Real Talk

Suicidal Ideation: Opening Up About Vulnerable Moments

by Kevyn Gohu
October 14, 2024

While suicide is a very difficult topic to talk about, suicidal ideation is even harder. How does one want to live and die at the same time?

While very few push through (and succeed) in committing suicide, many of us have probably experienced suicidal ideation. It’s not the typical “Ugh, I want to die!” that we usually shout when we’re stressed. The line of thought in suicidal ideation is much deeper; in some cases, the thoughts are usually more intrusive, affecting even their daily lives. The thoughts consume most of their energy, often leaving them in two different states: one where they don’t move at all and the other where they do things with reckless abandon.

The most distressing part here is that they think about taking their lives almost 80% of the day.

What is Suicidal Ideation?

Suicidal Ideation is defined as a thought process wherein we think about committing suicide or are in the process of planning to commit suicide (Oquendo & Baca-Garcia, 2014; Klonsky, Dixon‐Luinenburg & May, 2021; Madigan et. al, 2023). Oftentimes, it starts as a single thought when we’re stressed. However, the more we are in a stressful situation (i.e. abuse, etc.) then, it eventually leads to our wish to “remove” ourselves from the situation and see no other way, thus making death an option (Harmer, Lee, Duong, Saadabadi, 2020).

Suicidal ideation or having suicidal thoughts can be a sign of having Major Depressive Disorder, Bipolar Disorder Type I and II, and many other mood and anxiety-based disorders.

What causes a person to think about suicide?

Suicide ideation, like most mental disorders, is brought upon by two things: stressful situations and factors that can reduce the distress from the situations.

According to a 2021 research highlight from USA’s National Institute of Mental Health, kids as young as 4 years old can start thinking about suicide with the act itself being committed by those as young as 5 years old. The common causes included a pre-existing mental disorder such as ADHD or depression, distressing family situations such as a custodial battle, divorce, parents abusing drugs or alcohol, and school-related issues like expulsion, suspension, and bullying (Kasen & Chen, 2020; McManimen and Wong, 2020, Stewart et. al, 2020).

Suicidal Ideation in the Philippine Context

In the Philippines, suicidal ideation can work in layers. It first comes from a distressing situation; this can be in the form of financial struggles, school issues, family problems such as marital discord, and even sexual assault from a family member. However, it’s the lack of social connectedness would be the proverbial final nail in the coffin (Reyes, et. al, 2020; Quintos, 2022). It’s the feelings of “sumobra na” or how some describe it as “daming patong-patong” that often hint at suicidal ideation.

We see it in kids and adults who feel “lonely” even if they’re physically around people. It’s that moment wherein people could be partying their lives out yet, absolutely feel no joy. They may look it only because of deindividuation — an instance wherein people do behaviors they normally don’t because everyone else is doing it. It was a term coined by psychologist Leon Festinger in 1950 when understanding what drove people to be anti-social.

Unlike social support, the former emphasizes the affected person’s feelings on being included. Considering that pakikipagkapwa is one of the Philippines’ core values as a culture, the feeling of belonging somewhere or having someone listen can play a big role in reducing the number of suicidal thoughts in a day (Chiu and Vargo, 2022).

It’s not common in the Philippines! Or is it?

Unfortunately, Philippine data for suicidal ideation may be severely underreported. A lot of these reports are self-reported, meaning they can be influenced by a variety of reasons as to why kids and adults won’t mention having suicidal ideation. While kids fear having the emotional blowback from their parents finding out especially if it’s from another distressing situation like sexual assault via a family member (Vega and Lorenzana, 2022), teens and young adults often cite several reasons such as the way they were raised or not having anyone:

“But God/ the priest said it was wrong.” / “Sabi ni Lord/ father mali…”

“My parents said that it was selfish/stupid of me to even think of that [suicide].”/ “Ambobo ko daw na gusto ko magpakamatay.“

“I shouldn’t even be suicidal! There’s no reason to be! I have friends, family, money — why should I be?”

