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If thoughts of death have crossed your mind during a low period in your life, you may have experienced suicidal ideation. Suicidal ideation, or thinking about killing yourself, is not uncommon, and most people who consider the idea of hurting themselves will not go through with these impulses. Nevertheless, suicidal thoughts must always be taken seriously, especially if they’re accompanied by heavy drinking, drug use or a history of mental illness.
Suicidal ideation can run the gamut from brief images of self-harm to a preoccupation with your own death and the development of an actual plan. Whether you’re going through a difficult time in your life or you struggle with chronic depression, your chances of acting on these ideas are much greater if you abuse drugs or alcohol. According to the U.S. Surgeon General, substance abuse is the second greatest risk factor for following through on suicidal thoughts. The first greatest risk factor is having a mood disorder like depression or bipolar disorder.
What can you do if you or someone you love feels suicidal? Getting help for drug addiction or alcoholism can be a crucial first step in recovering your peace of mind and creating the healthy, stable future you deserve.
What Causes Suicidal Ideation?
For a happy, emotionally stable person, the thought of killing oneself is hard to imagine. Yet we’ve all been through situations that were so hard to tolerate that we felt there was no way out. A painful divorce, the loss of a loved one, financial difficulties and legal problems are common causes for suicidal ideation.
Drug addiction and alcoholism are underlying factors for many people who are contemplating suicide. Central nervous system depressants like alcohol, opioid pain relievers and prescription tranquilizers may seem like a good way to escape feelings of sadness or despair, yet these drugs can actually make your mood worse. Drugs and alcohol also impair your judgment, making you more likely to act on a suicidal impulse instead of reaching out for help or waiting until you feel better.
Mental illness can significantly increase the risk of suicidal thoughts. Feelings of despair and a lack of interest in life are common symptoms of clinical depression and may also indicate that someone is at risk of attempting suicide. According to the National Alliance on Mental Illness, other red flags of suicidal ideation include:
- Withdrawal from social situations or termination of friendships
- Hostile or aggressive behavior that’s out of character
- A sudden lack of attention to personal hygiene or appearance
- Changes in weight or appetite
- Physical symptoms like headaches or an upset stomach
- Increased use of drugs or alcohol
- Constant physical and emotional fatigue
- A preoccupation with death
- Giving away valuable possessions
- A sudden improvement in mood after a long period of depression, indicating that the individual has made the decision to go through with a plan for suicide
People with psychiatric conditions like schizophrenia, obsessive-compulsive disorder and post-traumatic stress disorder may not be able to control their suicidal thoughts. They may think about harming themselves day and night, even if they’re afraid of actually going through with a suicidal plan. Alcohol and drugs may be used to mask these thoughts, but eventually substance abuse will only make the intrusive ideas worse.
How Serious Are Suicidal Thoughts?
Mental health professionals and addiction counselors are trained to identify signs of suicidal ideation and to gauge how likely you are to act on these thoughts. For most people who have suicidal thoughts, these ideas are only temporary. But there’s no way to be absolutely certain that someone who’s feeling depressed and hopeless won’t go through with a plan for suicide.
Assessment tools like the Columbia-Suicide Severity Rating Scale help psychologists, therapists and counselors evaluate suicidal ideation. These questionnaires, which are designed to be used by trained professionals, ask for information such as:
- Whether you have a desire to be dead or to stop existing, and how long you’ve had these feelings
- Whether you’ve had general, undefined thoughts about killing yourself, without any specific plans in mind
- Whether you’ve considered various methods of suicide, such as overdosing on prescription drugs
- Whether you’ve taken steps to carry out these plans, like hoarding pain medications or buying a gun
- Whether you’ve actually attempted suicide in the past
During the course of an interview with a mental health professional, you might be asked how often you think about harming yourself and whether you can stop those thoughts when you want to. You may also be asked whether there are any factors in your life that could stop you from killing yourself, such as family relationships, religious beliefs or a fear of death. If you know someone who’s been talking about suicide, or you’ve been thinking about suicide yourself, it’s imperative to get help immediately.
Substance Abuse and Suicide
Substance abuse itself can be a form of passive suicidal behavior, undermining your physical health, your emotional well-being and your dreams for the future. The medical journal QJM notes that long-term alcohol abuse significantly increases the risk of suicidal thoughts or suicide attempts, especially in middle-aged men. But older adults aren’t the only ones at risk of fatal self-injury. The National Bureau of Economic Researchreports that suicide is the leading cause of death among adolescents, and that alcohol and drug use are often involved in successful suicide attempts among young people. A study of college students who drink heavily points to a strong connection between alcohol abuse and suicide:
- Over 8 percent of college-age binge drinkers thought about killing themselves.
- Close to 2.4 percent of these drinkers actually tried to kill themselves.
- College students living in areas where alcohol prices are higher are less likely to attempt suicide.
- Alcohol and drug use can lead to isolation, separation from family, poor academic performance and low self-esteem — all of which may predispose a young person to suicidal thoughts.
Substance abuse can contribute to suicidal ideation in a number of ways. Drugs can trigger painful emotions that may cause you to think about hurting yourself. Intoxication may also make you overlook the positive aspects of your life, such as close friendships or hopeful job prospects. If you’re struggling to overcome addiction, frequent relapses may cause feelings of hopelessness, making you feel that you’ll never have the healthy, happy life you want.
Suicide Prevention and Rehab
The thought of dealing with a loved one who has suicidal thoughts can be frightening. You may fear saying something that will make your friend or family member feel even more hopeless about life. You might worry that if you call a professional for help you’ll only drive the person you care about to take action on his or her suicidal ideas. In fact, the help you offer may save someone’s life. The American Foundation for Suicide Prevention states that between 50 and 75 percent of people who are planning to kill themselves tell someone close to them about their intentions. By stepping in to intervene, you could prevent suicidal ideas from turning into a suicide attempt.
If you’re the one who’s feeling despondent about the future, you may have run out of hope. Addiction combined with depression, stressful life events or serious losses might persuade you there’s no point to trying for a better life. If you’ve been through rehab before, you may feel that you’re doomed to fail again. Addiction treatment professionals can get you started on the process of healing by helping you overcome the disease of chemical dependency while addressing the underlying factors behind your self-destructive impulses.
Inpatient drug or alcohol rehab is often recommended for individuals with advanced suicidal ideation. In a structured, supportive environment, you can get the medical care you need as you detox from drugs and begin the first phases of rehabilitation.
Your treatment team may recommend that you participate in an intensive rehab plan that includes the following components:
- Individual therapy to help you learn positive, life-affirming behaviors
- Group therapy with your peers to give you a sense of strength and hope
- Dual diagnosis treatment for mental health disorders like depression, bipolar disorder or borderline personality disorder
- Family counseling to build healthier relationships
- Behavioral modification classes to teach you the skills you need to face life’s triggers and temptations
- Medication therapy to help you fight cravings for drugs or alcohol
- Holistic therapies like massage or acupuncture to complement your comprehensive treatment program
Teaching you how to create a life that’s worth living is one of the most important goals of rehab. In this sense, suicide prevention is at the heart of any successful recovery program. At Axis, we give you the support you need to find a sense of purpose, restore your self-esteem and regain the desire to lead a rewarding life. Our confidential hotline offers a vital source of help 24 hours a day, seven days a week. When you’re ready to take that first step toward recovery, we’re here to get you started.