How to cope with chronic suicidal thoughts…

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.

  1. 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.
  2. 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.”
  3. 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.
  4. 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).
  5.  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.

  1. Delay. Delay. Delay.
  2. Distract. Distract. Distract.
  3. Remind myself of reasons why I need to stay alive (aka my kids)
  4. Listen to nature sounds on Spotify.
  5. 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)
  6. Take a walk outside, ideally in nature.  Breathe, move my body.
  7. Drink a hot beverage (tea, hot chocolate, coffee)
  8. Reach out to a trusted friend (I may or may not tell the person I’m struggling)
  9. Blogging (others may use journaling, art or other creative outlet)
  10. 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)
  11. Disassociate or zone out (ensure that it is safe to do so)
  12. 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!

Things to do instead of self harm

recovery-is-possible

I’d like to share some ideas for readers who have struggled with, or currently struggle with, self harming behaviour of any kind.  Self harm can include physical injuring, substance abuse, eating disorder habits, workaholism, over exercise etc.

Personally, I find harm reduction models to be the most effective in reducing self harming behaviour.  Because self harming is a coping method, and has served a purpose, it is often difficult to abstain from doing it.  I also believe that the majority of habitual self harming behaviour is shame and avoidance based in at least some ways.   I have found it easier to live with the idea that I will sometimes engage in behaviours that are not 100% beneficial to my health.  By acknowledging this openly, I reduce the level of shame I feel when I do make a mistake, slip or relapse.  Relapse is a part of recovery in a harm reduction model.  I don’t need to feel ashamed if I go back to my old way of coping in a crisis.  Those ways worked for me for a long time and they are  habitual and comfortable to slip into.

If I have a slip, I don’t make a big deal about it.  I just move forward and try to make a different more self caring choice in the future.  Removing the intense lens of self judgment from the situation has been helpful for me.

When suggesting alternatives to self harming behaviours, I acknowledge openly that not all options are available to all people.  This is not  a list that says “you should do this” but just some options that have worked for me personally.  Using the word “should” can increase feelings of guilt and shame if you do engage in self harm. I highly encourage you to use this as a model, and make your own list that feels right for you.  Give yourself permission to explore different coping options, keep the ones that work and leave the ones that do not.  Personalizing your recovery plan is another factor that will lead to greater success within harm reduction.

  1. Give yourself permission to struggle.  It’s okay that you feel bad right now.  Your feelings will have a beginning, a middle and an end and you can survive them.  Sitting with your feelings is an option, even if it is very uncomfortable
  2. Get safe.  Often urges to self harm are a red flag for me that I’m not feeling safe or I’m feeling overwhelmed.   Reduce any stress you have control over.  Relocate to an environment that feels secure.
  3. Spend time in nature.  The trees are not oppressive, nature is forgiving.  Nature can just mean getting outside, walking around the block, sitting in a park and breathing deeply.  Noticing the colours in the leaves outside.
  4. Wrap yourself up in warm blankets, quilts, cozy sweaters etc.  For me feeling safe often involves feeling warm and wrapped up tight.  Sometimes even the weight of the blankets is calming to me
  5. Prepare a hot or cold beverage.  The warmth or chill of the cup in your hands can help to ground you.  Focus on the temperature of the glass, and the feeling of the cold or warm liquid in your mouth.  Taste the flavours in your drink and take time to breathe.
  6. Draw, scribble, write, paint -express your feelings.  Artistic self expression has helped me avoid self harm.  You don’t need to be an artist to do this, you don’t need expensive art supplies.  Sometimes just a piece of paper and pen is enough.  Feel free to destroy your creation after.
  7. Reach out.  Call a friend, a family member, a support or crisis line.  If you don’t feel comfortable calling anyone, try going to a public place like a library or coffee shop and just break the isolation by sitting there with people around you.  Talking to a safe person is often a good way to work through urges to self harm.  You have the choice to tell the person you are struggling or not.
  8. Distract yourself with an enjoyable TV show, youtube video, magazine, book or music.  Lose yourself in another world for a short time.  Choose something that will cheer you, not something triggering.
  9. Exercise.  Use your large muscle groups.  Walk, do jumping jacks, stretch, yoga, lifting cans in your kitchen, anything you feel able to do and have access to.  Moving your body can help you process intense feelings like anger.
  10. Connect with spirituality, meditate, religion etc.  Connect with a higher power.  For me this means visiting nature and getting in touch with how small I am compared with the power of the natural world
  11. Spend time with someone very young or very old, or a pet.  Volunteer, connect with a family member, visit a neighbour with a new baby, offer to pick up groceries for a senior living in your area.  Walk your neighbour’s dog, take care of your own pets. Helping others, even in small ways, can be an option and alternative to self destructive coping.  For me, being able to help another person reduces my sense of shame and hopelessness and increases my connections.
  12. Hug a stuffed animal.  Sometimes I need comfort and stuffed animals are a good option for me and help me feel safe.
  13. Spend time around water.  Take a bath or shower.  Walk by the river, ocean or lake.  Go swimming.  Run warm or cold water over your hands and wrists.   Flowing water can be very calming.
  14. Use positive affirmations, ideally ones you have prepared yourself.  Sometimes self harming is driven by negative self talk and negative shame based messages you are giving yourself.  You can find ideas for affirmations on the internet and rework them to suit your purpose.  If an affirmation seems unrealistic try adding “I’m learning to…” at the beginning.   For example, “I’m learning to love myself.
  15. Remind yourself that you are doing the best you can.  That you are surviving and sometimes that is enough.  Some days all we can do is survive and that’s okay.

These are just a few ideas I’ve worked with over the years.  I hope you find them helpful.  Please feel free to comment with your coping ideas!