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Suicidal thoughts can be extremely unpleasant, overwhelming, and isolating. The mind may begin to think there is no way forward when life's obstacles become too great. Even though these thoughts are upsetting, they frequently represent severe emotional and psychological distress, rather than a genuine want for it to pass away. The good news is that there is always hope, healing, and assistance available. People can overcome suicidal thoughts and re-establish a sense of security and connection with the correct support networks, emotional resilience tactics, and self-regulation methods.
This article explains what suicidal thoughts are, why they occur, how to identify their physical and emotional signs, and helpful and healthy coping mechanisms, and how online therapy can help in this process.
What are Suicidal Thoughts?
Suicidal thoughts, often referred to as ‘Suicidal Ideations’, are “thoughts about a preoccupation with killing oneself, often as a symptom of a major depressive episode, where most instances of suicidal ideations do not move towards to attempted suicide, which is the act of killing oneself” (American Psychological Association, 2018). These thoughts can range from fleeting ideas to detailed planning to act on the thoughts (Klonsky et., 2016).
Suicidal ideation is a complex phenomenon that is impacted by a number of social, biological, psychological, and environmental variables. It can be a symptom of underlying distress, rather than a specific, single "disorder," arising from the interaction between a person's inner emotional environment and their exterior surroundings (Turecki & Brent, 2016).
The World Health Organization (2023) reports that over 700,000 individuals die by suicide each year, and many more attempt or consider suicide. This suggests that suicide thoughts are significantly more prevalent than most people realize and should be treated with compassion rather than stigma. Anybody, regardless of age, gender, or background, might have suicidal thoughts, which frequently coexist with illnesses like depression, PTSD, anxiety disorders, bipolar disorder, substance abuse, or chronic pain (O'Connor & Nock, 2014).
Why Do Suicidal Thoughts Emerge?
Suicidal thoughts do not have a single, universal source. Rather, a complex combination of biological elements, psychological vulnerabilities, emotional suffering, and environmental stressors leads to suicide ideation. These ideas usually arise when a person feels hopeless or emotionally isolated or stuck because their internal coping mechanisms can be overburdened or exhausted.
Psychological Factors
Suicidal thoughts are frequently fostered by intense psychological challenges. A person's resilience may be weakened by continual emotional overload, unresolved trauma, chronic stress, or lingering feelings of inadequacy. Suicide risk has been repeatedly associated with emotional dysregulation, or the inability to control strong emotions (Van Orden et al., 2010). Many people experience suicidal thoughts when their emotional pain gets difficult to cope with, that they start looking for a way to "escape," which reflects a desire for relief rather than death.
Social Isolation, And Feelings of Loneliness
People are emotionally vulnerable when they feel alone or detached since humans are designed for connection. They are inherently drawn to knowledge, connection, and a feeling of belonging. Feelings of loneliness and isolation can have a significant negative impact on mental health when those emotional requirements are not satisfied. Being physically alone is simply one aspect of social isolation; another is feeling emotionally cut off, ignored, or misinterpreted even in social situations.
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Biological and Neurochemical Factors
Suicidal thoughts are influenced by emotional and contextual circumstances, but a person's susceptibility might also be increased by a strong neurological component, making it difficult for certain people to regulate their emotions, manage stress, and is not a prediction of someone developing suicidal thoughts.
- Role of Serotonin: A neurotransmitter that plays a role in emotional equilibrium, impulse control, and mood regulation. Lower serotonin functioning has been linked to greater impulsivity, anger, and trouble controlling strong emotions, all of which can increase the likelihood of suicidal thoughts (Mann et al., 2005).
- Role of Prefrontal Cortex: This is the area of the brain in charge of planning, making decisions, solving problems, and logical reasoning. Individuals who have suicidal thoughts may exhibit decreased activity, which makes it more difficult to explore potential solutions, think through the repercussions, or slow down reactive impulses.
- Role of Amygdala: Another important part is played by the amygdala, which is involved in processing fear and emotional responses. The amygdala can become hyperreactive – reacts more strongly to negative stimuli. This might intensify upsetting thoughts, heighten emotional sensitivity, and raise emotions of powerlessness or fear.
- Genetic Predisposition: Genetic markers and family histories of mood disorders, depression, or suicide can increase vulnerability, affecting how the brain processes stress and emotions rather than directly generating suicidal thoughts. Individuals with these tendencies may have lower stress thresholds or respond more strongly to emotional distress (Oquendo et al., 2014).
