What It is:
Suicidality involves the thoughts, urges, and behaviors associated with a wish or plan to take one’s own life. Suicide is a major public health problem for both children and adults, and it is one of the top 10 leading causes of death for adults in the US. A similar yet distinct behavior is called nonsuicidal self-injury and includes any behavior that causes damage to the physical self without the intent to die (e.g., cutting, burning).
Suicidality and suicidal thoughts are diverse experiences and it is worth differentiating a few different types. Individuals can have what we call intrusive thoughts of death or suicide. Intrusive means that you have these thoughts, but do not want them. You have no desire, intention, or plan to harm yourself. Intrusive thoughts are considered separate from other kinds of suicidal thoughts and are most associated with Obsessive-Compulsive Disorder (OCD).
Other people have thoughts of death and suicide that are more consistent with how they feel or what they want. We often speak of three different types of these thoughts:
- Passive suicidal thoughts. These are thoughts that involve a desire to die without an intent to make that happen. These can be thoughts or wishes to die by natural causes or an accident.
- Ambivalent suicidal thoughts. These are thoughts where someone feels conflicted between wanting to die and wanting to live at the same time. Ambivalent thoughts can come with a plan to harm oneself or there may be no plan to do so.
- Acute suicidal thoughts. These are thoughts where someone both wants to die and has an intent to act on this- either now or in the near future. These thoughts may extend into planning, writing suicide notes, or may include behaviors such as making a suicide attempt.
Having suicidal thoughts or experiencing suicidality is often a consequence of emotional distress, but suicidal thoughts are not a stand alone mental health disorder. Some people find their suicidal thoughts very distressing and want to get rid of them, while others find them soothing or comforting. However these thoughts are experienced, we believe that it is possible to target the source of suffering that may cause a person to consider death as an option. Treatment is most often geared at these underlying reason that someone is considering suicide, which can include environmental circumstances (e.g., oppression or abuse), physical circumstances (e.g., a chronic health condition), and/or mental health concerns like depression or emotion dysregulation.
Does This Sound Familiar?
- I think about dying often and can get stuck in those thoughts for long periods of time.
- I have used suicide hotlines, called 911, or taken myself to the ER because I do not trust that I can keep myself safe.
- I sometimes search for how to kill myself on the Internet or read about others that have attempted suicide.
- My thoughts about death or suicide bother me; I feel ashamed or guilty and don’t like to talk about them.
- Sometimes I wish I could just go to sleep and never wake up or die in a car crash.
- When I am feeling particularly overwhelmed or upset, I start to fantasize about how it would be easier if I just disappeared.
- I feel conflicted about both wanting to die and also wanting to live.
- I’ve started to plan how or when I would kill myself and/or have started writing a suicide note.
- I often think about how no one would miss me or others would be better off if I were gone.
Associated Concerns
Suicidality and self-injury in adults often co-occur with depression, anxiety and stress, shame, Obsessive-Compulsive Disorder, and/or traumatic experiences.
Other commonly associated difficulties include Bipolar Disorder, Borderline Personality Disorder, emotion dysregulation, and emotional avoidance.
Specialty Services at TAP:
Below is a list of empirically supported assessments or therapies that one or more of our specialists provide. Click on an intervention to learn more!