Post-traumatic stress disorder (PTSD) can feel like being stuck in a nightmare, and it’s not unusual for some people to experience thoughts of suicide.
Post-traumatic stress disorder (PTSD) can occur after you experience trauma.
PTSD can be an overwhelming state of existence in which you feel as though you can never escape what you’ve been through.
Your body isn’t aiming to punish you by developing PTSD. Your brain may just be trying to cope with your experience in the only way it knows how — repeat exposure.
Being bombarded with reminders and flashbacks can take its toll, though. Sometimes, the fear and anxiety may feel like too much to overcome. For some people, this may trigger suicidal ideation.
Suicide prevention
If you are experiencing suicidal thoughts, remember that you’re not alone. Resources are available to you if you need to talk with someone right away:
- Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
- Text “HOME” to the Crisis Textline at 741741.
Not in the United States? You can find a helpline in your country with Befrienders Worldwide.
According to the
Living with PTSD may increase your chances of suicide ideation or attempt. As many as 27% of people diagnosed with PTSD have attempted suicide.
Other factors can contribute to an increase in suicidal ideation with PTSD, including your profession or gender.
A 2021 research review looking at suicide rates among U.S. veterans and active service members of the post-9/11 wars found that PTSD contributed to a suicide rate four times that of any other military combat-related deaths.
First responders — firefighters, police officers, and paramedics — also report higher rates of PTSD and an increased incidence of suicide.
Among civilians, a cohort study from 2021 of more than 3 million people suggested that PTSD accounted for 3.5% of suicides in women and 0.6% of suicides in men. Also, experts estimated that 54% of suicides among people living with PTSD were directly related to PTSD and not co-occurring conditions.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and modern clinical practice, there are 5 potential classifications of PTSD.
- Uncomplicated PTSD: PTSD in its classic clinical form, outlined in the DSM-5
- Complex PTSD: severe psychological symptoms arising from chronic, repeat trauma over long periods of time
- PTSD with dissociative symptoms: symptoms of PTSD with the presence of persistent derealization or depersonalization
- PTSD with delayed expression: achieving full PTSD diagnostic criteria 6 months or longer after the experience of trauma
- Co-morbid PTSD: diagnosis of PTSD coincides with another mental health condition, like depression
Acute stress disorder (ASD)
Acute stress disorder (ASD) is often listed as a subtype of PTSD, but it’s considered a diagnosis in its own right.
ASD is used to describe PTSD-like symptoms that occur within the first 30 days of a traumatic experience. While all PTSD starts with ASD, ASD doesn’t always evolve into PTSD.
If you’ve been diagnosed with PTSD, your symptoms may fall into four categories:
- Intrusion: involuntary, intrusive memories, distressing and recurrent dreams, flashbacks or other awareness-altering reactions, physical or mental distress toward reminders of the trauma
- Avoidance: seeking to avoid any thoughts, feelings, or emotions linked to the event, avoiding people, places, things, or situations that bring back memories or thoughts about the trauma
- Cognitive and mood alterations: difficulty recalling or remembering details about the traumatic experience, persistent negative beliefs toward yourself or the world around you, decreased interest in things that once brought joy, feelings of detachment, inability to experience positive emotions, like satisfaction or happiness
- Changes in arousal and reactivity: emotional outburst, irritability, self-destructive behavior, over-active startle response, sleep disturbance, challenges concentrating, hypervigilance
The challenge with suicide is that many of the warning signs may be subtle, or hidden away in private.
This is part of the reason why suicide can be so shocking for those who remain — you may not have seen it coming.
Survivor guilt
If you’ve lost someone to PTSD suicide, you may be wondering what you could have done differently to support them or change their decision.
The reality is that PTSD is a complex mental health disorder and suicide ideation can sometimes be a result of that condition.
There may not have been anything you could have done or said to change the outcome.
While everyone experiences suicide ideation differently, possible warning signs or behaviors of PTSD suicide can include:
- a PTSD diagnosis, particularly complex PTSD
- talking about suicide, wanting to die, or “being better off dead”
- feeling burdened by guilt or shame
- seeing yourself as a burden to others
- persistent hopelessness or despair
- unbearable emotional or physical distress
- increased risk-taking
- self-destructive behaviors
- changes in sleep patterns
- social withdrawal
- mood swings
- substance use and abuse
- researching of fixating on suicide and the process of suicide
It’s not always easy to talk openly about PTSD and suicidal ideation.
You may be concerned that talking about your feelings might mean discussing the traumatic events that led to your PTSD, which is not something everyone is ready for.
If you’re experiencing thoughts of suicide due to PTSD, it’s important to get help right away.
If you or a loved one are in danger of self-harm or suicide, consider contacting a local behavioral health hospital. These inpatient facilities have 24/7 intake and assessment and can offer faster, more appropriate care than a regular hospital or emergency room.
You can find your nearest behavioral health hospital with the SAMSA search tool.
Once you receive care, speaking with a mental health professional can help. Not only are these trained experts able to diagnose PTSD, they can offer you an outlet for telling your story without judgment and in confidentially.
Treating PTSD with suicidal ideation generally starts with taking steps to treat PTSD.
Treatment plans often depend on many individual factors, including the severity of your symptoms and if you’re also living with a co-occurring condition, like depression.
Treatment plans typically include a mixture of approaches, including:
- medication
- therapy
- self-care and lifestyle changes
Therapy
Various forms of therapy can be very effective in treating PTSD, including:
- cognitive behavioral therapy (CBT)
- cognitive processing therapy (CPT)
- cognitive therapy (CT)
- somatic experiencing (SE)
- prolonged exposure (PE)
- present-centered therapy (PCT)
- theta-burst transcranial magnetic stimulation (TBS)
- dialectical behavior therapy (DBT)
- reconsolidation of traumatic memories (RTM)
- eye movement desensitization and reprocessing (EMDR)
Medications
Medications can be used to treat PTSD and may be an option to aid in easing some symptoms.
Antidepressant and anti-anxiety medications are two of the most common types of medications prescribed for PTSD.
Self-care
Self-care and lifestyle changes can also be helpful for managing PTSD symptoms, especially:
- exercising regularly
- spending time outdoors and in nature
- eating nutritious foods
- meditation and mindfulness
PTSD can feel like rubbing salt into an open cut. You’ve already been through the experience, but now your brain won’t let you have any peace.
In this vicious cycle of reexperiencing, it can be natural to crave relief. For some people, the strain of PTSD may lead to suicidal ideation or even attempts.
You can escape PTSD without considering suicide.
Some PTSD treatment options have shown success rates of over 90%. With so many options available for customized PTSD treatment, it’s never too soon to reach out for help.
If you’re ready to seek help but don’t know where to start, check out Psych Central’s guide to finding mental healthcare today.