Suicidal ideation
Suicidal ideation, often simply called suicidal thoughts, is a complex and deeply personal experience where an individual contemplates ending their own life. It's not a mental health diagnosis in itself, but rather a profound symptom that can arise from various underlying conditions, life circumstances, or even medication side effects. Understanding this spectrum of thoughts—from fleeting considerations to detailed plans—is crucial, as it represents a significant risk factor for suicide and a critical area where support and intervention can make a life-saving difference. Suicidal ideation exists on a spectrum, ranging from passive thoughts of not wanting to live to active planning, and is a strong predictor for suicide attempts. A wide array of factors, including mental health disorders, significant life events, medication effects, and family dynamics, can contribute to the presence of suicidal thoughts. Early detection, comprehensive assessment, and tailored treatment — involving therapy, supportive environments, and sometimes medication — are vital for prevention and management.
AI Summary
Suicidal ideation, often simply called suicidal thoughts, is a complex and deeply personal experience where an individual contemplates ending their own life. It's not a mental health diagnosis in itself, but rather a profound symptom that can arise from various underlying conditions, life circumstances, or even medication side effects. Understanding this spectrum of thoughts—from fleeting considerations to detailed plans—is crucial, as it represents a significant risk factor for suicide and a critical area where support and intervention can make a life-saving difference.
- Suicidal ideation exists on a spectrum, ranging from passive thoughts of not wanting to live to active planning, and is a strong predictor for suicide attempts.
- A wide array of factors, including mental health disorders, significant life events, medication effects, and family dynamics, can contribute to the presence of suicidal thoughts.
- Early detection, comprehensive assessment, and tailored treatment — involving therapy, supportive environments, and sometimes medication — are vital for prevention and management.
Suicidal Ideation: An Invisible Struggle
Suicidal ideation refers to the thought process of having ideas or ruminations about the possibility of dying by suicide. It's important to understand that this is not a diagnosis on its own, but rather a symptom that points to underlying distress.
These thoughts can vary widely in intensity and detail, from fleeting considerations to comprehensive planning. Passive suicidal ideation involves simply wishing one were dead or imagining being gone, without concrete action. Active suicidal ideation, however, involves actual preparation or forming a specific plan to end one's life.
While most people who experience suicidal thoughts do not act on them, these thoughts are considered a significant risk factor. Statistics reveal a stark reality: in 2019, 12 million U.S. adults seriously considered suicide, and over 47,500 died by suicide. These thoughts are also notably common among teenagers, underscoring a widespread public health challenge.
Suicidal ideation is closely associated with conditions like depression and other mood disorders, yet it can also stem from various other mental health challenges or adverse life circumstances. Mental health experts advocate for treatment for anyone experiencing suicidal ideation, regardless of diagnosis, due to the inherent risk it carries.
Defining the Concept
Globally, health organizations provide clear definitions. The ICD-11, for instance, describes suicidal ideation as 'thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans.'
Similarly, the DSM-5, a key diagnostic manual in the United States, defines it as 'thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one's own death.' These definitions help clinicians recognize and categorize the severity of such thoughts.
The U.S. Centers for Disease Control and Prevention (CDC) offers a more concise definition, encompassing it as 'thinking about, considering, or planning suicide.' Regardless of the specific wording, the core message remains consistent: these are serious thoughts requiring attention and support.
Intriguing Terminology
While 'suicidal ideation' is the clinical term, 'suicidal thoughts' is a more common and accessible synonym. These terms describe the same spectrum of internal experiences, helping to destigmatize the conversation around mental health.
Interestingly, not all thoughts of death or harm are necessarily suicidal ideation. Psychologists refer to a sudden, pronounced thought of performing an act that would lead to one's death, without a history of suicidal ideation, as an intrusive thought. A common example is the 'call of the void' or high place phenomenon—that fleeting urge to jump when standing somewhere high, even when you have no intention of doing so.
Unpacking the Risk Factors
Understanding what contributes to suicidal ideation is crucial for prevention and intervention. Risk factors are broadly categorized into three main areas: psychiatric disorders, various life events, and specific aspects of family history.
Mental Health Links
Suicidal ideation is a prominent symptom across numerous mental disorders, though it can also manifest in response to extreme adversity without a formal diagnosis. Many psychiatric conditions significantly increase the risk, often through a complex interplay of symptoms and experiences.
