Suicidal ideation—defined as thoughts or preoccupations with ending one’s life—is a major public health concern, often serving as the gateway to suicide attempts and completed suicides. The phenomenon is multifactorial, rooted in biological vulnerabilities, psychological mechanisms, and socio-cultural contexts.
Tracing the origins of suicidal ideation requires an interdisciplinary approach, integrating perspectives from philosophy, history, psychiatry, neuroscience, sociology, and public health. This review explores the conceptual evolution of suicidal ideation, its neurobiological underpinnings, psychological frameworks, cultural determinants, and integrated models, while reflecting on implications for prevention and policy.
Suicide claims nearly 800,000 lives annually, making it one of the leading causes of death worldwide (WHO, 2021). For every completed suicide, there are estimated to be at least 20 suicide attempts, with suicidal ideation serving as a critical precursor (Nock et al., 2008). Unlike suicide itself, ideation is less visible yet equally dangerous, reflecting the internalisation of psychological pain, hopelessness, and perceived disconnection.
Understanding the origin of suicidal ideation is essential for designing effective interventions. While medical sciences focus on neurobiology and psychiatry, social sciences examine cultural scripts, moral interpretations, and structural inequalities. This article reviews the historical, biological, psychological, and socio-cultural foundations of suicidal ideation, before analysing contemporary integrative models.
In ancient Greece and Rome, suicide was debated in moral and political terms. Plato condemned suicide as cowardice, whereas Stoic philosophers such as Seneca regarded it as an expression of rational autonomy in the face of suffering. Aristotle argued that suicide violated duties to the state, situating it within civic responsibility.
Christianity: The medieval Church framed suicide as a mortal sin, often punishing families by denying burial rites.
Hinduism and Buddhism: Suicide was not universally condemned but seen through the lens of karma, detachment, and suffering. Certain forms, such as ritual self-sacrifice, were historically valorised.
Islam: The Qur’an strictly prohibits suicide, equating it with transgression against divine will.
By the Enlightenment, philosophers such as Hume challenged religious prohibitions, viewing suicide as an individual right. The sociological turn came with Émile Durkheim’s Le Suicide (1897), which shifted focus from individual pathology to social integration and regulation, identifying types of suicide (egoistic, altruistic, anomic, fatalistic) that remain influential in contemporary studies.
Reduced serotonergic activity, particularly low levels of 5-HIAA in cerebrospinal fluid, has been consistently linked with suicidal ideation and attempts (Mann, 2003). Dysregulation affects impulse control, aggression, and mood regulation.
Hyperactivity of the hypothalamic–pituitary–adrenal (HPA) axis contributes to chronic stress responses, with abnormal cortisol rhythms frequently observed in suicidal individuals.
Twin and family studies suggest heritability of suicidal behaviour at 30–50% (Voracek & Loibl, 2007). Candidate genes include variants of the serotonin transporter gene (5-HTTLPR) and genes associated with neurotrophic factors.
Functional MRI reveals hypoactivity in the dorsolateral prefrontal cortex (reduced cognitive control) and hyperactivity in the amygdala (heightened emotional reactivity), highlighting the dual role of impaired regulation and exaggerated distress in suicidal ideation.
Beck (1967) proposed that hopelessness and cognitive distortions create vulnerability to suicidal ideation. Individuals with rigid, dichotomous thinking are more likely to interpret stressors as insurmountable.
Joiner (2005) emphasised two primary drivers:
Perceived burdensomeness (feeling like a liability to others).
Thwarted belongingness (lack of social connectedness).
These constructs predict ideation, while the capability for suicide (through habituation to pain or fearlessness about death) predicts attempts.
Freud’s theory of suicide as aggression turned inward remains relevant. Modern psychodynamic perspectives highlight early attachment disruptions and unresolved grief as key origins of suicidal ideation.
Durkheim classified suicide into four types:
Egoistic – low social integration.
Altruistic – excessive integration (e.g., ritual sacrifice).
Anomic – societal normlessness (economic upheavals).
Fatalistic – excessive regulation (oppressive conditions).
This framework underscores that suicidal ideation is not merely individual but socially situated.
Social Media: Exposure to cyberbullying, unrealistic comparisons, and suicide contagion.
Economic Stressors: Job insecurity, poverty, and inequality.
Cultural Scripts: Romanticisation vs. stigmatisation of suicide affects ideation prevalence.
Studies indicate rising suicidal ideation among adolescents and young adults, particularly in low- and middle-income countries, where access to mental health services is limited.
Suggests that genetic predispositions and neurobiological vulnerabilities interact with environmental stressors, producing suicidal ideation when resilience is overwhelmed.
Pain and hopelessness generate ideation.
Ideation intensifies when connectedness is lacking.
Attempts occur when individuals acquire the capability (through exposure to pain, self-harm, or access to means).
O’Connor (2011) emphasises that defeat and entrapment trigger suicidal ideation, while volitional factors (e.g., impulsivity, access to lethal means) determine transition to behaviour.
Japan: High rates of suicide ideation linked with cultural normalisation and economic stress.
India: Academic pressure, dowry-related stress, and lack of psychiatric services contribute significantly to adolescent ideation.
Western Contexts: Loneliness, substance use, and mood disorders are major predictors.
WHO’s Live Life Framework: Emphasises restricting access to lethal means, fostering social connectedness, early identification, and responsible media reporting.
Digital Interventions: AI-based suicide risk detection and telepsychiatry can identify ideation early.
Community-Based Programs: Gatekeeper training (teachers, peers, primary physicians) improves recognition and intervention.
The origin of suicidal ideation is best understood through a biopsychosocial lens, recognising that neurobiological vulnerabilities, psychological constructs, and socio-cultural contexts interact to produce risk. No single theory suffices; rather, an integrated model that accounts for historical, cultural, and medical perspectives is essential. Prevention strategies must move beyond reactive interventions toward proactive, systemic, and culturally sensitive approaches
Beck, A. T. (1967). Depression: Clinical, Experimental, and Theoretical Aspects. New York: Harper & Row.
Durkheim, É. (1897). Le Suicide. Paris: Félix Alcan.
Joiner, T. (2005). Why People Die by Suicide. Harvard University Press.
Klonsky, E. D., & May, A. M. (2015). The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework. International Journal of Cognitive Therapy, 8(2), 114–129.
Mann, J. J. (2003). Neurobiology of suicidal behaviour. Nature Reviews Neuroscience, 4(10), 819–828.
O’Connor, R. C. (2011). The integrated motivational–volitional model of suicidal behaviour. Crisis, 32(6), 295–298.
Voracek, M., & Loibl, L. M. (2007). Genetics of suicide: A systematic review of twin studies. Wiener Klinische Wochenschrift, 119(15-16), 463–475.
World Health Organisation. (2021). Suicide worldwide in 2019: Global health estimates. Geneva: WHO.
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