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Suicidal Ideation

Suicidal ideatoin (SI), or suicidal thoughts,  is the persistent, and sometimes infrequent, contemplations of ending one’s life.  Suicidal ideation may also manifest as imagining oneself no longer being apart of the world or indifference to being alive.  Suicidal ideation is often associated with various other mental health conditions, including depression, anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD), and others.  It can also occur in response to significant life stressors such as a loss of a loved one.

It’s important to note that not everyone who experiences suicidal ideation will act on these thoughts.  However, having suicidal thoughts on a frequent basis warrants an assessment by a professional and should not be delayed.  The severity of SI is often hard to assess, but if these thoughts start turning into a plan, or increase in frequency or intensity, then emergency help is urgently needed.

Suicidal Ideation
Suicidal-Ideation-Header

Take It Seriously and Find Help

Ketamine has a robust body of science to support the use of the drug reducing suicidal ideations, often with significant results within the first treatment session.  Co-morbid conditions of SI, such as depression and anxiety are concurrently treated with depression.  In other words, ketamine is used to not only safely and rapidly reduce thoughts of suicide, but also treat the source of the SI.    

We encourage patients during their ketamine treatment to stay connected with family, friends, and other support networks.  Working with either one of AVYIA’s therapists, using ketamine assisted psychotherapy, or a patient’s own therapist, has been shown in studies to enhance the efficacy of recovery.  

What Are the Statistics Say?

Prevalence

Prevalence

Center of Disease Control (CDC) in 2020 states 12.2 million American adults seriously thought about suicide, 3.2 million made actual suicide plans 1.2 million individuals attempted suicide.

Age of onset

Age of onset

Suicidal ideation can occur at any age, but it is most common among young people. According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death for individuals aged 10-34 in the US.

Gender differences

Women are more likely than men to experience suicidal ideation. However, men are 3.9x more likely to die by suicide than females, in part due to their increased use of lethal means.

Comorbidity

90% of those who died by suicide had a diagnosable mental health condition at the time of their death and are associated with mental health conditions such as depression, anxiety, PTSD, drugs and alcoholism.

Method

In 2021, firearms were the most common method of death by suicide, accounting for a little more than half (54.64%) of all suicide deaths. The next most common methods were suffocation (including hangings) at 25.80% and poisoning (including drug overdose) at 11.56%.

Access to treatment

Although effective treatments for mental health conditions associated with suicidal ideation are available there may be significant disparities in access to care based on factors such as race, ethnicity, and socioeconomic status.

What are the Signs and Symptoms of Suicidal Ideation?

It is essential to recognize the symptoms early if you, a friend, or a family member experience suicidal ideations.   Recognition of these signs can help you seek timely assessments and potentially life-saving interventions.  Suicidal ideation signs and symptoms vary from individual to individual, but they may exhibit one or many of the following signs:

  • Expressing a desire to not be alive, regretting being born, or suggesting that others would be better off without them.
  • Withdrawing from social contact and avoiding others.
  • Preparing for suicide, such as obtaining a weapon or researching methods.
  • Engaging in risky behaviors, such as excessive alcohol or drug use.
  • Showing signs of anxiety or becoming easily agitated.
  • Wanting to give away personal belongings or treating others as if they may not see them again..

Depression and Suicidal Ideation (Suicidal Depression)

Although “suicidal depression” is not an official clinical diagnosis, it typically refers to individuals who have major or clinical depression and are experiencing suicidal thoughts.  It’s important to note that not everyone will exhibit the same signs, and some individuals may conceal their feelings.  However, here are some common symptoms that may be indicative of suicidal ideation:

Feelings of guilt

Feelings of guilt, worthlessness, and sadness

Signs of anxiety, agitation, irritability or anger

Signs of anxiety, agitation, irritability or anger

Emotional distress, hopelessness, despair

Emotional distress, hopelessness and despair

Absence of passion for activities and hobbies

Loss of interest in prior hobbies and passions

Fatigue, changes in appetite or weight

Fatigue, changes in appetite or weight

Insomnia or difficulty getting out of bed

Insomnia or difficulty getting out of bed

Increase in risk-taking activity

Increase in risk-taking or abusive behaviors

At Home Ketamine Therapy in Seattle Metropolitan Area

Verbalizing about dying and/or giving away possessions

Preoccupation with death

Preoccupation with the topic of death

If you or a loved one are having worsening thoughts of hurting yourself or others, or intend to carry out such a plan, you must call 911 or seek emergency help.  Acting immediately in these situations could be the difference between life and death.

