Symptoms of Depression: Preoccupation With Death

Preocupation With Death
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Whether you have been diagnosed with a mood disorder like major depression or bipolar disorder or another mental health disorder, you may be familiar with the symptom that involves a preoccupation with death. This can involve passively wishing you were dead, actively beginning to plan your death, or becoming absorbed with thoughts of dying. Even if you haven't been diagnosed with a mental health disorder, you may have come to a place in your life where you wish you were dead.

What to Do if You Have Suicidal Thoughts

If you or someone you love is experiencing suicidal thoughts, you need to:

  • Reach out: Assuming you're the one thinking about death, call a trusted family member or friend and tell him. The people who love you want to help. If you feel that there's no one you can talk to, reach out to a clergy member or call the National Suicide Prevention Lifeline at 1-800-273-8255 any time. When you're the loved one of someone who seems suicidal, ask her directly if she's thinking about harming herself. Despite popular belief, this won't plant the idea, but it will let the person know that you care enough to ask. If she says she's having these thoughts, make sure she's safe, find out how active the thoughts are, and get her some help.
  • Remember that feelings are temporary: Your life may feel out of control at the moment and like it'll never get any better, but these feelings, like all emotions, will fade. Don't do anything drastic or impulsive that will cause a ripple effect of hurt throughout your family and community. There are people who care about you and want you to live, whether or not it feels like it.
  • Get help: If you feel a strong urge to commit suicide right now or in the near future, call 1-800-273-8255 or go to the National Suicide Prevention Lifeline's website to chat with someone. They're available 24 hours a day, 7 days a week. If you are having thoughts of death and dying, but no immediate plans to harm yourself, see your doctor as soon as possible. You may have a mental health disorder or, if you've already been diagnosed with one, you may need a medication adjustment or psychotherapy.

Suicidal Ideation

Suicidal thoughts, or suicidal ideation, are one of the hallmark symptoms of both major depression and the depressive episodes found in bipolar disorder. Suicidal ideation has two forms: active and passive.

Passive Suicidal Ideation

Passive suicidal ideation involves thinking about death to a marked degree, which may take the form of imagining yourself dead or wishing you were dead, but having no plans to harm yourself. For example, you may envision yourself lying in a casket or wish that you could die in your sleep or in a car accident. You may imagine what will happen at your funeral and obsess about what to leave people in your will, but you aren't actively planning anything. You may even have religious or philosophical beliefs that keep you from letting your suicidal thoughts become anything more than thoughts.

"I wish I were dead" is a common phrase that most people utter without meaning, but when you're depressed, that thought can become fact. You should take it seriously when anyone in your life says this. Keep in mind that passive suicidal ideation can turn into active suicidal ideation very quickly. In fact, there are usually elements of both passive and active suicidal ideation going on in a person's mind with no clear separation. Where you are on that spectrum between passive and active can indicate a great deal about where you are in terms of your mental health disorder.

Active Suicidal Ideation

With active suicidal ideation, "I wish I were dead" progresses to thoughts or plans of making it happen. You may be tipped over the edge by a stressful event, or the progress of your mood disorder may be to blame. Suicidal thoughts are nearly always caused by a combination of factors that result in you feeling like you are trapped, overwhelmed, out of control, a burden to others, and/or your life will never get any better.

Whether or not you have a plan in mind for suicide, these thoughts must be taken very seriously. Some of the highest risk factors for completing suicide include a history of previous suicide attempts, having a substance use problem, the presence of significant life stressors, and access to firearms or other lethal means. Active suicidal ideation is also dangerous because research shows that your decision-making processes are altered when you attempt suicide. It's important to get help immediately if you or a loved one is experiencing active suicidal ideation.

Major Depression vs. Bipolar Depression

Bipolar depression is similar to major depression. The main difference is that if you have bipolar disorder and you're experiencing a depressive episode, you may be more likely than a person with unipolar depression to have a "mixed" type of episode, which includes agitation (both mental and physical), irritability, anger, and anxiety.

Single symptoms are rarely present. For example, when you're going through a depressive episode in bipolar disorder, you might experience any or all of the following symptom types and have no symptoms at all of suicidal ideation, which comprises group 6:

Group 1—Changes in Activity Levels:

  • Fatigue
  • Insomnia
  • Lethargy
  • Social withdrawal
  • Loss of interest in pleasurable activities

Group 2—Physical Changes:

Group 3—Emotional Pain:

  • Loss of self-esteem
  • Feelings of helplessness
  • Feelings of despair and/or hopelessness
  • Crying for no apparent reason
  • Feeling sad for extended periods of time

Group 4—Difficult Moods:

  • Irritability
  • Worry/anxiety
  • Anger
  • Feeling agitated

Group 5—Changes in Thought Patterns:

  • Indecision
  • Disorganization
  • Difficulty concentrating
  • Memory problems
  • Loss of interest in your health, appearance, or hygiene

Another person could have an entirely different combination of symptoms and be no less depressed than the first. The important thing is to be aware of what the symptoms of bipolar depression are so that you can identify them in yourself or someone you care for and seek help accordingly. And, as mentioned above, if you've been diagnosed with bipolar disorder and you're experiencing suicidal thoughts, talk to your doctor. You don't have to continue to feel this way.

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