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Suicidal Ideation & Attempts

Updated: May 18, 2023

If you are in crisis, call the toll-free National Suicide Prevention Lifeline (NSPL) at

1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

Suicide is a scary topic for many people. One most people refuse to touch. I will admit, it’s scary for me, too. You never know how words on a blog post, or written down, or sent in a text will be taken by the party reading. You never know who you will upset, or trigger. What chords you might hit, and what the reactions might be. Suicide takes more lives than cancer, heart attacks, and car accidents, yet we hear the least about it.

Every time someone talks about or memorandum something controversial, they’re putting themselves out on a proverbial branch, and handing the reader a proverbial saw. It scares most people right out of saying the things that need to be said. It has happened with me, as soon as last year. I’m not perfect, I’m working on it, but while I do, I won’t let it hold me back when I feel like I can push through the fear and use my voice.

Trigger Warning

Let this be your trigger warning. This post is about suicide, mental health disorders, warning signs, risk assessment, ways you can help, and resources you can point to for when you can’t.

When I was a teenager, I wasn’t considered “popular”. No one really wanted to admit they liked me, but behind the scenes, I was the person many went to when shit went wrong. I had no idea what I was doing at the time, but I gave relationship advice, sat people through their fears, talked them through insomnia and drug addictions. I wasn’t qualified, by any means, but I had a strong desire to help people, especially if they were asking for it.

A friend of mine who was having lady problems called one day and said they had ended it. For real this time. There was no getting back together. He was distraught and angry. Angry at himself for the ways he had acted, angry at the way she had treated him, angry at the world for not getting it. Under all that anger was grief and sorrow. He didn’t know how to deal with his grief. I did the typical friend thing and told him there were other fish in the sea. Ones that weren’t so hard to catch, and didn’t try to jump out of the tank every time they glimpsed the ocean. He calmed down, and we went on our way.

A couple days later, he called in the middle of the night and confessed he had been thinking about suicide. We talked for hours about what that would mean for his family, for the girl, and for his future. We talked about fun times we’d had. I thought we were getting somewhere and he was focusing on the future. I would later find out, he was actually saying goodbye.

I was dating his ex step-brother at the time. They lived in different towns, this friend 2 hours away. The next day I told my boyfriend about the conversation and that I was worried about him. We decided right away we needed to go see him. We cleared it with our parents, as we weren’t of age, yet, and headed off. Our plan was to stay with his Dad overnight, make sure he was ok, and then head home the next day.

We were 45 minutes into our drive when we responded to a voicemail we had gotten while out of service. My friend had shot himself. Before we had even left, but he had just been found. We kept going, but waited at his Dad’s house. We held him while he cried soul-wrenching tears. While he slammed his fist into the ground and grieved the future his son would never see. He wasn’t 18 yet when he took his life, and there was so much he didn’t get to experience.

The funeral was huge. There was only standing room in the back, and they projected the service out into the halls so people could stand and be there, even if they couldn’t see. He was loved. He is missed. He isn’t forgotten, but when he took his life, he felt like he was. He felt like everything was lost. Like there was no other option than to take his life. You see, all this took place in Montana, where going to a “shrink” is a bad thing. Getting help is a sign of weakness. He could have gone to someone qualified, even a school counselor, but he didn’t. While I struggled with blaming myself for a while after that incident, I have come to realize there isn’t anything I would have done differently with that friend with what I had at the time. If he were to come to more educated, well-rounded and experienced (aka aged) me, I would encourage him to get counseling. To get professional help.

Suicide is almost always planned out over a period of time. It’s rarely spontaneous, even if it looks that way and they concealed their pain effectively. You can’t change them, or how they think, but you can make the environment around them safer. Sometimes professional help isn’t within reach for everyone, which is the purpose of this blog and our services. To help narrow the gap between people and help.


  • Suicide is defined as death caused by self-directed injurious behavior with intent to die as a result of the behavior.

  • A suicide attempt is a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior. A suicide attempt might not result in injury.

  • Suicidal ideation refers to thinking about, considering, or planning suicide

  • Depression refers to feelings of severe despondency and dejection. Self-doubt creeps in and that swiftly turns to depression

The Impact

I find statistics sobering. They tell us on a macro level how suicide affects us. According to the Centers for Disease Control and Prevention (CDC) WISQARS Leading Causes of Death Reports, in 2019 (the most recent reports):

  • Suicide was the tenth leading cause of death overall in the United States, claiming the lives of over 47,500 people.

  • Suicide was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 44.

  • There were nearly two and a half times as many suicides (47,511) in the United States as there were homicides (19,141).

Something to take away from these numbers, is that you, or your loved ones, aren’t alone. You aren’t the first, or the last, to go through this.

Suicide and suicide attempts cause serious emotional, physical, and economic impacts. People who attempt suicide and survive may experience serious injuries that can have long-term effects on their health. They may also experience depression and other mental health concerns. The financial toll of suicide on society is also costly. Suicides and suicide attempts cost the nation over $70 billion per year in lifetime medical and work-loss costs alone.

It’s easy to see suicide is an issue. One that needs continual attention. There have been recent advancements with the installation of 988 as an emergency call line for suicidal ideation. This line will be up and active July 16, 2022. It’s something to celebrate as it is a huge advancement in the awareness of suicide and it’s impacts. Acknowledgement is crucial to social change. Until this emergency line is active, you can continue to reach out to 1-800-273-TALK as an alternative.

