Suicidal ideation and suicidal intent are two different things. It’s important to know the distinction and how to respond to them both.
Suicidal thoughts are a regular part of my life, and that’s not uncommon in the United States. In 2020, NIHM’s research found that 12.2 million adults reported having serious suicidal thoughts over the course of the year.
Even though suicide is the 12th leading cause of death in the United States, our society treats suicidal behavior as taboo. But the thing is, when we don’t authentically talk about suicide, we continue to perpetuate the stigma and make it more challenging for people to get the help they need. That’s why I want to share my story.
I’ve fantasized about ending my life since I was a young teen. Whenever my depression spiked up, or I faced heavy emotional turmoil, my suicidal thoughts appeared. I talked to some friends about what was happening, and they got scared. They told my mom, who took me to a therapist.
While my friends and family were doing their best to keep me safe, I felt massively betrayed. All I wanted was to share my thoughts with someone and feel some validation and support. Instead, my friends immediately saw me as a danger to myself and reported my thoughts to my mom.
That experience made me believe that society sees people experiencing suicidal thoughts as untrustworthy and dangerous. After that, I wasn’t so comfortable opening up and sharing my feelings with others because I feared punishment.
So, I went through life believing I had to keep my mouth shut about my suicidal thoughts or else I’d be admitted to a psychiatric hospital against my will.
That is until I found myself at my lowest low. I’d suffered from suicidal fantasies throughout the years, but they became unbearable in the summer of 2021, and I decided to go to an inpatient psychiatric hospital for treatment voluntarily.
While in the hospital, I was surrounded by many patients who didn’t choose to be there. They were the ones who attempted suicide or had a specific plan in place to take their own lives. When I left the hospital and met up with my regular therapist again, she explained that she’d never send a patient to a psychiatric hospital simply for sharing thoughts about suicide.
It’s essential to understand the difference between suicidal ideation and suicidal intent. Suicidal ideation is when one considers taking their own life. It’s incredibly broad — it can range from someone thinking about suicide once in their life to another person thinking about it daily, or even coming up with a potential plan to end their life. That means many people who deal with suicidal ideation will never attempt suicide, while others are at high risk of taking their own lives.
If therapists send every patient who experiences suicidal ideation to the psychiatric ward, we’d have massive overcrowding issues, and patients wouldn’t get the right help. While it’s essential to send people in immediate danger of dying by suicide to inpatient psychiatric units for their protection, it’s just as crucial to listen to those who aren’t intending to take their own lives and help them feel safe.
That’s where suicidal intent comes in. When a patient brings up suicidal ideation to their therapist, the therapist is trained to ask questions that determine whether or not the patient is in danger. Suicidal ideation can include:
However, if a patient has suicidal intent, their therapist is required to reach out to the authorities. Suicidal intent means someone has a specific plan of action to take their own life. Suicidal intent can include:
Learning about the difference between suicidal ideation and suicidal intent helped me realize that I can open up about thoughts of suicide without fear of being sent away for treatment without my consent. I know my therapist trusts me to be honest with her, and I rely on my therapist to keep me safe.
Today, I’m open with my therapist about my suicidal thoughts when they pop up, and it’s been a game-changer for my recovery. The suicidal thoughts feel less scary and powerful when I can break them apart in therapy and understand why they’re coming up in the first place.
I’ve learned many strategies in the past year that help me manage a crisis and tackle suicidal thoughts when they appear.
I started to notice that I experience suicidal ideations in times of stress or when my emotions get really big and hard to handle. Simply understanding the patterns of my suicidal thoughts helps me see them as less dangerous and more as a symptom of my depression to coexist with until they pass.
When thoughts of not wanting to exist come up, I now have tools to help me cope. Distraction is my go-to. If I notice those feelings coming up, I know I need to take a break and do something relaxing that I love, like watching TV, playing with my dog, going shopping, or spending time with friends.
Sometimes, however, distraction doesn’t work, and it feels like I can’t think about anything except for how miserable I am. When those moments come up, I focus on self-soothing skills to get me to a level where I can use distraction to cope. For me, self-soothing activities include:
Another thing I like to do when these thoughts come up is to journal and practice positive self-talk. Understanding my feelings is crucial to picking apart the suicidal thoughts and seeing them for what they are: a symptom of my depression and co-occurring mental health conditions. As long as I keep my journaling inquisitive and full of positive self-talk, it can help. However, if I spiral into those suicidal thoughts in my journal, it can make things worse.
Talking with my therapist has been the most helpful tool for combatting suicidal thoughts. I have an incredible therapist who always makes me feel validated and safe when I share my thoughts with her. She knows the right questions to help me get to the bottom of why I feel this way in the first place, and she gives me tools to distract and self-soothe when I’m feeling low.
As a society, we need to do better. People who have suicidal thoughts are treated like outcasts, making it more likely that they’ll feel alone and take their lives. If only we stopped portraying suicidal behavior and thoughts as dangerous and instead saw them as symptoms of those who desperately want a fulfilling life, we could save thousands of lives every year.
Medically reviewed on September 20, 2022
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