Some people live with thoughts of suicide every day. I have lived this way. It’s hell. Persistent suicidality can happen in depression, although it’s not talked about very much. There is a notion that people think about suicide, and they either get help, which rids them of the thoughts, or act on the thoughts. And while I have no doubt some people have had that experience, for many, this just isn’t reality. Even the best treatment can’t always rid a person of constant thoughts of suicide.
What Are Suicidal Thoughts Like Every Day?
Thoughts of suicide differ from person to person, but for me, as a writer, the thoughts of suicide would come as words. “I want to die,” would circle in my head minute after minute, hour after hour. And every time, I would have to force myself not to act on those thoughts. It is an extreme form of hell when the thing that your brain tells you that you want the most is something you have to deny yourself every single fucking minute of every single fucking day. It’s excruciating.
And while the words would be clear as day in my mind, for some people, suicidality is more like a movie that runs in their heads 24/7. A movie with a horrific ending that your brain tells you must happen but that you have to fight against.
Suicidal thoughts every day feel like razor wire being dragged across my skin over and over — they leave me bloody and wounded.
Persistent Suicidal Thoughts Are Intrusive Thoughts
These persistent suicidal thoughts are what are known as “intrusive thoughts.” Intrusive thoughts are most closely associated with obsessive-compulsive disorder (OCD) but happen to many people — with or without a mental illness. Intrusive thoughts are thoughts that keep popping into your head even though they cause you distress and you don’t want them there.
Persistent suicidal thoughts can also be attributed to rumination. Rumination is defined as “compulsively focused attention on the symptoms of one’s distress and on its possible causes and consequences, as opposed to its solutions” (although, in the case of suicidal thoughts, suicide is usually seen as the solution).
Doesn’t Treatment Help Constant Suicidal Thoughts?
Well, yes and no. Treatment absolutely does help constant thoughts of suicide; the trouble is that treatment doesn’t necessarily help constant thoughts of suicide right away. As people under treatment for mental illness know — the first medication is rarely the right or best one. So you can get treatment — psychiatric and psychological — and still suffer from suicidal thoughts every day.
In time, however, I believe that treatment and coping skills win the day. Those are the only things that are going to help with serious, persistent thoughts of suicide.
How I Handle Thoughts of Suicide Every Day — A Coping Skill
There are three parts to what I do with everyday suicidal thoughts:
- Acknowledge the suicidal thought.
- Talk back to my suicidal thought.
- Think about something else.
As an example, after I’ve obsessively told myself I want to die for the umpteenth time in a day, I might say to myself:
- I know you want to die.
- You know the rules — no kill; no die.
- Let’s get a glass of water.
(And yes, I have a rule called, “No kill; no die.” I live with a lot of rules that I’ve made up. They’re helpful for me because they tell me how to act without having to constantly think things through. Of course, that is for another post.)
Over and over, I acknowledge the existence of thoughts. Over and over, I tell myself I’m not allowed to commit suicide. And then, over and over, I try to distract myself.
One might argue that this is a losing equation if the thoughts just keep coming back and back. I would argue that it’s a winning equation, though, in that I am not dead.
(Understand that the above is used in conjunction with proper medical treatment for my bipolar disorder. It’s that treatment that eventually irradicates the thoughts, but the above is a coping skill to use while waiting for that to happen.)
Other Ways to Handle Persistent Suicidal Thoughts
There is one really important other thing to remember: Suicidal thoughts can lead to death.
And if you’re in a situation where the suicidal thoughts are literally to a point where they’re going to kill you, you need to take extra steps because the above likely won’t be enough. If you’re in danger of acting on suicidal thoughts, you need to get help immediately. Do not pass Go, do not collect $200. Get to a doctor’s office, or a psychologist’s office, or a hospital immediately and be honest about what you’re thinking and feeling. Your life is valuable and important. It is too valuable and important not to take this step.
If you’re in need of immediate suicidal thoughts control, you may be admitted to a medical facility. This is not nearly as bad as it sounds. I’ve done it. I’ve checked myself into a hospital for suicidality. It was not a party. It was not a cakewalk. But it kept me alive, and that’s what it needed to do while waiting for my medication to take effect.
Another option for fast help with thoughts of suicide every day is electroconvulsive therapy (ECT) — yes, shock therapy. I’ve tried this one, too, and it isn’t as bad as it sounds either. While this therapy isn’t guaranteed to stop the suicidal thoughts, it has a very good track record of helping people with even the severest of depression — sometimes starting after only one treatment. This is not a silver bullet, as there are many things to consider with ECT (like possible memory loss), but it absolutely has been life-saving for some.
One other thing, medication is typically good at treating an illness, not suicidality specifically, in all but one case: lithium. Lithium’s anti-suicidal effect isn’t necessarily fast, but in the long run, taking lithium can save your life.
You Aren’t Alone with Thoughts of Suicide Every Day
Basically, what I’m saying is this: if you have thoughts of suicide, you aren’t alone. I’ve been there, and so have many others. You can get through this horrible situation. Use coping skills, therapy, and medical treatment to do it. You don’t have to live with thoughts of suicide every day.
Help for Suicidal Thoughts
If you’re looking for help with thoughts of suicide, you can start here.
Aren’t suicidal thoughts sometimes rational? What if your life is hell and there’s no way to improve it? What if you have multiple medical conditions, symptoms are getting worse, you are in some form of pain all the time, and you can’t focus, feel, care or function well enough physically to do anything that brings quality to life? Are you supposed to just sit around being a hurting vegetable? Thinking about suicide isn’t necessarily a form of intrusive thought; it may also be a strategy for escape from an impossible life. Sometimes the best we can do to end our suffering is to end our lives.
And I don’t think medications remove suicidal thoughts. I first started thinking of killing myself when I was taking lithium, because I felt so awful on it. There is no magical medication that will make life livable. A mental health medication won’t take away chronic pain, or functional limitations, or nagging symptoms you’ve had for years that are simply getting in the way of having a real life. The best bipolar medications do is keep mania away, they don’t even allow me to think, feel or concentrate enough to distract myself from my problems. They certainly don’t change the long-term “unlivable” quality of my life to “livable”. And the more health problems that accumulate, and the more severe the symptoms get, the less and less room there is for any kind of life or hope.
Hospital stays only prolong the process of getting to suicide, they don’t prevent it if the conditions of life never change. You can stop someone temporarily from killing themselves by keeping them in a ward, but dumping different mental health meds on them will not take away chronic pain or functional limitations.
Suicide is the end result of a hopeless, unlivable life. It’s not just a random impulsive thought. I DON’T go around with the thought all day long. It doesn’t circle in my brain. It’s not an impulse. But I think about it here and there because there are no solutions and I don’t think I can bear this long-term.
i been living with sucidal thoughts for awhile, i tell my self go to sleep and not wake up, i hate my life. Even thou i have 6 kids and married i feel so alone. What can i do, i been drinking alot to do deal with evrydathin but feel so alone, my husband is in a another state to support ud us but feel so alone.
at age 60 and a lifetime of bipolar 1, i am so opposed to suicide even though i affirm each individual’s right to decide. we’ve lost so many many good people this way. for me it is pure luck that i have survived; i no longer want to tempt fate.
my strategy for pushing suicidal thinking away is to tell myself, hey, you’ve considered this so many times before, in the end you always want to live. because, really, i do not want to die. i know this in my heart. so i try to short-circuit the rumination by believing that some of us are meant to go this way, some of us are not. close friends and relatives who have gone by their own hands, i do believe that in some way it was their fate, tragic as that may be.
but i know one thing: suicide is not my fate. so why waste time thinking about it?
I like the Buddha’s approach (and yours) to these suicidal thoughts:
1. Acknowledge the thought
2. Invite the speaker, in this case Mara, in for tea
3. Then get up from the table and get to your next errand, apologize first for leaving Mara alone.
Most important: Get help if in crisis.
In the worst of my suicidal urges, I took one dose of an antipsychotic medication. It helped me slow my suicidal thinking. Then I could step back from what I understood was an idea not based on reality. Therapy helped as well.
For alcohol issues, I would consult your on-line Where and When AA Meeting Guide to get to the nearest meeting for social support ASAP. AA has prevented many suicides.
I never actually WANTED to die, even in my most painful moment. There have been times of suicidal intrusive thoughts though, which are a combination of thought and impulse. They tend to come at times when I suffer from feeling that my body is a bit unreal/depersonalization, maybe because it makes me feel out of control physically. But my ”method” for handling it is similar to yours, I think that it is just not ok and try to distract myself.