the age of onset, the more likely they were to make this transition. From what I can remember of my primary school years, among all the trauma I endured, this was the case for me, too.
My Experience With Suicidal Ideation
For most people, suicidal ideation is a temporary issue. These kinds of thoughts won’t last forever. But for me, they’ve been a part of my life since attending primary school as a child. Most of the time, my suicidal ideation is fleeting, not lasting longer and a few minutes, but they’re always with me. I’m so used to the thoughts that they don’t bother me anymore. I have no intention of acting upon them, they’re just background intrusive thoughts that pop into my head from time to time.
The kind of suicidal ideation I get is largely existential in nature, rather than planning and thinking about a suicidal method. The kinds of thoughts I get are stuff like, “life is meaningless, it doesn’t matter if you’re alive or not, so why bother living?”; “what’s the point of being alive?”; and “my life is meaningless, what’s the point of going on”.
When I was in school, these thoughts were daily, even in primary school. It was a relentless wave of thoughts telling me I’d be better off dead. I even covered my English exercise book in drawings of stickmen killing themselves in lots of different ways. All this made me an unstable child looking for something to give me some sort of stability. Eventually, that stability came from metal music, which helped reduce my suicidal impulses, because it gave me an identity I could base myself, which I’d been lacking until then.
But even though I’d started to become more stable, my suicidal ideation has never stopped. They’re just not relentless anymore or as emotionally jarring. I’m as used to these suicidal thoughts as I’m as used to hearing my inner voice in general. They are me and I am them. They’re no longer harmful to me, they’re just a part of who I am.
However, if my depression and stress get too bad, then my suicidal ideation will shift over to thinking of suicidal methods. In those situations where I switch to methods, I’ll become fixated on a specific method and it’ll be all I can think about while mentally falling apart. I’ll often be trapped in this single thought of how I’m going to kill myself for hours, which is a step up from how I used to be. In the past, it’d take minutes from having these thoughts to actually trying. So being consumed by these thoughts for hours and not acting on them is quite an improvement, although it may not sound like it. Progress is progress.
Risa’s Experience With Suicidal Ideation
Risa from Alated Bibliophile was kind enough to share her experience of suicidal ideation after I did a shout out on Twitter looking for people willing to talk about this for my readers. I wanted to offer another perspective other than my own. So, in her own words, this is Risa’s experience with suicidal ideation.
I’ve struggled with crippling anxiety and depression since I was young, which manifested itself in severe shyness and chronic stomach aches. I wasn’t aware of anxiety at this age and therefore had no idea how to handle it. My parents did their best to help me, but there was so much going on at this time and there was only so much we could do when I didn’t even know how to express what was wrong with me.
From ages seven to twelve, my grandfather passed away, we moved my grandmother in—who had Alzheimer’s and steadily began to decline in the three years she lived with us—she passed away, a close family friend passed away, and then the uncle I was closest to passed away. At age fourteen, I felt my first sting of heartbreak; age fifteen, I was in a slightly abusive relationship; ages sixteen through eighteen, I stood by my boyfriend’s side as he dealt with consequences for actions he’d made earlier on, something that, in hindsight, I wish I’d handled differently; age twenty, I was diagnosed with several chronic illnesses; age twenty-two, my boyfriend broke up with me after seven years of dating and many promises of spending our lives together.
These were all defining moments in my life that greatly contributed to my depression, and throughout all this, there was this voice in my head that told me to give up. Sometimes the thought would keep me up at night and I would lie in bed, staring at my ceiling with tears falling down my face, wishing life were easier.
Around the ages of twelve to eighteen, I tried to cope with self-harming. Toward the end of this “phase,” I was put on some medication that started to help me. I also learned to utilise healthier coping mechanisms, such as journaling, prayer, meditation, counselling, and learning to rely on those who love me—namely, my parents and my wonderful husband.
I won’t lie; I still struggle with depression and anxiety, but I no longer entertain the idea of suicide as a way out. But, I can’t pinpoint the exact moment these thoughts ended, although I do know, for me, the things that helped me the most were what I mentioned previously: my faith in Jesus, writing, and reading. Not everything that works for me will work for others, but if you are struggling, I do so encourage you to reach out. If you can’t talk to those closest to you, talk to your doctor. If that isn’t an option, do some research into online therapy or a support group. There are always, always, other options than giving up. Whether you believe it or not, you are loved, and you deserve the chance to take care of yourself.