A lot of times, these thoughts are also what prevent Filipinos from seeking help. Notice how these have a social element? There’s always someone or something that should validate the rightness or wrongness of suicidal ideation.

If any of those thoughts hit home then, know that you’re not alone. Suicidal ideation can hit anyone and can be caused by a lot of things. It doesn’t always have to be traumatic like a car accident, death, disease, and the like; sometimes, it can be caused by an emotionally unstable and immature environment at home (Quintos, 2023).

It most especially skyrocketed during the pandemic because, for some kids and parents, face-to-face classes and onsite work were their escape from the emotionally dysfunctional home.

Sometimes, being positive is what aggravates it.

Usually, what do Filipinos say whenever someone expresses these kinds of thoughts?

“Ah kaya yan!” / “Oh you can do it!”

“Laban lang!” / “Just keep fighting!”

“Kaunting tiis na lang!” / “Just a little more.”

“Ay magdasal ka nalang! Bahala si Lord!” / “Just pray. God will take care of it.”

“Di naman siya ganoon ka-grabe.” / “It’s not that big a deal.”/ “It could’ve been worse.”

While they can be encouraging in most circumstances, it’s the timing and delivery that eventually decide if the statements are appropriate. In a state of distress, hearing these things can feel and look dismissive. No matter how well-intended, in the mind of a person who’s frustratedly used every possible resource — physical, mental, spiritual, and emotional, statements like these can make them ignore their negative emotions.

What To Do When You Come Across or Suspect Someone of Having Suicidal Ideation

We all want to help out but, the kind of help we extend matters. When people reject it, some of us take it as a personal offense and an act of ungratefulness. But the truth is — the help we extended wasn’t what they needed or wanted. Know that there’s no one way to resolve these kinds of situations but it all focuses on one objective: making sure they’re heard.

So based on the situation, some of these responses can work:

1. Ask how they are.

In Philippine context, asking anyone how they are is the first step to building a connection. Although we’re used to extremely loud “Hi’s!” and “Hello’s!”, this is one of the situations where speaking in a low and hushed tone with a smile gets them talking. Some people are known to match energies so when the initial conversation is loud, any chances of getting them to talk more about serious things disappear.

“Kamusta” or “Anything happen today?” can be quite powerful when delivered right.

2. Make small decisions for them.

It may sound counterproductive to make small decisions for them but consider this: everything in their life is flying out of control; they have no idea how to fix things or at least gain control. Asking them stuff like, “How do you want me to help?” or “What do you want to eat?” is adding another decision to make and their mental load is reaching capacity.

Especially if we’re friends with them, they probably have a pattern or a go-to for food or even a cool drink. Getting that for them can help reduce the load.

3. Stay calm. Don’t react.

It’s normal to react wildly to the thought of someone possibly committing suicide, especially if it’s a loved one like our own kids. But the last thing they need is a loud shout; that kind of jolt can send them retreating deeper into their thoughts. Instead, sit with them and ask, “Want to talk about it?” It sends two messages: we want to connect and we’re willing to listen.

Make sure we actually do though. Resist all urges to quote any social element — yes, that includes religion. Some individuals may have suffered bad experiences from religious people and referencing God just makes it worse (Quintos, 2023).

4. Find someone who can.

Not all of us are skilled in mental first aid so, find someone who can. Navigating suicidal ideation or thoughts is uncharted territory for many parents but this is where we can use the perk of being friends with our kids’ friends: they’ll probably have a better idea of what they’re going through. It may hurt us a bit, knowing that our kids aren’t relying on us. But doing so doesn’t make us a bad parent; if anything, it makes us better because we’re making a decision that ultimately is for our kid’s welfare.

There’s also the mental health hotline at 09663514518.

5. If we find out it’s because of us, accept it.

Nothing makes us more defensive than being confronted with our parental mishaps or failures. It can make us thing, “This kid’s so ungrateful!” especially after we’ve sacrificed years, our dreams, and a lot of things so they could thrive. But the thing is, we forget: we’re still human; messing up is still a possibility. And again, maybe the parenting that worked on us isn’t helping them. They’re a different individual after all.