If you have suicidal thoughts but don’t have a plan, or don’t intend to harm yourself, then AVYIA’s ketamine program should be strongly considered to prevent your harmful thought from worsening into actions.  AVYIA prioritizes patients with suicidal ideations and will see you as soon as we can, often the same day.  Even after the first treatment, some patients have reported ketamine to significantly improve suicidal thoughts and symptoms of depression.  As with any treatment program, our goal is complete disease remission. 

Wilkinson ST, Ballard ED, Bloch MH, Mathew SJ, Murrough JW, Feder A, Sos P, Wang G, Zarate CA Jr, Sanacora G. The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis. Am J Psychiatry. 2018 Feb 1;175(2):150-158. doi: 10.1176/appi.ajp.2017.17040472. Epub 2017 Oct 3. PMID: 28969441; PMCID: PMC5794524.

Ketamine for Suicidal Ideation

Conventional treatments for suicidal ideations often target the mental health issues that contribute to or exacerbate them.  This often involves talk therapy and medications for conditions like depression, anxiety, and mood stabilization.  In emergency situations, inpatient therapy is often used to manage safety.  This process can sometimes take weeks or months to make sufficient and effective progress.

However, ketamine therapy offers a unique approach to treating suicidal ideation.  Unlike traditional medicines such as SSRI’s, ketamine therapy can provide possible relief in a matter of hours, rather than weeks to months.  Ketamine can quickly restart connections in the brain, promoting neuroplasticity and treating even the most persistent of mental health conditions.  More and more doctors and scientists have observed ketamine’s safety and effectiveness, and it’s remarkable promise in treating mental health disorders and suicidal ideation.

Ketamine therapy can be especially beneficial for those who struggle with long-term treatment compliance.  Taking pills and going to therapy for months on end can be hard for some.  For those that prefer immediate results that lasts, AVYIA’s IV ketamine program consists of 6 treatments over 3 weeks.  AVYIA does not recommend patients come off of their existing treatment programs.  However, ketamine therapy is a great addition to existing treatment regimes, as well as a great alternative.  AVYIA’s ketamine therapy has helped many patient’s suffering from acute and chronic mental health diseases in a more timely manner. 

Ketamine for suicidal Ideation

Albott, C. S., Lim, K. O., Forbes, M. K., Thuras, P., Wels, J., Tye, S., & Shiroma, P. (2019). 3525 improvement in suicidal ideation after repeated ketamine infusions: Relationship to reductions in symptoms of posttraumatic stress disorder, depression, and pain. Journal of Clinical and Translational Science, 3(s1), 46–46. https://doi.org/10.1017/cts.2019.110

When to Consider Therapy for Suicidal Ideation

If you’ve tried any or all the below treatments and have found less than optimal relief, or short-lasting relief, then ketamine is worth exploring.  It can be overwhelming to constantly battle mental health illness and navigate through the health care system, so we are happy to provide a free consultation to discuss whether ketamine is a good fit for you.      

Here are some other types of treatment interventions:

Psychotherapy

Psychotherapy or Cognitive Behavioral Therapy (CBT)

These sessions with a therapist can be beneficial, but they require significant commitment, and it's not always clear when they will provide relief.

Antidepressants

Antidepressants or Mood Stabilizers

It's common to treat related depression and anxiety with medication, but finding an effective fit can be challenging. They take time to test, and their effectiveness can decrease over time.

Self-Medication

“Self-Medication”

When prescribed treatments aren't effective or affordable, patients may risk self-medication.

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation

Several studies have investigated the use of TMS for suicidal ideation, and although there have been some positive findings, the results have been mixed for many.

Electroconvulsive Therapy

Electroconvulsive Therapy

A procedure that involves passing electrical currents through the brain to intentionally induce a controlled seizure. ECT can be effective, but the cost and time commitment can be overwhelming.

Hospitalization

Hospitalization

Inpatient therapy can be helpful for assessing care plans, but it's temporary and can quickly become emotionally and financially draining for suicidal patients.

From Desperation to Healing: Ketamine's Impact on Suicidal Thoughts

Not everyone who is thinking about suicide desires death.  For many, it’s a cry for help because they don’t see any other option.  Help does indeed exist and there is a way out.  If you or someone you know is struggling with suicidal thoughts, encourage them to seek immediate support from a mental health professional or call/text “988” Suicide & Crisis Lifeline.

AVYIA believes that ketamine can save and change lives.  We also don’t believe in false promises or claims.  All of our treatment programs are evidenced-based, and science-backed.  In addition to the treatment of mental health illnesses, AVYIA hopes to provide support to those whom are struggling and in need of healing.  Its transformative effects can bring relief, allowing individuals to break free from the depths of despair and embrace life with newfound strength and clarity.  This effective treatment can foster a sense of renewal, guiding the mind away from darkness and empowering the will to live. 

