Despite the advancements being made to deepen the conversation about mental health and remove the stigma applied to those with mental illness, the topic of suicide is still avoided by many and considered socially taboo. Suicidal ideation is widely considered a result of mental illness or, in the absence of existing illness, attributed to acute or repetitive trauma. However, some individuals may have an inherent disposition to suicidal ideation that begins as early as childhood or develops independently of any mental illness. Indeed, suicide and suicidal ideation has been examined by philosophers for centuries, yet little has changed in the way society views this condition. This calls for a reassessment of the way we look at, talk about, and treat suicidal ideation.

By examining essentialist causes of suicidal ideation, treatment can expand beyond the medical-only model of treatment through sometimes unnecessary medication that may, in fact, exacerbate the condition. Understanding that suicidal ideation is a natural human condition can open a dialogue that can be ultimately beneficial in helping those who struggle with these thoughts. This greater understanding can serve to remove stigma surrounding suicidal ideation, creating a more compassionate environment with strong support systems, which will not only serve those who feel isolated by the content of their own thoughts, but help anyone, regardless of their difficulties, understand they are not alone.

Clinical care for suicidal ideation often follows the guidelines for other mental health disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard by which psychiatrists are meant to diagnose mental illness and offers suggestions for treatment. In their review of suicidal ideation in the DSM, Rutgers University researchers Fehling and Selby point out, “In the DSM-5 and earlier versions of the manual, suicide is conceptualized primarily as a specific symptom of Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD), or as a possible negative consequence of other psychiatric diagnoses” (Fehling and Selby par. 3). This convention of treatment has penetrated the common consciousness, where the average armchair psychiatrist would attribute suicidal ideation to these mental illnesses – and with good cause: the DSM is the industry standard.

While the DSM does set a clinical standard, the diagnosis criteria for mental illness and suicidal ideation varies across fields and the use of nomenclature is just as broad. In the article Suicide, Suicide Attempts, and Suicidal Ideation, researchers from the University of British Columbia point out the differences in terminology between mental health professionals, schools, and the legal system. They note that, “Such diversity impedes the ability to combine knowledge from disparate studies and publications and limits the advancement of suicide knowledge and prevention” (Klonsky, et al par. 8). Their examples include the variance between “simple one- to two-item screenings [e.g., “Did you ever seriously consider suicide?] to full assessments that capture frequency, severity, planning, communication, and intent” (par. 9). These seemingly inconsequential inconsistencies point out only some of the flaws of diagnosing and treating suicidal ideation as a mental illness. Unless suicidal ideation is treated as an independent disorder, there will continue to be individuals who are misdiagnosed, mistreated, and medicated incorrectly, which can exacerbate their condition. Additionally, in the eyes of the law, suicidal ideation is often met with confrontation by law enforcement and mandatory seventy-two-hour holds in a psychiatric facility. This can often lead to a worsening of symptoms, mistreatment by medical staff and, at worst, death of the already suffering individual at the hands of police officers who are not qualified to deal with mental health conditions.

Aside from mental illness, suicide and suicidal ideation is often attributed to acute or repetitive trauma. In the study, Types and Number of Traumas Associated with Suicidal Ideation and Suicide Attempts in PTSD, the researchers from the University of Regina correlate trauma to rates of suicidal ideation, with some of the most common causes being physical and sexual assault, exposure to war, stalking, and illness (LeBouthillier). While this does demonstrate a positive correlation between trauma and suicidal ideation, there are outliers in the data that report no trauma. The study also only points out the increase in rates when associated with PTSD but doesn’t account for the many individuals who suffer trauma and are not consequently suicidal.

Considering the shortcomings of diagnosis and treatment of suicidal ideation, there are grounds to establish independent diagnostic criteria. In fact, the American Psychiatric Association has identified Suicidal Behavioral Disorder as a “condition for further study” for inclusion in a future edition of the DSM (Fehling and Selby par. 3). This could be a major step forward in considering suicidal ideation as independent from or comorbid to mental illness or PTSD.

Clancy Martin, a philosophy professor who specializes in suicidal ideation, writes extensively on the inherent desire to end one’s life, even in children. He proposes that this way of thinking be treated more like addiction than by clinical means. He writes, “Wanting to kill yourself is like an extreme version of the relief you find after drinking a few glasses of wine…And in fact this theory is really just and elaboration of the Buddha’s idea that the desire for self-annihilation is among our most basic forms of suffering, or Freud’s idea that the desire for life and the desire for death are two sides of the same coin” (Martin 53). Addiction is a common affliction and is often treated far more gently than suicidal ideation. After all, what laws have been enacted to imprison and addict for simply thinking about their addiction?

Martin’s supposition that individuals are predisposed to suicidal thinking is backed up by some empirical evidence. In an aggregate study of suicidal ideation in adolescents, Dr. Marie-Claude Geoffroy and her team at the Douglas Research Center find several children under the age of twelve dealing with suicidal thinking. They concluded that “The prevalence of suicidal ideation was higher in studies that included child-reported outcomes (10.9% for child only and 10.4% for child and parent combined) than for parent-only reported outcomes (4.7%)” (Geoffroy, et al). Those holding the common belief that suicidal ideation is the result of mental illness would likely be surprised to learn that over ten percent of children under the age of twelve also struggle with these thoughts. These figures also highlight the suggestion that even children are aware of the stigma surrounding suicide, as the child-only reported figures are more than double of the parent-only reported figures. This leads to the assumption that over half of children impacted by suicidal ideation are not comfortable sharing their struggles with their parents, which can lead to an increase in the severity of their negative thoughts.

Suicidal ideation is not a modern phenomenon and has been weighed on by philosophers for millennia. Both Plato and Aristotle wrote about suicide, generally concluding that it was cowardly and illicit. Though Plato did make exceptions for the corrupted mind and extreme personal misfortune. Other philosophers, such as the Stoics, found suicide to be acceptable as a human right of autonomy. The Stanford Encyclopedia of Philosophy compares these viewpoints: “To contemporary readers, the most striking feature of Plato’s and Aristotle’s texts on suicide is their relative absence of concern for individual well-being or rights. Both limit the justifications for suicide largely to considerations about an individual’s social roles and obligations. In contrast, the Stoics held that whenever the means to living a naturally flourishing life are not available to us, suicide may be justified, regardless of the character or virtue of the individual in question” (par. 18).

Much of the modern stigma surrounding suicidal ideation as shameful comes from Christianity. Saint Augustine of Hippo, an early theologian who was influential in the development of Western Christianity wrote, “It is not without significance, that in no passage of the holy canonical books there can be found either divine precept or permission to take away our own life, whether for the sake of entering on the enjoyment of immortality, or of shunning, or ridding ourselves of anything whatever. Nay, the law, rightly interpreted, even prohibits suicide, where it says, ‘You shall not kill’” (Augustine 20). This belief continues today in modern Christianity and, by proxy, Western society. However, this dogmatic approach, as opposed to even that of Plato, leaves no room for exceptions and deepens the divide between those with suicidal ideation and those who may judge them. Like those who are shamed by Christian morality for deviation from cis-gender heteronormality, those who consider suicide are often cast out by those who would otherwise proselytize on the compassion of their religion. The result being the decrease in the likelihood that an individual would seek help when struggling with suicide.

It’s through reexamining this bias that we can seek a better alternative than isolation or medication. True compassion is hearing the suicidal individual and offering support. Not through toxic positivity with statements like, “You have so much to live for,” or, “Others have it so much worse,” or, “Think about how that will hurt others,” but by acknowledgement that these thoughts exist and it does not make someone bad or less of a person by having them. These thoughts may never cease, regardless of treatment, but adding shame will not increase an individual’s desire to live, nor will it diminish the addictive pattern of thought.