And for those of you who have loved ones who are struggling, my biggest piece of advice as someone who struggled myself is to just be there. Let them know that you’re always willing to sit and listen to them—without judgment or unsolicited advice—and tell them how much you love them and how much their presence adds to your life. I was fortunate enough to have a wonderful support system and I can honestly say I would not be here without them. Be gentle with your loved ones, but be gentle with yourself as well.
As Risa said, one of the best ways you can help someone with suicidal ideation is to just be there for them. But if you want to be prepared in case they transition from suicidal ideation to acting on those thoughts, then you could try reading my article ‘Suicide And Suicide Prevention: Advice And Information‘. You can read that article by clicking here.
Furthermore, if you or anyone is struggling with suicidal ideation, then consider completing a safety workbook to help protect yourself. I have an article on that too, which you can find by clicking here. The article comes with a couple of free to download workbook, or, if you’d prefer, you can spend a few pennies and buy the safety workbooks from my shop.
Suicidal ideation is a very real problem for a lot of people. The biggest risk that comes with suicidal ideation comes in the first year, where transition to attempting suicide is most likely to happen. After the first year, that transition is less likely as they’ll have become used to the thoughts, much like I did. Thus, be the mate you’d want to your friends and talk to your children about mental health. To help with that, check out my article on teaching children about mental health: How To Teach Children About Mental Health.
As always, leave your feedback in the comments section below. Also, please share your experiences of suicidal ideation in the comments section below as well. Don’t forget to bookmark my site and if you want to stay up-to-date with my blog, then sign up for my newsletter below. Alternatively, get push notifications for new articles by clicking the red bell icon in the bottom right corner.
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Botega, N. J., Barros, M. B. D. A., Oliveira, H. B. D., Dalgalarrondo, P., & Marín-León, L. (2005). Suicidal behavior in the community: prevalence and factors associated with suicidal ideation. Brazilian Journal of Psychiatry, 27, 45-53. Retrieved from https://www.scielo.br/j/rbp/a/pY8Vgdd8ZnYFPXrqc5zydhB and https://doi.org/10.1590/S1516-44462005000100011.
Broderstad, A. R., Eliassen, B. M., & Melhus, M. (2011). Prevalence of self-reported suicidal thoughts in SLiCA. The survey of living conditions in the Arctic (SLiCA). Global health action, 4(1), 10226. Retrieved from https://www.tandfonline.com/doi/full/10.3402/gha.v4i0.10226%40zgha20.2011.4.issue-s1 and https://www.tandfonline.com/doi/pdf/10.3402/gha.v4i0.10226%40zgha20.2011.4.issue-s1.
Evans, E., Hawton, K., Rodham, K., & Deeks, J. (2005). The prevalence of suicidal phenomena in adolescents: A systematic review of population-based studies. Suicide and Life-Threatening Behavior, 35(3), 239–250. Retrieved from https://doi.org/10.1521/suli.2005.35.3.239 and https://guilfordjournals.com/doi/abs/10.1521/suli.2005.35.3.239.
Gliatto, M. F., & Rai, A. K. (1999). Evaluation and treatment of patients with suicidal ideation. American family physician, 59(6), 1500. Retrieved from https://www.aafp.org/afp/1999/0315/p1500.html.
Nock, M. K., Borges, G., Bromet, E. J., Alonso, J., Angermeyer, M., Beautrais, A., Chiu, W. T., de Girolamo, G., & Williams, D. (2008). Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. The British journal of psychiatry, 192(2), 98-105. Retrieved from https://www.cambridge.org/core/services/aop-cambridge-core/content/view/BDD6458A563389FFE7E5226B7533BE98/S0007125000233886a.pdf/div-class-title-cross-national-prevalence-and-risk-factors-for-suicidal-ideation-plans-and-attempts-div.pdf, https://pubmed.ncbi.nlm.nih.gov/18245022, and https://doi.org/10.1192/bjp.bp.107.040113.
Reinherz, H. Z., Tanner, J. L., Berger, S. R., Beardslee, W. R., & Fitzmaurice, G. M. (2006). Adolescent suicidal ideation as predictive of psychopathology, suicidal behavior, and compromised functioning at age 30. American Journal of Psychiatry, 163(7), 1226-1232. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/ajp.2006.163.7.1226 and https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.2006.163.7.1226.
SAMHSA. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53). Retrieved from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report.
You, S., Van Orden, K. A., & Conner, K. R. (2011). Social connections and suicidal thoughts and behavior. Psychology of addictive behaviors, 25(1), 180–184. Retrieved from https://doi.org/10.1037/a0020936, https://pubmed.ncbi.nlm.nih.gov/21142333, and https://content.apa.org/record/2010-25604-001.