For instance, individuals with borderline personality disorder often exhibit recurrent suicidal behavior and thoughts; studies show a high percentage have attempted suicide multiple times. Other disorders with strong links to suicidal ideation include:
Risk Factor Category Specific Conditions Mental Disorders Major Depressive Disorder Mental Disorders Anxiety disorders Mental Disorders Autism spectrum disorder Mental Disorders Bipolar disorder Mental Disorders PTSD and C-PTSD Mental Disorders Personality disorders Mental Disorders Schizophrenia and Psychosis Mental Disorders Substance use disorders Mental Disorders Eating disorders (Anorexia, Bulimia, Binge eating)
Medication and Its Complex Role
The relationship between medication and suicidal ideation can be nuanced. While antidepressants are widely used to alleviate depression symptoms, some studies indicate a connection between certain medications and an increased risk of suicidal thoughts, particularly in younger individuals, especially at the start of treatment. However, for many, these same medications are life-saving.
Due to these concerns, the U.S. Food and Drug Administration (FDA) issued strict warnings for antidepressant manufacturers in 2003, highlighting the potential for increased suicidal thoughts and behaviors. This remains a topic of ongoing research and clinical discussion, emphasizing the need for careful monitoring when starting new treatments.
Beyond prescribed medications, the use of sedative-hypnotic drugs like alcohol and benzodiazepines also significantly increases risk. A high percentage of suicides occur while individuals are under the influence, and chronic alcohol use disorder is present in a substantial number of cases. Benzodiazepines, though prescribed, can also have pro-suicidal effects due to side effects like disinhibition or withdrawal.
Life's Unfolding Impact
Significant life events are powerful predictors of increased suicidal ideation, often by triggering or exacerbating psychiatric conditions. The specific events can differ between age groups, but their impact is undeniable and requires careful consideration.
Key life events that are strongly linked to an elevated risk of suicidal ideation include:
Risk Factor Category Specific Life Events Life Events Alcohol use disorder, especially solitary binge drinking Life Events Belonging to a minoritized gender expression, sexuality, or other minority group Life Events Unemployment or major changes in life standard (e.g., relocation) Life Events Chronic illness or persistent pain Life Events Loss of loved ones or relationship rejection Life Events Social isolation and loneliness Life Events Unplanned pregnancy Life Events Bullying, including cyberbullying and workplace harassment
One of the most potent indicators of future suicidal ideation or attempts is a history of previous suicide attempts. This underscores the critical need for ongoing support and intervention following any such incident.
Other factors like military experience, particularly with co-occurring PTSD or depression, community violence exposure, and even undesired changes in body weight (increased BMI for women, severe decrease for men) also contribute to heightened risk.
The Influence of Family
Family history plays a crucial role in an individual's risk for suicidal ideation. Having parents with a history of depression, for instance, significantly increases the likelihood of their offspring experiencing similar struggles. Studies have shown a direct correlation between parental depression and suicidal ideation in adult children.
Moreover, experiences of abuse—physical, emotional, or sexual—during childhood and adolescence are strong predictors. Family violence and residential instability, such as frequent family disruptions, also contribute to a heightened risk of developing suicidal thoughts later in life.
Relationships with Parents
The quality of parent-child relationships, especially during adolescence, has a notable impact on suicidal ideation risk. Research suggests that closeness with a father can be protective for sons in early and middle adolescence, while closeness with the opposite-sex parent can be particularly beneficial for both boys and girls at different stages.
Conversely, parental detachment can exacerbate suicidal ideation in adolescent boys already experiencing depression. Critically, parental unacceptance of a child's expressed LGBT sexuality is a significant and well-documented factor contributing to a higher risk of suicidal thoughts among youth.
Pathways to Prevention
Early detection and effective treatment are the cornerstones of preventing suicidal ideation from escalating into suicide attempts. Alarmingly, a study of individuals who died by suicide revealed that 91% likely had at least one mental illness, yet only 35% were receiving treatment. This highlights a critical gap in care that early identification can help bridge.
The challenge often lies in motivating individuals with long-term suicidal ideation to seek professional help and continue treatment. Strategies to improve engagement include:
Prevention Strategy Description Increased Access Making therapy treatment more readily available, especially in early stages of distress. Public Education Enhancing public awareness about when and how psychiatric help can be beneficial. Equal Focus Recognizing that those facing adverse life conditions may have risks comparable to those with diagnosed mental illness, ensuring broad support.
