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Suicide is a heavy topic that no one likes to talk about. However, it’s a serious, devastating occurrence with a far-reaching effect.
According to a fact sheet from the American Foundation for Suicide Prevention, 12 million Americans had suicidal thoughts, and about 1.4 million tried to carry out those suicidal ideations. Among those whose deaths resulted from suicide, men were 3.63 times more likely than women to end their lives. Women, however, attempted suicide 1.66 times more than men. Tragically, in 90 percent of the suicide deaths, the individuals had a diagnosable mental health disorder or condition.
Individuals with psychiatric disorders, particularly bipolar disorder, depression, schizophrenia, post-traumatic stress disorder (PTSD), and substance abuse, are at higher risk of suicide. So, too, are those with anxiety disorders, especially severe anxiety. Veterans and military personnel, members of the LGBTQ community, and white men ages 44-64 and 85 and older are also more impacted by suicide.
When considering therapies that address suicidal thoughts, it’s important to recognize that there’s no single approach that’s universally effective. Below, we explore five therapies that address suicidal thoughts.
Cognitive Behavioral Therapy (CBT)
Explanation of CBT and Its Foundational Principles
CBT is a form of psychotherapy that helps individuals understand how their thoughts, feelings and experiences influence their behaviors. Because this goal-oriented therapy addresses the underlying causes of a behavior, rather than the symptoms of a behavior, it’s commonly used to treat anxiety, depression, and phobias.
Some foundational principles of CBT include:
- Identifying and challenging unhelpful or negative thought patterns
- Learning more constructive ways of thinking
- Practicing new skills in real-life scenarios
How CBT Addresses Negative Thought Patterns Contributing to Suicidal Ideation
Cognitive-behavioral therapy for suicide prevention (CT-SP) has shown impressive results in reducing suicidal thoughts and repeat suicide attempts, reducing depressive symptoms, and increasing hope. A primary treatment focus is reducing suicide risk factors and increasing coping skills.
Central to the therapy is the tenet that the individual will continue to have stressors and problems, but armed with effective coping skills, they’ll no longer be automatically triggered to suicidal behavior. This form of suicidal therapy includes a strategy for relapse prevention and making use of a hope kit to help prevent subsequent suicidal behavior.
Key Techniques Used in CBT
Therapists using CBT guide individuals through a range of techniques to help them change and manage their thoughts and behaviors. This often includes:
- Cognitive Reframing: This technique involves challenging distorted or negative thoughts and replacing them with more balanced thoughts.
- Behavioral Activation: This encourages individuals to participate in hobbies and activities they enjoy, helping them improve their moods and avoid negative thinking.
- Activity Scheduling: This involves creating a daily schedule, helping the individual become more productive and experience a sense of accomplishment.
- Mindfulness Techniques: Deep breathing, meditation and muscle relaxation exercises help with stress management.
- Journaling: Keeping a record of thoughts and moods, including the situations that trigger suicidal thoughts, help individuals and their therapists identify and address patterns.
Dialectical Behavior Therapy (DBT)
Introduction to DBT and Its Origins
DBT is a form of CBT that was designed to treat those exhibiting chronic suicidal behavior. It combines the core principles of CBT with coping strategies such as mindful awareness, distress tolerance, and acceptance. Rather than suppressing intense emotions or uncomfortable thoughts, individuals observe these as casual observers. They learn to accept themselves and their situations while also working toward addressing and changing harmful thoughts, including suicidal ideations.
Benefits for Individuals Experiencing Suicidal Thoughts
For someone experiencing chronic suicidal thoughts, dialectical behavior therapy (DBT) is an effective therapy to reduce suicidal attempts and ideation. Individuals suffering from borderline personality disorder, for example, not only need therapy for suicidal ideation that can help ensure their safety, but they also need to learn new skills and access resources that can lessen their fixation with suicide.
Chronic suicidality isn’t something that a person can tell themselves to stop thinking about. However, they can learn how to better respond to the thoughts that come to them. That’s where DBT can help. This type of therapy has been described as CBT that’s combined with Zen Buddhist principles.
