What is suicidal depression?
Suicidal depression is not a clinical diagnosis, but it is a term you may see. Instead, most mental health experts call it "depression with suicidal thoughts."
Clinical depression or major depressive disorder (MDD) is a mood disorder. While there is no definite cause of depression, the American Foundation for Suicide Prevention says depression may be related to a variety of factors, such as the physical structure of the brain, brain chemicals, hormones, or genetics.
When someone has clinical depression with suicidal ideation as a symptom, it means they are experiencing suicidal thoughts as part of their overall health symptoms. However, it is important to remember that the vast majority of people with depression do not go on to commit suicide.
Other symptoms of major depression or clinical depression include:
lack of interest in daily activities
- Changes (increase or decrease) in sleep and appetite
- feeling of despair
- sad feeling
- uneasy feeling
- Difficulty concentrating, thinking, or making decisions
It should be noted that suicidal thoughts can also occur outside of clinical depression and in conjunction with other mental health conditions, such as anxiety, post-traumatic stress disorder, or substance use disorders.
It can be difficult to know when someone is considering suicide, so we encourage others to be aware of changes in behavior, thoughts, or moods that may indicate a worsening mental health condition.
However, don't be afraid to ask someone if they are having suicidal thoughts, especially if they are experiencing significant life stress. Listen to the other person uncritically and offer to stay with them until professional help arrives.
If you are concerned about something you have noticed, or realize that you or someone you know is having suicidal thoughts, it is important to seek support and further help from a mental health professional.
What are the signs of suicide?
While not an exhaustive list, some of the more common signs that you or someone you know may be considering suicide include:
- Make statements about feeling helpless, hopeless, and worthless
- Major changes in mood
- Talk about wanting to die
- Says there is no reason to continue living
- Stay away from friends, family, social interaction
- write about death
- Give away personal items
- Excessive drinking or drug use
- aggressive behavior
- Buy weapons or collect and save pills
- Saying goodbye to friends, family and loved ones
- Increased anxiety or irritable behavior
What is "passive suicide"?
Some people divide suicidal ideation into two categories: passive and active. In this context, passive suicide refers to suicidal thoughts without a concrete plan to carry out the act. Still, Marshall noted that passive suicide is not a clinical term and most mental health professionals avoid using it.
Any suicidal thoughts are cause for concern because they are often a sign of distress. Sometimes someone may express a non-specific death wish and it is important that we are not afraid to follow up and specifically ask them if they are having suicidal thoughts and then take steps to contact them to offer help.
What are the common risk factors for suicidal depression?
Risk factors play a crucial role in understanding suicide. That's why Marshall says if you think someone is having suicidal thoughts, it's always important to have open and direct communication with them and take extra steps to pay attention and contact them to offer help.
We are learning more every day about the factors that may contribute to suicidal ideation as part of clinical depression, and know that these factors may be biological and environmental in nature or may be related to past history and life stressors.
With that in mind, here are some common risk factors for suicide:
- Have a family history of suicide
- substance abuse
- Mood disorders, such as depression
- chronic illness
- Previous suicide attempt
- A significant loss or other sudden stressor
- History of trauma or domestic violence (physical or sexual abuse)
- your age, especially if you are 15 to 24 or over 60
How to treat suicidal depression?
There are many ways to treat clinical depression with suicidal ideation, but it may vary based on severity and personal factors.
As treatment reduces depressive symptoms, some people may see a decrease in the frequency or intensity of suicidal ideation, but for others, this may not be the case, or their suicidal ideation may continue.
Working with individuals to ensure they are safe during these times and able to manage periods of suicidal ideation is a key component of a mental health treatment safety plan.
There are also evidence-based treatments, such as dialectical behavioral therapy and cognitive behavioral therapy, that can help with symptoms of depression and suicidality.
It is important to let your mental health provider know that you are having suicidal thoughts, whether accompanied by symptoms of depression or not, so that your provider can plan the best treatment for you.
Drugs such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and selective serotonin norepinephrine reuptake inhibitors (SNRIs) are the most commonly used antidepressants.
In addition to support from a mental health professional, it can also be helpful to take steps to stay healthy, stay connected, and be proactive about your mental health needs.
Here are some of her tips:
- Practice self-care, such as regular sleep and exercise, and maintain healthy nutritional habits
- Have open, honest conversations about what you or others with depression may be experiencing and feeling with suicidal ideation
- Learn and recognize the warning signs of depression with suicidal ideation
How to prevent suicidal depression?
As with other mental health conditions, early detection and treatment are key factors in reducing the risk of suicide. Adequate mental health treatment for clinical depression can help many people reduce suicidal thoughts.
It is crucial to seek support for suicidal thoughts that may occur outside the context of clinical depression. The important message is don't wait. If you're not sure whether you or someone you know has suicidal thoughts—either as part of a depression diagnosis or on its own—don't be afraid to ask.
What is the outlook for people suffering from suicidal depression?
If treated appropriately, the outlook for people suffering from depression and suicidal ideation is positive. A combination of psychotherapy, medication, and self-care can reduce symptoms of depression.
However, if suicidal thoughts worsen or increase in intensity, outpatient treatment may not be enough. In this case, hospitalization is usually recommended.
Additionally, a new category—suicidal behavior disorder (SBD)—has been recommended as a diagnosis for further research and may be accepted in future editions of the Diagnostic and Statistical Manual of Mental Disorders, according to a 2021 review article .
The goal of the proposal is to increase opportunities for mental health professionals to assess suicide risk outside of the suicidal ideation category of MDD.
Depression accompanied by suicidal ideation is not something you should deal with on your own. If you are currently being treated for depression, it is important to tell your therapist that you are having suicidal thoughts.
If these thoughts or feelings are new to you or you have never sought help, ask for a referral from a health care professional or contact a mental health specialist in your area.
If you have thoughts of harming yourself, you are not alone. can help. Call a medical or mental health professional or a crisis or prevention hotline to talk to someone who can help you find the support you need. Please call the Suicide Prevention Lifeline.
If you are in imminent danger of harming yourself or others, contact a trusted friend or family member, or if you cannot reach someone you can trust, call for emergency medical care.
Hong Kong Samaritan Suicide Prevention Association: 2389 2222
Samaritans 24-hour multilingual service: 2896 0000
Lifeline: 2382 0000