By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.


You are not alone; suicidal ideation occurs when someone is considering taking his or her own life. It is the constant dwelling and preoccupation with suicide that heightens the risk. It is this state of being preoccupied with such matters that increase the probability of someone considering carrying out personal self-harm. The term suicidal ideation is the formation of ideas or concepts associated with a personal plan to commit suicide.

Suicidal thoughts are not uncommon and the thoughts are most prevalent when someone is experiencing extreme stress and depression. In a majority of cases, suicidal thoughts are temporary, but in other cases, the thoughts may be chronic and associated with a more  profound psychological diagnosis. Either way, in all cases, those experiencing and  expressing suicidal thoughts should be taken seriously.

Please understand that you are not defective; and having such thoughts is not a sign of weakness, craziness, or a particular character flaw. Suicidal thoughts are an indication that you are struggling with temporary and misguided feelings. It is the preoccupation of such thoughts that often leads someone to make drastic decisions. When we are engrossed with self-defeating thoughts; our personal perspectives on our world may become bleak, unfavorable, and discouraging. It is through these perspectives that an individual may lose hope, confidence, and enthusiasm for life.


According to the Centers for Disease Control, CDC, there has been a steady rise of suicide across the United States, which has seemingly affected all races, ages, gender, and ethnicities. In fact, among those who committed suicide, nearly half occurred in 27 states, and of those individuals; there was no known mental health condition. Suicidal thoughts do not discriminate.

The CDC has monitored this unmistakable rise from 1999 to 2016, which has seemingly affected all but one state- Nevada. Nevada is said to have a decline of one percent during this same time period while Montana has led with an uptick in suicide by 29.2 per 100,000  residents. While the national average of 13.4 per 100,000 is significantly lower than  Montana; the average remains extraordinarily high and is of grave concern.

Sadly, the United States lost more than 44,965 people to suicide in 2016. It is significant given that these same statistical numbers are nearly double that of homicide at 19,362.  Suicide is the 10th leading cause of death in the United States. Significantly, suicide was the second leading cause of death between ages 10 to 34 and fourth among people ages 35 to 54.

The CDC’s statistical data is not only concerning, but should serve as a wake-up call. As a nation, we need to start considering the mental health needs of our people. In the United States, mental health issues are a leading cause of disability; poor job and academic performance; family and community issues; and many other psychosocial issues. When an individual is incapable of receiving the necessary care for his or her mental health; there is a greater probability that they may find themselves making choices that place them at risk.

For those who are suffering from suicidal thoughts, there is a higher probability of substance abuse and other at-risk behaviors. If an individual has a mental health disorder, whether or not it has been diagnosed, there is a higher probability of suicidal ideation. Of those who committed suicide, nearly 90 percent met the diagnostic criteria for at least one mental health disorder.


There are many risk factors for suicidal thoughts, attempts, and fatalities. Individuals suffering from suicidal thoughts are more apt to contemplate suicide if struggling with a  mental health disorder. Anyone who has witnessed or has a working knowledge of a successful suicide, has a higher probability of accepting suicide as an option.

“The escalating suicide rate is a profound indictment of the country’s mental health system. Most people who kill themselves have identifiable psychiatric symptoms, even if they never get an official diagnosis.”

The Risk Factors:

• Mental health conditions
• Chronic physical health issues, chronic pain and chronic fatigue
• Traumatic brain injury, TBI
• Family history of suicide or suicidal ideology
• Personal history of suicidal thoughts or attempts
• Sudden job loss or loss of a significant relationship
• The use of legal and illegal substances
• Domestic violence, abuse and neglect
• Victims of child abuse, neglect, and maltreatment
• Financial instability
• Social isolation
• Anyone who is living a lifestyle that may place them at-risk


The indicators may be subtle or blatantly apparent. The suicidal indicators may stem from  verbal and/or nonverbal communications. An individual who is thinking of committing suicide may never speak openly of his or her feelings.

Be aware of sudden changes of mood, thoughts, or behaviors. Suicidal individuals may have a preoccupation with death or may begin discussing wills and other financial matters.

Be aware of conversations that involve:
• Suicide or homicide
• Feelings of hopelessness and utter despair
• Having little to no reason to live
• Being a burden unto others
• Chronic psychological and emotional pain
• Delusional or intrusive thoughts

Be aware of the behavioral cues:
• The intentional withdrawal from others
• An increased use of alcohol or other substances
• The intentional withdrawal from normal routines and activities
• Loss of appetite or increased appetite
• Disturbed sleep or lack of sleep
• Searching for methods to end his or her life
• Chronic fatigue
• An increase desire to be isolated from others
• Conversations that involve giving away prized possessions

Be aware of changes in mood:
• Depression or severe despondency
• Anxiety, stress and nervous excitement
• A strong feeling of annoyance, displeasure or hostility
• Loss of interest
• Humiliation, shame and blame
• Relief and sudden improvement

There are no absolute preventive measures, but rather, there are many tactics that may prevent someone from following through with his or her suicidal thoughts:
• Learn to identify the warning signs
• Reduce access to alcohol and other substances
• Reduce access to weapons and other potential hazards
• Avoid arguing, threatening or raising your voice
• Do not avoid contacting the authority if you suspect someone is suicidal
• Have a working knowledge of professional providers

Do not avoid seeking care. Contact a professional if you are struggling with suicidal thoughts.
It is not uncommon to feel an avoidance towards mental healthcare. Mental healthcare and mental illness have been plagued with stigmatization. It is important that we begin by accepting mental illness as normal. The following are recommendations for eliminating the stigmatization:
• Be educated with the facts concerning mental illness.
• Be empathetic to those that are struggling with suicidal thoughts.
• Avoid the stereotyping of those struggling with a mental health condition.
• Consider establishing an accountability partner: someone that you can lean upon, have your voice heard, and they too can mirror the same needs in times of desperation.
• Encourage those struggling with a mental health condition.
• Be involved in your community. This will allow you to see that you are not alone in this game called life.
• Avoid comparisons. Do not compare yourself to others.
• Monitoring your conversations. Deny room for conversations that are belittling or disparaging of another’s character. Discourage any conversations that are rooted in the belittling of mental healthcare or mental illness.
• We must begin to change the perception of mental illness. After all, mental illness is an illness and should be treated as all other physiological illnesses.
• Develop a crisis plan- this should be developed before a crisis ensues.

As we begin treating mental illness as a normal condition and mental healthcare as a normal avenue for treatment; we will begin the process of promoting a healthier life. The immediacy of care is of the utmost importance for all individuals suffering with mental illness and suicidal ideation.

If you, or you know of someone that is having suicidal thoughts, call The National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to for a list of additional resources. Do not avoid helping a friend in crisis. Time is often of the essence. If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States and is free and confidential.

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
References Provided Upon Request