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Thoughts of Suicide

If you are experiencing thoughts of suicide, you are not alone. Research shows us that any given time, one in twenty people might have thoughts of suicide of varying intensity. Unfortunately presence of such thoughts means that you have reached a point of significant emotional distress, might feel trapped, helpless, perceive yourself as an undesired burden on others or feel a profound sense of disappointment in relationships that were meant to be mutually nurturing.  

However awful life might feel at the moment, it is important not to act on thoughts of suicide. First, thoughts of suicide vary in intensity and the sense of emotional pain does not last forever even if it might feel so at the moment. Second, humans are adaptive problem solvers. With time we either find a solution to things that currently seem unsurmountable or find a way to adapt and live with them. Third, suicide attempts might be fatal or cause long lasting physical damage. Most actions we take in life can be corrected. Suicide truly is a permanent solution to a temporary problem. Finally, suicide attempts tend create more emotional damage for you and your loved ones. People emerge from suicide attempts thinking that they are weak because of their failure to take their own life (“I can’t even kill myself”) or because they no longer trust themselves (“What did I just do? I am my own worst enemy.”). Furthermore, once a person attempted suicide, the risk of future attempts increases exponentially. Plus, what happens to relationships after an attempt? Those who care for you will be looking out for your safety but at the same they are now less likely to confide in you and make you part of important life decisions.

To stay safe, make sure that you have a safety contact person who is familiar with your situation and willing to offer emotional support. Alternatively, call a warm line, crisis line or 911. Each hospital has a crisis team in the emergency department and a worker will be available to talk to you on a short notice.  

It is important to disable the suicide plan. For example, if you were thinking about an overdose, make sure that you do not have easy access to medications – having to walk to a store might be enough to clear your head and stop you from acting on impulse.

Think short-term and postpone any rash actions until you have talked to someone. You might have great difficulties imagining your future but it might be easier to imagine the next 2-3 days when you have a coping plan in place. A crisis worker will help you prepare a safety plan.

Staying safe is a crucial and necessary first step. However we need to do something about the life circumstances and the pain that caused thoughts of suicide in the first place. Otherwise you might end up by living from crisis to crisis. The diagram to the right outlines predisposing, precipitating and perpetuating factors that impact people’s thoughts of suicide.  

The work typically starts at the level of perpetuating factors that include our beliefs, behaviours, body reactions and relationships. We learn to put our thoughts in perspective so that the necessary action plans might be implemented to take care of the situation that triggered the distress. Sometimes we cannot “take care” of the situation but we can learn to adapt to it, albeit most significant life events require both: willingness to change and to adapt. Divorce or diagnosis of a serious illness require action (e.g., going through the legal process associated with divorce or going to medical appointments and getting the necessary treatment) as much as they require adaptation (e.g., learning that it is still possible to form new relationships or even survive on one’s own after the divorce or learning to grab moments of respite and joy during remission). 

Behaviours and thoughts might become self-defeating (addictions, risk taking, the “who cares” attitude that robs people from becoming genuinely engaged in anything). Most typically, when experiencing an emotional crisis, behaviours are emotionally driven. That means that we will do anything we can think of that would immediately reduce emotional pain irrespective of consequences.

Predisposing factors are tackled last. Our coping style depends on our biological makeup that affects the speed with which our mood changes from neutral to super-charged. Our life experiences inform the protective rules we have developed for ourselves to avoid repetition of painful life events. Sometimes those rules might have outlived their usefulness, become over-rigid and limiting.  As with anything else that we do to protect ourselves, letting go of such rules is not an easy task. The bad news is that bad things happen to good people, irrespective of the rules that we are willing to live by. However the good news is that once we manage to adjust our coping style to compensate for our biological predisposition, we become much more resilient.