Suicidal Ideation: Symptoms, Treatment & Management (2023)

Suicide ideation is thoughts, ideas, wishes, considerations, contemplations, or preoccupations relating to death and suicide. It is sometimes referred to as suicidal thoughts or suicidal ideas.

Suicide is the second leading cause of death, after unintentional injury, among Americans between the ages of 10 and 34 and in the top 10 leading causes among all ages. Nearly 5% of adults, and nearly 12% of adults between the ages of 18 and 25, have serious thoughts of suicide.

Suicide ideation is often connected to a major depressive episode, but not always. It can also be linked to other mental health disorders, substance abuse, trauma, extended grief, or compromised health.

Suicide Prevention Hotline

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Suicidal Ideation: Symptoms, Treatment & Management (1)

What Is Suicide?

Suicide is death by oneself or the act of someone taking their own life.

Risk Factors

While suicidal ideation is most often associated with depression or a major depressive episode, this is not always the case. People living with other mental health disorders, such as mood disorders, and even people without mental health disorders, can experience suicidal ideation. In addition, those with a substance abuse disorder, chronic illness, or experiencing grief are also at an increased risk.

Friends and family members of people who have completed suicide are at an increased risk of suicidal ideation. Suicide contagion is when exposure to suicide or suicidal behavior in one's social network, including friends, family members, and even media can result in increased thoughts of suicide, as well as suicide behaviors including attempts and deaths.

Genetics may play a role in the risk of suicidal ideation and suicidal behavior. Mental health conditions linked to suicidal ideation, such as depression, run in families, so people with a family history of mental illness are at an increased risk of experiencing suicidal ideation themselves. However, some things can help reduce the risks, and family history does not mean a person will have suicidal thoughts.

Suicidal Ideation Risk Factors

Risk factors that make someone more prone to experience suicidal ideation include:

  • Major depressive episode
  • Other mental health disorders such as schizophrenia or bipolar disorder
  • Substance abuse
  • Addiction
  • Trauma
  • Extended grief
  • Compromised physical health
  • Chronic or terminal illness
  • Chronic pain
  • Past suicide attempts
  • Connection to someone who has died by suicide
  • Lack of a supportive community
  • Disability
  • Limited access to health care
  • Genetics

Warning Signs

Warning signs that someone is thinking about suicide may be noticed by the people around them, including friends and family members. These warning signs may include talking about dying and other negative thoughts or they may be expressed through feelings of hopelessness, being trapped, or behavior changes.

(Video) What is Suicidal Ideation?

Signs To Look Out For

Signs that indicate that someone may be experiencing suicidal ideation include:

  • Extreme mood swings
  • Talking or thinking about wanting to kill themselves
  • Talking or thinking about being a burden to others
  • Sleeping excessively or not enough
  • Changes in eating habits
  • Isolation and withdrawal
  • Extreme guilt or shame
  • Research related to death and ways to die
  • Gifting important belongings
  • Making a will
  • Excessive risk taking, such as drinking and driving or using hard drugs

Treating Suicidal Ideation

Suicidal ideation can be treated with medications or psychotherapy (talk therapy). Medications and psychotherapy can be used together. Cognitive behavior therapy (CBT) and dialectical behavioral therapy (DBT) are the two most common types of psychotherapy used to prevent suicide.

Depending on the severity, medication and psychotherapy treatments may be provided through an appointment with a healthcare provider or at an in-patient facility such as a hospital or mental health facility.

Choosing the Right Therapist

A significant part of treating suicidal ideation is identifying and treating other mental health conditions that may occur with suicide ideation. For example, suicide ideation is more likely to occur in people living with schizophrenia, depression, and bipolar disorder.

Certain medications have been shown to decrease the risk of suicide. These include a medication called Clozaril (clozapine) that can be used to prevent suicide among people living with schizophrenia. Lithium, which is used in bipolar disorder, and antidepressants, can be used in people with depression. In some instances, people with suicidal ideation may need to be hospitalized for their safety until the underlying condition is adequately treated.

If you or a loved one are struggling with depression or suicidal ideation, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Management & Prevention

In addition to psychotherapy and medications, there are other things that can be done to manage and prevent suicidal ideation and suicide. Many lifestyle behaviors impact suicide risk, including:

  • Relationships
  • Addiction to the internet
  • Nutrition
  • Work stress
  • Activity level
  • Substance use
  • Weight

It can be helpful to focus on developing and strengthening relationships with friends and family or members of a support group, seek treatment for internet and substance addictions, and maintain a healthy lifestyle to reduce these risks.

