2 November 2018

SUICIDE

Are You Feeling Suicidal?

If you’re thinking about suicide, your pain may seem overwhelming and permanent. But there are
ways to cope with suicidal thoughts and feelings and overcome the pain.

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

Last updated or reviewed on February 25, 2023

If you're having suicidal thoughts

No matter how much pain you’re experiencing right now, you’re not alone. Many of us have had suicidal thoughts
at some point in our lives. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, or
weak, or flawed. It only means that you have more pain than you can cope with right now. But with time and
support, you can overcome your problems and the pain and suicidal feelings will pass.

Some of the finest, most admired, needed, and talented people have been where you are now. Many of us have
thought about taking our own lives when we've felt overwhelmed by depression and devoid of all hope. But the
pain of depression can be treated and hope can be renewed.

No matter what your situation, there are people who need you, places where you can make a difference, and
experiences that can remind you that life is worth living. It takes real courage to face death and step back from
the brink. You can use that courage to face life, to learn coping skills for overcoming depression, and for finding
the strength to keep going. Remember:

01. Your emotions are not fixed—they are constantly changing. How you feel today may not be the same as
how you felt yesterday or how you'll feel tomorrow or next week.
02. Your absence would create grief and anguish in the lives of friends and loved ones.
03. There are many things you can still accomplish in your life.
04. There are sights, sounds, and experiences in life that have the ability to delight and lift you—and that
you would miss.
05. Your ability to experience pleasurable emotions is equal to your ability to experience distressing
emotions.

Why do I feel suicidal?

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
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Many kinds of emotional pain can lead to thoughts of suicide. The reasons for this pain are unique to each one of
us, and the ability to cope with the pain differs from person to person. We are all different. There are, however,
some common causes that may lead us to experience suicidal thoughts and feelings.

Why suicide can seem like the only option

If you are unable to think of solutions other than suicide, it is not that other solutions don't exist, but rather that
you are currently unable to see them. The intense emotional pain that you're experiencing right now can distort
your thinking so it becomes harder to see possible solutions to problems—or to connect with those who can
offer support.

Therapists, counselors, friends, or loved ones can help you to see solutions that otherwise may not be apparent
to you. Please give them a chance to help.

A suicidal crisis is almost always temporary

Although it might seem as if your pain and unhappiness will never end, it is important to realize that crises are
usually temporary. Solutions are often found, feelings change, unexpected positive events occur. Remember:
suicide is a permanent solution to a temporary problem. Give yourself the time necessary for things to change
and the pain to subside.

Even problems that seem hopeless have solutions

Mental health conditions such as depression, schizophrenia, and bipolar disorder are all treatable with changes
in lifestyle, therapy, and medication. Most people who seek help can improve their situation and recover.

Even if you have received treatment for a disorder before, or if you've already made attempts to solve your
problems, know that it's often necessary to try different approaches before finding the right solution or
combination of solutions. When medication is prescribed, for example, finding the right dosage often requires an
ongoing process of adjustment. Don't give up before you've found the solution that works for you. Virtually all
problems can be treated or resolved.

Take these immediate actions

If you're feeling suicidal at this moment, please follow these five steps:

Step #1: Promise not to do anything right now

Even though you're in a lot of pain right now, give yourself some distance between thoughts and action. Make a
promise to yourself: “I will wait 24 hours and won't do anything drastic during that time.” Or, wait a week.

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
 2 November 2018

Thoughts and actions are two different things—your suicidal thoughts do not have to become a reality. There is
no deadline, no one's pushing you to act on these thoughts immediately. Wait. Wait and put some distance
between your suicidal thoughts and suicidal action.

Step #2: Avoid drugs and alcohol

Suicidal thoughts can become even stronger if you have taken drugs or alcohol. It is important to not use
nonprescription drugs or alcohol when you feel hopeless or are thinking about suicide.

Step #3: Make your home safe

Remove things you could use to hurt yourself, such as pills, knives, razors, or firearms. If you are unable to do
so, go to a place where you can feel safe. If you are thinking of taking an overdose, give your medicines to
someone who can return them to you one day at a time as you need them.

Step #4: Don't keep these suicidal feelings to yourself

Many of us have found that the first step to coping with suicidal thoughts and feelings is to share them with
someone we trust. It may be a family member, friend, therapist, member of the clergy, teacher, family doctor,
coach, or an experienced counselor at the end of a helpline.

Find someone you trust and let them know how bad things are. Don't let fear, shame, or embarrassment prevent
you from seeking help. And if the first person you reach out to doesn't seem to understand, try someone else.
Just talking about how you got to this point in your life can release a lot of the pressure that's building up and
help you find a way to cope.

