Depression and Thoughts of Suicide


Suicidal thoughts are thoughts about hurting yourself or taking your own life. Suicide is the act of taking your own life. Suicide can be linked to depression. Suicidal thoughts can happen to anyone—young and old, male and female—for a number of reasons. Usually, suicidal thoughts occur when a person is in intense emotional pain and doesn’t see a way out. The things that cause this type of pain are different for everyone. Suicide is often preventable.

There are multiple risk factors for suicide, including:

  • Age
  • Gender
  • Poor physical and mental health
  • A history of violence
  • A family history of suicide
  • Having weapons in your home
  • Having recently been released from a long stay in prison or jail
  • Hanging out with others who talk about suicide or encourage you to take your own life
  • Traumatic events

Path to improved well being

Even though it feels like your pain will never end, suicidal thoughts often are caused by a treatable health problem. This includes physical medical conditions such as depression. Depression is a serious medical condition. It changes the chemicals in your brain. It affects your moods, thoughts, and emotions. It can make it hard or impossible for you to feel happy, remember good times, or see solutions to your problems. If you have been treated for depression in the past, you may need to try other treatments to find the one that works.

Some of the things you can do when you are feeling depressed include:

  • Reach out for help. Call the National Suicide Prevention Lifeline at 988. You are not alone. You may feel like your loved ones don’t care. But people want to help you. Tell someone what’s going on. Call a friend or family member, your family doctor, or your church.
  • Avoid things that trigger suicidal thoughts. These things are different for everyone. Common triggers include being alone, drinking alcohol, and doing drugs. Spend time with family or friends every day. Make your home safe by getting rid of alcohol, drugs, and the things that you used or planned to use to hurt yourself.
  • Give it time. You do not have to act on your suicidal thoughts. Make a promise to yourself that you will give yourself time to ask for help and seek treatment.
  • Take care of your health and wellness. Follow your doctor’s eating and exercise advice. Get plenty of sleep. Learn how to deal with stress. Find and do things that you enjoy. If you’re taking medicine to treat depression, don’t skip your medicine. Take the right amount at the right time.
  • Work with a professional. This could be a psychiatrist or a counselor. Don’t be afraid to open up to the professional. You should tell them what you are feeling and don’t hide anything.

Things to consider

Suicidal warning signs include:

  • Feeling trapped or hopeless
  • Feeling like you need an escape
  • Feeling unbearable physical or emotional pain
  • Focusing on death, dying, or violence
  • Feeling that friends and family would be better off without you
  • Making a plan or searching for a way to take your life
  • Feeling guilt or shame
  • Using drugs and alcohol more frequently
  • Increased anxiety
  • Withdrawing from family and friends
  • No longer having an interest in the things you used to enjoy
  • Changed eat and sleep patterns
  • Extreme anger, rage, or revenge
  • Giving away things that once mattered to you
  • Saying goodbye to friends and family
  • Writing a note, making a will, or putting your affairs in order

Questions to ask your doctor

  • What’s the difference between depression and feeling down?
  • Does everyone think about suicide at one time or another, even if it’s short-lived?
  • Is there medicine I can take?

Resources

After a Suicide Attempt

Lifesavers Guide

National Institute of Mental Health: Suicide Prevention

National Suicide Prevention Lifeline

Supporting Your Loved One after Suicide Attempt

Talk Saves Lives

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Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.





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Depression Is Common and Treatable


My nurse asked Megan to fill out a simple questionnaire that helps identify whether a person may have depression. Megan’s high score on this questionnaire indicated a possible diagnosis of depression. After looking at her responses, I talked with her. Megan told me she felt a little embarrassed to be admitting out loud that she was struggling. Like many people, she had a hard time explaining exactly what she was feeling. She took several long pauses, but I was careful not to interrupt.

Megan told me that she was feeling both sad and anxious at the same time. “I feel like I’m coming out of my skin,” she said. Although she felt tired all the time, she couldn’t fall asleep at night. She would often toss and turn for hours, usually thinking about past mistakes. Sometimes, she wished she could just disappear. Fortunately, she had not thought about hurting or killing herself.

As Megan talked, I noticed her body language and speech patterns. She fidgeted with her hands a lot, and she looked mostly at the floor. I asked some questions to make sure she was safe and to rule out other things that can make depression worse. Megan said that she was not using drugs or alcohol or engaging in high-risk sexual practices. She said that she felt safe at home and elsewhere, but she wasn’t comfortable talking about her feelings with her parents. I thanked her for having the courage to come in and ask for help. She admitted it had been hard for her.

I let Megan know that it’s common for depression and anxiety to go hand in hand. I explained that they don’t just cause psychological symptoms. They can also affect you physically and cause symptoms like chest tightness, fatigue, headaches, and jitteriness. Since I could tell that Megan held a lot of her feelings in her body, I recommended taking a few minutes each day to put on music and dance. Dancing is a great activity to help relieve tension and improve your mood. I also taught Megan a relaxation technique to use whenever she was feeling anxious. It’s a simple, effective exercise called soft-belly breathing. It involves breathing slowly in through your nose and feeling your belly fill with air before breathing out through your mouth.

In addition to counseling, I prescribed a low dose of an antidepressant for Megan. (Learn more about antidepressants and how to take them safely.) I explained to Megan that it can take several weeks for an antidepressant to start working. Side effects from these medicines usually decrease after a couple of weeks.

When a person starts taking medicine to treat depression, there is a risk of increased suicidal thoughts, particularly in young people. Although this is rare, I discussed the risk with Megan and made sure she had a plan, just in case. She already knew about suicide hotlines that are accessible by phone, text, or online (for example, the National Suicide Prevention Lifeline at 1-800-273-8255). She also identified a friend to call if she had thoughts about hurting herself. I assured her that she could always call her counselor or my office, or go to an emergency room if she needed help right away.

I asked Megan to come back for a follow-up visit in 1 week so I could see how she was tolerating the antidepressant. She told me it was a relief to talk about her feelings. She felt hopeful that her symptoms would improve over time. As Megan’s family doctor, I’ll continue to guide her treatment for depression and provide needed care and support.

Reach Out for Help

People who have depression sometimes think about suicide. If you have thoughts about hurting yourself, tell someone. Tell your doctor, your friends, or your family. You can also call a suicide hotline, such as the National Suicide Prevention Lifeline at 988.

Get help right away. There are people who can help you. Depression can be successfully treated.





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