Suicidal thoughts and depression often go hand-in-hand. In many cases, suicidal ideation is one of the major warning signs of depression. However, not everyone with depression experiences suicidal thoughts, and not everyone with suicidal thoughts is depressed. This complex relationship warrants a deeper look into how suicidal ideation links to depressive disorders.
Suicidal thoughts refer to any self-reported thoughts or preoccupations about suicide or taking one’s own life. These suicidal ideations can range from fleeting thoughts to extensive fantasies and planning. Suicidal ideation exists on a spectrum, from mild to severe.
Depression refers to a collection of psychiatric disorders characterized by persistent feelings of sadness, hopelessness, and loss of interest. The major types of depressive disorders include:
- Major depressive disorder
- Persistent depressive disorder (dysthymia)
- Bipolar disorder
- Seasonal affective disorder
- Peripartum depression
- Premenstrual dysphoric disorder
People with depression experience feelings of extreme sadness, fatigue, difficulty thinking and concentrating, and loss of energy and motivation. These symptoms interfere with daily life and normal functioning.
The link between suicidal thoughts and depression
Research shows a strong correlation between suicidal ideation and depression:
- About 60% of people who die by suicide suffered from some form of mood disorder like depression.
- Approximately 65% of people with depression experience suicidal thoughts.
- 90% of people who die by suicide had a diagnosable psychiatric disorder at the time of death, most commonly a depressive disorder or substance abuse disorder.
These statistics demonstrate an overlap between suicidal ideation and depression. Some key reasons for this overlap include:
- Biochemistry – Depression involves changes in brain chemicals like serotonin, dopamine and norepinephrine, which influence mood. These same neurotransmitters also regulate suicidal thoughts.
- Hopelessness – Depressive disorders create distorted, negative thinking patterns. Feelings of hopelessness increase the risk of suicidal thoughts emerging.
- Impulsivity – Depression reduces impulse control and decision-making abilities, making a person more likely to act on suicidal urges.
- Psychache – Suicidal thoughts may arise as an escape mechanism from the extreme psychological pain and distress of depression.
In many cases, treating the underlying depression can alleviate suicidal thoughts. However, suicidal ideation may also emerge as a side effect of antidepressant medication, particularly in children and adolescents. Close monitoring is required during treatment.
Warning signs of suicide risk
Most people with depression do not become suicidal. But certain patterns and risk factors can signal increased risk for suicidal ideation and behaviors. These include:
- Previous suicide attempt(s)
- Family history of suicide
- Concurrent substance abuse disorder
- Access to lethal means of suicide
- Impulsive and aggressive tendencies
- Hopelessness or expressing no reason to live
- Withdrawal from family/friends or feeling isolated
- Dramatic mood changes
- Talking about death or suicide
- Making plans or preparations for suicide
A suicidal person may begin to put personal affairs in order, give possessions away, acquire means for suicide, or become suddenly cheerful after a period of depression. These could all indicate high imminent risk that warrants an immediate intervention.
Suicidal thoughts without depression
Although depression accounts for the majority of suicidal ideation, there are some instances where suicidal thoughts can occur without depression:
- Bipolar disorder – During manic or mixed episodes, a person may experience a rush of energy and impulsivity that leads to suicidal acts.
- Schizophrenia – Psychosis, hallucinations and delusions may cause someone to become suicidal.
- Borderline personality disorder – Impulsivity and emotional dysregulation creates suicidal behaviors.
- Psychiatric emergencies – Suicidal thoughts can be a reaction to severe panic attacks, post-traumatic reactions or psychosis triggered by stress, trauma or substance abuse.
- Situational crises – Events like divorce, job loss or financial ruin can trigger suicidal thoughts, even without depression.
Whenever suicidal ideation arises, prompt evaluation and treatment are essential, regardless of the underlying cause.
Warning Signs in Teens
Suicide is the second leading cause of death for teenagers. Here are some potential warning signs of suicidal thoughts in teens:
| Emotional Warning Signs | Behavioral Warning Signs |
|---|---|
| – Hopelessness | – Increased risk-taking behaviors |
| – Rage, anger, seeking revenge | – Engaging in reckless behavior |
| – Feeling trapped | – Withdrawal from friends, family, society |
| – Dramatic mood changes | – Acting anxious or agitated |
It’s important to initiate a conversation with teens about any emotional or behavioral changes that seem out of character for them.
Preventing suicide
If you notice the warning signs of suicide in yourself or someone else, immediate action is required:
- Remove means for suicide, like guns, knives or stockpiled pills
- Calmly talk to the person about suicide
- Call the National Suicide Prevention Lifeline at 1-800-273-8255
- Take the person to an emergency room or mental health professional
- Provide emotional support and encourage them to continue treatment
Proper treatment significantly reduces suicide risk. Up to 90% of suicides can be prevented through early recognition, treatment and support.
Treatment options
If suicidal thoughts are associated with depression or another mental health disorder, comprehensive treatment is necessary, typically involving:
- Medication – Antidepressants or mood stabilizers help relieve underlying symptoms.
- Psychotherapy – Counseling provides coping techniques for suicidal urges and skill building for depression.
- Hospitalization – Those at imminent risk may require hospitalization for stabilization and safety.
Treatment takes time but can be life-saving. Support from family and friends also aids recovery.
Coping strategies
Alongside professional treatment, individuals can use coping strategies to overcome suicidal thoughts on their own:
- Avoid drugs and alcohol
- Make a safety plan outlining suicide alternatives and resources
- Engage in positive social activities
- Join a support group to feel less alone
- Do activities that bring purpose or enjoyment
- Let out feelings creatively through art, music, or writing
- Adopt self-care and stress management techniques
Having a trusted friend or family member to call also helps diffuse suicidal thoughts when they arise.
Conclusion
Suicidal thoughts have a complex association with depression. While suicidal ideation can arise from non-depressive causes, depression remains the leading risk factor. Comprehensive treatment of underlying psychiatric disorders along with support, coping strategies and safety precautions are imperative to overcoming suicidal thoughts and saving lives.