Suicidal but not depressed (Top 5 tips)

In the following article, we will discuss, if it is possible for a person to have suicidal thoughts without actually being depressed, what can make a person have suicidal thoughts? What

does suicidal thoughts or suicidal ideation mean?, the symptoms, causes and prevention.

Is it possible for a person to be suicidal without being depressed?

Yes, it is possible for a person to be suicidal without being depressed. Suicide, suicidial ideation, is strongly associated with depression, but it may not be true for all the cases. People who do not suffer from major depression, can also have suicidal thoughts. 

An epidemiological Catchment Area study, investigating suicidal ideation in people with general medical conditions, found that only 34% of the patients met the criteria for major depression. Read more about it here. 

Another study of adult primary care practitioners states that, 7% of the older adults, with no depression, expressed suicidal thoughts. 

The risk of suicide, is generally assesed with screeing for depression in the pateint, but since not all people with suidical thoughts are clinically depressed, it is not the most reliable method.  

Why do people feel suicidal? 

People can feel suicidal, due to a variety of problems, that aren’t related to, or that can be associated with depression.

Here are some reasons why a person may feel suicidal

Mental Health Problems

There are quite a few mental health conditions that can lead a person to feel suicidal. Depression, Bi-polar disorder, Borderline personality disorder, schizophrenia are some of them. 

Substance misuse

It is possible that the use of certain drugs like cocaine, ecstasy, ketamine cause suicidal thoughts in the mind of the person who takes it. These thoughts tend to occur after one has come down from the effect of the drugs , and tend to  resolve themselves, but if they last, the person should seek professional help. 

Ingestion of these substances often lowers one’s inhibitions, and increases their impulsivity, hence increasing the probability that they might act on their suicidal thoughts. 

Experience of a loss

People who experience a significant loss in their lives, can also have suicidal thoughts. The loss can be that of a person, a relationship, a job etc. 

People can also have suicidal thoughts based on the fear of loss alone. For instance, a person may be scared of academic failure and contemplate taking their own life. 

Traumatic experience 

People who have experienced trauma, like childhood sexual abuse, rape, physical abuse can have suicidal thoughts, even years after the experince. 

Illness and chronic pain

A person who has been diagnosed with a disease that has no cure, or a person who is experiencing pain everyday due to some medical condition, it is likely that they will have suicidal thoughts. Sometimes suicide is seen as a way of “dying with dignity” or as “taking back control of their lives” by these patients. 

Some of the medical conditions associated with a higher risk of suiicde are, cancer, parkinson’s disease, HIV\AIDS etc.

Hopelessness 

People often tend to feel stuck in situations, and hold the belief that things will not get better. It may be academic, personal or professional. To an outside observer, it may seem easy to understand that things can get better. Such people can also experience suicidal thoughts.  

What exactly is suicidal ideation?

Suicidal ideation refers to a thought process in which a person thinks about, or plans the act of committing suicide. It can be a detailed plan or just a fleeting consideration. This term, does not involve the act of actually committing suicide. 

Not all people who have suicidal thoughts are depressed. Suicidal thoughts can occur due to various reasons such as, mental illness, stress, chronic pain\ terminal disease, abuse , trauma etc. 

Signs and symptoms

A person experiencing suicidal thought may show the following sign and symptoms:

Isolating themselves, talking about being  a burden to other people, experiencing feelings of worthlessness, getting their affairs in order, isolating themselves, talking about suicide or death, feeling hopeless about their future, increased use of drugs and alchohol, expressing remorse or self-critiscm. 

How is suicidal ideation diagnosed?

If you are experiencing suicidal thoughts\feelings, please seek professional help immediately.

When you see your doctor, they may ask a series of questions to assess the severity of the situation. Some of them could be , how long have you had these thoughts? Have you ever had these thoughts before? Have you ever attempted suicide before? Do you have a history of depression?

Along with these, your doctor may also ask you to answer a questionnaire. 

How is suicidal ideation treated?  

The treatment plan will be decided according to the severity. Antidepressants or anit-anxiety medications may be prescribed. These medications will help you manage your symptoms.  

The treatment will also include talking to a therapist. 

People who experience these symptoms benefit largely from cognitive behavior therapy.

How can you prevent suicidal ideation?

Understanding your depression and suicidal thoughts triggers might help you prevent or better manage them in the future.

Keep track of stressful circumstances and how you handle them. Maintain a journal to better understand and control your emotions. Find stress-relieving activities, such as exercise or conversing with a friend. 

Seek help as soon as you notice the first indications of depression. Read more about coping with suicidal ideation here

FAQs

What should you do if someone tells you they are thinking about suicide?

If someone tells you they are thinking about suicde, then you just take their statements very seriously, listen without any judgement and make sure they get professional help. Do not leave that person alone and limit their access to alcohol,drugs.

Is suicide related to implusiveness?

The tendency to act without thinking through a plan or its ramifications is known as impulsiveness. Because it is a symptom of a variety of mental problems, it has been connected to suicidal behavior, frequently in conjunction with mental disorders and/or substance abuse. 

Borderline personality disorder in young females, conduct disorder in young males, and antisocial behavior in adult males are the mental diseases with impulsiveness most connected to suicide. For middle aged men, alcohol and substance use are also considered. 

In older adult suicides, impulsivity appears to have a smaller impact. The presence of impulsiveness as a symptom of attention deficit hyperactivity disorder is not a major risk factor for suicide in and of itself. Aggressive and violent actions, such as homicide and suicide, have been associated to impulsivity.

What biological factors increase the risk of suicide? 

Researchers believe that low serotonin levels in the brain are linked to depression and suicidal conduct. Low levels of a serotonin metabolite called 5-HIAA have been found in the cerebral spinal fluid of people who have tried suicide, as well as in postmortem studies of suicide victims’ brains.

Understanding the biology of suicidal behaviour has several purposes, one of which is to enhance therapies.

 Scientists have discovered that in people with major depression and suicidality, serotonin receptors in the brain become more active, which explains why medications that desensitise or down-regulate these receptors (such as serotonin reuptake inhibitors, or SSRIs) have been found to be effective in treating these conditions.

Does alcohol and other drug abuse increase the risk for suicide?

Several recent nationwide surveys have shed light on the link between the use of alcohol and other drugs and suicidal behaviour.

 Lower minimum-age drinking regulations were linked to greater teenage suicide rates, according to a study examining minimum-age drinking laws and suicides among youths aged 18 to 20.

Suicide ideation was observed among people with depression in a major study of individuals who drink alcohol.

People who said they had attempted suicide at some point in their lives were more likely to have a depressive disorder, and many also had an alcohol and/or substance misuse disorder, according to another study. 

Over 20% of all non-traffic injury deaths linked to alcohol consumption were suicides, according to a study.

Can the risk for suicide be inherited?

Suicide risk is linked to familial and genetic variables, according to a growing body of evidence. Suicide risk is increased by significant psychiatric conditions such as bipolar disorder, major depression, schizophrenia, alcoholism and substance abuse, and some personality disorders that run in families.

This is not to say that people with this family history are destined to commit suicide; it just implies that they are more vulnerable and should take actions to mitigate their risk, such as seeking diagnosis and treatment at the first symptom of mental illness.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116433/
https://pubmed.ncbi.nlm.nih.gov/29992837/
https://www.medicalnewstoday.com/articles/193026

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