Are You Struggling with Suicidal Ideation?

December 17, 2020

By definition, suicidal ideation defines the feelings one experiences when they want to take their own life or are thinking about and considering suicide. Suicide rates are alarmingly high among adolescents and teens in the United States. According to a recent report by the Centers for Disease Control and Prevention, the rate of suicide for those between ages ten and twenty-four increased by almost 60% between 2007 and 2018. To put these numbers in a clearer context, in 2007, the suicide rate was 6.8 per 100,000, and in 2018 the rate was 10.7 per 100,000. In short, in a community of 100,000 people, approximately eleven young people would lose their lives to suicide. According to the Centers for Disease Control and Prevention, Suicide is the tenth leading cause of death nationwide.

Types of Suicidal Ideation

Many people do not realize there are two types of suicidal ideation. First, there is passive suicidal ideation. This type occurs when someone “wishes they were dead” or that they could die, but they do not actually have any plans to commit or attempt suicide. Active suicidal ideation is the exact opposite. In this case, one is not only thinking about suicide but also has the intent to do so and has made or is making a plan to take their life. Suicidal ideation is one of the symptoms common in various depressive disorders, bipolar disorder, and other mental health conditions. Unfortunately, it occurs with frequency in adolescents and teens without a history of mental illness.

Warning Signs and Symptoms

Passive suicidal ideation can progress to active suicidal ideation quickly and without warning. Therefore, as a parent or caretaker, you will want to keep an eye out for certain behaviors or warning signs if you are concerned about your teen. Some of the more common warning signs that your teen may be thinking about or contemplating suicide include: 

Changes in Behavior or Increased Isolation

Teens often spend a great deal of time by themselves. In many cases, this is not abnormal. However, if you notice they are increasingly isolating themselves from loved ones, it may be a good idea to monitor this behavior a little closer. Again, increased isolation can be a symptom of many different things. In addition, changes in behavior or mood are also common symptoms of other mental health conditions but can indicate potential suicidal thoughts. If your teen is having increased mood swings, anger, rage, or irritability that is excessive or beyond normal, consider talking to them about their emotions and what they’re feeling. 

Increased or New Risk-Taking Behavior

Sometimes people who struggle with suicidal ideations will increase the level of risk-taking behavior. This may be because they have decided they want to end their life and therefore increased risk is of less concern. In some cases, they may begin using or misusing substances either for the first time or at an increased rate. They may also participate in other risky behaviors such as unprotected sex, driving while intoxicated, or engaging in criminal activity.

Planning and Preparing

It is not uncommon when someone is struggling with suicidal ideations for them to begin planning or preparing. If you notice your teen begins giving away possessions, talking about death or suicide, or acts as though they’re saying goodbye to friends and loved ones, this should be a red flag. These behaviors could very well be indicative that your teen has either made a plan or is considering doing so. Suppose you notice any of these behaviors, or you see your teen is attempting to access a means to carry out a plan such as procuring medication, drugs, or a firearm. In that case, it is critical that you reach out for help at a teen treatment facility like Hillcrest immediately. 

If you are concerned that your teen is thinking about or planning suicide, talk to them! There is an unfortunate misconception that conversation could give them the idea to follow through with their thoughts. Asking and communicating shows that you are concerned and that you care for them. It is also essential to be aware that passive suicidal ideations are no less severe than active suicidal ideations as passive can quickly evolve into active. 

Risk Factors for Suicidal Ideation

There are many reasons why someone may experience suicidal ideations. Often, thoughts and emotions related to suicide arise out of situations of hopelessness or lack of control in one’s life. They may occur due to relationship problems, trauma, crisis, financial difficulties, or a host of other emotional challenges that push someone over the edge. Preexisting or coexisting mental health disorders such as depression or post-traumatic stress disorder can also contribute to heightened emotions that lead to suicidal ideations. There are several different risk factors that may also contribute to suicidal thoughts. These risk factors are as unique as the individual, and how they impact (or do not impact) your teen will vary. Certain examples include a previous suicide attempt, mental illness, traumatic brain injury, having a substance use disorder, and a family history of suicide, among others. 

