Have you or someone you know had suicidal thoughts? It’s a lot more common than you think. In this episode, the Savvy Psychologist explores the warning signs and ways to cope with suicidal ideation.
Suicidal thoughts are a lot more common than you might think. That's why it's crucial to be aware of suicidal behaviors in yourself or friends and family, and ways you can prevent suicide.
Did you know that suicide is the 10th leading cause of death in the US? In 2019, nearly 1.4 million suicide attempts were made and over 47 thousand people died by suicide.
Women are more likely to attempt suicide, but men are more likely to die by suicide—in fact, the highest rate of suicide is in middle-aged white men, with white males accounting for nearly 70% of suicide deaths in 2019.
The National Suicide Prevention Lifeline can be reached at 1-800-273-8255.
It's also important to note that there are alarming trends within groups of marginalized people. For example, suicide rates are higher in those who identify as lesbian, gay, bisexual, or transgender, likely due in part to hostility and discrimination against LGBTQIA+ individuals. The suicide rate for American Indian and Alaskan Native individuals was 1.6 times higher than the all-race suicide rate in the US in the late 2000s. From 2003 to 2017, Black youth experienced a significant upward trend in suicide rates, with the largest annual percentage in the 15 to 17 age group and among girls.
This may all feel like just a bunch of statistics, but they feel startling to me and drive home the point that we all need to be aware of how suicide and suicidal thoughts can impact us as individuals and look out for each other. No group of people is immune to suicidal thoughts, behaviors, attempts, or deaths.
Scoping out suicidal behaviors in yourself or others
So, what behaviors should you be on the lookout for?
First, I want to say that it’s not uncommon to have a fleeting suicidal thought even if you don’t have a diagnosable mental illness. Many people have had a low day and thought to themselves, "I wish I wasn’t alive right now."
This is an example of passive suicidal thoughts. Passive suicidal ideation occurs when you wish you could die or that you were dead, but you don’t have an intention or plan to commit suicide. Active suicidal ideation involves the thoughts, intention, and plan to follow through on suicide.
Here is a list of potential risk factors to look out for:
- If a person has a history of suicidal behaviors which include a history of attempts, aborted attempts, or self-injurious behavior (e.g. cutting, burning).
- Current or past mental health diagnoses like depression, bipolar disorder, psychotic disorders, substance use disorders, traumatic brain injuries, ADHD, PTSD, and personality disorders like Borderline Personality Disorder.
- They may start to show signs that they have lost interest in things, feel a sense of hopelessness, powerlessness, worthlessness, intense shame, impulsivity, irritability and anger outbursts, anxiety/panic, and insomnia.
- They might pull back from others and they may talk about wanting to die, kill themselves, or that they are a burden.
- There can also be triggering events that lead someone to be vulnerable to suicide. Typically these events lead to humiliation, intense shame, or feelings of desperation. Examples include loss of a job or relationship, changes in health status.
- Along the same lines as the above, those who struggle with chronic illness or pain may be at risk, as well as those with a history of physical or sexual abuse. Having a close friend or loved one who has died by suicide can also be a triggering event.
- Access to firearms is a risk factor.
It’s also important to mention protective factors against suicide, as those are typically utilized in safety planning. Examples can include religious beliefs, ability to cope with stress, good frustration tolerance, responsibility for loved ones or pets, social support, and positive therapeutic relationships.
6 tips for dealing with suicidal thoughts
1. Don't be afraid to call 911 if necessary or use hotlines for guidance
If you or someone you love seems to be at high risk for suicide, don’t hesitate to contact crisis professionals if needed. People often have fears about being strapped into a straight jacket and locked away for the rest of their lives, but that’s not how things are done these days.
For my patients and my colleagues, most of the time there is a 72-hour turnaround if someone is hospitalized. The point is to get you stabilized and return you to outpatient care for ongoing services.
I’ve had some patients say to me in one breath that they plan to kill themselves and in the next breath, when I bring up hospitalization, say, “but I can’t miss work!” My standard response is "I’m pretty sure your funeral will lead to more missed days on the job." The National Suicide Prevention Lifeline can be reached at 1-800-273-8255. You can also find local hotlines and crisis centers near you and keep a list for reference.
2. Don’t lie to your therapist (and if you don’t have a therapist, get one)
Be upfront about your suicidal thoughts with your therapist. I’m a doctor, so I’m trained on how to assess and treat suicide. However, I can’t help you if I don’t know about it!
It is not uncommon for me to check in each session with new patients who have a history of suicide or with established patients who start showing warning signs. A therapist isn’t going to judge you and they aren’t immediately going to send you to the hospital just because you’ve had one thought about jumping in front of a train. Be open, be honest—we are here to help you.
3. Remember that suicidal feelings are just that—feelings
You don’t have to act on feelings. They tend to pass over time if you are taking care of yourself and getting treatment.
For those of you who may struggle with chronic suicidality, remember that it’s a symptom of your mental illness. What this means is that it’s not truly how you feel; it’s in many ways just a flare-up of your depression or whatever mental illness you may be struggling with. In the same way that cramping may be a symptom of IBS, suicidal ideation is the symptom of several mental disorders. You wouldn’t carve out your stomach to cure IBS and you shouldn’t end your life to cure depression. While it may not always feel that way, your suffering is temporary, and there are much better means to quell your pain than harming yourself. This too shall pass.
4. You are not weak or bad because you struggle with suicidal thoughts
Don’t judge yourself! In fact, doing so only feeds the suicide snake, and we want to starve it.
You’re also not a burden. The people who love you have never had the thought that they would be better off without you around. If you live in environments where you’ve been verbally abused and made to feel like the world could do without you—the environment is the problem, not you.
5. Abstain from drugs and alcohol when you are feeling suicidal or having a low mood
It will certainly only make the situation worse.
6. Find ways to cope when you're feeling bad
Refer to my episode from a few weeks ago, 3 Ways to Cope When You're Feeling Bad. These strategies also work to reduce the anguish around suicidal thoughts and behaviors.
More importantly, if you often struggle with suicidal thoughts, find ways to cope ahead of time. Write out a list of both professional and personal contacts in the event of an emergency. You’d be surprised how many times even a brief phone call can improve mood.
Create a coping skills box; this can be physical or digital. I like to suggest that patients keep letters, emails, and screenshots of loving text chains to refer to during low moments. When we are feeling suicidal, we often tell ourselves that no one loves us or that we are a detriment to those that we care about, and having access to this material helps to combat those thoughts.
Keep a playlist of your favorite movies, shows, or YouTubers to perk you up. I have a tendency to go for childhood nostalgia during these moments. Some of my favorites include Drop Dead Fred, Pretty in Pink (the Try A Little Tenderness scene is iconic), Bring It On, or Shrek.
Going for a walk or getting a little exercise might also be helpful. Many of my patients have also enjoyed arts and crafts during these times; they’ve used adult coloring books, crocheting, or scrapbooking to help. Some have even learned how to play instruments during their low periods. Meditation or prayer has been known to aid in low moments as well.
I can’t stress enough that simply by being a human being on this planet that you have value.
I can’t stress enough that simply by being a human being on this planet that you have value. It is sometimes hard to see your own value, but it doesn’t mean it’s non-existent. Often, we just need an Antique Roadshow appraisal of the situation to bring a new perspective when it all feels hopeless. I tell my patients that I can't help you if you’re dead, but every breath you take is laced with the ingredients needed to build a life worth living.
I would absolutely adore it if you would let me know your go-to feel-good movie or TV show, it might be helpful to someone else in the future. Let me know in the comments on Instagram @kindmindpsych, via my email at firstname.lastname@example.org, or leave a voicemail at (929) 256-2191. And remember, if you or someone you know is struggling with suicide, you can call the National Suicide Prevention Hotline at 1-800-273-8255.