# Coping with Suicidal Thoughts



## Daniel (Jun 24, 2009)

Coping with Suicidal Thoughts
_Centre for Applied Research in Mental Health and Addiction_
carmha.ca

*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. 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.
*
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 1-800-SUICIDE (1 800-784-2433).

*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.

_*Safety Plan
*_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 energy into sorting out problems that have contributed to you 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.

1. Do activities to calm/comfort myself.
2. Remind myself of my reasons for living.
3. Call a friend or family member.
4. Call a backup person if person above is not available.
5. Call a care provider (psychologist, psychiatrist, therapist).
6. Call my local crisis line.
7. Go somewhere I am safe.
8. Go to the Emergency Room at the nearest hospital.
9. 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.
*
How can I better understand my suicidal thoughts and feelings?
*
Some problems and experiences, especially those that have been around for a long time, can leave you feeling hopeless and overwhelmed. At these times, you may think that you have no options left. You may think about suicide as a way to escape intense emotional pain.

People who kill themselves often think that their problems are unbearable and can’t be fixed. They feel like nothing they have tried has or will change their situation. Their emotional pain can distort thinking so it becomes harder to trust, or to see possible solutions to problems, or to connect with available love and support. Even if it seems that you can’t stand another minute, it is important to remember that feelings (e.g., grief, anger, sadness, loneliness, shame), especially at this intense level, don’t last forever. Sometimes thoughts of suicide can become very strong, especially if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol, particularly when you feel hopeless or are thinking about suicide.

Some of the thoughts you may be having are:
• believing there are no other options
• sensing your family or friends would be better off without you
• thinking you’ve done something so horrible that suicide is the only option
• experiencing unbearable pain that feels like it will go on forever
• wanting to escape your suffering
• wanting to let your loved ones know how much you hurt
• wanting to hurt or get revenge on others

Your feelings of pain are very real. However, it is important to know that there is hope. With the help of professionals and the support of family and friends, you can learn about what is causing your suffering and how you can change or manage it.

Hurting or killing yourself are not your only options. Professionals can help you learn new skills for dealing with your pain. These might include:


developing new skills to cope
seeing your problems in a new light
improving your ability to handle intense and painful emotions
improving your relationships
increasing your social supports
medications.
_*Some other things that may lead you to think of suicide are:
*_
*Mental health problems:* Some mental health problems, such as depression or anxiety, can increase feelings of suicide. Mental health problems are treatable. It is important to talk to your doctor if you feel low, depressed, or anxious. Counseling or medication may help. There are also free resources that can help (e.g., the Antidepressant Skills Workbook, at CARMHA).

*Conflict with loved ones:* You may feel that your family or friends would be better off without you. It is important to remember that conflict with others doesn’t last forever. Ending your life is not a way to solve that conflict. We know that people who lose a loved one to suicide say that their lives are not better off.

*Loss:* Many different types of loss can increase the chances you may feel suicidal. Some examples that may set off feelings of suicide include: a break-up; losing a job; losing social status; or losing a loved one or friend. Knowing someone who has died by suicide can increase the chance that you think of suicide as an option. As difficult as your loss may seem, there are people and services that can help you get through difficult times, such as Griefworks BC (1-877-234-3322).

*Financial/legal problems:* Financial or legal problems, such as overwhelming debt, gambling problems, or problems with the law, can be very stressful. It is important to know that there may be free services that can help you deal with financial or legal problems. These include the Credit Counselling Society (1-888-527-8999), the Problem Gambling Help Line (1-888-795-6111), or the Legal Services Society (1-866-577-2525).

*Lack of connection to friends and others:* Thoughts of suicide can increase if you spend a lot of time alone, or don’t feel you can tell anyone your problems. Talk to someone, like a professional, about ways that you can increase social supports in your life. You may feel that the people that are in your life don’t understand the pain you arefeeling. Talk to a professional about ways that you can let others know of the pain and unhappiness you are feeling. The Social Supports wellness module at Here to Help gives ideas for how to improve your social supports.

