Bipolar disorder can involve symptoms of depression, which sometimes can lead to thoughts of suicide. Support is available.

Not everyone who lives with bipolar disorder experiences the condition in the same way. But for those who experience intense depressive episodes, thinking about the end of life can be recurrent.

Bipolar disorder is a manageable condition, and treatment is available and effective. What you feel is valid, but it doesn’t have to be permanent. You’re not alone.

A word of caution

Suicide is a difficult topic, and it’s natural to experience intense emotions when reading about it.

While it is possible for someone with bipolar disorder to think about suicide, this isn’t always the case.

The information in this article comes from reputable sources and has been reviewed by a medical expert. Still, no expert information can replace your personal experience and how you navigate your mental health condition.

If you’ve been thinking about suicide or suspect someone you love has, you’re not alone. Consider reaching out for support:

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Bipolar disorder has the highest rate of suicide among all mental health conditions. This rate is about 10 to 30 times higher in people living with bipolar disorder than in the general population.

As many as 60% of people with the condition have attempted to end their lives at least once.

Still, bipolar disorder symptoms manifest differently from person to person, and not everyone with the condition will think of or attempt suicide.

“Self-harm behavior is highest in individuals [living with bipolar disorder] who have the personality trait of impulsivity,” explains Stephanie Wijkstrom, a professional mental health counselor in Pittsburg.

The more impulsive someone with the condition is, the more likely they may be to engage in thoughts of suicide and self-harming behaviors, she adds.

Impulsivity is typically associated with episodes of mania. However, it can also manifest during phases of depression. Thoughts of suicide are more common during these depressive episodes.

Because of this, research suggests thoughts of suicide are more recurrent for people living with bipolar II disorder, which involves longer episodes of depression.

It’s important to keep in mind that impulsivity alone isn’t a predicting factor for thoughts or attempts of suicide.

In a recent study, researchers found that impulsivity wasn’t the main factor in suicidal thoughts in people with bipolar disorder. Still, it could play a role when other personality traits, such as high empathy, and substance use disorder were also present.

Bipolar I disorder vs. bipolar II disorder

In general, bipolar disorder always involves intense mood episodes. These could be between depression and mania, or between depression and hypomania.

Bipolar I disorder is diagnosed when you go through at least 1 episode of mania that lasts at least 7 days. This episode may present with symptoms of psychosis and could require hospitalization. Sometimes, you won’t experience major episodes of depression.

Bipolar II disorder, on the other hand, typically involves changes in mood that shifts from depression to hypomania. You will also experience symptoms of depression that last 2 weeks or longer.

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Suicide as a symptom in bipolar disorder

Thoughts of suicide and self-harming behaviors can be symptoms of bipolar disorder, although not everyone with the condition experiences them.

Many factors may contribute to someone experiencing suicide ideation or the desire to self-harm while living with bipolar disorder.

Systematic review data suggests these behaviors in bipolar disorder may be influenced by:

  • family history of suicide
  • early onset of bipolar disorder
  • progressive severity of mood episodes
  • the extent of depressive symptoms
  • rapid changes in mood
  • coexisting mental health disorders
  • substance use disorder

The suicide safety plan

If you think often about suicide during an episode of depression, consider creating a safety plan that you could use during those times.

A safety plan often involves:

  • a list of situations, moods, behaviors, and images that may help you recognize when you may be more likely to engage in these thoughts
  • coping strategies the help prevent self-harm
  • contact information for family and friends who are ready to provide support
  • names and numbers of mental health professionals, care networks, and emergency assistance
  • a safe environment to go where self-harm options are limited
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Dr. Benjamin Gibson, a pharmacist and functional medicine specialist in San Antonio, says, “We all feel bad on any given day when reality doesn’t meet expectations.”

When you’re supporting someone who lives with bipolar disorder, it’s important to remember that “bad days” for them may mean severe adverse thoughts and self-harm behaviors.

Also, bipolar disorder may require professional support. If you’re not trained to treat bipolar disorder, there’s only so much you can do.

Gibson and Wijkstrom say you can support someone during these times by:

Being a mediator

When someone is experiencing suicide ideation, they may know that help is needed, but they may not reach out.

You may want to learn more about bipolar disorder. This can help you recognize some of the symptoms.

If someone you love is going through a mood episode, you can help them get the support they need. For example, you could make the calls or drive them to their health professional or support group.

Reminding them this is a symptom, not reality

Wijkstrom says that a common statement among people who’ve attempted suicide is that they believe the world will be better off without them.

You might want to validate how they feel and suggest that these thoughts are influenced by the condition and may not be how others feel. This is a feeling coming from a symptom, not reality.

Consider talking about how symptoms of bipolar disorder can be managed, and when this happens, they might feel differently. It may be important not to act on a temporary feeling.

Helping provide the ‘safe space’

If you know someone considering suicide, try to provide immediate support. This means being available in person on short notice.

Once you’re with them, you can scan the room and remove any possible self-harm tools. You can also practice ways to provide comfort in a moment of intense emotions. This can help you be there for them while waiting for emergency care services if needed.

If you find staying in the same place challenging, consider having a backup plan so that you can take them to a location where they feel safe and comforted.

For some people, living with bipolar disorder may mean thinking about self-harm and suicide, particularly during episodes of depression.

You might feel confused and afraid when these thoughts appear. This is depression talking to you. But depression and bipolar disorder can be managed.

Treatment for bipolar disorder can help with these feelings. Things can improve and support is available.