How to Manage Thoughts of Suicide and Get Support

Article By: Michael Kerr and Crystal Raypole

Active thoughts of suicide involve clear and specific thoughts about suicide or plans to take your own life.

Dealing with thoughts of suicide?

Active thoughts of suicide involve clear and specific thoughts about suicide or plans to take your own life.

But suicidal thoughts can also take a less-defined, or passive, shape. Maybe you don’t have an actual plan to die, but you:

have frequent thoughts about death and dying
have spent time thinking about ways to die
believe you don’t deserve to keep living
wish you could simply stop living
Whether they’re passive or active, persistent thoughts about suicide and death can leave you feeling overwhelmed, hopeless, and unsure where to turn for support.

Plus, talking about these thoughts can be tough. You may not know how to start sharing them with others, for one. But you might also worry about their potential responses:

“Why would you want to die? You have a great career, a relationship, and so many people who care about you.”
“But you’re not even depressed.”
“I can’t believe you’d put that pain on your family.”
What many people don’t realize is that suicidal thoughts are fairly common. In fact, 12 million adults in the United States seriously thought about suicide in 2019, according to the Centres for Disease Control and Prevention (CDC).

You can also have these thoughts even if you don’t have depression, or any other mental health diagnosis (more on that below). Often, suicidal thoughts simply mean you’re experiencing more sadness and pain than you know how to manage.

It’s natural to want to put a stop to pain and unhappiness, and suicidal thoughts might surface when you can’t envision a way out from your distress. But you do have options for getting support with handling these thoughts.

Need help now?
If you’re having thoughts of suicide, you’re not alone.

To get help right away, consider reaching out to a free and confidential crisis helpline.

Trained crisis counsellors can offer:

compassionate, judgment-free support for suicidal thoughts
guidance on finding coping strategies that work for you
additional resources for getting support nearby
They won’t give you advice or tell you what to do, but they can help you move from a moment of crisis to a calmer frame of mind.

What to do if you’re experiencing active suicidal thoughts
First, know that anyone can experience suicidal thoughts. These thoughts don’t represent a weakness, flaw, or personal failing. They’re nothing to feel guilty or ashamed over, either — no matter your situation.

If you’re considering methods of suicide or actively thinking about ending your life, these steps can help you stay safe while you work on getting more longer-term support:

Reach out. Trusted loved ones can listen and offer emotional support. They can also help you stay safe. If you’re not sure who to turn to, start with a crisis counsellor: They’ll listen with compassion and offer guidance on ways to reach out.

Go somewhere safe. Getting to a safe location can make it easier to avoid acting on suicidal thoughts. You might try a library or other public space, a friend’s house, or somewhere else you feel comfortable, like even a different room in your house.

Lock up or get rid of weapons. Safety also means staying away from weapons, medications, or other possible methods of suicide. A friend or family member can help you remove these items or stay with you, especially if you need to continue taking medication. They can offer one dose at a time so you don’t have access to excess pills.

Avoid alcohol and other substances. Drinking alcohol or using substances might seem helpful for numbing painful and unwanted emotions, but you might find they actually worsen depression and suicidal thoughts.

Try grounding techniques. Going for a short walk, cuddling a pet, and 4-7-8 breathing are all examples of grounding techniques that can help you stay in the present during a moment of intense distress. Not sure how to get started? A crisis counsellor can also talk (or text) you through trying them out.

Do something that helps you relax. Listening to music, savouring a favourite food or beverage, or looking at photos (or videos) of people and animals you love can help you feel calmer and less distressed.

The feelings of pain and despair might not immediately improve, and addressing suicidal thoughts can take time and professional support. But taking the first steps toward managing these thoughts can help you get enough distance to regain some hope and explore more long-term methods of relief.

How to handle passive thoughts of suicide
Again, suicidal thoughts don’t always mean having a specific plan to die. You might wish you were dead, for example, or frequently think about dying, even if you have no intentions of attempting suicide.

These passive suicidal thoughts are still serious, though. These tips can offer a starting place for managing them:

Recognize the signs. For some people, passive suicidal thoughts never become active. But these thoughts can eventually lead to suicide planning or an attempt. Noting early signs, like hopelessness, a sense of being trapped, or feeling like a burden to others, can suggest it’s time to reach out for help.

Get professional support. Working with a trained mental health professional is generally the best way to manage thoughts of suicide. A therapist can offer guidance with identifying possible triggers and exploring treatment options, plus help you create a safety plan.

Work on a crisis plan. Research suggests safety planning can go a long way toward helping you stay safe in a crisis. Safety plans typically involve compiling lists of triggers or early signs of suicidal thoughts, coping tips, and contact information for supportive loved ones or professionals in one place. A therapist or loved one can help you develop a plan, but you can also use a template to get started yourself.

Stay connected. Feelings of guilt or a sense of being a burden can lead you to avoid loved ones, but staying in touch with the people who care about you can make it easier to navigate a mental health crisis. Try reaching out to someone you trust by saying, “I’m having a hard time. Can you keep me company?”
Find positive distractions.

Activities you enjoy could help ease dark or painful thoughts and even rekindle some feelings of joy by helping you remember a few reasons to keep living. Reading a good book might remind you how excited you are for the next volume in the series, while taking your dog for a good long jog might remind you of their unconditional affection and companionship.

