Suicidal Ideation – The Bigger Picture You Need To Be Aware Of

by Claudia Cole

Worried about where your thinking goes when under stress? ‘Suicidal ideation’ can happen to the best of us, and it’s important we know how to handle it.  

*Need urgent support? Call the Samaritans 24-7 at 116 123.  If you’re in danger of hurting yourself or someone else, contact 999 for emergency services or go straight to A&E.

What is suicidal ideation?

According to the Samaritans, 1 in 5 individuals have thought about suicide at some point in their lives. 

Suicidal ideation is a fancy way to describe suicidal thinking and ideas. The term was created by psychologists to try to pinpoint and research how suicidal thinking works. But there isn’t a typical suicide victim, and there isn’t ‘typical’ suicidal thinking, either.

So not all researchers agree on what does and doesn’t fit under ‘ideation’. Contemplating, wishing for, or being preoccupied with death and ending your life is ideation. But some want to include suicidal planning under the term, while other psychologists protest it is a different category entirely, as it comes with far greater risk. 

Passive vs active ideation

To clarify this confusion ideation is sometimes divided into ‘passive’ or ‘active’.

Passive suicidal ideation is when you’re having thoughts of suicide but with no actual plans to act on it, like fantasies of going to sleep and never waking up. 

Active suicidal ideation is when you have some level of intent to act on such thoughts and may have created a plan to carry them out.

Why does suicidal thinking matter?

Suffering from passive suicidal ideation does not alone mean you will ever try to take your own life.

A 2021 global World Health Organisation study that interviewed over 85 thousand subjects found  that two thirds of those who deal with suicidal ideation never make a single attempt at taking their life.

But ideation certainly does raise your risk of suicide and should  be taken seriously. This is particularly true if it’s your first year of having suicidal thoughts, or if you have a mood or impulse control disorder, factors the same study found elevated one’s risk. 

By recognising you have a problem with passive ideation you can learn the warning signs that it is starting for you, and take note if it has arrived with other symptoms that put you at risk of moving towards ‘active’ ideation (more on that below). You can then take steps to keep yourself safe.

Who is most likely to suffer from suicidal ideation?

Photo by Engin Akyurt for Pexels

Anyone can deal with this issue.

Although statistics do suggest men are more likely to actually take their own lives, while women are more likely to suffer from suicidal ideation.

Why do I suffer from suicidal thoughts?

There is no single explanation for what causes suicidal ideation, and it is different for each person. Some people have a mind that is caught in black and white thinking due to childhood trauma, and their mind goes to suicidal ideation in the face of any kind of life stress. 

For many, though, ideation is triggered by feeling overwhelmed by life and struggling to cope. This can happen if we are facing things like financial difficulties, losing a loved one, health issues, or prolonged stress.

Suicidal ideation can also be associated with mental health disorders. Unsurprisingly, research shows it is frequently experienced in those with major depressive disorder.

And ideation is a symptom of borderline personality disorder, with up to ten per cent of those who have BPD unfortunately going on to successfully act on their thoughts. 

Other factors that may increase the risk of experiencing suicidal ideation include:

• if you have attempted suicide in the past
• substance abuse and addiction
• struggling with extreme loneliness
• having experienced significant trauma or abuse
• being a victim of bullying
• socioeconomic inequalities.

*Only recently started experiencing ideation, and also started taking a new medication? Note that there are several medications that can lead to ideation, including ADHD meds, HRT, corticosteroids, birth control, and seizure medications.  If you are concerned it’s important to talk to your doctor. 

What can I do if I’m experiencing suicidal ideation?

So what can you do if this is you, and you tend to often think about death and ending your life?

1. Identify triggers.

Try paying close attention to any potential triggers. Is it an environment? A person? A habit you are indulging in? Start to question the choices that cause suicidal thinking and consider what other choices you could make instead. If you don’t seem to have triggers and think your ideation might be part of a mental health disorder, it’s a good idea to see a mental health professional for advice. 

2. Find a healthy way to move through your thoughts.

This might be free form journalling, it might be talking to a trusted friend or support group. A helpful coping tool can also be engaging in healthy activities that take you away from thinking entirely, such as spurts of intense exercise and practicing mindfulness.

2. Get the support of someone you can trust. 

photo by Ketut Subiyanto for Pexels

If you don’t have a friend or family member you can trust, consider working with a therapist or counsellor. You can talk to your GP who can refer you to therapy. Here in that UK the NHS often offers cognitive behavioural therapy (CBT) which helps you manage your thinking. For faster access and greater choice of what kind of therapy you try, consider booking privately. 

3. Make a safety plan.

A personal safety plan is a suggested tool to help keep you safe in times of distress or when you’re experiencing suicidal thoughts.  The steps of safety planning mean writing out your personal:

• warning signs (how to know you are feeling suicidal)
• coping strategies (things that take your mind off what’s upsetting you that you can do by yourself)
• people and settings that can provide healthy distraction
• who you can ask for help
• professionals you can contact in crisis (including help lines)
• what you can do to make your environment safe.

The Samaritans provide a free template for  a safety plan here.

Other important warning signs

Ideation is only one of the signs you are at risk for taking your life, and it’s important to pay attention to whether your thinking comes with other connected signs. These include:

• feelings of entrapment 
• a sense of worthlessness
• a deep sense of hopelessness
• feeling intense emotional pain 
• or total numbness and fatigue (depression)
• withdrawing from loved ones or avoiding social interactions
• losing interest in daily life or the future
• severe shifts in mood
• an increase in substance use or misuse
• engaging in impulsive or risky behaviour
• looking at methods of suicide.

Feelings of entrapment are particularly important to pay attention to, if new research is anything to go by. A British study carried out across four years that looked at repeat suicidal behaviour, for example, ranked feelings of entrapment as a higher risk factor than ideation and depression.

Useful resources that can help if you are feeling suicidal

Stay Safe provides guidance and tools to create a safety plan to help with emotional distress and self-harm, including online tutorial videos and templates.

Side By Side is a supportive online community by Mind where you can connect, listen, and share your experiences.

Samaritans is a free 24 hour helpline providing a one-to-one listening service for anyone struggling or experiencing emotional distress. Call 116 123 (free from any phone).

Shout offers a confidential 24/7 text service for those in crisis and in need of immediate help. If you want some support but prefer not to talk over the phone. Text SHOUT to 85258. 

The Mix is a service for those under 25s, providing support and advice, including a helpline and crisis messenger. Call 0808 808 4994. Text THEMIX to 85258.

Need someone to talk to? Our hand-selected team of therapists in London are known for being some of the best, all with over ten years of experience. Or use our sister site HarleyTherapy.com for affordable UK-wide therapy you can choose based on user reviews. 

Claudia Cole is a London-based writer and journalist. She is passionate about sustainable living, mental health, and wellbeing.