If we're to have a have a chance at turning around rising suicide rates, researchers say we need to understand more about the way suicide progresses – the developments that lead from suicidal thoughts to the act that takes a person's life.

An important part of that progression is time. How long does suicidal ideation persist for in a person's mind? How long before those thoughts prompt an individual to attempt suicide? And how does an individual's perception of time influence things?

In a new study, researchers investigated these questions, surveying a group of over 280 participants.

The cohort encompassed individuals who had recently attempted suicide, people with depression currently experiencing suicidal thoughts, non-suicidal patients with depression, and healthy controls without a history of mental illness or drug abuse.

Participants conducted a variety of tests, designed to measure things like their level of depression and anxiety, but also protocols that gauged levels of impulsivity, and a time estimation task that probes how fast or slow an individual perceives time to be passing.

In the results, the researchers found that among the individuals who had attempted suicide, the amount of time they contemplated suicide was dominated by two distinct patterns: those who thought about suicide for less than 5 minutes, and those who thought about it for longer than three hours.

Similarly, the suicide action interval – the time difference between the decision to commit suicide and the resulting attempt – showed a significant split in the data, with the majority of patients indicating either less than 5 minutes, or longer than three hours.

In addition to this, the researchers found that the perception of time slowing was linked to severity of suicidal ideation, with individuals contemplating suicide thoughts for up to three hours showing increased time slowing in their time estimation results.

"The main take home message is that a considerable number of persons who attempt suicide do so impulsively," first author and psychiatrist Ricardo Caceda from Stony Brook University told PsyPost.

"A second point is that during a suicidal crisis individuals tend to experience time very slowly, likely contributing to the worsening of the experience of intense psychological distress."

While there are limits to how much we can conclude from the results, the researchers suggest that a heightened sense of time passing slowly could reflect a kind of "derealization- or depersonalization-type phenomena", with similar alterations in time perception having been seen in previous research with soldiers, and in patients with post-traumatic stress disorder.

"The experience of time slowing or dilation in suicidal patients, likely triggered by overwhelming psychological pain, may in turn worsen the perception of inescapability from psychological pain," the researchers write in their study.

"It could be hypothesized that the height of a suicidal crisis could be a dissociative-like state, triggered by overwhelming psychological pain and characterized by a slowed perception of time."

Beyond the hypotheses on the effects of time perception, the researchers hope their new data on timings related to suicidal contemplation and the suicidal action interval could help inform new clinical understandings, giving doctors more awareness of risk factors related to time, which might one day help improve suicide prevention strategies.

The findings are reported in European Neuropsychopharmacology.