Screening tools like the Psychological Distress scale (K10) can be effective in early detection, as demonstrated by an Australian study. Participants scoring 'very high' on this scale were found to be 77 times more likely to report suicidal ideation than those in the low category, providing a clear indicator for intervention.
Even when individuals do seek help, open communication is vital. A Finnish study showed that while 41% of suicide victims had seen a healthcare professional shortly before their death, only 22% discussed their suicidal intent during their last visit. This underscores the importance of clinicians proactively asking about suicidal thoughts.
New perspectives are emerging on how to address suicidal ideation. Some research suggests that internet-based support can be highly effective, possibly due to increased accessibility and reduced stigma. Others propose that viewing suicidal ideation as purely an 'illness' might be an obstacle, suggesting it can sometimes represent a complex cost-benefit analysis in life/death considerations, requiring a more holistic approach than just 'treatment.'
Assessment and Management
A thorough assessment is the first step in managing suicidal ideation, involving a comprehensive look at an individual's situation. This integrates information from various sources, including clinical interviews, medical exams, standardized psychological tests, and reviews of personal history.
Assessment Tools
Mental health professionals use both unstructured clinical interviews, where they tailor questions to the individual, and structured interviews, which follow predefined formats to rate the frequency and intensity of symptoms. This allows for a detailed understanding of the person's unique challenges.
Article
Suicidal ideation
Suicidal ideation, or suicidal thoughts, is the thought process of having ideas or ruminations about the possibility of dying by suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life circumstances without the presence of a mental disorder.
On suicide risk scales, the range of suicidal ideation varies from fleeting thoughts to detailed planning. Passive suicidal ideation is thinking about not wanting to live or imagining being dead. Active suicidal ideation involves preparation to kill oneself or forming a plan to do so.
Most people who have suicidal thoughts do not go on to make suicide attempts, but suicidal thoughts are considered a risk factor. During 2008–09, an estimated 8.3 million adults aged 18 and over in the United States, or 3.7% of the adult U.S. population, reported having suicidal thoughts in the previous year, while an estimated 2.2 million reported having made suicide plans in the previous year. In 2019, 12 million U.S. adults seriously thought about suicide, 3.5 million planned a suicide attempt, 1.4 million attempted suicide, and more than 47,500 died by suicide. Suicidal thoughts are also common among teenagers.
Suicidal ideation is associated with depression and other mood disorders; however, many other mental disorders, life events and family events can increase the risk of suicidal ideation. Mental health researchers indicate that healthcare systems should provide treatment for individuals with suicidal ideation, regardless of diagnosis, because of the risk for suicidal acts and repeated problems associated with suicidal thoughts. There are a number of treatment options for people who experience suicidal ideation.
Definitions
Suicidal ideation
The ICD-11 describes suicidal ideation as "thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans".
The DSM-5 defines it as "thoughts about self-harm, with deliberate consideration or planning of possible techniques of causing one's own death".
The U.S. Centers for Disease Control and Prevention defines suicidal ideation "as thinking about, considering, or planning suicide".
Terminology
Suicidal ideation
Another term for suicidal ideation is suicidal thoughts.
When someone who has not shown a history of suicidal ideation experiences a sudden and pronounced thought of performing an act which would necessarily lead to their own death, psychologists call this an intrusive thought. A commonly experienced example of this is the high place phenomenon, also referred to as the call of the void, which is a sudden urge to jump when in a high place.
A euphemism for suicidal ideation is internal struggle, while voluntary death and eating one's gun are a synonym and a euphemism, respectively, for suicide itself.
Risk factors
Suicidal ideation
The risk factors for suicidal ideation can be divided into three categories: psychiatric disorders, life events, and family history.
Mental disorders
Suicidal ideation is a symptom of many mental disorders but can also occur in response to adverse life events without the presence of a mental disorder.
