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]

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 Psychomotor 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

Questions to ask to patients with suicidal ideation
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?