An Explanation of Suicidal Thinking In Plain Mama English

An Explanation of Suicidal Thoughts in Plain Mama English

Last week, Katherine received the following question from a Warrior Mom:

What is considered a “suicidal” thought, ideation, or gesture? I remember being asked by my physician if I was having suicidal thoughts, and I honestly didn’t know if I should say yes or no. I wasn’t making plans in my head to kill myself when I was in the deepest of depression, but I was having fleeting weird thoughts about things like “what would it be like to throw myself down the stairs?” and “my family would be so much better off without me here because I cause them so much stress,” etc. There were many days that I know I just kept holding on because my baby needed me and loved me and I couldn’t bear the thought of leaving him. But was this considered being suicidal? I honestly still don’t know. When you look up “suicidal thoughts” on medical websites, there’s no plain mama English description on what this could be; it is focused on the emergent and description of planning and/or acting on these plans to try to kill yourself. I figure other moms out there may be just as clueless as I am and it could be useful to have a plain mama description of this so we know if we should say yes or no to that scary question from our doc.

It is a terrifying place to be when the thought of suicide or harming yourself comes into your head. Moms who suffer from postpartum depression do not always go to this place even though they may be suffering greatly. But those who do are usually dealt an additional level of uncertainty and fear: Does this mean that I am really crazy? Will I be locked up for these thoughts that I am having? Will my baby be taken away? Will anyone even notice if I am no longer here? Usually, for these moms, the thought of harm and/or suicide comes from one of two places: Either the belief that her family will be better off without her or the feeling that she is in so much pain that she can’t go on.

And, there is of course a spectrum with respect to the nature of these thoughts. There are the moms who are in such distress that they have fleeting thoughts of wanting to escape it all. There are the moms who have fleeting thoughts about putting themselves in harm’s way. There are the moms who know that, despite their thoughts, they would never choose to follow through with these actions. There are the moms who wonder if they might follow through if things get bad enough. There are the moms who have a plan about what they would do to hurt themselves. And there are the moms who have already made a commitment to do so.

So, as for the question above:

What, in “plain mama English” is suicidal thinking?

Technically speaking, a mom is having “suicidal thoughts” if and when she begins to think about hurting herself and/or ending her life. These thoughts are, indeed, red flags and a very necessary reason to seek out help.  It is true that not every mom with postpartum depression having these thoughts will act them out, but any time that the thoughts occur, those of us in the field of postpartum depression treatment and mental health will pay attention and note that a mom is really, really suffering. 

In my practice, any time a mom talks about having had thoughts like this, I put my “medication talk” in a whole new category. Medications are a very important part of treatment for moderate to severe cases of postpartum depression and are usually a relatively quick way to reduce symptoms. My lead towards medication in these instances are NOT because I think these moms are “crazy” or “insane” or “unfit” to be moms, but rather because I know from their thoughts that they are suffering greatly, and I simply don’t want them to have to struggle like that.

Clinically, a “suicide assessment” has to be done any time that a mom discloses that she is having thoughts of hurting herself or ending her life. When moms, like the one above, disclose these thoughts and then assure me that they have no intention of following through, I will make a verbal commitment with them that they will let me know if they do begin to think seriously about acting upon these thoughts or if these “thoughts” become “urges” (meaning that they are being drawn by an impulse to act upon their thoughts). And, if they are not already, I will let them know that I think medication treatment is imperative. For moms who have a plan or who fear that they really may put themselves in harms way, hospitalization is a necessary part of her treatment simply in order to get her immediate relief and to protect her.

Examples of Suicidal Thoughts

The Mayo Clinic lists the following as “warning signs” for suicidal thinking:

  • Talking about suicide, including making such statements as “I’m going to kill myself,” “I wish I were dead,” or “I wish I hadn’t been born”
  • Getting the means to commit suicide, such as getting a gun or stockpiling pills
  • Withdrawing from social contact and wanting to be left alone
  • Having mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying, or violence
  • Feeling trapped or hopeless about a situation
  • Increased use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Doing risky or self-destructive things, such as using drugs or driving recklessly
  • Giving away belongings or getting affairs in order
  • Saying goodbye to people as if they won’t be seen again
  • Developing personality changes, such as becoming very outgoing after being shy

Any time a mom with postpartum depression is struggling with the above symptoms, it is absolutely important for her to reach out for appropriate support, even if it is hard to do so. In fact, acknowledging suicidal thoughts, answering “yes” to the question “are you having suicidal thoughts,” and being honest with yourself and others is usually the hardest part. But please, please know that you do not need to suffer in this way. Even if you have gotten very used to doing so. You owe it to yourself to live your life without these (even fleeting) thoughts or fears. And your babies and families do need you.

~ Kate Kripke, LCSW

If you’re looking for a specialist in PPD, check out our list of Postpartum Depression Treatment Programs & Specialists.

