Suicidal Thoughts - a guide

Dealing with suicidal thoughts

If you need help RIGHT NOW, please contact the Samaritans or other national helpline

There are times in life when we might feel totally, hopeless, helpless, overwhelmed with emotional pain. It can seem like there is no other way out of our problems, we've run out of ideas, possible solutions. Our problems seem unfixable. The pain feels like it will never end. We believe we've run out of options, and suicide is the only answer left.

Maybe the suicidal thoughts come to mind, you might have mixed feelings about them. Suicidal thoughts are very common, but can be frightening and confusing. We tend to avoid talking about them, so we don't realise how common they are.

Suicidal thoughts are a sign to change something in your life - NOT to end your life!

For some people, suicide may be a way of getting back at others, or showing them how much pain you're in. But after suicide, you won't be there to see that they feel guilty, or finally understand your pain.

Feelings will pass. Depression feels permanent, but it's transient. Things will change. Depression comes and it goes.

Over 90% of people who survive a potentially lethal suicide attempt, do not go on to kill themselves.

It is a temporary crisis, an attempt to stop the inner pain. You will get through this tunnel and come out the other side. The feelings will pass!

Depression and pain distort our thinking. It can seem like we're wearing very dark tinted 'gloomy specs'. Everything looks different to how it really is.

Thoughts are thoughts - not necessarily how things are, although it certainly feels like the thoughts are true. Thoughts affect the way we feel, and thoughts and feelings affect the way we react, what we do (see CBT page).

Suicidal thoughts can result when we experience too much pain, without having enough resources to cope.

We therefore have two ways to get us through this horrible time:

Reduce our pain - felt both emotionally and physically
Increase our coping resources

REDUCE THE PAIN

Self-soothing

Do something that will help you feel better, right now
Perhaps collect items into an emergency bag or box that you can turn to
Use all five senses to find things that will soothe you

Vision
Focus your attention on looking at something nice, nature, a painting, watching a favourite programme or movie

Hearing
Listen to a favourite piece of music, sounds of nature, sing

Smell
Really notice smells - favourite soap, food, essential oil

Taste
Use sensation of taste to focus your attention. Eat mindfully - savouring each moment

Touch
Wear soft comforting socks, stroke a pet, give yourself a hand massage

A useful reminder, using the 5 senses, to help you shift focus of attention and ground you into the present moment:

5 things I can see

4 things I can hear

3 things I can touch

2 things I can smell or taste

1 breath. Then continue to just notice your breathing and the sensations of breathing in your belly

Avoid drugs and alcohol

Whilst it seems like they help for a while, they will make your problems worse.

Ask yourself:

Are these thoughts facts or my opinion? They may FEEL true, but are they actually true? (Talk to someone to hear what they have to say! or ask yourself "What would x say about this?")
What has helped me feel better in the past?
What can I do right now that will help me feel better?
What gives my life meaning? What are my goals, dreams or life values? E.g. Family, friends, pets, helping others, faith, spirituality, community life, connecting with nature.

Tell yourself:

Use positive coping statements
I've coped this far, I can get through the next .... (day, hour, 10 minutes)
Things will look better in time.
Depression is temporary - this will pass.
Depression is distorting my thinking - these thoughts are the voice of depression. They are not facts. I don't have to act on them.
The vast majority of people get better from depression. I will look back and be pleased that I chose to live.

Write things down

Safety Plan worksheet & Safety Plan Cards (PDFs)
Alternative Thoughts & Actions worksheet (PDF)
Crisis Management Plan worksheet (PDF)

INCREASE COPING RESOURCES - IMMEDIATE STEPS

Take one step at a time

Take things a little at a time. Set out to get through the next day, the next week or month, perhaps the next hour or even less. Tell yourself: "I've got through so far, I can get through the next hour".

Grounding Techniques

Help for Distress - Now

Distraction

Do something else, and focus your attention fully on what you're doing, e.g.
Gardening
Household chores
Physical exercise - walk, run, cycle, dance
Tapping (Emotional Freedom Technique)
Reading - magazine, self help book
Television
Seek out a supportive discussion forum on the internet
Learn something new on the internet
Use an Imagery technique
Help someone else
Go to the park, the beach - pay attention to nature
Visit someone
Music
Stroke a pet
DIY
Feed the birds
Sudoku or crossword
Do something creative: painting, writing, knitting, play a musical instrument, make a collage, bake a cake, cook a meal, arrange some flowers, make a website or blog

STOPP (or worksheet PDF version)

Talk to someone - now!

A friend or family member
A telephone helpline (E.g. Samaritans 116 123)
A health professional
Go somewhere you'll feel safe - be with other people
Go to the local Accident & Emergency department
Call the local emergency number (E.g. 999, 112, 911)

INCREASE COPING RESOURCES - LONGER TERM STEPS

Take action!

We can only change our situations by changing something about the way we think, or what we do
Complete a Multimodal Treatment Plan

Plan activity and routine

Increase your activity PDF
Plan activites to achieve, connect with others & enjoy (ACE)
Get into a daily routine and stick with it - get up at the same time each day, go to bed at the same time, plan an activity each morning, afternoon and evening
Do things you enjoy, or used to enjoy, or you think you might enjoy: Energising vs Draining Activities
Set realistic goals
Write it down: Weekly Planner, Activity Diary or ACE Log PDFs

Look after yourself

Eat healthily PDF, balance sleep, treat physical or mental health problems, avoid drugs and alcohol, get regular exercise PDF

Systematically work through a problem

Work through a problem
Get help from an appropriate person or agency (E.g. Citizens Advice Bureau)

Maintain or improve relationships

Connect and be with others
Call, text, email - friends or family
Create new contacts - join a local support group or an online discussion forum
Repair relationship: Relationship Worksheet

Lower your expectations

Sometimes life can feel like we're struggling to drive or cycle up a long and steep hill, in top gear. The motor just can't get us there. It works really hard, but it's impossible to get up that steep hill in top gear. We need to change down a gear or two. Changing down gives the motor more torque, and is much better able to drive those wheels up that hill, albeit a bit slower.
We often try to struggle on in top gear, expecting so much of ourselves, of others, of life itself. Sometimes we need to change down a gear. Slow it down, reduce the struggle. Carry on, but in a lower gear.
Pace & Plan PDF

Write a daily diary or journal, or use these worksheets: