Suicidality

It can be hard to discuss, but it’s crucial to address suicidality. This term describes the broad spectrum of thoughts and feelings a person may experience regarding the termination of their own life. It’s not a singular state but rather a continuum, ranging in severity. Suicidality encompasses any thought, plan or action that is connected to suicide. It’s important to recognize that suicidality often reveals profound emotional distress and isn’t a reflection of personal weakness.

If you, or someone you know is at risk of harming themselves, call or text 988, the 988 Suicide & Crisis Lifeline, for immediate support.

A large part of suicidality is suicidal ideation. Suicidal ideation refers to the experience of having thoughts about suicide. This doesn’t imply that a person desires death or will attempt to end their life. It simply means that these thoughts are present. For some people, these thoughts may be passing, appearing occasionally. For others, these thoughts may be persistent and extremely hard to manage. It can feel like their mind is fixated on a distressing thought pattern.

Suicidal thoughts vary in nature. The two primary categories of suicidal thoughts are:

Passive suicidal ideation — Passive suicidal ideation involves thinking about death or having a desire not to be alive, without any specific plans for taking action. A person may think, “I wish I could just disappear,” or “Life would be easier if I weren’t here,” but they don’t consider how these outcomes may happen. In this case, death is perceived as a potential relief, but not as an actively pursued goal. 

Active suicidal ideation — Active suicidal ideation is a more acute state. It happens when a person has thoughts about suicide and formulates a plan. They are contemplating how they would end their life, and they may have acquired the necessary means. Someone with active suicidal ideation may think, “I’m going to take all of these pills, and I know where to find them.” This is a serious warning sign, showing that the person requires immediate intervention. 

Understanding the difference between passive and active ideation is crucial:

Passive suicidal ideation — “I wish I weren’t here.” (A wish)

Active suicidal ideation — “I’m going to do this, and here’s how.” (A plan)

Active ideation shows a substantially elevated risk level. A person who is experiencing active suicidal ideation is in a critical state of emergency and requires immediate professional help. While passive ideation is also a serious concern that should be addressed, active ideation indicates a more immediate and urgent threat.

What factors can increase the likelihood of someone experiencing suicidal thoughts? A multitude of factors can contribute, including psychological factors, sociocultural influences and biological considerations.

A significant part of what leads to suicidal thoughts involves a person’s psychological state. This includes conditions such as:

• Depression
• Anxiety disorders
• Bipolar disorder
• Personality disorders
• Trauma
• Substance use disorders
• Previous suicide attempts

Factors outside of a person’s internal state can also play a significant role in contributing to suicidal thoughts. These sociocultural influences may include:

• Social isolation
• Lack of support
• Stigma
• Access to lethal means
• Cultural factors
• Exposure to suicide

There may also be biological factors that can contribute to suicidality, including:

• Genetics
• Brain chemistry

Beyond the thoughts themselves, certain actions and behaviors can indicate a higher risk level of suicide. These are often referred to as suicidal tendencies.

Recognizing the warning signs and symptoms of suicidality is vital. If these signs or symptoms are present in yourself or someone you know, it’s crucial to seek help. Some common warning signs and symptoms include, but aren’t limited to:

Talking about wanting to die — The person expresses statements such as, “I wish I were dead” or “I don’t see any reason to live.”

Seeking means of suicide — There is evidence that the person is searching online for methods of self-harm or attempting to get items such as pills or weapons. 

Making a suicide plan — A particularly serious indicator is the formulation of a plan that includes the details about how, when and where the person intends to end their life. 

Feelings of hopelessness — The person experiences a pervasive sense that nothing will ever get better and that there’s no point in trying to make things better. 

Feelings of worthlessness — The person believes they are a burden to others or their life lacks any worthwhile meaning. 

Feeling trapped — They believe there is no escape from a painful or unbearable situation. 

Withdrawing socially — They start to pull away from friends, family or previously enjoyed activities. 

Changing sleep patterns — They begin to experience excessive sleepiness or significant insomnia. 

Changing appetite — They have a noticeable increase or decrease in food consumption, which may also lead to weight changes. 

