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:

  1. Acknowledge the suicidal thought.
  2. Talk back to my suicidal thought.
  3. 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:

  1. I know you want to die.
  2. You know the rules — no kill; no die.
  3. 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.