Suicidal ideation history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Overview
The most common symptoms of suicidal ideation disorders are: Talking about no reason to live, wanting to be left alone, forming a plan for the suicide attempt, changes in eating or sleeping, preoccupation with death/ dying, getting affairs in order- making a will or giving away possessions.
History and Symptoms
- Talking about having no reason to live
- Forming a plan for the suicide attempt
- Wanting to be left alone
- Violent or rebellious behaviors
- Running away
- Difficulty concentrating
- Hopelessness
- Depression
- Despair
- Paranoia
- Delusions
- Psychosis
- No hope for the future
- The belief that nothing will get better
- Changes in eating or sleeping patterns
- Seeking out lethal means to end their life
- Preoccupation with death or dying
- Getting affairs in order – making a will, giving away treasured possessions
- Saying goodbye to loved ones
- Acting recklessly
- Previous suicide attempts
- Psycho motor agitation
- Insomnia
- Dramatic mood swings
- Anger
- Anxiety
- Sudden change to extreme happiness
- Talking about wanting to die
- Anhedonia
- Hallucinations
- Vague somatic physical symptoms
- Decline in work or scholastic performance
- Withdrawing from once-pleasurable feelings
- Sudden and extreme personality changes
- Sudden sense of calm
- Increased usage of alcohol or drugs
- Worsening of emotional health
- Neglecting personal appearance
- Panic attacks
- Angst
- Extreme remorse
- Alteration in sleeping or eating habits
- Residual scars from previous attempts or injuries
Evaluation of a patient with suicidal ideation
| New patients |
| Ask about a history of psychiatric illness and substance abuse; if present, ask about a history of suicidal ideas and attempts. |
| Using the CAGE questionnaire, screen for alcohol abuse. |
| Perform a mental status examination, with emphasis on mood, affect and judgment. |
| New and established patients with evidence of major depression, substance abuse, anxiety disorder or a recent stressor |
| Ask about suicidal ideation and furtherance of plans (including access to lethal means). |
| Identify symptoms associated with suicide |
| Review risk factors associated with suicide |
| Interview family or significant other, if indicated. |
| Synthesize and formulate a treatment plan. |
| Questions to ask to patients with suicidal ideation |
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| Delineate extent of suicidal ideation |
| When did you begin to have suicidal thoughts? |
| How often do you think about suicide? Do you feel as if you're a burden? Or that life isn't worth living? |
| Did any event (stressor) precipitate the suicidal thoughts? |
| Do you have any stressors |
| What makes you feel better |
| What makes you feel worse |
| Do you have a plan to end your life? |
| What stops you from killing yourself (e.g., family, religious beliefs)? |
| Do you have access to fire arms |
| Have you changed your will or life insurance policy or given away your possessions? |