Suicidal thoughts are a sign of emotional distress and are often caused by prolonged stress, unmanaged mental health conditions, or recent tragedy or loss.
It can be difficult to speak about suicidal thoughts, but talking with a mental health professional may reduce your risk of suicide.
If you’re having thoughts of death or suicide, make an appointment with a psychiatrist or other mental health professional. They can assess your risk and connect you with the right level of care.
If you’re having thoughts of suicide or death*, one of the best things you can do is confide in someone who can help you navigate these thoughts. This might be a psychiatric provider, therapist, or other qualified mental health professional. While it may feel uncomfortable to speak about something so personal, remember that psychiatric providers are trained to support and guide people through these exact moments.
*If you or a loved one is experiencing suicidal thoughts or thoughts about harming themself or others, please call or text 988 on any phone for the Suicide & Crisis lifeline, contact a local crisis line, or head to the emergency room immediately. Any of these resources will ensure that the person in crisis receives support right away. For more information on getting help, go to 988lifeline.org
Why it’s important to talk to a psychiatrist about suicidal thoughts
It can be difficult to admit when you're feeling hopeless or down — especially when these feelings lead to thoughts of suicide. But the truth is, you’re not alone. According to data from 2022, more than 13 million U.S. adults had serious thoughts of suicide in the past year.
People experience suicidal thoughts for many reasons. Some of the most common risk factors for suicide include prolonged stress, unmanaged mental health conditions, and recent tragedy or loss. If something in your life is causing you to think about suicide, it’s best to consult someone who can help.
It’s especially important to reach out for help if:
1. You’re finding it difficult to enjoy life
Does it seem like nothing brings you joy lately? If it feels difficult to find happiness or meaning in life, consider sharing those thoughts with someone who can help.
2. You’re experiencing active suicidal ideation
Suicidal thoughts can range in severity. On one end of the spectrum is passive suicidal ideation. This involves thoughts of death, like, “I wish I wasn’t here,” or, “It would be easier if I just disappeared.” With active suicidal ideation, on the other hand, a person has a plan for taking their life and intent to follow through.
3. You have an existing mental health condition
Thoughts of self-harm or suicide can be symptoms of unmanaged mental health conditions like social anxiety, depression, or obsessive-compulsive disorder (OCD). If you’re experiencing suicidal ideation, your psychiatric provider can adjust your treatment plan to help you manage distressing thoughts and feelings.
4. You feel like you have no other options
Suicidal thoughts often stem from deep emotional pain. Feeling like a failure or a burden to others can cause people to feel like they have no other options.
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How to tell your psychiatrist about suicidal thoughts
Not everyone who experiences suicidal thoughts wants to take their own life. Many people just want a way to stop feeling the way they do. If you’re unsure how to bring up the subject or ask for help, here are a few tips to start the conversation.
Prepare your thoughts in advance. You may find it helpful to write down some notes before your session. This includes the types of thoughts you’ve had, how often they happen, and what triggers them.
Keep it simple. If you're not sure where to start, keep it simple. For example, you could say, “Lately I’ve been feeling like I don’t want to be here anymore,” or, “I’ve been having thoughts about dying, and I’m not sure what to do.”
Be honest about your experience. It's important to be honest with your psychiatric provider, even if it makes you feel scared or vulnerable. Glossing over your feelings or skipping important information may prevent you from getting the right type of care.
Consider your goals. What do you hope to gain from the conversation? Are you looking to discover the root cause of your thoughts or to seek crisis intervention services?
What happens when you tell a psychiatrist about suicidal thoughts
After opening up to your psychiatric provider, they’ll likely ask some follow-up questions to assess your current situation.
This might include questions like:
“How often do you have suicidal thoughts?”
“Do you have a plan to take your own life?”
“Have you ever tried to harm yourself?”
From there, next steps depend on the severity of your thoughts and symptoms. Your psychiatric provider may suggest medication, talk therapy, or self-care strategies to reduce stress. Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are both helpful approaches for managing self-harm behaviors and suicidal thoughts.
Your psychiatrist might also encourage you to create a mental health safety plan. This is a personalized resource that people can use to navigate emergency situations, like active suicidal ideation. This safety plan will look different for everyone but typically includes warning signs, coping strategies, contact information for your mental health provider(s) and the people in your support network.
It should also include crisis support lines like:
988 Suicide & Crisis Lifeline: Call or text 988
Crisis Text Line: Text HOME to 741741
Will your conversation be confidential?
Psychiatrists, psychiatric mental health nurse practitioners (PMHNPs), and other healthcare providers are bound by patient privacy laws. This means whatever you discuss during your sessions will remain confidential. That said, there are a few exceptions to this rule.
Psychiatric providers can report patient conversations if that person is at serious risk (meaning they have a plan, intent, and means) of harming themself or others. This isn’t to get anyone in trouble. Rather, the goal is to connect you with the right resources to improve your health and well-being.
Can a psychiatrist involuntarily commit you?
If your suicidal thoughts are considered a mental health emergency, your psychiatric provider might consider involuntary commitment. This is a legal process designed to help people access mental health services, even when they don’t want care or think they need it.
While this may sound scary or like a violation of your rights, the goal is to help people become safe and stable enough to resume their daily life. Civil commitment criteria vary by state, but this typically happens when your symptoms pose an immediate health and safety threat or prevent you from attending to your basic personal needs.
For example, you may be admitted to an acute psychiatric care facility. There, you’ll work with a team of providers to stabilize your mental health and transition to a long-term treatment plan for your symptoms, needs, and goals.
When someone shares suicidal thoughts, as providers, it’s our responsibility to make sure they’re safe. We may ask clarifying/detailed questions, create a safety plan, or escalate it to hospitalization if necessary.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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Suicidal thoughts are often a sign that someone is having a hard time coping with challenging situations or emotions. If this sounds familiar, know that speaking with a psychiatrist can help you work through your thoughts and find happiness and fulfillment.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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