Questions surrounding suicide

Chat tonight gave me some interesting things to think about...

I once heard that everyone likes to fantasize about their own demise... but if that were the case, wouldn't everyone be bordering along mental distress? If so, why does everyone psychopathologize thoughts regarding suicide if they are in fact, quite common?

Also, what constitutes having suidical ideations vs. thoughts about suicide? Or are they the same thing?

I hope this doesn't go against forum rules as I'm not currently suicidal, just asking some questions. I'll put a trigger just in case.

Thanks
Jacq

It's good that you put a trigger on this so sensitive people can avoid this thread. It's too bad suicide is such a taboo subject for some people. I think if there wasn't such shame and fear attached to it - then we talk more openly where it may end up saving lives. I believe veiling it in secrecy deters people from reaching out for help!!

I don't think everyone fantasizes about their own demise. I know I don't - I always boast about how I plan on living until at least 100+ yrs LOL. I lost a brother to suicide a year and a half ago. I think it's important for families who've lost loved ones to suicide - not to feel ashamed and sweep it under the carpet.

Thanks (((((((lynn))))))))
I'm so sorry to hear about your brother, that must have been awful.
I hope you make it too those 100 years too
Jacq

*******trigger warning!!!!!********

I hope this doesn't go against forum rules as this isn't a suicidal post, rather my thoughts on the symptoms of depression that could lead to it, and I'm glad you brought it up jacq because I wonder about these things myself and I think it's as important a symptom to talk about as any other, but I'm glad you put the trigger and I'm adding one to my post just in case.

I'm not an expert but I think that the difference with "normal" people's thoughts of suicide and/or self-harm comes down to frequency and degree. At some point we probably all think about it in terms of our own mortality, because we realize that we're not going to live forever and our minds go over possible scenarios -- whether self-inflicted or not -- that might result in death. The other thing too is that suicide statistics or articles on mental health are published quite frequently, and it might lead someone to wonder whether they'd be capable of having such thoughts and then carrying them out.

Depression can be identified when someone has these kinds of thoughts to a great degree, ie they are preoccupied by thoughts of death/dying or suicide. It's one of the things you get asked routinely in the course of therapy/diagnosis (or if it isn't, it's definitely something I got asked a lot). In a lot of cases they might come up with a plan or a particular scenario that goes round their minds. Suicide can be seen as a form of relief/escape from the feelings of sadness/despair that depression invokes, which is when those thoughts become dangerous.

I also think it's important to remember that depression does NOT equal suicidal thoughts/ideation, and that the taboo society places on suicide actually leads to a lot of the stigma related to depression/mental health. I'm sure there are a LOT of people on this forum who are depressed but who aren't suicidal. But we generally tend to hear about the cases of depression that did lead to self-harm, and it frightens people because it overrides our most basic survival instincts. It makes a lot of people look mortality in the eye and I think it makes them uncomfortable. It made me incredibly uncomfortable to talk about when I actually was suicidal because I was afraid that people would instantly think I was a "nut job" or in need of immediate hospitalization. But I think it does need to be talked about, openly, both to remove some of the stigma attached to depression and to show that suicidal people need to be taken seriously, need to be helped, and should not be ostracised but rather comforted and cared for in what can often be the most miserable/terrifying period of their life.

(((((Rebecca))))
Thanks for your input.. much appreciated.

I think you are right in that the media has a lot to do with how suicide is framed. This is particularly true around issues such as SI/SH. It just makes me so frustrated because there are times (such as now) where I feel that it is important to me to be discussing this issue, however, like I said, I don't plan on following through why any of these thoughts. Like any other symptom of depression (as you mentioned) it is something that at times needs to be addressed.

As for the frequency and degree... I think that you are right. Thanks for that clarification.


Jacq

Those are some interesting questions...

I don't know how anyone could possibly know whether it's true that "everyone likes to fantasize about their own demise". My gut feeling is that most people wonder what death is like, whether they will see that famous "tunnel of light", what's on the other side (if anything), and so forth. But I don't think that most people without a mental illness think about death-by-suicide more than once in a blue moon. They're too busy living. (I could be wrong, of course; that's just my impression.)

I think that suicidal thoughts are pathologized for two reasons. First, they tend to indicate the possible presence of real pathology, that is, depression.