We encourage our patients to continue working with their therapists and counselors when receiving ketamine therapy.  Patients have reported that ketamine treatment can help them approach their situation more objectively, with less despair and apprehension. 

* Microdosing costs $150 per month for most patients. For patients who require higher dosages, the cost may increase due to the higher cost of the medication. Microdosing patients are required to have an at-home visit before commencing the medication.

Riggs, L. M., & Gould, T. D. (2021). Mechanisms of Ketamine Action in Depression: Current Understanding. Annual Review of Clinical Psychology, 17, 207-231. https://doi.org/10.1146/annurev-clinpsy-072120-014126

FAQ

Oftentimes, suicidal ideation may occur if depression or other mental health conditions are left untreated.  It is essential to note that suicidal ideation is a sign of significant distress and emotional pain, and seeking professional help is crucial for anyone experiencing these thoughts.  Some common factors that may contribute to suicidal ideation include: 1) feelings of hopelessness, 2) traumatic experiences (i.e. physical or emotional abuse, loss of a loved one, or a major life crisis…), 3) social isolation, 4) financial or relationship problems, 5) substance abuse, 6) previous suicidal behavior.

Depending on the severity and frequency, SI can be an emergency.  Having a plan, or urge to carry out that plan to harm to yourself or others warrants immediate help.  Call 911 or go to the ER.

Less frequent or severe thoughts require good judgement, often coming from loved ones rather than the patient themselves.  Still, seeking professional help is strongly advised.  There are multiple suicide hotlines available; call/text “988” Suicide & Crisis Lifeline.  Don’t hesitate to treat this issue.  

AVYIA’s IV and intranasal routes of ketamine provide the most immediate relief, but we don’t good data on how long remission lasts due to multiple factors that can affect mental health illness.  An estimated 38% or more of patients have reported complete remission of disease after completing multiple treatments (6-10) in some studies. If is difficult to know who will achieve remission, and how long treatment is required to achieve remission.  Other studies and patients have report symptom relief from ketamine provides several weeks or even months after a successful course of treatments.  Relapse of symptoms are treated with booster sessions periodically until remission is achieved.  

Daily microdosing in tablet form is a good alternative to IV or intranasal routes.  On average, patients are in disease remission after 9 months, however, symptoms relief typically is within days of starting the medication. 

We also recommend patients work with a therapist during their ketamine therapy.  This is called ketamine-assisted psychotherapy. This treatment combination reduces risk of relapsing.

AVYIA’s ketamine therapy program is performed in the comfort of your home. Being in the comfort of one’s own home can help reduce anxiety and stress associated with medical settings. Patients may feel more at ease and relaxed during the treatment. At home, the treatment is convenient and more accessible, plus it has a higher level of privacy compared to a clinic. More importantly, having loved ones nearby can provide emotional support during and after the treatment. Building family support is one of the key ingredient in avoiding suicidal thoughts. Last but not least, at home treatment offers flexibility in scheduling and the patient receives one-on-one care from the medical provider. 

No.  We aim for disease remission in every ketamine treatment program.  We don’t know when patients will achieve it, but AVYIA will be with patients every step of the way.  While we can’t promise any results, the evidence in the science of ketamine gives us no hesitation to offer this safe and effective tool.  

AVYIA’s IV and intranasal routes of ketamine provide the most immediate relief, but we don’t good data on how long remission lasts due to multiple factors that can affect mental health illness.  An estimated 38% or more of patients have reported complete remission of disease after completing multiple treatments (6-10) in some studies.

Daily microdosing in tablet form is a good alternative to IV or intranasal routes.  On average, patients are in disease remission after 9 months, however, symptoms relief typically is within days of starting the medication. 

The ketamine treatment is essentially painless. Apart from a slight sensation of a needle prick during the initial infusion line setup, you will not feel any discomfort and might even find the experience enjoyable.  

 

AVYIA uses sub-anesthetic, or low doses of ketamine.  However, our IV or intranasal ketamine program has the potential to induce a psychedelic or dissociative effect, which may result in an “out of body experience” and possible mild hallucinations.  This phenomenon is believed by many clinicians to create a sense of detachment from negative thought patterns and emotional distress, offering a temporary relief from the intense emotions associated with suicidal ideation.  Many experts believe the dissociative effects promote neuroplasticity, which aids in resetting the brain’s neural connections to combat mental health illnesses.  While undergoing the ketamine experience, individuals may attain a fresh perspective on their thoughts and emotions, allowing them to view their challenges from a different angle and alleviate the intensity of distressing feelings.