Searching for Hope: The Best Therapies for Suicidal Thoughts to Consider by Madison Rowohlt MA, LAC

If you’re coming across this article, it means that for whatever reason you are curious about suicide. Whether you decided to search for yourself, a loved one, or sheer wonder, know that you’re not alone in wanting to understand more about this phenomenon. We are exploring various therapies for suicidal thoughts to help you or someone you care about manage and cope with these ideations.

Suicide has been written about and researched for centuries, helping us to unpack the factors that lead to a complete suicide, and identify the most helpful treatment options to manage and cope with these ideations.

Understanding Suicidal Thoughts and Behaviors

So, what is suicidality? This term is commonly used when an individual experiences both suicidal ideation and intent. Suicidal ideation refers to thoughts about wanting to end one’s life, while suicidal intent involves a plan or method to do so.

There is also a distinction to make between passive and active suicidal ideation. Someone with passive suicidal ideation might experience thoughts about wanting to end their life, not wake up in the morning, or disappear. Alternatively, someone with active suicidal ideation has the intent of following up on these thoughts and feelings.

There are usually behavioral signs that someone is thinking about ending their life. These might include:

Expressing feelings of hopelessness
Engaging in risky behaviors (e.g, increased substance use)
Changes in sleep patterns, often too much or too little
Withdrawing from social connections
Expressing feelings of calmness or giving away personal belongings once an individual has decided to end their life

In terms of heightened risk, you might already know that suicides in the United States have increased significantly over the past decade, especially for young people (U.S. Department of Health and Human Services [HHS], 2024). Suicidality is also more common for those who are American Indian/Alaskan Native and for men over the age of 75 (HHS, 2024). Understanding this has allowed researchers and clinicians to improve treatment options and approaches.

There is also an understanding that, in many communities and cultures, discussing feelings of wanting to end one’s life is a big fat NO and very stigmatized. A lot of shame and embarrassment can accompany suicidal thoughts. However, one thing we know for sure – talking about suicide does not increase suicidality (Dazzi et al., 2014). So, with all of that said, let’s discuss some therapies for suicidal thoughts. Perhaps you will see one that feels like a good fit.

Best Therapies for Suicidal Thoughts

Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) focuses on helping individuals non-judgmentally accept their thoughts and feelings while committing to actions that align with their values. ACT encourages individuals to practice mindfulness, acknowledging that receiving the present allows us to shift and change what we need to live a more personally fulfilling life. By learning to accept negative emotions and thoughts, individuals can reduce their impact and influence, cultivating a greater sense of purpose and meaning (Barnes et al., 2021).

Cognitive-Behavioral Therapy (CBT)

Cognitive-Behavioral Therapy (CBT) is a highly effective treatment for suicidal ideation (Wu et al., 2022), focusing on identifying and shifting unhelpful thought patterns and behaviors that contribute to suicidality. CBT typically involves more structured, goal-oriented sessions where therapy participants learn to recognize and challenge thoughts, feelings, and beliefs that underpin suicidal ideation through a variety of techniques and skills. CBT empowers individuals to develop a more positive and adaptive outlook on life.

Dialectical Behavioral Therapy (DBT)

DBT is well-known for being effective in the treatment of suicide (DeCou, 2019). Developed by a psychologist who was once suicidal herself, DBT offers a space for individuals to talk through intense emotions and experiences, such as suicidal ideation.

DBT therapists want to help you discover and remove any barriers that get in the way of living a meaningful life through four major skill sets:

Mindfulness
Distress tolerance
Emotion regulation
Interpersonal effectiveness

When working with a DBT therapist, be prepared to stay in the present and future, and maintain a strong therapeutic relationship with your therapist.

Ecotherapy

Ecotherapy, also known as nature therapy or green therapy, offers a holistic approach to treating suicidal ideation by infusing nature into the therapeutic process. This practice is based on evidence that mindfully engaging with natural environments can significantly reduce the negative emotions and thoughts associated with suicide (Summers & Vivian, 2018). Animal-assisted therapy, nature walks, and gardening are just a few activities that ecotherapists use to help foster a greater sense of peace and connection.

Psychodynamic Therapy

One of the longest-standing forms of therapy, psychodynamic (also known as psychoanalytic) treatment aims to uncover and address the underlying emotional conflicts and distress contributing to suicidal ideation. Therapy participants will process unresolved issues from the past and learn how they impact present thoughts and behaviors. Working through the roots of problems has been proven to support healthier coping mechanisms and an overall reduction in the frequency and intensity of suicidal thoughts (Yakeley & Burbridge-James, 2018).

Frequently Asked Questions about Suicide

Q: If someone is self-harming, does that mean they are suicidal?

A: The short answer is, no. Unfortunately, it’s not uncommon for individuals who experience emotional pain to engage in self-harm. Self-harm, similar to suicide, is often a means of trying to end pain. However, not everyone who self-harms (through cutting, burning, scratching, etc.) is suicidal. Self-injury does put someone at a higher risk of completing suicide because they are more experienced with harming the physical body.

Q: Could my loved one just be saying they’re suicidal for attention?

A: It’s possible, but if someone is so desperate for attention that they suggest they are suicidal, chances are other significant mental health needs that need to be supported. It is also helpful to think about this person seeking connection rather than attention.

Q: I think someone I know is thinking of suicide, but if I ask them about it won’t I just be putting the idea in their head?

A: Many people have thought this, but the research continues to tell us that asking about and discussing suicide does not increase suicidality. On the contrary, broaching the topic of suicide helps to destigmatize the topic and increases help-seeking behavior.

Q: This all just seems too hard and I think I am beyond help.

A: Working through these painful emotions can be hard, but no one is beyond help! As mentioned above, many people have contemplated and attempted suicide, allowing us to understand causes, risk factors, and helpful treatments to support you in feeling like you are leading a meaningful life. There is hope.

The skilled clinicians at the Lukin Center offer a safe, supportive space for anyone to share these thoughts, feelings, and behaviors. The Lukin Center provides a wide range of mental health services to individuals, families, couples, and others in need of counseling. Our compassionate professionals are dedicated to treating various issues, including those that are often linked to suicidal thoughts.

We specialize in addressing depression, anxiety and mood disorders, and trauma, offering personalized therapies tailored to each individual’s unique needs. Contact us today to begin your journey toward a healthier, more fulfilling life.

If you need help immediately, please contact the Suicide and Crisis Lifeline (988).

Madison Rowohlt, LAC | Lukin Center, Bergen County Moms — Madison Rowohlt, LAC | Lukin Center for Psychotherapy

Madison Rowohlt, LAC, is a Licensed Psychotherapist and Certified Clinical Trauma Professional at Lukin Center for Psychotherapy who specializes in working with tweens, teens, and young adults struggling with symptoms relating to: trauma, anxiety, mood disorders, behavioral concerns, interpersonal difficulties, and life transitions. With experience in the school setting, Madison has advanced training supporting youth through identity exploration, self-injury, and substance related issues.

As a therapist, Madison meets clients where they are at and utilizes a strength-based, trauma-informed, collaborative approach. Her treatment method is grounded in Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Motivational Interviewing (MI). While integrating mindfulness and humor, Madison seeks to empower those she works with to lead emotionally healthy and fulfilling lives through a combination of evidence-based treatment and clients’ personal goals and objectives. She believes in the power of a strong therapeutic alliance to cultivate resilience and promote acceptance and change.

Madison is currently a full-time Doctoral Student in Montclair State University’s Counseling Psychology PhD program. She earned both her Bachelor of Arts in criminology and Master of Arts in counseling at The College of New Jersey, where she focused on working with youth through a social-justice based lens.