Second, however, is the fact that suicidal thoughts are a cultural taboo in most Western societies. One must not go public with suicidal thoughts, just as one must not go public with thoughts of violence or thoughts of incest, for example. I believe that this is because open acknowledgement that one is having any of these kinds of thoughts tends to frighten other people. I suspect this fear is partly practical and realistic (that is, people don't want suicide or violence or incest to occur for very good reasons), but also is partly a function of the way it reminds the listener that he or she too has had taboo thoughts or desires. People tend to feel guilt and shame about their own taboo thoughts, so we have an implicit social contract not to mention such thoughts to each other. Or so I believe.

As for suicidal ideation and thoughts about suicide, as far as I know they are the same thing.

Thanks for raising some thought-provoking questions!

BlueOak

Thank you. This was a very interesting topic. And your facts are correct. As I think about it always, but don't plan to do it....It's just plan ole thoughts... Thanx again

Hi, everybody! For what it's worth, not all that long ago I asked my pdoc to clarify for me what "suicidal ideation" meant to professionals. He emphasized "suicidal ideation" is not just thinking about death or about one's own death, it's thinking about taking your own life. I vaguely remember asking further about the issue of intent, and he said something like this: "suicidal ideation" includes thoughts not accompanied by intent.

I stress these are my memories of my pdoc's comments, not official pronouncements from the Temple of Psychdom.


PS: Thanks for bringing this up, Jacq, and to everyone for their contributions!

I suspect that suicidal thought are also more detailed and thought out in a realistic way than are the average persons thoughts of their own death or vague "I wish I would die" type of momentary fantasies. never been normal so I wouldn't know

I find I frequently think about su but in a passive way eg I think about how I would, mentally compose a note and organize funeral arrangements...but the key is this is a passive thing. it's distressing but doesn't concern pdoc cos it's a passive desire to not exist with no actual intention to do anything. Very rarely does it actually become an active desire to not be here anymore. Maybe 3 times in the last 2yrs. That's when I get worried cos I'm crawling the walls, very very agitated, that I might impulsively do something permenant against my usually-better judgement.
Anyway the point of my waffle, thinking about su not bad or dangerous, though distressing, while actively wanting to do something to die is the time to get some outside help. I also think this is a very good topic as these thoughts are very common in depression and frequently have nothing to do with the actual act. It's important to have an outlet for these thoughts where u know the other person isn't going to freak out thinking u intend to carry out ur thoughts.

*Willow*

**trigger just in case..."

I think of it this way (simplistically). Some people are feeling bad and think "I wish I was dead". What I think they may mean and what I meant when I would say/feel this way was I WISH I COULD STOP HURTING SO BAD THAT I WANT TO DIE.

I was in real at one point where I became hopeless and thought out - in detail - how i was going to exit life if something didn't get better SOON.

Thankfully I called a crisis-line and it lead to me finding my first genuine help with the painful issues of my past.

This is a touchy subject and I hope I did not distress anyone, my motive was just the opposite. I only wrote from my own experiences, I make no claim to having proper training in this area

I agree with Multipixie. I have been wanting to express this. When mental illness causes so much mental anguish that one considers suicide a viable solution, then one is "suicidal" and the more pain that accumulates, the more that solution looks inviting.

When a person is thinking about committing suicide, it is termed "suicidal ideation". The longer one remains suicidal and entertains suicidal ideation, the more likely it is that suicide will become a reality. The window for intervention occurs in that period of time. If a person has more tools in their toolbox, has coping skills, has been in therapy and has learned alternatives that may lessen the pain they are experiencing, or experiences intervention, they have a better chance of making it through the worst of their period of anguish.

So, it isn't unusual for someone to experience periods of being suicidal or to have suicidal ideation without ending up committing suicide. It does need to be monitored, however.

I think that thoughts of suicide, whether in the mentally healthy or the mentally ill, often relate to questions of CONTROL. No one wants to think of themselves as being helpless.

I know this is being tacked on to the end of this thread but I wanted to add it anyway.

