Dear Alex, that is called suicidal ideation
It refers to the presence of recurring passive or active thoughts of self-harm or suicide. These thoughts are commonly associated with mental health conditions such as depression.
They may include feelings that life is not worth living, a desire to cause harm to oneself, or making (or not making) plans to act on such thoughts.
Types of suicidal ideation
- Passive suicidal ideation: Thoughts of not wanting to live, without any intention or plan to act on them.
- Active suicidal ideation: Thoughts of suicide accompanied by an intention or a plan to act. Some people may withdraw socially or feel a temporary sense of relief after making a plan.
Suicidal thoughts rarely occur in isolation. They are often linked to symptoms such as persistent low mood, loss of interest in pleasurable activities, fatigue, poor concentration, low self-esteem, excessive guilt, sleep disturbance, appetite changes, or feelings of agitation.
Causes of suicidal thoughts
1. Genetics
- Higher risk if a first-degree relative has experienced depression.
- Twin studies suggest heritability of 40–50 per cent for identical twins, 20 per cent for fraternal twins.
- Adoption studies show increased risk even without a direct family history.
2. Organic causes
- Physical illnesses, especially endocrine disorders.
- Certain medications, such as corticosteroids, oral contraceptives, beta-blockers, clonidine, metoclopramide, theophylline, and nifedipine.
3. Psychosocial factors
- Adversity in childhood: parental loss, poor bonding, inadequate or overprotective care, physical or sexual abuse.
- Adversity in adulthood:
- For women: lack of a confiding relationship, caring for more than three young children.
- For men: unemployment, divorce, or loss of custody.
- Recent life events: bereavement, divorce, marital separation, imprisonment, unemployment, or the death of a close relative.
4. Cognitive errors
- Magnification: Exaggerating the significance of a failure and ignoring past successes.
- Overgeneralisation: Extending failure in one area of life to all other areas.
- Personalisation: Believing one is entirely to blame for failures, disregarding external factors.
Treatment
- Counselling and supportive therapy can be effective for mild cases.
- Sleep hygiene advice may help when sleep disturbance is a problem.
- Hospitalisation may be required if there is high risk of self-harm. In such cases, treatment may include antidepressant medication alongside therapy.
Please seek counselling or therapy in case you are experiencing such thoughts.