Psychodynamic Therapy
Overview of Psychodynamic Therapy and Its Focus on Underlying Psychological Issues
Psychodynamic therapy is a form of talk therapy that focuses on identifying the deep-seated emotions and unresolved conflicts that affect a person’s thoughts, feelings and behaviors.
For those experiencing suicidal thoughts, a therapist may use this modality to explore past traumas, unresolved grief and feelings of worthlessness. Although these emotions and experiences may not be immediately apparent during moments of suicidal thoughts, they may contribute to the underlying emotional pain that acts as a trigger.
During therapy sessions, the therapist guides the patient in examining their past and present relationships and personal experiences. This helps the individual gain a better understanding of themselves, which may lead to developing more constructive coping mechanisms and a reduction in suicidal thoughts.
Techniques Used to Explore Unresolved Conflicts and Subconscious Influences
Psychodynamic therapy incorporates a range of techniques to help the individual explore unresolved conflicts and grief and subconscious influences. These may include:
- Free Association: This technique involves the individual talking about whatever comes to mind, letting the therapist identify common themes and perceptions.
- Dream Analysis: With this technique, the therapist helps the patient analyze their dreams to reveal subconscious thoughts and conflicts.
- Exploration of Early Experiences: The therapist and individual explore the individual’s early relationships and examine how they may shape current thoughts and behaviors.
- Resistance Analysis: The therapist pinpoints the topics and emotions the individual avoids talking about, looking for indicators of unresolved conflicts or painful memories.
Interpersonal Therapy (IPT)
Explanation of IPT’s Focus on Social and Relational Aspects
IPT is a structured form of therapy that focuses on improving an individual’s relationships and the way they function in social settings. While this modality was originally developed to treat depression, it’s been adapted to other mental health conditions and may help individuals reduce suicidal thoughts.
IPT operates on the idea that interpersonal relationships and social factors contribute heavily to mental distress, including thoughts of suicide. It explores four main areas, including:
- Interpersonal conflicts
- Changes in life roles
- Grief and loss
- Social isolation or difficulties in forming and maintaining relationships
How Improving Relationships Can Reduce Suicidal Thoughts
As individuals improve their relationships and become more confident in social interactions, they often experience a decrease in suicidal thoughts. IPT helps patients build stronger support systems, learn to effectively resolve conflicts, adapt to changes in life roles, and develop healthy communication strategies. These provide a boost in self-esteem and self-worth and give individuals access to emotional support and practical help during difficult times. This connectedness serves as a key protective factor against suicide and often reduces suicidal ideation.
Medication-Assisted Therapy
Description of How Medication Supports Therapeutic Interventions
For many individuals, medication-assisted therapy plays a vital role in treating suicidal thoughts. This therapy can be combined with talk therapy to help with managing mental health issues that contribute to thoughts of suicide.
Types of Medications Often Prescribed
The types of medications used depend on the mental health condition and may include:
- Antidepressants
- Mood stabilizers
- Antipsychotics
- Anxiolytics
Alternative and Emerging Therapies
Although not a primary intervention for reducing suicidal thoughts, physical activity, yoga, meditation, and mindfulness are proven therapies that help individuals with depression and other mental health disorders cope with recurring or chronic suicidal ideation and behaviors. As such, these therapies should be utilized as adjunctive approaches, with counseling and other psychiatric modalities the main interventions.
Conclusion
While there’s no one-size-fits-all approach to treating suicidal ideation, there are numerous effective therapies that help individuals address the conditions, traumas and circumstances that contribute to unwanted thoughts.
If you are experiencing suicidal thoughts, have recently thought about suicide, talked about it, or are currently thinking about suicide, this isn’t an issue to tackle on your own. Please seek immediate help by calling 911, a local emergency phone number or crisis hotline, or the National Suicide Prevention Lifeline (800-273-8255).
At FHE Health, we have counselors who can help you deal with mental health issues and suicidal thoughts. Counseling for suicidal thoughts is an important part of treatment for depression, bipolar disorder, PTSD, substance abuse, eating disorders, and schizophrenia. Suicide is preventable. Contact FHE Health to get help today.