Before I went into hospital in May, I had who was by far the worst psychiatrist I have ever had in my life. I should have been in hospital in February but it took until May to convince this man that my depression was serious enough to be put into hospital. By the time he agreed to put me in, (this is no joke) I was actually getting ready to do something irreversible, when my cell phone rang to tell me he had an opening and I could see him. Of course, I had already seen him four previous times and he only raised the dosage of my antidepressant.

This was the closest I ever came to actual suicide. I have been in treatment on and off for 25 years. But it just was that bad.

I am glad to see this thread. Suicidal ideation is a problem for many of us at PC and I do think it needs to be addressed sometimes and not ignored. It's just that there is such a fine line between suicidal ideation and actions and it's hard to determine where someone is at, especially on-line. I wonder what, or who, determines what is ok to talk about and what is not. I know there is some question in chat rooms. Maybe a moderator or Doc John could help us with language, so we can discuss it but keep it safe.

I want to thank everyone for their very thoughtful input on this thread. And thank you jacq10 for posting it.

Since a member requested some clarification on what is acceptable discussion about suicide at PC, I'll be happy to try to explain. Of course, if there is something anyone doesn't understand or has questions about, please feel free to ask!

DocJohn has made a Community Guideline regarding the discussion of suicide strictly for the safety of the membership. The guideline states the following:

So, in other words, a member cannot come onto the forums and say for instance, "Tonight is the night I will do myself in", or, "I attempted suicide by ingesting too many pills last night".

I believe that a discussion such as what you are having here is absolutely fine. Talking about the difference between ideation and actual planning may help someone who is teetering on the edge to understand that they may need to ask for help and to actively seek it.

By allowing anything other than the ideation discussion or such as what you are talking about here would set our membership up for a very difficult triggering time. Since this is the internet and we are not with an individual who is threatening to harm themselves, we would be sitting here worrying and wondering and being highly triggered for this individual. Not to mention that the majority of us are not trained in how to talk down an individual from following through on their acts. Even the mods/admin are not trained in that area. While we would do our best to help, there is only so much anyone can do.

PC does not want to make suicide a taboo subject by any stretch of the imagination. It is a sad fact of mental illness. But we certainly want to keep the membership as safe as we can.

Take good care!

Thanks for the clarification !
((((((((((((Sabby)))))))))))

Jacq,

I don't think this is accurate....most people are so busy living their lives they don't have time to think about their demise.....let alone suicide (demise placed in their own hands). Those thoughts are not common. I am not sure how common they really are in the world of mental illness either. From my own experience.....I never dealt with mental illness until I was 43 & there was no mental illness in any of my family background....it didn't hit until I lost my career which was my identity....& had a bad marriage from the beginning....so didn't even have that once I lost my career....(my career was my escape from my bad marriage)......had heard of suicide in passing before that, but never heard of anyone ever thinking those thoughts.

Suicidal ideations are just the thought about ending one's own life.......thoughts about suicide are when the person actually thinks of how & when.....a more concrete defining it in their own life. Suicide attempt is actually taking the action without it ending their life. Suicide is actually taking the action & having end their life.

Sadly, my anxiety/depression ended up in many attempts....looking back at that period of my life, it's a black hole & I feel so blessed that none of my attempts ended up more than just an attempt as I would have missed the wonderful life I have ended up with.

I have no idea how many attempts.....or what triggered them other than the hopeless feeling I was feeling & didn't care about living anymore. Others looked at my life & wondered what in the world was wrong....husband had his career, we had our daughter, I had my horse now & was learning my dressage riding again, I had my cute eskie dog that we were showing....I was involved with our community flute choir & even involved with the music at church......so what in the world was wrong???? I knew that I just didn't feel good about where I was without MY CAREER....the only thing I had ever wanted in my life & the whole aerospace industry was going downhill.....couldn't get another job....too high paid & not the right experience for another company to want to hire me. To others that sounded like such a trivial issue......but to me it wasn't.....all the therapy in the world couldn't fix my problem. No one had any idea how to handle what I was going through including my pdoc.....other than to stuff me in the hospital, hoping to get me medically stable & get through where I was, hoping that somehow I would get my act together. Months of inpatient treatment....months of outpatient treatment......NOTHING helped. This went on for about 5 years.

