September 06, 2017

By Marta Manning, Ph.D.

If you or someone you know is experiencing a mental health, suicide or substance use crisis or emotional distress, reach out 24/7 to the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) by dialing or texting 988 or using chat services at to connect to a trained crisis counselor. You can also get crisis text support via the Crisis Text Line by texting NAMI to 741741.

I’ll never forget my mother two days after her suicide attempt. It was the beginning of winter and she had recently been diagnosed with bipolar disorder. After a stay in the ICU and two days of medication, she was just regaining some clarity when I spoke to her. She knew there was still a long road ahead, but at that moment, she was grateful to the people who saved her. She no longer understood why she wanted to take her life.

Several months before her attempt, my mother had shown many of the risk factors for suicide. I was 17 at the time, just starting college, and it felt as if the world was falling apart when her undiagnosed symptoms worsened: She developed various paranoid delusions that terrified her, her driving and spending became increasingly reckless, as did her uncontrollable rage. Later, she would tell us that she had thought about suicide for many months. She likened depression to being trapped inside a burning building.

With no earlier experience with mental illness or plan for how to handle psychiatric emergencies, our family had no idea what to do or where to turn. We didn’t know that suicidal thinking is usually an emergency that requires immediate treatment. If my mother had received care when her suicidal thinking first started, we could have averted a possible tragedy.

What Causes Suicidality?

Myths about suicide prevail despite advances in our understanding of mental illness. Many people see a suicide attempt as an intentional act or a destructive, conscious decision made by a rational evaluation of one’s options. But actually: Suicidal ideation is a symptom of mental illness. In fact: 90% of suicides are completed by people who live with mental illness. People experiencing depression, bipolar disorder, schizophrenia, schizoaffective disorder and borderline personality disorder experience suicide rates as high as 15-20%, although the risk varies depending on diagnosis.

Research suggests that suicidal behavior may be a reaction to the imbalance of various neurotransmitters, including serotonin, which leads to altered thinking patterns. In some cases, psychotic delusions can cause suicide attempts, as people seek escape from paranoia and frightening visions.

When we try to rationalize a person’s suicide—such as the tragic deaths of brilliant and successful people like Chris Cornell, Robin Williams and Chester Bennington—it often doesn’t make sense. But the truth is, mental illness doesn’t have to make sense. So instead of picking apart the reasons for suicide, we need to tackle its root cause: mental illness.

Seek Help When You Need It

The good news is mental illness can be treated and managed through a combination of medication, therapy and lifestyle changes. This means: Suicide is preventable through diagnosis and treatment. And a person experiencing suicidal ideation has the power to be their own first line of defense because most people are aware when they are having thoughts of suicide. And because you can recognize that you’re experiencing suicidal thoughts, you have a chance to save a life. The life of a very important person: you!

So, try to be aware of your thought patterns as they happen. It can be helpful to keep a journal so you can track any thoughts that seem out of character for you, are frightening or lead to impulses like self-harm. In the journal, include any relevant factors that could affect your thinking at the time. For example, alcohol, substance use, stress or lack-of-sleep can all serve as triggers for mental illness symptoms.

If you start having suicidal thoughts, make an appointment with your doctor and honestly tell them what’s going on. Communication is key when seeking help for suicidal ideation and impulses. Treat this symptom as you would anything else—like heart pain, bleeding or fainting.

You can also seek help from family members or friends. Again, be direct in communicating with them about your situation, as many people are poorly informed about mental illness and suicide. Simply stating exactly what you need can be very helpful.

If your suicidal thoughts reach a level where you have a plan, the means to complete an attempt and a timeline, call the National Suicide Prevention Lifeline or 911. If you’re unsure whether you would call 911 for yourself while in crisis, consider making a preemptive emergency action plan. The plan should be written with any involved parties agreeing on what steps should be taken if a crisis occurs, for example: “My brother will take me to the ER.” With a set of guidelines in place and memorized by everyone involved, it will be much easier to seek help from the right place when the time comes.

When you’re in crisis, it’s too easy to make a rash decision. If you have a diagnosed mental illness, please make a pact with yourself to reach out if you ever have serious thoughts of suicide. Haven’t you ever dreamed of saving someone’s life?

Now is your chance.


If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255
or text “NAMI” to the Crisis Text Line at 741-741.


Marta Manning is the Chapter President of NAMI Midland in Midland, Michigan. A survivor of Bipolar I Disorder, Marta is passionate about advocacy and community support for individuals living with mental illness and their families. She contributes actively to patient right committees, local hospital improvement initiatives, and work with local police in jail diversion programs. Marta has a doctorate in chemistry from Rensselaer Polytechnic Institute and works as a research chemist in the petroleum industry.

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NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).