Increasing substance use — They may have an increased reliance on drugs or alcohol. 

Giving away possessions — The person begins to distribute their valued belongings or make arrangements for their affairs. 

Saying goodbye — They express farewells to others like they are anticipating a final departure. 

Increasing agitation — They display increasing restlessness or edginess. 

Participating in reckless behavior — The person engages in dangerous or high-risk activities that could lead to their death. 

Experiencing sudden mood improvement — There is a seemingly abrupt shift to a happier mood in a person who has been severely depressed. This may indicate that they have made a decision to end their life and are experiencing a sense of relief.

Suicidal thoughts and tendencies can have a significantly disruptive impact on a person’s life, making it challenging to:

• Maintain work or school performance
• Engage in basic self-care
• Keep healthy relationships
• Experience pleasure

The difficulty of these experiences can create a sense of constriction and darkness, making it seem like their world has become increasingly limited and bleak. 

Seeking help as early as possible is crucial. Early intervention can help prevent the situation from deteriorating and pave the way for a more effective recovery. It’s essential not to wait until a crisis point is reached. If you or someone you know is experiencing suicidal thoughts, even if they’re not being acted upon, reaching out for support is vital. Call or text 988 to reach the 988 Suicide & Crisis Lifeline.

Fortunately, help is available for those struggling with suicidality. At Guidelight, we offer programs and therapeutic interventions that can significantly improve outcomes. These programs help people gain insights into the origins of their thoughts and develop healthier coping skills. 

Guidelight provides programs tailored to varying levels of need:

Intensive Outpatient Program (IOP) — An IOP is a program designed for people who need more support than weekly traditional therapy but don’t need inpatient hospitalization. Our IOP is approximately three hours per day for three days each week. The average treatment duration is six weeks in length and offers one-on-one therapy sessions with a highly trained therapist, where individuals can learn healthy coping skills through compassionate and comprehensive care. Group therapy sessions provide people the chance to connect with others facing similar challenges, share experiences and learn from their peers. Medication management is also available if needed. Our IOP allows for flexibility without sacrificing needed support. Participants of IOPs attend sessions during the day or evenings and continue to live at home and keep some of their daily routines. 

Partial Hospitalization Program (PHP) — A PHP offers a more intensive level of care than an IOP. Participants spend approximately five hours a day, Monday through Friday, for approximately two weeks in a supportive environment receiving comprehensive and compassionate care. Our PHP is suitable for those who need more intensive treatment but don’t require 24-hour care. In our PHP, clients receive specialized individual and group therapy and medication management. Our PHP also includes therapeutic activities that help boost self-awareness, interpersonal skills and overall well-being. Like IOPs, PHPs allow for a higher level of care while still doing activities you enjoy and staying at home at night. 

In both levels of care, Guidelight uses a range of evidence-based therapeutic approaches, all aimed at promoting well-being and safety. These therapeutic approaches include:

Cognitive behavioral therapy (CBT) — CBT helps people identify the connections between their thoughts, feelings and behaviors. It helps teach techniques for changing negative thought patterns that contribute to suicidal feelings, effectively helping to break the cycle of despair. 

Behavioral action — Depression often causes people to withdraw from previously enjoyed activities, which can make negative moods worse. This technique helps people gradually reengage in these activities, even when motivation is low, to promote a sense of well-being. 

Dialectical behavior therapy (DBT) — DBT is particularly beneficial for those who experience difficulty managing intense emotions. DBT teaches skills such as mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. 

Stanley-Brown safety planning intervention — This intervention involves developing a personalized, step-by-step plan to ensure safety during times of suicidal thoughts. The plan includes identifying supportive contacts, detailing coping skills and making the immediate environment safer. It provides people with a practical tool to navigate moments of crisis. 

Suicidality is a serious issue, but it’s important to emphasize that help is readily available, and recovery is possible. Recognizing the signs and symptoms and knowing where to seek help are important first steps. 

Everyone has a seat at Guidelight. Contact our team today for more information or to schedule an initial evaluation.