Focus on self-care. Making sure to take care of your physical needs may not necessarily reduce thoughts of suicide. But you may find them easier to manage when your physical needs are being met. As best you can, try to eat balanced meals and stay hydrated, get some physical activity (even stretching or moving around your house), and aim to sleep 7 to 9 hours each night.

Even when life’s challenges and painful moments feel most overwhelming, it can help to remember you’re not alone. Opening up about how you feel may not change your situation or completely banish those thoughts, but sharing those thoughts with a loved one or therapist can make it easier to get the right kind of support.

What causes suicidal thoughts?
Suicidal thoughts don’t have one single cause. They might begin for any number of reasons.

In some cases, they might be a symptom of an underlying mental health condition, like:

major depression
bipolar disorder
substance use disorders
eating disorders
post-traumatic stress disorder (PTSD)
But not everyone with these conditions will have thoughts of suicide. You can also experience suicidal thoughts without an underlying mental health condition. In fact, 54 percent of people who died by suicide don’t have a diagnosed mental health condition, according to 2018 statistics from the CDC.

A family history of mental health conditions, suicidal thoughts, or suicide can make it more likely you’ll experience suicidal thoughts, too.

Experts believe certain genes could play a part in suicidal thoughts and behaviour, though research is still in the early stages.

In a small 2020 study, researchers also found that children with a parent who had attempted suicide tended to face more stress in life and have more difficulty regulating emotions. Both of these factors can contribute to suicidal thoughts or attempts later in life.

Other risk factors
Other factors that might increase your chances of experiencing suicidal thoughts include:

major life stressors or challenges, including divorce, loss of a loved one, financial concerns, or legal difficulties
having a friend or loved one who died by suicide
chronic pain
chronic or life threatening health conditions, such as cancer
isolation or bullying at school or work
family or relationship abuse
having weapons at home
attempting suicide in the past
How to offer support
Maybe you’ve noticed some concerning signs in a friend or loved one’s behaviours, such as:

mentioning feelings of guilt or hopelessness
saying they feel like they’re burdening you or making your life miserable
avoiding the people they usually spend time with
giving away treasured belongings
seeming very calm after a period of intense distress
sleeping much more than usual
using substances more often
taking risks with their safety, such as driving very fast or without a seat belt, mixing alcohol and substances, or using substances unsafely
On one hand, you might wonder if they’re thinking about suicide. On the other hand, you might worry that asking them will give them the idea, if they’re not.

But that’s just a myth. Evidence suggests asking about suicide generally won’t increase these thoughts.

In fact, asking about suicidal thoughts can have more of a positive impact: When you bring up the topic yourself, you let them know you’re willing to listen and offer support.

It’s possible to experience suicidal thoughts without any obvious risk factors. These feelings can intensify when someone feels guilty, unworthy, or unable to ask for help or get support. You can support a loved one talking about suicide by taking them seriously and listening with compassion.

You may not know how to help, but sometimes simply being there for them can make a major difference. Keep in mind, too, that pain and emotional distress can make it much harder for them to recognize solutions that might seem obvious to you.

Getting help for suicidal thoughts
Coping strategies can help you manage thoughts of suicide in the moment, but they typically can’t help resolve the causes that contribute to these thoughts.

In other words, until you begin to identify and work through the concerns triggering these thoughts, they’ll likely keep coming back.

You don’t have to start this process alone. Support from a trained mental health professional can go a long way toward getting more lasting relief from these thoughts.

A therapist can offer compassionate guidance and professional support with:

identifying key triggers or causes, including signs of mental health conditions
developing a safety plan
exploring ways to share your thoughts with loved ones
building new skills to cope with suicidal thoughts, including emotion regulation, problem-solving, distress tolerance, and reframing unwanted thoughts
talking through possible solutions for overwhelming or distressing life challenges
Your therapist might ask questions about:

your thoughts of suicide, including how often you have them and what you do to cope
any other mental health symptoms you’ve noticed, like depression, anxiety, mania, or psychosis
past suicide attempts or thoughts
your family mental health history
They can also recommend helpful therapy approaches, such as cognitive behavioural therapy or dialectical behaviour therapy.

Getting support for any health, mental health, or emotional concerns prompting suicidal thoughts can often help ease those thoughts, not to mention prevent them in the future.

When searching for a therapist, remember that finding someone you can truly open up to can go a long way toward making therapy more successful. If you can’t trust your therapist, you may not feel able to share deeply distressing thoughts, concerns, or mental health symptoms.

Antidepressants and suicidal thoughts
In rare cases, certain antidepressant medications may pose a risk of increased suicidal thoughts, especially when you first start taking them.

If you do experience thoughts of suicide while taking an antidepressant or other psychotropic medication, connect with your psychiatrist or prescribing clinician right away — but keep taking the medication unless they change your dosage or prescribe a different medication.

Stopping a medication or changing your dosage without professional guidance is never a good idea, since this can make suicidal thoughts worse. It can also lead to withdrawal symptoms.

The bottom line
Right now, you may feel as if you have no way to escape the pain and unhappiness you feel. Remember, though, that nothing is permanent, not even the worst distress. Time, support from loved ones, and professional help can make the future seem much brighter.

Opening up to someone you trust is always a good first step. Sharing thoughts of suicide can help you realize you’re not alone, but knowing you have the support of someone you love can also make it easier to explore options for professional treatment.

As clichéd as it may sound, it can also help to take things one day at a time. Instead of thinking about tomorrow, or any pain the future could hold, try to stay present and remember: The future also offers opportunities for joy.


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