Facing the Loss Of A Loved One To Suicide

[Editor’s Note: November 19 is International Survivors of Suicide Loss Day. On this day survivors of suicide loss gather at hundreds of simultaneous healing conferences around the world every year to connect with others who have survived the tragedy of suicide loss and express and start to understand the powerful emotions we experience. For more information about a conference near you,  visit the American Foundation of Suicide Prevention.]

Facing the Loss of a Loved One to Suicide

My story of suicide loss begins more than 35 years ago. My cousin’s mom died by suicide when he was just a baby. All these years it never occurred to me that she was probably suffering from postpartum depression—or perhaps even postpartum psychosis—at the time of her death.

It’s not something my family openly discussed, but my perception had mistakenly always been “Oh, she must not have wanted to be a mom.” How very naive of me.

After years of experience with my own depression and mental health issues postpartum, it’s become clear to me that she was suffering like so many women from a postpartum illness like postpartum depression. She needed treatment that apparently she never got, in a time when such topics were even more taboo than they are today.

Last year, my life-long friend Dina died by suicide at Christmas. She wasn’t in the postpartum period at the time. (Her son was 15.) But many years ago when he was just over two, she came to me with suicidal thoughts. We were in our early 20s and I had yet to experience mental illness.

She and her husband were splitting up, and Dina believed her son would be better off not knowing or remembering her. I knew without a doubt that wasn’t true and found the courage to tell her parents and then husband what she told me.

It turns out that wasn’t her first suicidal ideation. In fact, she was probably predisposed to mental illness. And during that prime postpartum period with the stress of being a young mother and impending divorce, I wouldn’t be surprised if she had also been suffering from postpartum depression never properly treated. And I’ve come to learn that untreated postpartum illness often leads to ongoing chronic mental illness.

I’ve had other friends attempt and complete suicide, too many times in fact. I’ve also experienced my own times of suicidal thoughts. I write this not for shock value but because this is a topic that is so important to me to keep talking about. To advocate for mental health awareness. To help others feel not so alone in their struggles.

Today, most importantly I want to honor those of us who are surviving the loss of a loved one to suicide. The grief, the guilt, the intense sadness never fully goes away.

Suicide is a permanent answer to a temporary or often treatable problem. And it’s estimated that 90% of suicides are by people with mental illness that has most likely gone untreated, such as postpartum depression or psychosis.

The family and loved ones who are left behind suffer the consequences, the questions, the stigma. My cousin, my friend’s parents and son, me and other loved ones. For every death by suicide, there are tens or even hundreds more who are living with it every day, those who often times blame themselves for an act that, in all honesty, was out of their control. An act done out of intense pain and true illness.

The grief of suicide is not a competition. One person does not “grieve more” or have a right to grieve more than any other. I have the right to grieve Dina in my own way, just as each of her loved ones do. I say “in my own way,” because I’ve also learned that each of us lives with suicide loss in very different ways. And that’s okay.

If the grief and pain of loss begins to overtake you, it’s unbelievably important to seek the help and support you need to heal through the loss. To find others who understand. To share your story of love and loss with those who need to hear it. I promise it will help you too.

Today I’m here to say that I am the face of suicide loss. And I’m here if you need  me.

What beautiful person have you lost to suicide? How are you doing surviving his or her loss?  Share your story and break the stigma.


If you’re facing suicidal thoughts, reach out for help. Call 1-800-273-8255 to speak to someone at the National Suicide Prevention Lifeline.

Threats of Suicide Can Never Be Ignored

You’d think it would have happened sooner.  Seven years of advocacy and peer support for women with postpartum depression, and I hadn’t had to do it yet.

This was the day.

I am reluctant to get too involved in people’s lives.  I want to support everyone, but I also don’t want to butt in where I don’t belong.  I don’t know everything that goes on behind the front door.  I don’t even know where the front door is located most of the time, so how can I know the best way to support each individual other than to provide as much information and hope as I can? This time I had to push past that reluctance, as did others.  We called 911 to prevent a suicide.

When you see someone publicly threaten to kill themselves, there’s no way to no how serious the threat is.  Are they joking, or just blowing off steam? Are they about to do it? Right now?

[Read more…]

Is Maternal Suicide Overlooked As A Leading Cause of Maternal Mortality?

pregnancy depressionA new study finds that death by suicide and homicide are more common than “traditional” causes of maternal mortality in the U.S., such as infection or hemorrhage.  So why is it that those traditional causes of maternal death are so much more likely to be discussed and reported?

By analyzing records from the Centers for Disease Control (CDC), researchers at Georgia Health Sciences University found a total of 94 pregnancy-associated suicides — meaning women who killed themselves either during pregnancy or in the first year after birth — between 2003 and 2007.  This would work out to a rate of 2 suicides per every 100,000 births.  We don’t know whether any of these women were diagnosed with antenatal or postpartum depression, but we can guess it’s likely they were not, given the overall lack of awareness and screening for these illnesses.

The researchers also say there may be more maternal suicides of which we are unaware, because, as Science Daily reports, those numbers could be underreported, “… because the pregnancy or postpartum status was marked ‘unknown’ in the majority of female deaths in the CDC database.”

[Read more…]