Specific lifestyle changes may include eating a healthy, well-balanced diet, managing stress, and exercising. Activities such as yoga and meditation may also be helpful.


Suicidal ideation, sometimes referred to as suicidal thoughts or suicidal ideas, involves thoughts, ideas, wishes, considerations, contemplations, or preoccupations relating to death and suicide. People living with mental health conditions, substance misuse, extreme grief, and chronic illness are at an increased risk, but anyone can experience suicidal ideation.

Warning signs include changes in sleep or eating habits, extreme mood swings, talking about dying or being a burden to others, and isolation or withdrawal. These signs must be taken seriously by contacting a healthcare professional or the National Suicide Prevention Lifeline at 988 for support. Suicidal ideation can be treated, managed, and prevented with psychotherapy, medications, and lifestyle changes.

(Video) Suicide Prevention Treatment

A Word From Verywell

Suicidal ideation can be scary, both for the person experiencing the suicidal ideation and those around them, including family and friends. It is important to remember that suicidal ideation can be treated. If you or someone you know is experiencing thoughts of suicide or death, seek help immediately. It is possible to recover from suicidal ideation and go on to live a healthy, happy life.

Frequently Asked Questions

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Schreiber J, Culpepper L. Suicidal ideation. UpToDate.

  2. National Institute of Mental Health. Suicide.

  3. APA Dictionary of Psychology. Suicide.

  4. U.S. Department of Health and Human Services. What does "suicide contagion" mean, and what can be done to prevent it?.

  5. U.S. Department of Health and Human Services. Can the risk for suicide be inherited?

  6. National Institute of Mental Health. Warning signs of suicide.

  7. American Foundation for Suicide Prevention. Treatment.

  8. Berardelli I, Corigliano V, Hawkins M, Comparelli A, Erbuto D, Pompili M. Lifestyle interventions and prevention of suicide.Front Psychiatry. 2018;9:567. doi:10.3389/fpsyt.2018.00567

(Video) What's the Difference Between Suicidal Thoughts & Suicidal Ideation? Kati Morton

Suicidal Ideation: Symptoms, Treatment & Management (2)

By Ashley Olivine, Ph.D., MPH
Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development.

(Video) Relief from severe depression and suicidal ideation within hours: from synapses to symptoms


What are the three steps of suicidal ideation? ›

The primary tenets of the Three-Step Theory (3ST) are that (a) suicidal ideation develops due to a combination of pain and hopelessness, (b) connectedness is a key protective factor against escalating ideation in those high on both pain and hopelessness, and (c) progression from suicide ideation to attempts occurs when ...

What are the steps in helping someone who is suicidal? ›

Here's what you can do.
  • Encourage the person to call a suicide hotline number. ...
  • Encourage the person to seek treatment. ...
  • Offer to help the person take steps to get assistance and support. ...
  • Encourage the person to communicate with you. ...
  • Be respectful and acknowledge the person's feelings. ...
  • Don't be patronizing or judgmental.

What is the suicidal ideation questionnaire? ›

The SIQ assesses the frequency of suicidal ideation and serves as a valuable component in a comprehensive assessment of adolescent mental health.

What is the DSM 5 code for suicidal ideation? ›

81 Suicidal ideation may be assigned as a principal diagnosis if the clinician has confirmed that there is no underlying mental disorder.

What are three warning signs for someone who may be suicidal? ›

Warning Signs for Suicide
  • Talking about wanting to die or to kill oneself.
  • Looking for a way to kill oneself, such as searching online or obtaining a gun.
  • Talking about feeling hopeless or having no reason to live.

What are 3/5 behavior warning signs of suicidal? ›

Changing behavior, such as:
  • Making a plan or researching ways to die.
  • Withdrawing from friends, saying goodbye, giving away important items, or making a will.
  • Taking dangerous risks such as driving extremely fast.
  • Displaying extreme mood swings.
  • Eating or sleeping more or less.
  • Using drugs or alcohol more often.


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3. Reducing Suicidal Ideation Through Insomnia Treatment
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4. Suicide Risk Screening Training: How to Manage Patients at Risk for Suicide
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5. 9 Warning Signs of Severe Depression
6. Casually Suicidal | Sarah Liberti | TEDxAdelphiUniversity
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