There are several psychiatric disorders that appear to be comorbid with suicidal ideation or considerably increase the risk of suicidal ideation. For example, many individuals with borderline personality disorder exhibit recurrent suicidal behavior and suicidal thoughts. One study found that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts. The following list includes the disorders that have been shown to be the strongest predictors of suicidal ideation. These are not the only disorders that can increase the risk of suicidal ideation. The disorders where the risk is increased the greatest, in arbitrary order, include:
• Mood disorders • Major depressive disorder • Persistent depressive disorder • Bipolar disorder • Premenstrual dysphoric disorder • Anxiety disorders • Neurodevelopmental disorders • Autism spectrum disorder • Attention deficit hyperactivity disorder • Post-traumatic stress disorder • Complex post-traumatic stress disorder • Personality disorders • Borderline personality disorder • Psychosis (Detachment from reality) • Paranoia • Schizophrenia • Substance use disorders • Nightmare disorder • Gender dysphoria • Conduct disorder • Learning disorders • Specific learning disorder • Obsessive compulsive disorder • Eating disorders • Anorexia • Binge eating disorder • Bulimia
Medication side effects
Antidepressant medications are commonly used to decrease the symptoms in patients with moderate to severe clinical depression, and some studies indicate a connection between suicidal thoughts and tendencies and taking antidepressants, increasing the risk of suicidal thoughts in some patients.
Some medications, such as selective serotonin reuptake inhibitors (SSRIs), can have suicidal ideation as a side effect but can also be effective as antidepressants. Monitoring is advised for those who take SSRIs.
In 2003, the U.S. Food and Drug Administration (FDA) issued the agency's strictest warning for manufacturers of all antidepressants (including tricyclic antidepressants [TCAs] and monoamine oxidase inhibitors) due to their association with suicidal thoughts and behaviors. Further studies disagree with the warning, especially when prescribed for adults, claiming more recent studies are inconclusive in the connection between the drugs and suicidal ideation.
Individuals with anxiety disorders who self-medicate with drugs or alcohol may also have an increased likelihood of suicidal ideation.
Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide, with alcoholism present in between 15 and 61% of cases. Use of prescribed benzodiazepines is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects, such as disinhibition, or withdrawal symptoms.
Life events
Life events are strong predictors of increased risk for suicidal ideation. Furthermore, life events can also lead to or be comorbid with the previously listed psychiatric disorders and predict suicidal ideation through those means. Life events that adults and children face can be dissimilar, and for this reason, the list of events that increase risk can vary in adults and children. The life events that have been shown to increase risk most significantly are: Recent sociological work has increasingly emphasised meaning, culture, and meso-level mechanisms in explanations of suicide.
• Alcohol use disorder • Studies have shown that individuals who binge drink, rather than drink socially, tend to have higher rates of suicidal ideation • Certain studies associate those who experience suicidal ideation with higher alcohol consumption • Not only do some studies show that solitary binge drinking can increase suicidal ideation, but there is also a positive feedback relationship causing those who have more suicidal ideation to have more drinks per day in a solitary environment • Minoritized gender expression and/or sexuality or being a minority group of any kind • Unemployment • Chronic illness or pain • Death of family members or friends • End of a relationship or being rejected by a romantic interest • Major change in life standard (e.g., relocation abroad) • Other studies have found that tobacco use is correlated with depression and suicidal ideation • Social isolation • Unplanned pregnancy • Bullying • Cyberbullying • Workplace bullying • Previous suicide attempts • Having previously attempted suicide is one of the strongest indicators of future suicidal ideation or suicide attempts • Military experience • Military personnel who show symptoms of PTSD, major depressive disorder, alcohol use disorder, and generalized anxiety disorder show higher levels of suicidal ideation • Community violence • Undesired changes in body weight • Women: increased BMI increases the chance of suicidal ideation • Men: severe decrease in BMI increases the chance of suicidal ideation • In general, the obese population has increased odds of suicidal ideation in relation to individuals that are of average-weight • Exposure and attention to suicide related images or words
Family history
• Parents with a history of depression • Valenstein et al. studied 340 adults whose parents had experienced depression. They found that 7% of the offspring had suicidal ideation in the previous month alone • Abuse • Childhood: physical, emotional, and sexual abuse • Adolescence: physical, emotional, and sexual abuse • Family violence • Childhood residential instability • Certain studies associate those who experience suicidal ideation with family disruption
Relationships with parents
According to a study conducted by Ruth X. Liu of San Diego State University, a significant connection was found between the parent–child relationships of adolescents in early, middle, and late adolescence and their likelihood of suicidal ideation. The study consisted of measuring relationships between mothers and daughters, fathers and sons, mothers and sons, and fathers and daughters. The relationships between fathers and sons during early and middle adolescence show an inverse relationship to suicidal ideation. Closeness with the father in late adolescence is "significantly related to suicidal ideation". Liu goes on to explain the relationship found between closeness with the opposite sex parent and the child's risk of suicidal thoughts. It was found that boys are better protected from suicidal ideation if they are close to their mothers through early and late adolescence; whereas girls are better protected by having a close relationship with their fathers during middle adolescence.