So when they say it’s because of us, accept it. We can’t control what they feel but we can help them and ourselves learn and move forward.

Suicidal Ideation: It’s Never Easy to Talk About

Most Filipinos would shy away from talking about suicide. It usually takes knowing and accepting someone who committed to the act to even trigger talks about it. Other than that, they just stay as thoughts, and let’s be honest — suicidal thoughts can be isolating.

What makes it hard to break the thought pattern of those who suffer suicidal ideation is that they usually have real-life experience and a lot has happened. Suicide, for those afflicted with these thoughts or mood disorders, is often seen as “a way out.” A way out from what unfortunately is the next question which we and even they may not have answers to. The only thing they want is for the pain to stop.

But before it gets to them actively planning it, notice the signs! Connect with them, be a calming and temporary tether — any sort of loud reaction or defensive reaction will push them farther. Most especially if the person we’re dealing with is a loved one.

Global References

Harmer, B., Lee, S., Duong, T. V. H., & Saadabadi, A. (2020). Suicidal ideation.

Kasen, S., & Chen, H. (2020). Social context and change in suicide ideation in a community sample of youths. Social psychiatry and psychiatric epidemiology, 55, 319-327.

Klonsky, E. D., Dixon‐Luinenburg, T., & May, A. M. (2021). The critical distinction between suicidal ideation and suicide attempts. World psychiatry, 20(3), 439.

Madigan, S., Korczak, D. J., Vaillancourt, T., Racine, N., Hopkins, W. G., Pador, P., Hewitt, J. M. A, Almousawi, B., McDonald, S., & Neville, R. D. (2023). Comparison of paediatric emergency department visits for attempted suicide, self-harm, and suicidal ideation before and during the COVID-19 pandemic: a systematic review and meta-analysis. The Lancet Psychiatry, 10(5), 342-351.

McManimen, S., & Wong, M. M. (2020). Prospective investigation of the interaction between social problems and neuropsychological characteristics on the development of suicide ideation. Suicide and Life‐Threatening Behavior, 50(2), 545-557.

Oquendo, M. A., & Baca-Garcia, E. (2014). Suicidal behavior disorder as a diagnostic entity in the DSM-5 classification system: advantages outweigh limitations. World psychiatry : official journal of the World Psychiatric Association (WPA), 13(2), 128–130. https://doi.org/10.1002/wps.20116

Stewart, S. L., Celebre, A., Hirdes, J. P., & Poss, J. W. (2020). Risk of suicide and self-harm in kids: the development of an algorithm to identify high-risk individuals within the children’s mental health system. Child Psychiatry & Human Development, 51, 913-924.

Local References

Chiu, H., & Vargo, E. J. (2022). Bullying and other risk factors related to adolescent suicidal behaviours in the Philippines: a look into the 2011 GSHS Survey. BMC psychiatry, 22(1), 445.

Quintos, M. A. M. (2022). Experiences of suicide ideation and attempts among Filipino students: Prevalence, reasons, and help-seeking behavior. Social Sciences and Development Review Journal, 14(1), 1-1.

Quintos, M. A. M. (2023). Relationship Between the Youth’s Perspectives on Suicide and Their Suicide-Related Experiences. Social Sciences and Development Review 2023.

Reyes, M. E. S., Davis, R. D., Chua, C. A. P. Q., Olaveria, G. L., Pamintuan, L. J. E., Serrano, M. K. B., & Tan, J. L. E. C. (2020). Relative Importance of Social Support and Social Connectedness as Protective Factors of Suicidal Ideation Among Selected Filipino Late Adolescents. Suicidology online, 11(1).

Vega, P. A. G., & Lorenzana, R. C. (2022). Prevalence and risk factors of suicidal ideation among victims of child sexual abuse seen at the Philippine General Hospital Child Protection Unit. Acta Medica Philippina, 56(15).