The Cause

Suicidal ideation can be brought on by a multitude of factors. Suffering from mental health disorders, whether that be depression, PTSD, anxiety, postpartum depression, codependency loss, or OCD. The list of “causes” are endless. It’s simply different for every single person. What they can handle, and how far they can go before they have thoughts of ending their life. Everyone’s threshold is different. For people with mental health disorders, the rate of suicidal attempts is significantly higher. The exact numbers are unclear, but since suicidal ideation is a symptom of mental health disorders like major depression and bipolar disorder, the problem is far greater of a percentage for these populations

When does suicidal ideation develop? Two necessary conditions combine:

  1. Pain - different for everyone.

  2. Ideation becomes strong - intensifies when pain exceeds connectedness.

Ideation leads to action when there is the capability to make an attempt.

Warning Signs

  • Isolation from loved ones

  • Feelings of worthlessness, hopelessness, or disdain for the future

  • Irritability. Shorter fuse

  • Talk about what happens after you die, the afterlife, or estate plans

  • Talking like it’s goodbye

  • Sitting motionless for periods of time

  • Anxiousness

  • Increased risk taking. “Why not?” attitude

  • Creating a plan, and accessing what’s needed for the plan.

  • Insomnia, or sleeping more than usual

  • Recent loss

  • The 1,000 yard stare. At nothing. You’ll know it when you see it.

  • Pacing from room to room. Often not being able to remember what they came for

  • Weight loss or gain

  • Emotionless or withdrawn

Under the Radar Warning Signs

  • Heightened or excessive sense of responsibility

  • Discounted or dismissed hurt and sorrow

  • Strong belief in “Counting your blessings” as a foundation of well-being

  • Excessive worry and need to control the environment

  • Intense focus on tasks and being “valuable”

  • Judgemental about other people

  • Family history of suicide

  • Health problems. New diagnosis or worsening of symptoms

  • Worry about being a burden

  • Speaking of revenge

Risk Assessment

For loved ones helping someone through suicidal ideation or attempts.

Some things to ask yourself before trying to dive into a risk assessment with someone else:

  • How sensitive are you to this situation?

  • Have you ever dealt with anything like this before?

  • Do you believe this person is about to commit suicide?

  • Do you think they’re making it up?

  • Do you think this is for attention?

It’s ok to feel a little overwhelmed and scared and still help your loved one through this. If you have concerns about someone vying for attention, please make sure to call professionals immediately. Depending on the laws in your location, that may be calling the police, a hospital, or a mental health facility. If you feel like you are in danger, or the person you’re helping is in immediate danger, please call the authorities immediately.

Take this quiz to assess your risk of suicide.

Myth: Suicide is cowardly

Actually, it’s the opposite. Suicide takes a level of fearlessness most people don’t realize. You have to override your instincts of survival and fear to attempt suicide. You can’t kill yourself if you’re afraid of death.

Action Steps Out of Suicidal Ideation

  • Don’t be alone - seriously, your head is not a nice place to be so be around someone to help get yourself out

  • Have a plan for the hardest moments - I know its hard to preplan, I personally hate it. Especially pre-planning coping. But when you get into the worst of suicidal thinking, your brain is going to be even worse at coming up with a coping skill. For instance, I have a couple skills (like watching scooby doo to distract) and I have a couple people who are my call anytime, especially if you are thinking of killing yourself. This is seriously something you don’t want your depression to convince you to procrastinate on

  • Find reasons not to die. Stupid, I know, but it works. For the first 10 or so years of dealing with chronic ideation, it was my sisters. I couldn’t put them through it. As much as my brain convinced me everyone would be better off without me, I knew they wouldn’t. It was also several friends who were coping with the same feelings I was. For the last 10 years or so, it has been the meaning I’ve created for my life through my work. Having that sense of meaning and purpose is my lifeline. So find ways to make meaning in your life. It can be in the present or in the future. What are the ways you want to contribute to others and the world? What makes this suffering all worth it to you? Because life sucks and we are going to suffer. No matter what. If you find a way to make it mean something, you can flip the script on suffering.

  • The most important thing to preventing suicide and combatting ideation? Hope. I used to hate the idea of hope. Hope can be such a painful emotion when you live with depression. It feels like you are just setting yourself up to be let down and to have it all just come crashing down around you. The most devastating feeling to me is hope because when you have it and it's taken away, everything feels horrible. I can’t even create a feeling word that describes how it feels to have it taken away after having it. Its that agonizing, that nothing seems to do it justice. So I used to live as a vacuum of hope. No hopes? Can’t be let down by life, right? I realized in part that it was because I put too much weight on hope. Hope can be looking forward to the little things. Like, hoping to go to the movies this weekend or hoping that you can do something with your loved ones. Hope can be something big like graduating high school (or the feeling of pride you get when you prove someone wrong by graduating high school ;) ). Hope for little things and for big things. Hope for more than just one thing. Don’t use hope as a “life will be better when…”. I can’t tell you how destructive that was to my relationship with hope. It was too much pressure for that thing to be actualized. It's not that life will be better when my hope comes true, but it could be that I'll suffer a little less if my hope comes true.

If you are in crisis, call the toll-free National Suicide Prevention Lifeline (NSPL) at

1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

Additional Resources

Also visit your:

  • Primary care provider

  • Local psychiatric hospital

  • Local walk-in clinic

  • Local emergency department

  • Local urgent care center

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