Step #5: Take hope – people DO get through this

Even people who feel as badly as you are feeling now manage to survive these feelings. Take hope in this. There
is a very good chance that you are going to live through these feelings, no matter how much self-loathing,
hopelessness, or isolation you are currently experiencing. Just give yourself the time needed and don't try to go
it alone.

Reaching out for help

Even if it doesn't feel like it right now, there are many people who want to support you during this difficult time.
Reach out to someone. Do it now. If you promised yourself 24 hours or a week in step #1 above, use that time to
tell someone what's going on with you. Talk to someone who won't try to argue about how you feel, judge you,
or tell you to just “snap out of it.” Find someone who will simply listen and be there for you.

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
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It doesn't matter who it is, as long as it's someone you trust and who is likely to listen with compassion and
acceptance.

How to talk to someone about your suicidal thoughts

Even when you've decided who you can trust to talk to, admitting your suicidal thoughts to another person can
be difficult.

Tell the person exactly what you are telling yourself. If you have a suicide plan, explain it to them.
Phrases such as, ‘I can't take it anymore' or ‘I'm done' are vague and do not illustrate how serious things
really are. Tell the person you trust that you are thinking about suicide.
If it is too difficult for you to talk about, try writing it down and handing a note to the person you trust. Or
send them an email or text and sit with them while they read it.

What if you don't feel understood?

If the first person you reached out to doesn't seem to understand, tell someone else or call a suicide crisis
helpline. Don't let a bad experience stop you from finding someone who can help.

If you don't know who to turn to:

In the U.S. – Call the 988 Suicide and Crisis Lifeline at 988 or IMAlive at 1-800-784-2433.

In the UK and Ireland – Call Samaritans UK at 116 123

In Australia – Call Lifeline Australia at 13 11 14

In other countries – Visit IASP or Suicide.org to find a helpline in your country.

How to cope with suicidal thoughts

Remember that while it may seem as if these suicidal thoughts and feelings will never end, this is never a
permanent condition. You WILL feel better again. In the meantime, there are some ways to help cope with your
suicidal thoughts and feelings.

If you have suicidal thoughts and feelings:

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
 2 November 2018

Things to do

Talk with someone every day, preferably face to face. Even though you may feel like withdrawing, ask trusted
friends and acquaintances to spend time with you. Or continue to call a crisis helpline and talk about your
feelings.

Make a safety plan. Develop a set of steps that you can follow during a suicidal crisis. It should include contact
numbers for your doctor or therapist, as well as friends and family members who will help in an emergency.

Make a written schedule for yourself every day and stick to it, no matter what. Keep a regular routine as much
as possible, even when your feelings seem out of control.

Get out in the sun or into nature for at least 30 minutes a day.

Exercise as vigorously as is safe for you. To get the most benefit, aim for 30 minutes of exercise per day. But
you can start small. Three 10-minute bursts of activity can have a positive effect on mood.

Make time for things that bring you joy. Even if very few things bring you pleasure at the moment, force yourself
to do the things you used to enjoy.

Things to avoid

Being alone. Solitude can make suicidal thoughts even worse. Visit a friend, or family member, or pick up the
phone and call a crisis helpline.

Alcohol and drugs. Drugs and alcohol can increase depression, hamper your problem-solving ability, and can
make you act impulsively.

Doing things that make you feel worse. Listening to sad music, looking at certain photographs, reading old
letters, or visiting a loved one's grave can all increase negative feelings.

Thinking about suicide and other negative thoughts. Try not to become preoccupied with suicidal thoughts as
this can make them even stronger. Don't think and rethink negative thoughts. Find a distraction. Giving yourself
a break from suicidal thoughts can help, even if it's for a short time.

Recovering from suicidal thoughts

Even if your suicidal thoughts and feelings have subsided, get help for yourself. Experiencing that sort of
emotional pain is itself a traumatizing experience. Finding a support group or therapist can be very helpful in
decreasing the chances that you will feel suicidal again in the future.

You can get help and referrals from your doctor or from the crisis lines listed below.

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
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Identify triggers or situations that lead to feelings of despair or generate suicidal thoughts, such as an
anniversary of a loss, alcohol, or stress from relationships. Find ways to avoid these places, people, or
situations.
Take care of yourself. Eat right, don't skip meals, and get plenty of sleep. Exercise is also key: it releases
endorphins, relieves stress, and promotes emotional well-being.
Build your support network. Surround yourself with positive influences and people who make you feel
good about yourself. The more you're invested in other people and your community, the more you have to
lose—which will help you stay positive and on the recovery track.
Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a
sense of meaning and purpose. When you're doing things you find fulfilling, you'll feel better about
yourself and feelings of despair are less likely to return.
Learn to deal with stress in a healthy way. Find healthy ways to keep your stress levels in check, including
exercising, meditating, using sensory strategies to relax, practicing simple breathing exercises, and
challenging self-defeating thoughts.

