Suicidal Ideation

Suicidal Ideation

At some point during our childhood we come to understand the concept of death and gain awareness about our own mortality.  As human beings, it is normal and natural to contemplate death from time to time; and if a loved one has recently passed away, thoughts of death may be more prominent.  These thoughts may be general and existential, (e.g. is there an afterlife?) or they may be more specific.


Thoughts about your death can be overwhelming and scary.  Sometimes when people suffer from severe depression, anxiety, physical pain or other persistent afflictions, death can feel like a solution.  Thoughts about ending your own life- also known as suicidal ideation- is a common feature of depression.


There is a large degree of fear and stigma surrounding the topic of suicide, and many people are afraid to share these thoughts with others.  Clients may also resist discussing the issue with their therapist due to misconceptions about what constitutes grounds for a breach in confidentiality. A common concern is: “If I tell my therapist about my suicidal thoughts, I will be hospitalized.”  To clarify: your therapist has an obligation to breach confidentiality only if there is imminent risk of suicide.  This means that you would have to tell your therapist that you have a plan to kill yourself, means to carry out this plan, and the intention to do so in the immediate future.  


This is an important distinction because keeping suicidal thoughts to yourself  can lead to increased feelings of isolation. Conversely, talking about suicidal thoughts with a therapist, trusted family member, or friend can help you to process your emotions and look for safe alternative coping strategies.  A therapist can work with you to create a safety plan, which details actions for you to take during times of crisis. If your suicidal thoughts do escalate to the point where you can no longer stay safe, it is important that you seek help immediately.  


If you or someone you know is in danger, call the National Suicide Prevention Lifeline at 1-800-273-8255 for 24/7 free and confidental support.  You can also call 911 or go to the nearest emergency room.


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Written by Joanna Aslanian, MA, LPC