An article published in 2010 by Zappulla and Pace found that suicidal ideation in adolescent boys is exacerbated by detachment from the parents when depression is already present in the child. Lifetime prevalence estimates of suicidal ideation among nonclinical populations of adolescents generally range from 60 to 75% and in many cases its severity increases the risk of suicide. Parents who are unaccepting of their child's expressed LGBT sexuality create a hotbed for suicidal ideation (see under LGBT youth below).
Prevention
Suicidal ideation
Crisis hotlines, such as the National Suicide Prevention Lifeline, (988) enable people to get immediate emergency telephone counselling.
A caring letter written by hand
Early detection and treatment are the best ways to prevent suicidal ideation and suicide attempts. If signs, symptoms, or risk factors are detected early then the individual might seek treatment and help before attempting to take their life. In a study of individuals who died by suicide, 91% of them likely had at least one mental illness. However, only 35% of those individuals were treated or are being treated for a mental illness. This emphasizes the importance of early detection; if a mental illness is detected, it can be treated and controlled to help prevent suicide attempts. Another study investigated strictly suicidal ideation in adolescents. This study found that depression symptoms in adolescents as early as 9th grade is a predictor of suicidal ideation. Most people with long-term suicidal ideation do not seek professional help.
The previously mentioned studies point out the difficulty that mental health professionals have in motivating individuals to seek and continue treatment. Ways to increase the number of individuals who seek treatment may include:
• Increasing the availability of therapy treatment in early stage • Increasing the public's knowledge of when psychiatric help may be beneficial to them • Those who have adverse life conditions seem to have just as much risk of suicide as those with mental illness
A study conducted by researchers in Australia set out to determine a course of early detection for suicidal ideation in teens stating that "risks associated with suicidality require an immediate focus on diminishing self-harming cognitions so as to ensure safety before attending to the underlying aetiology of the behavior". A Psychological Distress scale known as the K10 was administered monthly to a random sample of individuals. According to the results among the 9.9% of individuals who reported "psychological distress (all categories)" 5.1% of the same participants reported suicidal ideation. Participants who scored "very high" on the Psychological Distress scale "were 77 times more likely to report suicidal ideation than those in the low category".
In a one-year study conducted in Finland, 41% of the patients who later died by suicide saw a healthcare professional, most seeing a psychiatrist. Of those, only 22% discussed suicidal intent on their last office visit. In most of the cases, the office visit took place within a week of the suicide, and most of the victims had a diagnosed depressive disorder. However, in Chinese and American samples of those who died by suicide, 37% and over 50%, respectively, were not diagnosed with a psychiatric disorder prior to their deaths. Therefore, some have advocated for a suicide-specific diagnosis. Proposed for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, the Suicide Crisis Syndrome (SCS) was developed by Igor Galynker in 2017 to detect an acute pre-suicidal state that does not include or rely on self-disclosure of suicidal ideation.
There are many centers where one can receive aid in the fight against suicidal ideation and suicide. Hemelrijk et al. (2012) found evidence that assisting people with suicidal ideation via the internet versus more direct forms such as phone conversations has a greater effect. In a 2021 research study, Nguyen et al. (2021) propose that maybe the premise that suicidal ideation is a kind of illness has been an obstacle to dealing with suicidal ideation. They use a Bayesian statistical investigation, in conjunction with the mindsponge theory, to explore the processes where mental disorders have played a very minor role and conclude that there are many cases where the suicidal ideation represents a type of cost-benefit analysis for a life/death consideration, and these people may not be called "patients".
Assessment
Suicidal ideation
Assessment seeks to understand an individual by integrating information from multiple sources such as clinical interviews; medical exams and physiological measures; standardized psychometric tests and questionnaires; structured diagnostic interviews; review of records; and collateral interviews.
Interviews
Psychologists, psychiatrists, and other mental health professionals conduct clinical interviews to ascertain the nature of a patient or client's difficulties, including any signs or symptoms of illness the person might exhibit. Clinical interviews are "unstructured" in the sense that each clinician develops a particular approach to asking questions without necessarily following a predefined format. Structured (or semi-structured) interviews prescribe the questions, their order of presentation, "probes" (queries) if a patient's response is not clear or specific enough, and a method to rate the frequency and intensity of symptoms.