Suicide crisis lines in the U.S.:

988 Suicide and Crisis Lifeline at 988 or IMAlive at 1-800-784-2433.

The Trevor Project offers suicide prevention services for LGBTQ youth at 1-866-488-7386.

SAMHSA's National Helpline offers referrals for substance abuse and mental health treatment at 1-800-
662-4357.

Suicide crisis lines worldwide:

In the UK and Ireland: Call Samaritans UK at 116 123.

In Australia: Call Lifeline Australia at 13 11 14.

In Canada: Call Crisis Services Canada at 1-833-456-4566.

In other countries: Find a helpline near you at Befrienders Worldwide, IASP, or International Suicide
Hotlines.

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
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More Information

Helpful links

01. If you are thinking about suicide, read this first - Tips for getting you through when you’re feeling
suicidal. (Metanoia.org)

02. Suicide information - Information for those considering suicide or have attempted suicide in the past.
(NHS)

03. Coping with Suicidal Thoughts (PDF) - How to understand your suicidal feelings and how to develop a
safety plan. (Consortium for Organizational Mental Health)

References

01. Depressive Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders. American
Psychiatric Association.

02. Stone, Deborah M. “Vital Signs: Trends in State Suicide Rates — United States, 1999–2016 and
Circumstances Contributing to Suicide — 27 States, 2015.” MMWR. Morbidity and Mortality Weekly
Report 67 (2018).

03. “Suicide Worldwide in 2019.” Accessed October 14, 2021.

04. Curtin, Sally C. “Increase in Suicide in the United States, 1999–2014,” no. 241 (2016): 8.

05. McHugh, Catherine M., Amy Corderoy, Christopher James Ryan, Ian B. Hickie, and Matthew Michael
Large. “Association between Suicidal Ideation and Suicide: Meta-Analyses of Odds Ratios, Sensitivity,
Specificity and Positive Predictive Value.” BJPsych Open 5, no. 2 (January 31, 2019): e18.

06. Rudd, M. David, Craig J. Bryan, Evelyn G. Wertenberger, Alan L. Peterson, Stacey Young-McCaughan, Jim
Mintz, Sean R. Williams, et al. “Brief Cognitive-Behavioral Therapy Effects on Post-Treatment Suicide
Attempts in a Military Sample: Results of a Randomized Clinical Trial With 2-Year Follow-Up.” American
Journal of Psychiatry 172, no. 5 (May 1, 2015): 441–49.

07. Stanley, Barbara, Gonzalo Martínez-Alés, Ilana Gratch, Mina Rizk, Hanga Galfalvy, Tse-Hwei Choo, and J.
John Mann. “Coping Strategies That Reduce Suicidal Ideation: An Ecological Momentary Assessment
Study.” Journal of Psychiatric Research 133 (January 1, 2021): 32–37.

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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Last updated or reviewed on February 25, 2023
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08. Simon, Gregory E, Carolyn M Rutter, Do Peterson, Malia Oliver, Ursula Whiteside, Belinda Operskalski, and
Evette J Ludman. “Do PHQ Depression Questionnaires Completed During Outpatient Visits Predict
Subsequent Suicide Attempt or Suicide Death?” Psychiatric Services (Washington, D.C.) 64, no. 12
(December 1, 2013): 1195–1202.

09. McCauley, Elizabeth, Michele S. Berk, Joan R. Asarnow, Molly Adrian, Judith Cohen, Kathyrn Korslund,
Claudia Avina, et al. “Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A
Randomized Clinical Trial.” JAMA Psychiatry 75, no. 8 (August 1, 2018): 777.

10. Fox, Kathryn R., Xieyining Huang, Eleonora M. Guzmán, Kensie M. Funsch, Christine B. Cha, Jessica D.
Ribeiro, and Joseph C. Franklin. “Interventions for Suicide and Self-Injury: A Meta-Analysis of Randomized
Controlled Trials across Nearly 50 Years of Research.” Psychological Bulletin 146, no. 12 (December
2020): 1117–45.

11. “NIMH » New Pathways for Implementing Universal Suicide Risk Screening in Healthcare Settings.”
Accessed October 14, 2021.

12. Bryan, Craig J., Jonathan E. Butner, Alexis M. May, Kelsi F. Rugo, Julia A. Harris, D. Nicolas Oakey, David
C. Rozek, and AnnaBelle O. Bryan. “Nonlinear Change Processes and the Emergence of Suicidal Behavior:
A Conceptual Model Based on the Fluid Vulnerability Theory of Suicide.” New Ideas in Psychology 57
(April 1, 2020): 100758.

https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

By Jaelline Jaffe, Ph.D., Lawrence Robinson and Jeanne Segal, Ph.D.

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