People who don’t struggle with chronic suicidal thoughts sometimes imagine suicide as the type of crisis that happens in the movies. And it can happen this way, but not for everyone. You know the cliched scene (we’ve all seen it) someone loses their job, breaks up with their partner, makes a terrible mistake, suffers the loss of a loved one etc. and they spend a dark night contemplating ending it all. Maybe they reach out, a friend comes over, makes them tea, stays up all night and talks them through it. Or maybe they are taken to a hospital emergency room, where staff admits, them and they are released a few days later, on medication and thankful that they are still alive.
Yes, single episode suicidal crises happen. They are terrifying and frightening and can be medical emergencies. If you are struggling with this type of crisis, you are not alone. Suicide is a permanent solution to a temporary problem. There is help available, even though reaching out can be scary.
But what if this isn’t your experience. What if, like me, you struggle with chronic suicidal thoughts, on and off, for decades? What if suicidal thoughts and suicidal impulses became, during times of trauma, part of your coping mechanisms? What if suicidal thoughts, ironically and paradoxically both threaten your life and help keep you alive? What if it isn’t just “one long dark night”? What if it isn’t something that a trip to the local emergency room and a short psychiatric admission can even touch? What do people like me do when they hit a rough patch?
It’s complicated. It’s complicated for a number of reasons.
- It’s very hard to even talk about suicide. It’s not an easy subject to bring up. I’m always afraid that people will either overreact (ie. treat it like the suicidal crisis described above and call emergency services) or under react (and ignore my disclosure or not offer support). Let’s face it, most people aren’t comfortable talking about suicide. If someone asks me: “How are you doing today?” they don’t want to hear “Actually I’m dealing with suicidal thoughts at the moment, thanks for asking.” It’s just not something I can say.
- If I do disclose that I’m having suicidal thoughts, most times people just sit there awkwardly. Try to figure out if I’m joking or serious. And then change the subject. Meanwhile, I’m sitting there, just as awkwardly, feeling guilty for making the situation awkward and not just saying “I’m fine.”
- See point #1. Talking about suicide is a societal taboo. I’ve had these thoughts for 20+ years. I’m still alive and I’m still finding it difficult to talk about them. There is something about this that doesn’t quite make sense.
- There is an incredible amount of shame related to this societal taboo. This means that not only do I feel suicidal, I also feel ashamed about it. I also feel afraid about the consequences that could occur if people find out and misunderstand what chronic suicidal thinking means (aka…911 calls, police, hospitals).
- Suicidal thoughts are not a “cry for help” or a “way to get attention.” Most of the time I deal with suicidal thoughts alone and people aren’t even aware that I’m having them. Even when I do disclose, I generally minimize how bad they are. I try to cope by myself as much as possible. Self harm has also been a very private thing in my life. For something to be a “cry for help” generally other people need to actually know about it! It would be more accurate for me to describe the suicidal thoughts as a way to gain control, the ultimate control, over an overwhelming or out of control situation in my life. It’s also related to obsessive compulsive thinking, and in that way can be circular and very difficult to control. Sometimes I have intrusive thoughts about suicide that are obsessive and not related to anything in particular in my life. They are disturbing to me and they are unwanted, arriving in my brain suddenly and then leaving.
So how do I cope with these chronic, obsessive suicidal thoughts? I use some combination of the methods below, depending on what type of thoughts I’m having, how long they last and how severe they are. It can be helpful to make your own “safety list” with various ideas that you can use when your suicidal thoughts make an appearance. I suggest that you create a variety of coping ideas, because chronic thoughts of self harm are very persistent and won’t likely go away with the use of just one distraction or grounding technique. If you are lucky enough to have a supportive partner/friend you can give them a copy of your safety list and they could help you use some of the skills in a crisis situation. For some folks, taking medication or calling a support line can be items on their lists.
- Delay. Delay. Delay.
- Distract. Distract. Distract.
- Remind myself of reasons why I need to stay alive (aka my kids)
- Listen to nature sounds on Spotify.
- Get in a safe space (aka my bed, under lots of warm blankets, away from anything potentially dangerous. This works best for the most severe thoughts when other techniques may not be safe)
- Take a walk outside, ideally in nature. Breathe, move my body.
- Drink a hot beverage (tea, hot chocolate, coffee)
- Reach out to a trusted friend (I may or may not tell the person I’m struggling)
- Blogging (others may use journaling, art or other creative outlet)
- Helping others, volunteer work, helping a friend in need (this works very well for me, but caution as it can lead to burn out if this is your only coping tool)
- Disassociate or zone out (ensure that it is safe to do so)
- Pay attention to your environment. Count things you can see, feel, touch, hear. Ground yourself in the present moment.
If you are coping with chronic suicidal thoughts, I hope that reading this post helps you to feel a little bit less alone. If you don’t struggle with them, I hope it helps you to understand them a little bit and maybe allows you to help others around you who might be living with them. Many people live with suicidal thoughts for years, it’s exhausting. So very exhausting and nothing at all like what is presented in the movies. But it has to be better than the alternative. So I keep trying and keep breathing! Keep hoping that it will get easier for all of us!