Suicidal thoughts can happen when feelings of hopelessness, isolation and despair become too heavy to bear. You might feel so overwhelmed with pain that suicide seems like the only way to release yourself from the burden you’ve been carrying. You should know that there is help available to deal with your feelings. Contacting a mental health professional can help you heal and experience joy and happiness again, no matter how impossible it seems right now.
Coping With Suicidal Thoughts
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Written by Dr. Joti Samra, R.Psych. and Dr. Dan Bilsker, R.Psych. (Lead Authors), Consortium for Organizational Mental Health (COMH; www.comh.ca), Faculty of Health Sciences, Simon Fraser University, Vancouver, BC.
I’m seriously thinking about suicide. What should I do?
If you are thinking about suicide, you are not alone. Many people have thoughts of suicide, for a number of reasons. Thoughts of suicide can be very scary. You probably feel hurt, confused, overwhelmed and hopeless about your future. You may feel sadness, grief, anger, guilt, shame, or emptiness. You may think that nothing can be done to change your situation. Your feelings may seem like they are just too much to handle right now. It is important to know that thinking about suicide does not mean that you will lose control or act on these thoughts. Having thoughts of suicide does not mean you are weak, or ‘crazy’. Many people think about suicide because they are looking for a way to escape the pain they are feeling.
Connect with others: If you are worried that you may lose control or do something to hurt yourself, tell someone. Make sure you are around someone you trust. If you live alone, ask a friend or family member to stay with you. If you don’t know anyone or can’t reach friends or family members, call your local crisis line.
Keep your home safe by getting rid of ways to hurt yourself: It is important to get rid of things that could be used to hurt or kill yourself, such as pills, razor blades, or guns. If you are unable to do so, go to a place you can feel safe.
Develop a safety plan: It is very helpful to have a written safety plan when you have thoughts of hurting yourself. Have a trusted family member, friend, or professional help you to complete this safety plan. Keep this plan somewhere you can see or find easily. Write down the steps you will take to keep yourself safe (see the following example). Follow the steps. If you follow these steps and still do not feel safe, call a crisis line, get yourself to a hospital emergency room or call 911.
If you have thoughts of hurting yourself, start at Step 1. Go through each step until you are safe. Remember: Suicidal thoughts can be very strong. It may seem they will last forever. With support and time, these thoughts will usually pass. When they pass, you can put energyi nto sorting out problems that have contributed toyou feeling so badly. The hopelessness you may feel now will not last forever. It is important to reach out for help and support. You can get through this difficult time. Since it can be hard to focus and think clearly when you feel suicidal, please copy this and put in places where you can easily use it, such as your purse, wallet or by the phone.
- Remind myself of my reasons for living
- Call a friend or family member
- Call a backup person if person above is not available
- Call a care provider (psychologist, psychiatrist, therapist)
- Call my local crisis line
- Go somewhere I am safe
- Go to the Emergency Room at the nearest hospital
- If I feel that I can’t get to the hospital safely, call 911 and request transportation to the hospital. They will send someone to transport me safely.
What Else Can I Do To Decrease Thoughts of Suicide?
It is always helpful to think of ways other than suicide that you can solve your problems. First, make a list of all the problems you are dealing with in your life. Second, make a list of all the solutions you can think of to those problems. You can ask someone you trust to help you with this. Dealing with 1 or 2 small problems can help to put an end to immediate feelings of suicide. Once you are thinking more clearly, you can tackle other bigger problems. You can find worksheets on Problem-Solving and Healthy Thinking in the Antidepressant Skills Workbook www.carmha.ca or at www.heretohelp.bc.ca
Even though your situation seems hopeless and you wonder if you can stand another minute of feeling this bad, there are ways to get through this and feel better. You don’t have to face this situation alone. Help is available. Here are a few ideas that you can use right now.