Major Life Events
Suicidal thoughts may arise as a result of extreme distress brought on by life situations that are too much for the mind to handle. Typical triggers consist of:
- A loved one's passing
- Divorce or breaks in relationships
- Stress related to money or unemployment
- Pressures from school or the workplace
- Debilitating or chronic sickness
A person's sense of security and identity might be upended by abrupt changes, making it more difficult to imagine a better future (Franklin et al., 2017).
Mental Health Conditions
Mental health issues and suicidal ideation frequently co-occur because these conditions might affect thought patterns, emotional regulation, and stress tolerance rather than because the individual is "weak." These can include:
- Major Depressive disorder
- PTSD or Complex-PTSD
- Anxiety Disorder
- Bipolar Disorder
- Borderline Personality Disorder
- Substance use Disorders
Feelings of Hopelessness
One of the best psychological indicators of suicide thoughts is hopelessness (Beck et al., 2015). It conveys the idea that one's current suffering will never get better, making one feel stuck in their situation. This is referred to as "entrapment" in the Integrated Motivational–Volitional Model (O'Connor & Kirtley, 2018), a mental state in which people think:
- “My suffering is unavoidable.”
- “I have no solutions left.”
- “I am finding it difficult to cope with everything.”
The Interpersonal-Psychological Theory of Suicidal Behaviour
The ‘Interpersonal-Psychological Theory of Suicidal Behaviour’ developed by Thomas Joiner, states that the desire for death by suicide is often resulted from the joining of two interpersonal states: perceived burdensomeness, and thwarted belongingness (Ribeiro & Joiner, 2009)
Perceived Burdensomeness
This refers to the possibly harmful false belief that a persons inadequacy and existence is a burden on friends, family, and/or society. The possibly harmful notion that one's death is more valuable than one's life can result from feeling like a burden to others. This feeling involves being a liability to loved ones, and when experienced concurrently and is perceived as constant and something that will never change, these feelings increase significantly, increasing the desire for suicide.
Thwarted Belongingness
Thwarted belongingness, or feeling cut off from friends, family, or other important social groups, is another risk factor for suicidal thoughts. This also includes feelings of loneliness, isolation, and a lack of emotional and physical connectedness to others. This psychological state results from an unmet need for social connection, and failure to maintain or achieve meaningful social relationships.
This theory further mentions that ‘perceived burdensomeness’ and ‘thwarted belongingness’ exist individually, bringing up suicidal thoughts, but when both exist concurrently, the intensity with which suicidal ideations emerge and higher.
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Early Warning Signs or Red Flags to Look Out For
A key component of prevention is identifying early warning indicators of suicide ideation. Suicidal thoughts seldom come "out of nowhere"; instead, they frequently emerge gradually as a result of behavioral, cognitive, and emotional shifts. Knowing these indicators can assist people in getting help early on or enable family members to step in before a problem gets worse.
Emotional Signs
These are indicators that may occur even before a person recognizes thoughts of suicide emerging, reflecting emotional exhaustion and/or distress.
- Hopelessness: A deep, persistent sense that the situation will not improve, or life has no meaning, leading to losing hope towards the future.
- Emotional numbness: Feeling "nothing at all," – emotionally detached, or incapable of being happy. Long-term stress, sadness, or burnout are common causes of numbness, which can make a person feel cut off from themselves and other people.
- Withdrawal from social settings: This disengagement is frequently unintentional and results from emotional exhaustion or overload. Feelings of loneliness, another recognized risk factor, are exacerbated by decreased social engagement.
Behavioural Signs
Signs that can be recognized through actions.
- Sudden changes in routine, including sleeping too much or too little, irregularity in eating habits, neglecting hygiene.
- Giving away personal belongings that especially includes items of emotional value.
- Engaging in risky behaviours such as reckless driving, substance abuse, or engaging in self harm.
- Actively searching for means by looking up information on suicide, different ways to act on it, or acquiring harmful items.
- Loss of interest in hobbies, work, academic goals, or passions.
Cognitive/Psychological Signs
These signs can go hand-in-hand or intensify as emotional signs accumulate.
- Persistent thoughts of being a burden to others.
- Constant thoughts of nothing changing in the future and things not getting better.
