Question: How can I tell when thoughts of harming myself or others are serious enough to get professional help?
Answer: Actually, many patients with some of the anxiety disorders, such as panic disorder and generalized anxiety, actually worry that their ruminations or thoughts mean that they're crazy or that they actually might act on their suicidal thoughts. And oftentimes it's actually the opposite, that they would never act on these thoughts. It's the thought itself that's disturbing to them.
However, there are individuals with posttraumatic stress disorder who can be profoundly depressed and feel hopeless and despondent. And they certainly can have serious suicidal thoughts. And sometimes come back -- as we know and combat veterans who have been in the theatre of war -- can have difficulty modulating their anger or rage and actually have homicidal thoughts that are quite serious. There's a variability.
I think some good guidelines would be if thoughts of suicide or homicide are really persistent and their accompanied with thoughts of a plan or a method, then you definitely should seek help from a mental health provider as soon possible.