By Mansi (@MansiSolanki)

Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Over the course of your life, if you experience mental health problems, your thinking, mood, and behavior could be affected. Many factors contribute to mental health problems, including:

Biological factors, such as genes or brain chemistry

Life experiences, such as trauma or abuse

Family history of mental health problems

And obviously with bad mental health comes bad thoughts,what we just read and one of the most frequent being suicide ideation.

Suicide is a major public health concern. Suicide is among the leading causes of death in many countries. Based on recent nationwide surveys, suicide in some populations is on the rise.

Suicide is defined as death caused by self-directed injurious behavior with intent to die as a result of the behavior.

A suicide attempt is a non-fatal, self-directed, potentially injurious behavior with intent to die as a result of the behavior. A suicide attempt might not result in injury.

Suicidal ideation refers to thinking about, considering, or planning suicide.

Here I am not going to tell you about suicide, rather I am going to tell you about suicide ideation.

Suicidal thoughts, also known as suicidal ideation, are thoughts about how to kill oneself, which can range from a detailed plan to a fleeting consideration and does not include the final act of killing oneself.

The majority of people who experience suicidal ideation do not carry it through. Some may, however, make suicide attempts. Some suicidal ideations can be deliberately planned to fail or be discovered, while others might be carefully planned to succeed.

Fast facts on suicidal thoughts

Here are some key points about suicidal thoughts.

The vast majority of people with suicidal thoughts do not attempt suicide.

Nearly all completed suicides are among individuals with mental illness

Causes of suicidal thoughts can include , and substance abuse

People with a family history of mental illness are more likely to have suicidal thoughts

People who own guns are more likely to complete suicide

Suicidal thoughts are preventable and there is plenty of help available .

Symptoms of suicidal thoughts

There are a number of signs and symptoms of suicidal thoughts; the list below contains some of the most common.

Common symptoms of suicidal thoughts include:

Appearing to feel trapped or hopeless

Appearing to have an abnormal preoccupation with violence, dying and/or death

Being in a heightened state of

Being very moody

Changing personality

Changing routine

Changing sleeping patterns

Consuming (more) drugs

Consuming more alcohol

Engaging in risky behavior, such as driving carelessly or taking drugs

Getting affairs in order

Getting hold of a gun, medications, or substances that could end a life

Giving stuff away

Having depression

Having

Impaired concentration

Increased self-criticism

Isolating oneself

Psychomotor agitation - such as pacing around a room, wringing one's hands, taking off clothing and putting it back on, and other such actions

Saying goodbye to others as if it were the last time

Seeming to be unable to experience pleasurable emotions from normally pleasurable life events such as eating, exercise, social interaction or sex

Seeming to have severe remorse

Talking about killing oneself, expressing regret about being alive or ever having been born.

A significant number of people with suicidal ideation keep their thoughts and feelings a secret and appear to show no apparent signs.

Now don't think these are the only thoughts that come with bad mental health but there are other thoughts which accompany the suicidal thoughts.

Some of those may be:

• I want to escape my suffering.

• I have no other options.

• I hate my life.

• No one understand me.

• I am a horrible person and do not deserve to live.

• I have betrayed my loved ones.

• My loved ones would be better off without me.

• I want my loved ones to know how bad I am feeling.

• I want my loved ones to know how bad they have made me feel.

Prevention of suicidal thoughts

Bad mental health is the most common cause of suicidal ideation and completed suicide. A significant number of mental problems, such as depression, can be successfully treated with medications and talking therapies, such as (cognitive behavioral therapy) or counseling.

Individuals with a mental illness/problem should see their doctor and get treatment.

The following may help lower the risk of suicidal ideation and suicide attempts:

Compliance - this means following your treatment plan, going to follow-up appointments, taking medications as instructed, etc.

Alcohol and illegal drugs - avoid them

Avoid isolation - try to stay connected to the outside world

Do exercise (swimming, running, soccer, etc.)

Eat a well-balanced, healthy diet

Family - involve your family in treatment, get their support. Ask them to come along to your sessions, health care professionals can help them acquire better coping and supportive skills

Focus on the good things in life (talking therapies may help you achieve this)

Get at least 7-8 hours continuous sleep every 24-hour period

Get treatment for a mental illness

Means of ending one's life - get rid of guns, knives and dangerous drugs.

Seek out things that give you pleasure, such as being with friends/family you like

Self help groups - sharing the anguish and anxieties that drive you towards suicidal ideation can be relieving and comforting. You will see how others got through it. If you can support other people you may feel better about yourself and those around you.

Findings from interviews with patients

This data is taken from and just been piled up here for your understanding and knowledge.

When patients were asked how they felt about being asked questions on suicidal ideation and behaviour, 38.6% stated that they did not mind being asked these questions – that they felt 'OK' or neutral about them. 26.7% stated that they were surprised at being asked such questions, and 25.7% reported feeling either upset, embarrassed or alarmed, or simply stated that they did not like being asked them.

'I felt terrible, it upsets me, but I want to tell the truth. Talking about it makes me think of it even more.'

'Felt ashamed because I'm letting myself down, and I'm embarrassed because I should be stronger. The questions get to you inside, because if you think of ending your life you have failed.'

When asked whether GPs ( general practitioners) should routinely screen people who were depressed about whether they had thoughts of trying to harm or kill themselves, 80.2% stated that they should, 4.0% stated that they should not, and the remaining 15.8% stated that they did not know .. People who thought GPs should screen for suicidal ideation said they should do so because it was important for people to have a chance to talk about their feelings, for the GP to get a complete picture of the person's mental health, and to identify people at risk of suicide.

'Because some people won't tell their friends and family but they might tell a doctor if they asked directly.'

'Yes, I felt when I was depressed in the past the GP didn't really have an understanding of how I felt.'

Those who thought that GPs should not ask such questions pointed to concerns about the impact this could have on people's mental health.

'If you don't have these ideas in your head it might give you ideas.'

'Doctors have a duty to support people, prolong life, not the other way, people might think they were suggesting that their time was up and it was time for them to go. I would be very suspicious if my doctor asked me this, why is he asking me this?'

Finally, patients were asked about how they felt GPs should ask such questions; respondents were equally divided between those who felt they should use a direct approach and those who felt that GPs should be careful about the language that they used and avoid terms such as 'suicide'.

'I think you shouldn't beat around the bush, just come out with it "have you thought about suicide?"'

'Better to ask it gently, like "would you ever think of taking your own life?" I don't like the word "suicide" and I don't think people should say the word when they are asking about it.'

'To say the word suicide in my Hindu religion is very shocking, it would be a very sinful thing to think about ... Be aware of religion before asking, be culturally sensitive.'

Conclusion

GPs and patients treated in primary care believe that people should be screened for suicidal ideation. However, an important minority of patients and GPs stated that asking or being asked such questions makes them feel uncomfortable. Research should be conducted to examine what effect, if any, screening for suicidal ideation has on mental health. In the absence of any clear evidence that screening is harmful, GPs and family doctors should assess the risk of suicide among vulnerable patients by finding out whether those with depression and other mental disorders have thoughts or plans to end their life. GPs should be trained to assess suicide risk as part of their general training in the assessment and treatment of mental disorders.