- Intrusive thoughts of death, even if there is no concrete plan.
- Strong belief that life has no purpose or meaning.
When To Take Suicidal Thoughts Seriously?
Even though subtle and ‘passing’ thoughts of suicide should be taken seriously or when someone else mentions it casually or “in passing”, certain indicators that reflect a higher intensity of risk:
- When thoughts become frequent or intrusive - thinking regularly about death or inability to stop thinking about ending their life.
- Having a specific plan - presence of a plan, no matter how small or vague, indicates a significant increase in the suicidal thoughts and shifting from ideation to intent.
- When there is access to means - having tools or methods to engage on the thoughts.
- History of self harm . suicidal thoughts, or previous attempts.
Strategies to Manage Suicidal Thoughts
Creating a Safety Plan
Safety planning entails recognizing warning indicators, coping mechanisms, social resources, and crisis contacts. In times of hardship, writing things down can provide you a sense of control and quick direction (Stanley & Brown, 2012).
Grounding and Mindfulness Techniques
When suicidal thoughts feel overwhelming or intrusive, grounding exercises might help bring the mind back to the present. By stimulating the senses, controlling the neurological system, and lessening the severity of distress, these techniques break the emotional "spiral." Some examples of grounding techniques are:
- 5-4-3-2-1 Sensory Grounding Exercise, forcing the mind to external sensory input instead of the intense thoughts.
- Temperature-Based Grounding, where strong bodily sensations brought on by temperature variations aid in halting the neurological system's elevated stress reaction – splashing cold water on your face, holding an ice cube in your hand or popping an ice cube in your mouth, taking a cold shower, are different temperature-based grounding.
- Breathing Strategies are effective ways to reduce the intensity of emotions. They lessen the activation of the fight-or-flight response and aid in nervous system regulation. – box breathing, 4-7-8 breathing, diaphragmatic breathing (placing a hand on your belly and breathing deeply).
Strengthening Social Connections
Social belongingness is a protective factor against suicide. Speaking with dependable family members, friends, or support groups; relationships serve as a safeguard against loneliness and despair (Kleiman & Liu, 2013).
Increased Physical Activity
Frequent exercise can help control mood and lessen anxiety and depressive symptoms. Even simple exercises like yoga or walking can have a big emotional impact (Schuch et al., 2016).
How Online Therapy at Rocket Health Help?
Rocket Health is dedicated towards making therapy affordable and convenient for individuals struggling with, and trying to understand the challenges they face. Therapy can help in this process by identifying triggers that bring up suicidal thoughts, explore various grounding and mindfulness techniques, helping build social connections, along with using various approaches to help cope with the suicidal ideation like Cognitive Behaviour Therapy (CBT), Dialectical Behaviour Therapy (DBT), and various mindfulness-based approaches. Due to its widespread accessibility, online therapy enables early, preventive interventions.
Please contact your local emergency services or a suicide prevention helpline immediately if you are in immediate danger or have suicidal thoughts. Help is accessible around-the-clock, and you are not alone.
References
American Psychological Association. (2018). Suicidal ideation. In APA dictionary of psychology. https://dictionary.apa.org/suicidal-ideation
Forkmann, T., et al. (2019). Mindfulness-based cognitive therapy and suicidal rumination. Behaviour Research and Therapy, 120, 103437.
Klonsky, E. D., et al. (2016). Suicidal behavior: Advances in understanding and prediction. Annual Review of Clinical Psychology, 12, 307–330.
Kleiman, E. M., & Liu, R. T. (2013). Social support as a protective factor. Psychiatry Research, 210(3), 1–8.
Linardon, J., et al. (2019). Efficacy of online psychological interventions for mental health. Clinical Psychology Review, 76, 101832.
O’Connor, R. C., & Nock, M. K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1(1), 73–85.
Ribeiro, J. D., et al. (2018). Emotion dysregulation and suicidal ideation. Suicide and Life-Threatening Behavior, 48(1), 1–10.
Stanley, B., & Brown, G. K. (2012). Safety planning intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256–264.
Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behaviour. The Lancet, 387(10024), 1227–1239.
Tarrier, N., et al. (2013). Cognitive-behavioral interventions and suicide prevention. Behaviour Research and Therapy, 51(3), 142–149.
Van Orden, K. A., et al. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600.
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