Suicidal Ideation: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Suicidal Ideation?
A psychiatrist, a doctor who treats mental health conditions, or a therapist, a mental health professional who offers talk therapy, usually treats suicidal thoughts. Your primary care doctor can also listen and help you take the next step. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is suicidal ideation?
Suicidal thoughts or actions are a sign of extreme distress and a signal that someone needs help. The facts below cover suicide in general. Suicide is when people harm themselves with the goal of ending their life, and they die as a result. A suicide attempt is when people harm themselves with the goal of ending their life, but they do not die.
Suicidal thoughts are a sign of extreme distress. They are also a sign that someone needs help. Some people tell others about their thoughts, but others try to hide them.
Symptoms
Warning signs of suicide can include:
- Talking about wanting to die or wanting to kill oneself.
- Feeling empty, hopeless, trapped, or like there is no reason to live.
- Feeling unbearable emotional or physical pain.
- Talking about being a burden to others.
- Pulling away from family and friends.
- Giving away important possessions, saying goodbye, or putting affairs in order.
- Making a plan or looking for ways to die, such as searching online, stockpiling pills, or buying a gun.
- Extreme mood swings, using alcohol or drugs more often, acting anxious or agitated, or changes in eating or sleeping habits.
Causes and who gets it
People of all ages, sexes, and ethnicities can be at risk. Some things raise the risk, including:
- Having attempted suicide before.
- Depression, other mental health disorders, or an alcohol or drug use disorder.
- Long-lasting pain or a medical illness.
- A family history of a mental health disorder, substance use, or suicide.
- Family violence, such as child abuse, or having guns in the home.
- Stressful events, such as losing a loved one, money problems, or a breakup.
- Being exposed to another person's suicidal behavior.
- Being between 15 and 24 years old, or over age 60.
Most people who have risk factors will not attempt suicide.
How doctors diagnose it
If you have concerns about your mental health, tell your health care provider. The provider will listen and can help you figure out next steps.
Asking directly can be the best way to find out. A question such as, "Are you thinking of killing yourself?" can be the best way to identify someone at risk. Risk factors are important to keep in mind, but it is difficult to tell who will act on suicidal thoughts.
Treatment
Effective, evidence-based treatments are available. These include:
- Cognitive behavioral therapy (CBT), a talk therapy that helps people notice their thought patterns and think of other actions when thoughts of suicide arise.
- Dialectical behavior therapy (DBT), a talk therapy that teaches coping skills. It has been shown to reduce suicidal behavior in teens.
- A safety plan, with specific steps for what to do and how to get help when suicidal thoughts come.
- Safer storage of items that could be used for self-harm.
- Staying connected and following up with people at risk.
- Collaborative care, a team approach in which a care manager works with the person, their primary care provider, and mental health specialists.
When to see a doctor
If you notice warning signs of suicide, get help as soon as possible. This is true most of all after a change in behavior. Call 911 or go to the emergency room if you feel you may act on thoughts of suicide, or if there is an immediate life-threatening situation. If someone tells you they are going to kill themselves, do not leave them alone.
If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away. The Lifeline offers free, private support 24 hours a day, 7 days a week.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can listen to your concerns and help you find mental health care. They can also stay in touch afterward, which research shows can lower the risk of future attempts.
Common questions
Does asking someone about suicide put the idea in their head?
No. Studies have shown that asking people about suicidal thoughts and behaviors does not cause or increase such thoughts. Asking directly can be the best way to find someone who needs help.
What should I do if someone tells me they are thinking about suicide?
If someone tells you they are thinking about suicide, stay with them and get help right away. If they say they are going to kill themselves, do not leave them alone. Do not promise to keep it a secret. Tell a trusted friend, family member, or other trusted adult. You can also call or text 988, and call 911 if the danger is immediate.
Does having suicidal thoughts mean a person will act on them?
No one can tell for sure. It is difficult to tell who will act on suicidal thoughts. All talk of suicide should be taken seriously and needs immediate attention.
Can suicidal thoughts be treated?
Yes. Effective, evidence-based treatments exist, such as cognitive behavioral therapy, dialectical behavior therapy, safety planning, and collaborative care. Collaborative care has been shown to reduce suicidal thoughts.
Sources
- MedlinePlus - Suicide
- National Institute of Mental Health - Frequently Asked Questions About Suicide
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
