Suicidal Behavior
When a person thinks or talks about suicide, it’s called suicidal ideation. Any form of suicidal ideation is a red flag that should never be ignored. Parents, caregivers, friends, and peers should take any type of suicidal ideation in a loved one seriously. The potential consequences of downplaying suicidal ideation are simply too extreme: it can lead to a suicide attempt, and in the worst case, a preventable death.
Talking to a trained professional is the most effective way to prevent a suicide attempt.
Never Ignore Talk of Suicide.
If you or someone you love engages in suicidal ideation and is at risk or in crisis right now, call the National Suicide Prevention Lifeline at 988. If they’re in immediate danger, call 911 or go to the emergency room right away.
Treatment for Suicidal Behavior at BACA: Uncovering and Addressing the Root Cause
Suicidal Behavior: What is Suicidal Ideation?
The American Psychological Association (APA) offers this definition of suicidal ideation:
“Having thoughts of serving as the agent of one’s own death. Seriousness can vary, depending on the presence/absence of suicide plans and the degree of suicidal intent.”
The APA identifies two types of suicidal ideation:
Passive Suicidal Ideation
Passive suicidal ideation means an individual is thinking about ending their life. However, passive suicidal ideation means the individual has no fixed plans, means, or date/time to take their life. Passive suicidal ideation also includes “…indifference to an accidental demise which would occur if steps are not taken to maintain one’s own life.”
Active Suicidal Ideation
Active suicidal ideation means an individual has a suicide plan, the means to attempt suicide, and a specific date/time to attempt suicide. Active suicidal ideation also includes “…a conscious desire to inflict self-harming behaviors when…the expectation the attempt could produce a fatal outcome.”
Suicidal ideation is a very serious problem. With that in mind, it’s important for parents, family, and friends of any individual who engages in suicidal ideation to understand that although every person who engages in suicidal ideation does not go on to attempt suicide, almost everyone who attempts suicide engages in some type of recognizable and identifiable suicidal ideation beforehand.
Suicidal Behavior: Warning Signs of Suicide
The most common warning signs of suicide include:
- Previous suicide attempts
- Non-suicidal injury/self-harm
- Direct threats to take own life
- Acquiring means: buying a gun, finding medication and/or drugs for intentional overdose
- Forming an actionable suicide plan
- Frequent discussion of death, suicide, or both
- Persistent, severe hopelessness
- Uncharacteristic anger
- Excess anxiety or agitation
- Risk-taking
- Feeling trapped by life circumstances
- New or increased use of alcohol or drugs
- Withdrawal from friends and family
- Giving away possessions/saying goodbye
- Severe mood swings
- Frequent statements like “My life is pointless” or “Why even bother living?”
Factors that increase the risk of suicidal ideation escalating to a suicide attempt are called risk factors. Risk factors for a suicide attempt include:
- Diagnosis of mental health disorder
- History of trauma
- Family history of suicide
- Heavy alcohol/substance use
- Previous suicidal behavior
- Diagnosis of a serious/terminal medical condition
- Chronic pain
- Identifying as LGBTQIA+
- Being between age 10-24
- Death of a loved one
- Disrupted/unstable family or relationships
- Extreme social, emotional, or physical isolation
- Opioid use disorder (OUD)
Mental health disorders associated that increase suicide risk include:
- Depression (MDD)
- Bipolar disorder (BD I&II)
- Anxiety disorders (AD)
- Post-traumatic stress disorder (PTSD)
- Borderline personality disorder (BPD)
- Alcohol/substance use disorder (AUD/SUD)
- Attention-deficit-hyperactivity disorder (ADHD)
- Autism spectrum disorders (ASD)
Treatment for Suicidal Behavior: Listen, Watch, Learn
Research shows that although suicidal ideation itself is a clinical emergency, there is no specific treatment for suicidal ideation. Instead, the most effective treatment for suicidal ideation/suicidality in adolescents and young adults is to identify any underlying mental health disorders and offer treatment for those.
At BACA, teens and young adults who engage in suicidal ideation will receive a full psychiatric evaluation during which we collect:
- Full family mental health history
- Personal mental health history
- Full list of risk factors
- Full list or protective factors
- Detailed information on current life circumstances: stress, major events, recent disruptions, impending life changes
- Scores from suicidal ideation scales/metrics
- Current mental health status
- Current alcohol/drug use status
Once we have a complete picture of everything that may impact suicidal ideation or suicidality, we apply a comprehensive, holistic, integrated treatment model. Treatment plans at BACA include a combination of individual therapy, group therapy, lifestyle changes, and medication if needed. BACA clinicians augment these traditional treatment approaches with complementary modalities including mindfulness, meditation, and expressive therapies such as journaling.
Types of therapy at BACA:
- Individual therapy
- Cognitive Behavioral Therapy (CBT)
- Acceptance and Commitment Therapy (ACT)
- Motivational interviewing
- Solution focused therapy
- Group therapy:
- Coping groups
- Emotional processing groups
- Healthy living
- Family therapy
- Complementary therapies:
- Writing/journaling
- Mindfulness: meditation, breathing
- Drama therapy: role playing
- Psychiatric medication when indicated
At BACA, treatment plans include most, but not all, of the following:
- Individual, group, and family therapy
- Weekly individual psychiatry sessions
- Education about depression and depression treatment
- Lifestyle changes, including:
- Healthy eating
- Exercise
- Mindfulness
- Classes and workshops for family
- Medication, if needed
At BACA, we take the time to learn about each patient and understand what works for them. We design a treatment plan the leverages strengths, improves challenge areas, and gives each individual the greatest chance of resolving the issues or problems that lead to suicidal ideation and achieving stable, sustainable, long-term recovery.
