On World Suicide Prevention Day, our Chief Clinical Officer Sarah Bateup shares some information on suicidal ideation and what it means if you have thoughts about dying. If you're in crisis and require urgent support, please dial 999 or go to your nearest A&E. Alternatively, you can speak to The Samaritans in confidence 24 hours a day, 365 days a year. Call 116 123 for free.

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"There’s a reason so many pop songs are about heartbreak or loss: it’s something we all experience at one time or another. It’s likely that a few people reading this blog have memories of singing along to The Smiths’ How Soon Is Now? in the throes of teenage angst, feeling that the line “and you go home, and you cry and you want to die…” was written especially for them!

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When something horrible, sad or stressful happens, or we’re in a particularly low mood, it’s not uncommon to wish we simply weren’t here anymore, or to feel we’d be better off if we just didn’t wake up one morning.

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Thoughts like these can be disturbing and worrying – but there’s a really big difference between thinking about dying or killing yourself, and actually being suicidal. We call this type of thought ‘suicidal ideation’. Active suicidal ideation, on the other hand, is when someone has the intention to take their own life; they’ve made a plan, and they mean to carry it out.

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Suicidal ideation is a typical feature of many mental health or mood disorders, such as anxiety or depression, but it can happen to anybody at any time.

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It might be triggered by the ending of a relationship or a bereavement, when you don’t know how you’re going to cope without the person you loved, and feel that you don’t really want to go on without them. Destabilising life events such as redundancy or a diagnosis of illness might also leave you wondering what the point of your life is now.

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The thoughts associated with suicidal ideation can come in various different forms. You might simply wish that you were dead, for example, or perhaps fantasise about steering the car into a tree when you’re driving. Many thoughts like these are fleeting, but for some people they’re a constant hum in the background as they go about their day.

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It can be scary to have these thoughts, and it’s easy to end up ruminating on and worrying about them. The important thing to remember is that thinking about dying or taking your own life doesn’t mean you’re at risk of harming yourself. Nor is it anything to be ashamed of – you’re not ‘dark’ or twisted, and you’re certainly not being melodramatic!

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Passive suicidal ideation is actually a normal part of the process of coming to terms with something sad, unsettling or difficult, or when you’re at a low ebb. The fact is, we don’t like having to face unpleasant emotions such as fear, loss, loneliness or anxiety, and our response to these feelings when they come is to want to pull away from or avoid them. Our brains look for a solution – how to stop the awful feeling – and not being alive any more is one way of escaping. It’s not a helpful idea to have pop into our head, but it’s perfectly natural.

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Thoughts about dying or killing yourself tend to go away on their own. Sometimes they persist, however, and this can be distressing and exhausting. Talking about them with someone can often help – they become less frightening when they’re brought out into the light of day and examined. Cognitive behavioural therapy (CBT) is also an effective way of learning to manage thoughts like these, particularly if you have anxiety or depression." Sarah Bateup, Chief Clinical Officer, ieso