Standardized psychometric measures
• Beck Scale for Suicide Ideation • Nurses' Global Assessment of Suicide Risk • Suicidal Affect–Behavior–Cognition Scale (SABCS) • Columbia Suicide Severity Rating Scale
Management
Suicidal ideation
Treatment of suicidal ideation can be problematic due to the fact that several medications have actually been linked to increasing or causing suicidal ideation in patients. Therefore, several alternative means of treating suicidal ideation are often used. The main treatments include: therapy, hospitalization, outpatient treatment, and medication or other modalities.
Therapy
In psychotherapy, a person explores the issues that make them feel suicidal and learns skills to help manage emotions more effectively.
Hospitalization
Hospitalization allows the patient to be in a secure, supervised environment to prevent suicidal ideation from turning into suicide attempts. In most cases, individuals have the freedom to choose which treatment they see fit for themselves. However, there are several circumstances where individuals can be hospitalized involuntarily. These circumstances are:
• If an individual poses a danger to self or others • If an individual is unable to care for themself
Hospitalization may also be a treatment option if an individual:
• Does not have social support or people to supervise them • Has a suicide plan • Has symptoms of a psychiatric disorder (e.g., psychosis, mania, etc.)
Outpatient treatment
Outpatient treatment allows individuals to remain at their place of residence and receive treatment when needed or on a scheduled basis. Being at home may improve the quality of life for some patients because they will have access to their belongings and be able to come and go freely. Before allowing patients the freedom that comes with outpatient treatment, physicians evaluate several factors of the patient. These factors include the patient's level of social support, impulse control, and quality of judgment. After the patient passes the evaluation, they are often asked to consent to a "no-harm contract". This is a contract formulated by the physician and the family of the patient. Within the contract, the patient agrees not to harm themself, to continue their visits with the physician, and to contact the physician in times of need. There is some debate as to whether "no-harm" contracts are effective. These patients are then checked on routinely to assure they are maintaining their contract and avoiding dangerous activities (drinking alcohol, speeding, not wearing a seatbelt, etc.).
Medication
Prescribing medication to treat suicidal ideation can be difficult. One reason for this is that many medications lift patients' energy levels before lifting their moods. This puts them at greater risk of following through with attempting suicide. Additionally, if a person has a comorbid psychiatric disorder, it may be difficult to find a medication that addresses both the psychiatric disorder and suicidal ideation.
Antidepressants may be effective. Often, SSRIs are used instead of TCAs as the latter typically have greater harm in overdose.
Antidepressants have been shown to be a very effective means of treating suicidal ideation. One correlational study compared mortality rates due to suicide to the use of SSRI antidepressants in certain countries. The counties which had higher SSRI use had a significantly lower number of deaths caused by suicide. Additionally, an experimental study followed depressed patients for one year. During the first six months of that year, the patients were examined for suicidal behavior, including suicidal ideation. The patients were then prescribed antidepressants for the six months following the first six observatory months. During the six months of treatment, experimenters found suicidal ideation reduced from 47% of patients down to 14% of patients. Thus, it appears from current research that antidepressants have a helpful effect on the reduction of suicidal ideation.
Although research is largely in favor of the use of antidepressants for the treatment of suicidal ideation, in some cases antidepressants are claimed to be the cause of suicidal ideation. Upon the start of using antidepressants, many clinicians will note that sometimes the sudden onset of suicidal ideation may accompany treatment. This has caused the Food and Drug Administration (FDA) to issue a warning stating that sometimes the use of antidepressants may actually increase suicidal ideation. Medical studies have found antidepressants help treat cases of suicidal ideation and work especially well with psychological therapy. Lithium reduces the risk of suicide in people with mood disorders. Tentative evidence finds clozapine in people with schizophrenia reduces the risk of suicide.
LGBT youth
Suicidal ideation
Suicidal ideation rates among lesbian, gay, bisexual, transgender (LGBT) youth are significantly higher than among the general population. Suicidal ideation, which has a higher prevalence among LGBT teenagers compared to their cisgender and heterosexual peers, has been attributed to minority stress, bullying, and parental disapproval.
Within the LGBTQ+ population, transgender youths face the highest rate of suicidal ideation. It is estimated that 82% of transgender people consider suicide with another estimated 40% actually attempting to kill themselves.
South Korea
South Korea has the 2nd highest rate of suicide in the world and the highest in the OECD. Within these rates, suicide is the primary cause of death for South Korean youth, ages 10–19. While these rates are elevated, suicidal ideation additionally increases with the introduction of LGBT identity.