Suicidal ideation, or suicidal thinking, is the contemplation of ending one’s own life. These types of thoughts may arise in people who feel completely hopeless or believe they can no longer cope with their life situation. Suicidal ideation can vary greatly from fleeting thoughts to preoccupation to detailed planning.

Most people with suicidal ideation do not carry out an actual attempt, but some do. For every 25 attempts, there is one suicide death, according to the Centers for Disease Control and Prevention (CDC). Suicide is the tenth leading cause of death for all ages in the United States, and the third leading cause of death among 15 to 24 year-olds.

It is important to take people seriously when they express having suicidal thoughts. Research has shown that about one-fifth of people who die by suicide had talked to their doctor or other healthcare professional about their decision.

Symptoms or warning signs may include hopelessness, racing thoughts, insomnia or oversleeping, mania, loss of appetite or overeating, loneliness, alcohol abuse, excessive fatigue or low self-esteem.

Research has found a variety of risk factors for suicidal ideation including the following:

  • mood and mental disorders, such as depression, bipolar disorder or borderline personality disorder;
  • adverse life or family events, such as divorce, death of a loved one or loss of a job;
  • chronic illness or pain;
  • previous suicide attempt;
  • military experience;
  • witnessing family violence;
  • strained or non-existent relationship with opposite-sex parent in early to late adolescence;
  • owning a gun;
  • being the victim of abuse or bullying;
  • unplanned pregnancy;
  • and drug or alcohol abuse.

Patients with borderline personality disorder face an extraordinarily high risk of suicidal ideation and suicide attempts. One study showed that 73% of patients with borderline personality disorder have attempted suicide, with the average patient having 3.4 attempts.

Example: The psychiatric patient had a long history of depression and suicidal ideation with one one failed attempt.