Warning Signs of Suicidal Ideation You Should Know

Here’s what you need to know to identify suicidal ideation and provide support to a loved one.

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If you’re experiencing suicidal thoughts or are in danger of harming yourself, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988.

Everyone gets negative thoughts from time to time. These thoughts might involve feeling like you’re not good enough or embarrassing yourself. Then, there are cases in which a person has a suicidal thought or emotion, known as suicidal ideation. “Negative thoughts become suicidal ideation when they start to focus on death, dying, or wanting to end your life,” says Charlie Health Senior Primary Therapist Sarah Lyter, LCPC, MA.  

These thoughts can also involve believing “others would be better off without them, that they no longer want to be alive, or they think of ways to cause harm to themselves,” adds Charlie Health Primary Therapist and DEI Community Outreach Chair Asha Clark, LPC. Suicidal ideation can occur before a suicide attempt, which is why identifying and understanding suicidal ideation is essential to prevent harm. Read on to learn common signs of suicidal ideation and how to access mental health support if you notice them. 

Common signs of suicidal ideation

There are two types of suicidal ideations: passive and active. Someone experiencing passive suicidal ideation will have “less direct ideas about death and dying, such as not wanting to wake up in the morning, wishing you were never born, or wishing you weren’t alive,” says Lyter. By contrast, active suicidal ideation involves thoughts about death and dying along with intent or a plan for a suicide attempt. 

Both passive and active suicidal ideation can present in many ways, but there are some common indications an individual should be aware of. According to Lyter and Clark, internal signs that a person is experiencing suicidal ideation include:

• Hopelessness or worthlessness
• Sadness or loneliness
• Numbness
• Feeling trapped
• Helplessness
• Overwhelming emotional pain
• Wanting relief or escape
• Feeling not worthy of help or like a burden
• Worry you’ll never feel better
• Preoccupation with death
• Thinking about suicide or death

A person experiencing suicidal ideation might also live with another disorder, such as depressive disorder, one of a range of anxiety disorders, or bipolar disorder. While some of these conditions are risk factors for suicide, just because a person has a diagnosis doesn’t mean they are guaranteed to experience suicidal ideation or to attempt suicide. 

What suicidal ideation can look like from the outside

You can never know exactly what’s happening inside a person’s head — especially if they actively try to hide it. But, there are some statements and behaviors to look out for that can indicate someone you know is experiencing suicidal ideation. The most direct of these are often verbal indications. A person might openly make direct statements about suicide, such as saying things like “I wish I were dead” and “I want to kill myself,” explains Lyter. They also might make comments like “I don’t see the point anymore” and “I wish I could just disappear” or talk about life in the past tense. 

Then, there are behavioral changes to watch out for, such as those outlined above. “Sometimes a person becomes more isolated, or you’ll notice they begin to increasingly withdraw socially,” adds Lyter. “This person may eat less or more. Engagement in substance use, increased need for sleep, cry spells, inattentiveness, memory problems, irritability, or anger outbursts are some of the signs we typically see in clients who struggle with suicidal ideation.” Other examples of suicidal behavior to look out for include losing interest in previously enjoyed activities, neglecting self-care, and performing worse at school or work. 

Again, it’s not always possible to tell how another person feels. Clark notes that it’s possible for a person to “mask” their feelings and suicidal behavior to the point that it’s unclear from the outside. Asking someone intentionally to share how they’re feeling can help provide a look into whether they’re experiencing suicidal ideation. 

5 steps to take if a loved one is experiencing suicidal ideation

Do you know someone who seems to be experiencing suicidal ideation or has told you as much? You can take steps to help them through it and get the expert care they need. 

1. Create a safe space

Now is not the time to question someone or wait to see if they really need you. Instead, providing a clear, open door for discussion and support is critical. “Create a safe space for an open dialogue — listen non-judgmentally and with empathy, use direct questions, acknowledge their feelings, and remain calm so that your loved one can freely and honestly express how they’re feeling,” says Lyter. 

Clark recommends directly asking the person how you can help them decrease suicidal thoughts and alleviate the pain they feel.  Emotional support and validation are key to letting them know they’re not alone, and that their feelings are heard and taken seriously. 

2. Assess the risk

Understanding suicidal ideation and its risk factors can help you identify where a person’s mind is at. Now is the time to see if the person is experiencing passive or active suicidal ideation, says Lyter. Try to find out if they have a plan or intent — they might be willing to share this with you. However, remember that they might not share the whole picture with you, and it can be beneficial to air on the side of caution. Critically, work to determine if they have the means to attempt suicide. 

3. Ensure their safety

Each of these steps can and often should be done with the help of a medical professional. These experts can help you determine if a person is at high risk. If they are, then it’s critical not to leave them alone while getting rid of anything they could use to harm themselves, says Lyter. “If you are unable to keep this person safe, take your loved one to the emergency room immediately,” she adds.  

4. Develop a safety plan

You can help or prompt a person experiencing suicidal ideation to create a safety plan. A person’s mental health can suddenly worsen, and a safety plan can ensure there are steps in place to reduce these odds and maintain their well-being if it does. As Lyter explains, “A safety plan is a plan to use when they feel they are in crisis and should include a list of triggers, warning signs, coping skills, support persons, crisis resources, and ways to maintain environmental safety.” 

5. Help them seek professional help

A mental health professional can be a tremendous source of support for anyone experiencing suicidal ideation. They can also more acutely identify signs, supply mental health support, and suggest treatment plans for suicide prevention. Give the person in your life critical numbers to dial or text when their mental health worsens. “Have your loved one call a crisis hotline if they feel they are in crisis, or contact emergency services if they are at immediate risk,” says Lyter. “If your loved one is experiencing passive suicidal ideation, they may be appropriate for outpatient treatment. Seek professional help and enroll your loved one in treatment.” Clark reiterates this: “If a person identifies as having suicidal ideation with a plan or intent, it is important to encourage them to call 988 or discuss going to a hospital for further evaluation.” 

How Charlie Health can help 

If you or a loved one are struggling with suicidal ideation and need extra mental health support, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) offers more than once-weekly therapy for people dealing with serious mental health conditions, including anxiety, depression, bipolar disorder, and more. Our expert clinicians incorporate evidence-based therapies and suicide prevention strategies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.