What is Suicidal Behavior?

Suicidal behaviors are characterized by any self-inflicted injuries in which the person intended, at some level, to kill his or herself. Suicidal ideation, or the experience of thinking about death, dying, or harming oneself without acting on those thoughts, is often a precursor to suicidal behavior and is quite common in individuals who report feeling sad, hopeless, or depressed. Unlike major depression, suicidal behavior and suicidal ideation are not by themselves medical or mental health diagnoses; however, the presence of suicidal ideation or behavior is a clear and significant indicator of severe distress. Although these thoughts and behaviors are almost always seriously disruptive to a person’s life, suicidal ideation and suicidal behavior can be experienced differently from person to person.

What causes it?

Like depression, the causes of suicidal ideation and behavior are likely multi-determined. However, there are several risk-factors that put people at increased risk for suicide. One factor is feeling hopeless about the future, like nothing is ever going to get better. Another is having difficulty solving problems and crises that arise, such as coping with a divorce or getting fired from a job. A third risk factor is feeling that you don’t have enough or the right type of support from others in you life, like family and friends. Another risk factor is not following through with treatment recommendations from doctors and therapists, such as medications and psychotherapy. In addition, there might be other risk factors specific to the individual, such as drug and alcohol problems.

How common is it?

Suicidal behavior is a major mental health problem in the United States. Completed suicides account for more than 29,000 deaths each year. Many more people attempt to kill themselves but don’t succeed–roughly 500,000 people each year. Even though many people may not talk about it openly, suicidal ideation and behavior are common problems.

When does it begin?

Like depression, suicidal ideation and behavior can start at any time in a person’s life, from childhood through old age. However, most people who experience suicidal ideation and behavior first experience some degree of depression or significant life stress.

How is it treated?

Often, suicidal ideation and behavior are treated as part of a comprehensive treatment plan designed to reduce the symptoms of major depression. Consequently, many of the treatments that are effective for depression are also effective for suicidal ideation and behavior. However, many people who have struggled with these thoughts and behaviors for a long period of time find that a treatment focused on identifying their core goals and values, with the intention of developing a plan of action to achieve these goals and values, can be a useful supplement to conventional treatment. It is important to recognize that, for many people who experience suicidal ideation and behavior, the problems that drive these thoughts of self-harm have existed for a long time. Treatment is more effective when individuals experiencing these thoughts and behaviors understand that it will take time to change these problems and underlying risk factors.

What other problems are commonly associated with suicidal behavior?

Aside from the clear and serious risk of completing suicide, there are a number of other problems associated with suicidal behavior and ideation. Often, individuals who struggle with suicide have difficulty with interpersonal relationships. Friends and family may experience the suicidal impulses of a loved one as frightening and confusing. This fear and confusion may lead family and friends to protect themselves from the prospect of losing a loved one struggling with suicidal impulses by distancing themselves from that individual. Importantly, the individual struggling with suicidal impulses may be unaware of the impact their behavior has on family and friends. As well, individuals experiencing suicidal ideation and behavior may feel guilty or hopeless about these thoughts and feelings which, in turn, serves to exacerbate depressed mood and negative self-image.