Have no idea really when my thinking changed & my actions stopped.....but had no hospitalizations for suicide thoughts/attempts after that point. The strange thing is that I can't even figure out how my thinking got to that point or why I acted the way I did....like it was someone else during that time......but the problem is that going into therapy after I moved across the country & left my husband, the question comes up......then comes the fact that all the things I have had problems with are the things that are serious issues in therapy......suicide attempts & anorexia.........understading that I am not at that point in my life anymore but therapy is necessary to help me with another trauma I went through a few years ago & other issues I am struggling with.....but that was in the past.....somehow, it's almost impossible to convince anyone that it was in the past.

My past being in the past is nothing I really talk about unless someone else is struggling with something.......but that part of my past, being like a black hole.....I am trying hard for that black hole to be just that & for it to all stay there.

I realize that there are some things in our life that we feel at the time has no resolution.....that part of my thinking was true....there was nothing that ever changed about my situation & there was nothing that anyone could do to change that situation......but how I preceived the situation & how I could replace that situation with something else of more importance was what was really needed....unfortunately, it wasn't anything that anyone could do for me.....& there was no therapy that could do it either.......it was all up to me to figure it out & figure me out.........the struggle I am dealing with now has to do with a trauma that happened a few years ago when my Mother was dying of cancer (another good reason why my attempts were not successful....my Mother needed me to be here for her as I was her only family). I can't imagine that my thinking could ever return to that dark place in my life.....shoot, I can't even take a pill without choking let alone more than that.

I still struggle in my life......but I love every part of where I am & what I am doing.....I have found more value in my life in helping people since I left my husband 2 years ago......I may not have furniture in my house & I may not have my horses with me yet, but my life is more fulfilling than it ever was when I lived with my husband in California......& I thank God every day that I didn't have my way when I was trying so hard to be in control.

Hope this can give people some hope when they may feel none......we never know what the future really holds until we get there & when we end life before that wonderful future can arrive in our lives....we really cheat ourselves out of so much of the wonderful things in life....even if it feels hopeless at the time.

Debbie

I think that the taboo on suicide is very dangerous. I was suicidal for a good part of my last episode of depression but I didn't tell anyone about it for a long time. I was ashamed to be having those thoughts. On the one hand, I was suffering SO MUCH that I was looking for any kind of relief and while I wasn't making plans I did start consciously taking risks in my behaviour that could have led to injury or worse almost with the hope that they would. But I was so ashamed of it, I buried it. I had heard things like people who committed suicide were "taking the easy way out" or "thinking only about themselves, not the people they leave behind" and it terrified me and only enforced my depressed beliefs that I was a terrible, selfish person. Every doctor, T, or person who found out about my depression would ask if I was having thoughts of suicide and I outright lied to them and said no. I did not want to be judged and I also didn't want to be seen as "completely crazy" even by the people who were trained in dealing with my mental illness. It was stupid and dangerous and I should not have done it. I thought I could control it. I thought "okay, it's just thoughts, thoughts can't hurt me, and I WILL get help the minute I actively do something to put myself at risk" (which doesn't reeeeally make sense if you think about it but I wasn't thinking rationally by that point).

The thing with thoughts of death/dying/suicide is that thoughts really can't hurt you. What you DO about them can, however, and that's where I think the taboo comes into play ... We are not likely to make good choices when we're suicidal, and if we're afraid of what people will think of us for having those thoughts, then we're even MORE likely to make bad decisions surrounding getting help. I did not ever say out loud "I am thinking of suicide" or "I am thinking of ending my life", not once during the entire episode. I think the closest I came to it was something along the lines of "I'm having thoughts that might be dangerous". I remember whispering it to my mother, so quietly she had to ask me to repeat myself, and my whole body was shaking while I told her. One day all I said was that I did not feel safe. Even after I got help, I couldn't bring myself to actually SAY I was suicidal until I wasn't any more. Being depressed to that point is dangerous -- being ashamed of your suicidal thinking is even more dangerous because you're less likely to get help for it. I know that I'm very lucky. I had incredible support systems in place and people in my life who could get a good reading of where I was at without my having to tell them very much at all.

I guess my point here is that I'm glad we're talking about it. If a discussion like this had existed when I was having thoughts of suicide, I might not have been so reluctant to get help with it when I really needed to.

So... what does one do if they are having these thoughts? Or entertaining the possibility of SH acts? Does having these thoughts automatically put you in the "danger" zone? Should one be concerned if they're having difficulty pushing these thoughts from their mind?