An increase in community support, however, has been shown both anecdotally and through research to help those struggling with suicidal ideation. The Papageno Effect is a recent term coined to demonstrate that the presentation of healthy alternatives to suicide to be beneficial to sufferers. It’s named after the character Papageno from Mozart’s opera, The Magic Flute, wherein the character is considering ending his life until he is offered compassion by others. In contrast, the Werther effect, named after the novel, The Sorrows of Young Werther, is a term that indicates the likelihood of an increase in suicide modeling as a result of a negative media portrayal (Domaradzki par. 2-4).

Recent research, too, shows that an increase in real and perceived support can help with suicidal ideation and the surrounding feelings of isolation. In a study of adolescents, aged twelve to eighteen, Dr. Adam Bryant Miller and his cohorts from the UNC School of Medicine found, “Results from the linear regression analysis revealed that perceptions of lower school support independently predicted greater severity of SI, accounting for parent and close friend support. Further, the relationship between lower perceived school support and SI was the strongest among those who perceived lower versus higher parental support” (Miller, et al, par. 3). Independent of any mental health treatment, those who believe they have a support system they can access with their thoughts of suicide were less likely to have a suicide attempt and reported lower severity in their thoughts of suicide.

It is important to our personal and societal development to continually reassess our beliefs, both moral and scientific. Suicide is sometimes referred to as an epidemic, albeit one that is not studied as comprehensively as a virus might be. By relinquishing the moral high-ground in favor of compassion and support, we may help alleviate the suffering of those who deal with these harmful thoughts. Acceptance of suicidal ideation as a common and natural occurance can lead to more innovative ways to look at and address this issue in a safer way. Likewise, by revising the way that suicidal ideation is dealt with on a clinical level, better treatments may become available. The first thing that needs to change is how we view suicidal ideation, not as a disease or moral failing, but as a part of the human condition. By taking this first step on an individual level, we can enact change in our communities and for the sake of all people.

Works Cited

Augustine, Aurelius. “City of God”, Rev. Marcus Dods (trans.), T&T Clark, Edinburgh, 1871. https://www.gutenberg.org/files/45304/45304-h/45304-h.htm, Accessed 24 April, 2025.

Domaradzki, Jan. “The Werther Effect, The Papageno Effect or No Effect? A Literature Review”, International Journal of Environmental Research and Public Health, March 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC7967741/, Accessed 24 April, 2025.

Fehling, Kara B, and Edward A Selby. “Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements.” Frontiers in psychiatry vol. 1, 4 Feb. 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC7891495/, Accessed 24 April, 2025.

Geoffroy, Marie-Claude PhD, et al. “Prevalence of Suicidal Ideation and Self-harm Behaviors in Children Aged 12 Years and Younger: a Systematic Review and Meta-analysis”, The Lancet Psychiatry, vol. 9 issue 9, Sept 2022. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00193-6/abstract, Accessed 24 April, 2025.

Klonsky, E. David, et al. “Suicide, Suicide Attempts, and Suicidal Ideation”, Annual Review of Clinical Psychology, vol. 12, March 2016. https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-021815-093204, Accessed 24 April, 2025.

LeBouthillier, Daniel M., et al. “Types and Number of Traumas Associated With Suicidal Ideation and Suicide Attempts in PTSD: Findings From a U.S. Nationally Representative Sample”, Journal of Traumatic Stress, vol. 28, issue 3, June 2015. https://onlinelibrary.wiley.com/doi/abs/10.1002/jts.22010, Accessed 24 April, 2025.

Martin, Clancy. “How Not to Kill Yourself”, Vintage Books, 2023.

Miller, Adam Bryant, et al. “Role of Social Support in Adolescent Suicidal Ideation and Suicide Attempts”, Journal of Adolescent Health, vol. 56 issue 3, March 2015. https://www.sciencedirect.com/science/article/abs/pii/S1054139X14006946, Accessed 24 April, 2025.