Treatment and Therapy Options

If you are concerned that your teen is having suicidal thoughts, but they are not in crisis, your primary care provider may be the best first step in getting your teen the help they need. A primary care provider or their existing mental health provider may be able to recommend therapy, medications, and lifestyle changes that can help reduce the risk of suicide.


Psychotherapy or talk therapy is one of the most common forms of therapy used in mental health treatment. The most widely used psychotherapy model is cognitive-behavioral therapy or CBT. During therapy sessions at Hillcrest, your teen will work with a therapist trained to utilize cognitive-behavioral therapy (and other forms of psychotherapy) to help your teen examine and address the emotions which are leading to suicidal feelings. Therapy sessions will also help your teen learn new, healthy coping skills to use when faced with emotions or situations that bring about negative thoughts.

Another form of therapy used during treatment is Family therapy. Family is essential to therapy and recovery for many teens in mental health treatment. Involving loved ones such as parents (or caretakers) and siblings can help vital support (family members) sources better understand what your teen is going through, better understand the warning signs of suicidal ideation and improve family relationships and communication. 

Coping Strategies

As noted above, your teen and their therapist will develop and practice safe and healthy coping strategies your teen can use when emotion or situations become overpowering and negative thoughts occur. Coping strategies can help reduce suicidal ideation. A couple of the more common coping strategies your teen can use include:

Identifying Triggers

Triggers are events, situations, or people that lead to emotional turmoil. Some examples may be specific locations, former relationships, or situations that remind your teen of death or loss. It is most beneficial if they can eliminate these triggers, but if they cannot, their therapy provider can provide effective means for managing them. 

Maintain A Healthy Diet and Exercise Routine

Activity and a healthy diet can help your teen reduce stress and improve overall emotional well-being. Developing activities or hobbies that help to distract from emotional challenges can help reduce negative feelings and suicidal thoughts. Exercise and fun physical activity can serve as excellent distractions while improving physical and emotional health. 

Addiction Treatment

For some teens struggling with the thoughts and emotions that sometimes lead to suicidal ideation, substance use is also a contributing factor. In some cases, substance use is new and serves as a means of coping with intense emotions, depression, and anxiety. For others, existing substance use disorders may intensify. Addiction treatment can help your teen learn and practice alternative ways of coping that do not require substances.


In some cases, your teen’s therapist may prescribe medications to help treat underlying mental health conditions such as depression and anxiety. While medications may help to alleviate some of the symptoms associated with the mental health condition, they are not suitable for everyone in all situations, and therapy will still remain an essential component of your teen’s treatment plan. 

Feelings of stress, anxiety, or depression often affect teens differently and sometimes more intensely than adults. For some, the day-to-day stressors of merely “being a teen” can become emotionally overwhelming. When these powerful emotions are left unchecked, and your teen feels as though they do not have an outlet for emotional challenges, suicidal ideations may develop. If you are concerned, your teen may be struggling with these emotions, don’t ignore your concerns. Reach out and let them know you are there if they want someone to talk to or if they would prefer, offer to arrange an opportunity to speak to someone outside of the family. It is not uncommon for teens to struggle with opening up about painful fears and emotions to those closest to them. If you are unsure how to start the conversation or if you are concerned, your teen may need help with their feelings, reach out to Hillcrest today. 

Our experienced staff has more than three decades of clinical experience working with concerns pertaining to teen mental health. Our treatment and admissions team will work with your teen and family to develop a comprehensive, unique treatment plan that can address the concerns your teen has currently, as well as treating any underlying mental health or substance abuse disorders that may challenge or inhibit ongoing and long-term recovery. If your teen is in crisis, it is essential to seek help right away. If your teen is struggling with mental health or suicidal ideation, reach out to us at Hillcrest today.