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[Article revised on 13 July 2020.]
If you are assailed by suicidal thoughts, the first thing to remember is that most people who have attempted suicide and survived ultimately feel relieved that they did not end their life.
Some of the thoughts you may be having include:
- I want to escape my suffering.
- I have no other options.
- I am a horrible person and don’t deserve to live.
- I have betrayed my loved ones.
- My loved ones would be better off without me.
- I want my loved ones to know how bad I’m feeling.
- I want my loved ones to know how bad they’ve made me feel.
*Whatever thoughts you are having, and however bad you are feeling, remember that you have not always felt this way, and that you will not always feel this way.*
The risk of a person committing suicide is highest in the combined presence of:
- Suicidal thoughts.
- The means to commit suicide.
- The opportunity to commit suicide.
If you’re prone to suicidal thoughts, ensure that any means of committing suicide have been removed. For example, give tablets and sharp objects to a trusted person for safekeeping, or put them away in a locked cupboard or other hard-to-access place.
Also ensure that the opportunity to commit suicide is lacking. The surest way of doing this is by remaining in close contact with one or more people, for example, by inviting them to stay with you, or going to stay with them. Share your thoughts and feelings with these people, and, if you need it, don’t hesitate to ask for their support.
Failing that, there are a number of helplines that you can ring at any time of day or night. If needs must, you can even ring for an ambulance or take yourself to the Emergency Department.
Avoid alcohol and drugs, as these can cloud your thinking, leading to impulsive and dangerous behaviour. In particular, don’t drink or take drugs when alone, or when you’re going to end up alone.
Going to sleep can be a very good idea. Sleep is an escape from suicidal thoughts and associated feelings, and even a single night’s rest can completely shift one's outlook.
If you're having trouble sleeping, read my article on sleep.
When you’re feeling more stable, make a list of all the positive things about yourself, and make another list of all the positive things about your life, including those that have so far kept you going. Get some help with the lists, as your depression is very likely to be skewing your judgement. Keep the lists on you, and read them to yourself regularly and whenever you are assailed by suicidal thoughts.
On a separate sheet of paper, write a safety plan for the times when you feel like acting on your suicidal thoughts. Your safety plan could involve delaying any suicidal attempt by at least 48 hours, and then, as soon as possible, talking to someone about your thoughts and feelings. Discuss your safety plan with a health professional and commit yourself to following it.
Example of a safety plan
1. Read through the list of positive things about myself.
2. Read through the list of positive things about my life and remind myself of the things that have so far prevented me from committing suicide.
3. Distract myself from suicidal thoughts by reading a book, listening to classical music, or watching my favorite film or comedy.
4. Get a good night’s sleep. Take a sleeping tablet if necessary.
5. Delay any suicidal attempt by at least 48 hours.
6. Call Stan on (phone number). If he is unreachable, call Julia on (phone number). Alternatively, call my healthcare professional on (phone number), or the crisis line on (phone number).
7. Go to a place where I feel safe such as the community centre or the sports centre.
8. Go to the Emergency Room.
9. Call for an ambulance.
For the longer term, try to address the cause or causes of your suicidal thoughts in as far as possible. Discuss this with your doctor or another health professional, who will help you to identify and access the most appropriate forms of support.
You might also be interested my related article, Coping with Self-Harm
Neel Burton is author of Growing from Depression, Heaven and Hell: The Psychology of the Emotions and other books.
