Suicidal thoughts are thoughts about ending your own life, ranging from a vague wish not to be here any more to frequent, insistent thinking about dying. They are a sign of distress rather than a diagnosis, and are much more common than most people assume. Having them does not mean a person will act on them.
Key points
- Suicidal thoughts range from a passing sense that life is not worth living to persistent thoughts of dying.
- They are far more common than people think, and having them does not mean a person will act on them.
- They signal pain that has become hard to bear, not weakness or a fixed decision.
- They can change and pass, and how long they last differs from person to person.
- Asking someone directly about suicidal thoughts does not put the idea in their head.
Symptoms
- Thinking that life is not worth living, or wishing not to wake up; thinking other people would be better off without you.
- Hopelessness, feeling trapped, pain that feels unbearable, feeling like a burden, shame or feeling cut off from others.
- Passive thoughts (not wanting to be alive) and active thoughts (wanting to end your life) are both worth taking seriously.
Causes and risk factors
- Mental health conditions: depression, bipolar disorder, PTSD, psychosis, borderline personality disorder, eating disorders, previous self-harm.
- Alcohol and drugs, which lower mood and make distressing thoughts harder to manage.
- Life circumstances: bereavement, relationship breakdown, debt, job loss, insecure housing, loneliness, abuse.
Treatment
- A psychosocial assessment, at the earliest opportunity, covering current and past circumstances and what support is wanted.
- A safety plan made with a professional: triggers, warning signs, coping strategies, contacts, and limiting access to means of harm.
- A CBT-informed intervention tailored to the person, typically 4 to 10 sessions; medication is not recommended as a specific treatment for self-harm itself.
When to speak to a professional
- Thoughts that life is not worth living have lasted more than a few days or keep returning.
- Get urgent help the same day if you cannot keep yourself or someone else safe, or if you have harmed yourself.
- Samaritans: call 116 123, free, 24/7. Shout: text SHOUT to 85258. Call 999 if anyone's life is at immediate risk.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.