I guess if I had been thinking, I would have posted something like simply NO, it does not put one "in the danger zone" and it is common. I have had several therapists tell me that simply thinking about it is common. It's not really "OK" but it is common. We should pay attention to those thoughts but not necessarily panic.

I do so understand justfloating's post about feeling bad or worrying about admitting those thoughts. It does feel embarrassing to admit it sometimes. But it's part of the illness.

ok... these are just my thoughts, based on personal and professional experience (i used to work at a suicide-prevention crisis line)...

i think most people, if not all, think about death at some point. most ppl will even think about their own death e.g., who will come to my funeral? i want to see my children grow up, i want to have accomplished xyz etc. these thoughts are common - they do not express a desire to die. they are more an exploration of what happens after death, and a recognition that death happens to everyone.

on the other hand, i do not believe that everyone has thoughts about suicide. suicidal thoughts/ideation are the same thing. they are thoughts about your own death, and about wanting to bring about your own death. they usually occur when you are under an (unspecified) amount of distress - for some people this can be what outsiders would call very "minor" matters, but it is not for anyone to judge whether they are appropriate or not. i do not think that most of the population have suicidal thoughts, but i do think that it is more common than people are willing to speak about.

having thoughts about suicide does not necessarily mean that you intend to act upon those thoughts. this is why mental health professionals conduct a severity assessment when they find about that clients are thinking about suicide. we want to know plans in terms of how immediate, lethality, and how concrete they are.

so suicidal thoughts can occur in a context where there is minimal intent. usually it is a form of fantasy, a desire to escape whatever present distress is occuring.

however, yes - i do believe that suicidal ideation/thoughts should be taken seriously. firstly, they are the best (although not a perfect) predictor of someone actually attempting or completing suicide. secondly, even if intent is not there, i believe that even discussing these thoughts with a non-judgemental supportive person can be beneficial - help clarify why these thoughts are occuring, other things to do instead of attempting suicide etc. in my work, i have found that a lot of ppl see suicide as the only option available to them - but sometimes a bit of brainstorming from an outside perspective can help the client see there are many other options available also.

i think suicidal thoughts/ideation are serious, and shouldn't be a taboo topic in society. however, i dont believe that every instance of a suicidal thought is something that necessitates emergency services. if anyone is having suicidal thoughts, i would encourage them to talk to a professional. as someone who has worked in this area before, i appreciate when i am given the opportunity to work with someone who is having these thoughts in a "low danger" level i.e., they do not plan to harm themselves immediately. it provides an opportunity to discuss more life enhancing alternatives than, say, with someone who is in the process of attempting, where your options for immediate response are limited and more geared towards immediate safety.

edit: i am happy to receive pms if anyone wants to discuss this with me in private. i will keep trying to check back on this thread, of course, but sometimes my addled brain forgets which threads to follow up on .

I feel relieved this is being discussed openly. I had a post in here but then I chickened out and deleted it. In the past, I have needed to take myself to the emergency room because I did not feel safe. I have had a hard time knowing the line I need to cross to say I am not safe. I would like input on when someone should go to the er due to suicidal ideation. I suspect the more this is known more people would go get help and not sit and wonder.

MY therapist tells me that as I think of suicide so often and from such an early age they are really now just automatic thoughts, comfort gestures if you like...go figure that one out.

Most of the friends I have spoken with since being hospitalized for suicidal intent have expressed a desire to be supportive without having a clue what I have gone through. Many of them have experienced some degree of depression, but not suicidal thoughts, except perhaps briefly and in passing.

When I was in college I took a suicide prevention training to help peers in the dorm. The said that suicidal thoughts indicate depression, but not necessarily suicidal behavior, and to ask directly if a person has a plan. I've always thought of suicidal thoughts as just passing thoughts now and then and suicidal ideation as more frequent and perhaps more urgent thoughts. Really, the definition doesn't matter as much as knowing what kind of help a peson needs (therapy vs. emergency services). I believe follow up with anyone who has any kind of suicidal thoughts is critical because thoughts can progress to plans very quickly (in my experience). They're a red flag vs. a normal occurance.

I really like what Deli has to say in this thread.