Think of reasons for living:
Most people who think about suicide want to escape their pain, but they do not always want to die. When you feel low, it’s easy to stay focused on things that are negative and upsetting in your life. This makes it easy to think of suicide as the only option. Start thinking about some reasons you have for living. For example, many people have relationships with loved ones, pets they love, religion, goals and dreams, or responsibilities to others in their life that give them reasons to live and prevent them from acting on their suicidal thoughts. Think of all of the reasons you have for living. Write them down. Remind yourself of them when you are feeling low.
Remember things that have helped in the past:
Many people have had thoughts of suicide before. Think of some of the things that helped you feel better when you faced the same types of problems in the past. Some examples are: having faith and trust that time always helps; reaching out to friends and family; seeing a professional; going to a support group; following a safety plan; doing something you enjoy; not being alone; keeping a journal; or not drinking or using drugs.
Talk to a trusted friend, family member, or professional:
It is important to speak to someone you trust about how you feel. Sometimes just talking about how you feel can help. It is important to be open about all of your thoughts. If you have a suicide plan, it is important to tell someone what your plan is. People often say they are relieved that they shared how they felt with someone. Talking can help you feel less alone.
Get treatment for mental health problems:
It is important to get treatment for depression, anxiety, and alcohol and drug problems. Just seeing your family doctor may not be enough. It can help to see a mental health specialist, such as a psychologist or a psychiatrist. You can get referrals from your doctor or learn how to find a specialist from one of the referral lines listed on the last page. If you are already receiving treatment, speak up if your treatment plan is not working.
Do the opposite of how you feel:
When you have thoughts of suicide, it can be helpful to do the opposite of how you feel. For example, when people feel depressed they usually want to be alone. Doing the opposite, for example getting in touch with others, can help with feelings of depression.
Some examples of common problems and ideas for solutions are:
Problem: Depressed Mood:
- Call a crisis line for emotional support
short-term problem-solving and referrals for longer term help.
- See your family doctor to discuss options for treatment (e.g., medications, changes in medications, undiagnosed illnesses).
- Take care of yourself by resting, exercising regularly, eating regularly and spending time with friends.
Problem: End of Relationship:
- Talk to friends about the pain you feel.
- Get help from a crisis line or counselor.
- Join a social group.
How Can I Better Understand My Thoughts?
How can I decrease chances that I will feel suicidal in the future?
Get professional support:
You can get help and referrals from your doctor or from referral lines listed on the following page. If the first referral doesn’t work for you, ask for another.
Identify high-risk triggers or situations: Think about the situations or factors that increase your feelings of despair and thoughts of suicide. Work to avoid those situations. For example, going to a bar and drinking with friends may increase feelings of depression. If this is a trigger for you, avoid going to a bar or seeing friends who drink.
Taking good care of yourself is important to feel better. It is important to do the following:
- Eat a healthy diet;
- Get some exercise every day;
- Get a good night’s sleep;
- Decrease or stop using alcohol or drugs, as these can make feelings of depression and suicide worse.
Follow through with prescribed medications:
If you take prescription medications, it is important to make sure you take them as your doctor directed. Speak to your doctor if medications aren’t working or if side effects are causing you problems. If you have just begun taking antidepressants, it is important to know that symptoms of depression resolve at different rates. Physical symptoms such as energy or sleep may improve first. Improvement in mood may be delayed. Speak to your doctor if you are feeling worse.
Structure and routine:
Keep a regular routine as much as possible, even when your feelings seem out of control. Here are some tips for creating structure in your life:
- Wake up at a regular time;
- Have a regular bed time;
- Have planned activities in your day, such as going for a walk or going to the gym;
- Continue to go to work or school.
Do things you enjoy:
When you are feeling very low, do an activity you enjoy. You may find that very few things bring you pleasure. Think of things you used to enjoy doing at times you didn’t feel so depressed or suicidal. Do these things, even if they don’t bring you enjoyment right now. Giving yourself a break from suicide thoughts can help, even if it’s for a short time.
Think of personal goals:
Think of personal goals you have for yourself, or that you’ve had in the past. Some examples are: to read a particular book; travel; get a pet;move to another place; learn a new hobby; volunteer; go back to school; or start a family.
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