Understanding Suicide Part 2: Types of Suicide & Ideation

Types of Suicide/tendencies): There are a few different types of suicide as well as different stages of suicidal ideation and risk levels that must be considered. Understanding the different types of suicide can help understand some motivational factors that may contribute to ideation.

Impulsive Suicide: This type of suicide is an intentional attempt that occurs without warning or possibly without any prior indications of mental illness or depression. Research shows that this type of suicide typically occurs in correlation with drinking and substance abuse since the ingestion of these substances leads to the lowering of inhibitions, increased impulsivity, and risk-taking behavior (Houston, 2017).

Rational Suicide: This is a type of suicide that typically occurs with individuals who are facing a terminal diagnosis, or those who choose to end their lives for “considered reasons” as opposed to psychological or emotional reasons (Houston, 2017). These persons may argue that they have a natural, autonomous right to control the decision to end their life, particularly if they are unable to attain any quality of life status due to overwhelming disease, illness, or debilitation that makes life extremely painful, tortuous and uncomfortable.

Accidental & Indirect Suicidal Tendencies: This includes excessively reckless and incredibly harmful behaviors that have a high risk for death or serious injury, such as intentional drug mixing or overdosing, excessive alcohol consumption, driving under the influence without a seatbelt or helmet at extreme speeds or purposely engaging in intense physical violence or other dangerous activities.

Understanding Ideation

Suicide attempts and ideation or thoughts of wanting to die, often occur for those in a reactive state possibly due to an emotional or psychological trigger. Individuals are motivated for suicide in these states because, in the moment, suicide acts as an expression of their severe internal feelings. Such feelings may consist of hopelessness, isolation, or feelings of disconnection from social relationships. Suicide can also be motivated by abrupt life changes that prompt grief from the loss of family, jobs, homes, and other roles. When individuals are in such states they no longer see the value in continuing life with their pain. In an effort or desire to escape and seek immediate relief,  further ideation, planning and attempts ensue.

Ideation

When a person is at risk of self-harm or suicide chronically, they exhibit certain levels of ideation behavior for a variety of reasons. These levels measure and determine the severity of each person’s suicidal ideation. 

A person experiencing severe depression symptoms on a recurring basis, as seen in Bipolar disorder, may lead to expressing these feelings through vague or broad statements that are characteristic of suicidal ideation. 

For example, they may ambiguously state, “I don’t want to be here anymore.” or “I just can’t deal with this pain anymore.”Such statements may be considered vague because they can be interpreted in various ways by those who witness them. Many may not immediately recognize it as a precursor or indication that a person could be at risk for suicide, especially for those who experience chronic or frequent ideation. For this reason, it is important to explore statements such as this with caution and empathy.

A person may also be very direct in their communication of suicidal ideation by making a statement such as, “I don’t want to be alive anymore.” or “I just want to die.”

Often if a person is trying to communicate suicidal ideation in any manner, it is a cry for help and a plea for love, connection, and support that they perceive to be lacking in their world. Those who are only in the ideation stage are in the most important and critical stage to utilize prevention as an effective tool to de-escalate the ideation from progressing to the next level.

Planning & Means

The most critical and often the scariest stage of suicidal ideation involves the point at which the ideation or thoughts transition to the communication of desired action through planning and obtaining the means to carry out the plan. If there is any communication at this stage, it presents as escalated or very explicit ideation that also includes detailed plans to self-harm. 

An example of statements that could be communicated include, “Goodbye everyone, if you’re reading this I am already dead.” or ‘I’m going to end it all tonight with a nice pill cocktail.”

As you can see there are various levels of ideation that range from vague statements that declare internal pain, to sincere intentional planning to take action. You may even notice that in reading the example statements, you may have felt unsettled or anxious. Speaking with suicidal individuals can be very challenging and requires a level head despite what you may hear from them during the height of their crisis state of mind. For this reason, addressing the reasons why people commit suicide is vital to assist with prevention. Understanding the level of risk each person is at is also vital to understanding how to provide critical support. Theories that address this are called ideation-to-action theories; which are key to helping to identify and define these levels and reasons so that we can provide the most effective prevention.

Tune in to our next blog post in this Understanding Suicide series to learn more about Ideation to Action Models and more on suicide prevention. 

If you or a loved one is considering suicide, you are NOT alone. Please get help today! Help IS available and your life is worth it. 

Suicide & Crisis Prevention Lifeline: Call or text 988, 24 hours a day, 7 days a week. https://988lifeline.org/