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Suicidal Ideation Treatment: From Therapy to Lifestyle Changes

By: Serena Tanner • Edited by: Alyssa Hill • Subject Matter Expert Reviewed by: Brindusa Vanta, MD • 10 cited sources • Updated Oct 29, 2024

Suicidal ideation may be a painful—even debilitating—thing to experience or realize that a loved one is going through. You may feel like you’re out of control or that there’s no hope of relieving the pain. However, recovery is possible, especially if you reach out for help. Many treatments exist to help alleviate suicidal ideation and regain control of your life.

Key Takeaways

• Suicidal ideation means thinking about suicide.
• Suicidal ideation can be passive or active.
• Suicidal ideation treatment often includes a combination of talk therapy, medication, and lifestyle changes.

What Is Suicidal Ideation?

Suicidal ideation is the act of passively or actively thinking about suicide^[1]. Someone struggling with passive suicidal ideation may not feel motivated to live, but they have no plans to end their life. Active suicidal ideation refers to having a plan to take one’s life and a means to carry it out.

People with mental health conditions may be more prone to suicidal ideation. Other factors that can increase risk include:

• Chronic or ongoing pain
• Significant stress
• Family history of suicide
• Past abuse or trauma
• Losing a loved one recently
• Excessive alcohol or drug use

These thoughts don’t define you or guarantee that you’ll harm yourself in the future. You can take steps to seek help and recover.

What Treatments Are Available For People at Risk for Suicide?

People at risk of suicide have access to several treatment and therapy options that can help. For example, talk therapies may be paired with medication or inpatient treatment. Early intervention usually leads to more effective treatment, especially with a personalized plan in place.

In addition to psychotherapy and medication, alternative therapies have been evaluated for suicidal ideation. For example, transcranial magnetic stimulation (TMS), a non-invasive method that utilizes magnetic fields, shows potential to manage various mental health issues, including depression and suicidal thoughts.

Dr. Brindusa Vanta, MD

Psychotherapy Can Help Manage Suicidal Thoughts

Therapy for suicidal thoughts often provides valuable coping mechanisms and assists in behavioral changes that can reduce the risk of suicide^[2].

Cognitive Behavioral Therapy (CBT)

Under the CBT model, suicidal ideation refers to a problematic coping mechanism rather than a symptom of a mental health disorder. Therapists use specific CBT strategies to help individuals recognize the cause of their suicidal thoughts and cope with them, potentially preventing suicidal crises. These strategies include:

• Regularly monitoring and changing activities to encourage actions that improve life
• Challenging and restructuring automatic thoughts to improve mindset
• Improving decision-making by considering the pros and cons
• Creating and using reminders of helpful strategies when in a crisis

Dialectical Behavior Therapy (DBT)

In individuals with borderline personality disorder who think about suicide, DBT can lower suicide attempts by half compared to non-behavioral therapy, according to a research study^[3]. Rather than targeting an underlying disorder, such as depression, DBT specifically focuses on suicidal thoughts and behaviors. This typically involves tracking and identifying the causes of suicidal thoughts and finding solutions. 

In addition, DBT implements regular skills-based solutions to reduce short-term and long-term suicide risk. DBT acknowledges suicide as an attempt to solve an intense, emotional problem that you might feel unable to change. By creating alternate solutions and building skills, it’s possible to regulate those feelings of helplessness and regain control. 

Interpersonal Therapy (IPT)

IPT is effective in treating suicidal ideation, especially if the ideation is connected to depression^[4]. This short-term form of psychotherapy, typically lasting 12-16 weeks, aims to enhance interpersonal functioning to reduce or relieve symptoms^[5]. With learned coping strategies, relationships can improve, which in turn tends to alleviate symptoms that influence suicidal ideation.

Family Therapy

In many cases, family therapy takes the form of Attachment-Based Family Therapy (ABFT), which seeks to involve family members in treatment in order to improve the individual’s support system. It’s rooted in the basis that family attachment is fundamental for a positive sense of self. It can also be an invaluable resource for family members to learn about suicide prevention. 

Medications May Help Reduce Suicidal Feelings

Some medications, such as antidepressants and antipsychotics, can assist in reducing suicidal ideation. These medications work by improving the underlying mental health conditions commonly linked to an increased suicide risk. However, individuals undergoing medication management for suicidal ideation should be monitored carefully by healthcare providers. In some cases, these medications can increase the risk of suicide^[6].

Researchers found that ketamine, an anesthetic drug, also works as a rapid-acting antidepressant in treatment-resistant depression and suicidal ideation. A much lower dose of ketamine is given for depression compared to the dose necessary for anesthesia.

Dr. Brindusa Vanta, MD

Lifestyle Changes That Can Support Mental Health

While it’s important to seek professional treatment if you’re experiencing suicidal ideation, certain lifestyle changes can help you improve your mental health.

Regular Exercise and Maintaining a Healthy Diet

Regular physical activity is known to reduce stress, improve mood, and promote overall well-being. It can reduce symptoms of anxiety and depression and improve cognitive function^[7].

A healthy diet can also significantly impact your mood. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins improves gut flora health. The gut flora has many important functions, including serotonin production, a chemical associated with positive mood and well-being^[8]. 

Getting Enough Sleep Each Night

Your body needs adequate rest to regulate itself. When you don’t get enough sleep on a regular basis, you’re more likely to experience negative emotional responses, including suicidal ideation—particularly if you have been diagnosed with a mental health condition. Ideally, you should aim for 7-9 hours of sleep each night to support your mental health^[9].

Limiting Substance Use

Excessive drug and alcohol use can cause social isolation and interpersonal conflicts, increasing the risk of depression, anxiety, and suicidal behaviors^[10]. On top of that, it can actually worsen the symptoms of existing mental health disorders. 

Drugs and alcohol are also often used as self-medication. While it may dull the feelings in the moment, it can intensify the symptoms over time.

Joining Support Groups

Support groups and peer-led programs can also help with suicide prevention. These communities can be found locally and online, providing a supportive environment where members understand the feelings associated with suicidal thoughts. Gaining insight from shared experiences may help with coping.

Suicidal Ideation Can Be Managed

While suicidal ideation is serious, it’s also treatable. Even if you’re experiencing these thoughts now, there’s hope for a better tomorrow. Acknowledging the severity of the situation and reaching out for help is the first step in suicide and self-harm recovery. If you have a loved one who may be struggling with suicidal feelings, this understanding can assist you in helping them find and follow through with treatment.

Written by Serena Tanner

Serena Tanner attended the University of Washington, where she earned a degree in philosophy after many detours delving into human rights, law, psychology, and social work. Health and holistic wellness topics continue to hold a special place in her heart. When she's not reading or writing, she can be found exploring the Pacific Northwest with her two children and dogs.

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Edited by Alyssa Hill

Alyssa Hill is an experienced editor and health writer. She holds an M.A. in journalism from the University of Arizona and is also a certified somatic practitioner. A former content manager for multiple start-ups in the marketing and health/medical industries, Alyssa has extensive experience writing medically accurate and well-researched content, editing articles for clarity and SEO, adhering to strict guidelines, and ensuring all content is up to standards.

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Subject Matter Expert Brindusa Vanta, MD

Dr. Brindusa Vanta is a healthcare professional, researcher, and medical subject matter expert . She earned her MD degree from "Iuliu Hatieganu" University of Medicine, Romania. She has a special interest in mental health and has collaborated with psychologists and other mental health practitioners on various research projects focused on therapies to manage depression, age-related cognitive decline, trauma and stressor- related conditions.