*Drug and alcohol problems:* Using alcohol or drugs can make feelings of depression, anxiety, and thoughts about suicide worse. Drugs and alcohol can change the way you think about problems in your life. If drugs or alcohol are causing your problems, you can get information on treatment from the BC Alcohol and Drug Information and Referral Service (1-800-663-1441).

*Medical problems:* Medical problems such as diabetes, thyroid problems, chronic pain, or multiple sclerosis can increase chances that you may think about suicide. Make sure you have proper medical care for health problems. Some medications can increase feelings of suicide. It is important to speak to your doctor about this. You can also get information by calling the BC Nurse Line (1-866-215-4700) or the Living a Healthy Life with Chronic Conditions program (1-866-902-3767).

*Sexual identity issues:* People who are lesbian, gay, bisexual, or transgender may have a higher risk of suicide. Confusion about sexual identity and fears of possible or real rejection from family or friends can make things worse. There is support available. Prideline (1-800-566-1170) is a peer support and information phone line. Prideline is open 7 days a week, from 7:00 p.m. to 10:00 p.m.

*What else can I do to decrease thoughts of suicide?

**Problem-solve:* 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 at CARMHA or at www.heretohelp.bc.

*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
**Possible Solution:
*• Call 1-800-SUICIDE 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 a relationship
* *Possible Solution:
*• Talk to friends about the pain you feel.
• Get help from a crisis line or counselor.
• Join a social group.

*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.

*Self-care:* Taking good care of yourself is importantto 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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_*Useful Phone Numbers (24 hrs/day, 7 days/week)
*_1-800-SUICIDE (1-800-784-2433)
BC Nurse Line: 1-866-215-4700 (TTY deaf/hearing impaired number: 1-866-889-4700)
BC Mental Health Information Line: 1-800-661-2121
BC Alcohol and Drug Information and Referral Service: 1-800-663-1441
Problem Gambling Help Line: 1-888-795-6111

_*Other Useful Phone Numbers
*_Credit Counselling Society: 1-888-527-8999
Mood Disorders Association of BC: 604-873-0103
Early Psychosis Intervention Program: 1-866-870-7847
Griefworks BC: 1-877-234-3322
Legal Services Society: 1-866-577-2525
SAFER (Suicide Attempt Follow-up, Education and Research): 604-879-9251
Vancouver Crisis Centre: 1-866-661-3311

_*Useful Websites
*_Anxiety Disorders Association of BC: Anxiety BC
BC Schizophrenia Society: British Columbia Schizophrenia Society
Canadian Mental Health Association – BC Division: CMHA BC Division
Early Psychosis Intervention Program: Fraser Health Authority
BC Partners for Mental Health and Addictions Information: Here to Help
Mood Disorders Association of BC: mdabc.ca
Youth Support: YouthInBC - Be heard. Get help.

*Books
*Arena, J. (1995). _Step Back From the Exit: 45 Reasons to Say No to Suicide_. Milwaukee, WI: Zebulon Press.
Bilsker, D., & Paterson, R. (2005). _Antidepressant Skills Workbook_. Vancouver, B.C.: Centre for Applied Research in Mental Health and Addiction. Free download at: CARMHA.
Blauner, S. R. (2002). _How I Stayed Alive When My Brain Was Trying to Kill Me: One Person’s Guide to Suicide Prevention_. New York, NY: William Morrow.
Chabot, J. A. (1997). _A New Lease on Life: Facing the World After a Suicide Attempt_. Minneapolis, MN: Fairview Press.
Cobain, B. (1998). _When Nothing Matters Anymore: a Survival Guide for Depressed Teens_. Minneapolis, MN: Free Spirit Publishing Inc.
Conroy, D. L. (1991). _Out of the Nightmare: Recovery From Depression and Suicidal Pain_. New York, NY: New Liberty Press.
Quinnett, P. G. (1995). _Suicide: the Forever Decision. For Those Thinking About Suicide, and For Those Who Know, Love, or Counsel Them_. New York, NY: The Crossroad Publishing Company.

_This document is not intended to replace professional care with a therapist or physician._


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## David Baxter PhD (Jun 28, 2009)

Thread split to http://forum.psychlinks.ca/suicide/18257-feeling-hopeless.html


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