When Suicidal Thoughts are a Part of Daily Life
[Trigger warning for talking about suicidal thoughts. I would also like to remind people to read the whole blog post and know that I am under the care of an amazing psychologist who knows all of this. I am not at risk for suicide (which is what this post is raising awareness about.) I am taking a risk and being vulnerable in order to help others and raise awareness. I hope that it can be respected that I am able to take care of myself and assess my own situation, with the help of my therapist. Thank you for loving and caring about me.]
This week, September 6-12, 2015, is National Suicide Prevention week. In order to raise awareness about the broad spectrum of this issue, I want to talk to you about something that is rarely ever spoken about- living daily with suicidal thoughts.
Suicidal thoughts or ideations are “thoughts about how to kill oneself, which can range from a detailed plan to a fleeting consideration and does not include the final act of killing oneself,” according to Medical News Today.
Most mornings when I wake up the first thought in my mind is, “I hate being alive.” Throughout the day, if I fail to occupy my mind enough, I can get overcome with a feeling of an extreme weight crushing me and I think, “I just want to die” and I feel worthless and hopeless. I was recently looking through my old diary from when I was 11 years old, and I had the same thoughts. Back then it was “I just feel like I don’t want to be here anymore.”
Suicidal thoughts and fleeting thoughts about ways to die are common for me. My husband knows this. He knows that if he looks at the list of risk factors put out by the American Foundation for Suicide Prevention, I fit almost all of those risk factors. Under those circumstances, with anyone else, you would call 911 or go to an emergency room.
Why might you not do that in my case? Because in the risk factor list, they say that you need to see if the behavior is new or has increased. Since these thoughts are common for me, we assess if we need to call 911 by noticing if there are any new behaviors or an increase beyond my normal ebb and flow. I have never needed to call 911 or go to an emergency room, and I have never attempted suicide even though daily I think, “I want to die.”
For those of us for whom suicidal thoughts/ideations are “normal,” we are in a terrible spot. I have had therapists since I was 19 years old, and I always knew never to tell them I felt like I wanted to die, felt hopeless, or thought I was a burden to others. I knew if I said any of that, I would be immediately sent to the psych ward, when that was not what I needed. When you have daily suicidal thoughts, you live in fear. You cannot share the depth of your pain because you will be “sent away.” You fear will be taken away from your family and therapist- your actual support system that keeps your suicidal thoughts as thoughts and not as actions. Everything that is safe, everything that you know, will be taken away from you, so you can’t say anything. But, what you really need is to be able to tell someone, so they can help you.
It has not been until the last few years that I have told my therapists about these thoughts, and that was only when I had therapists I knew well enough to know that 911 would not be their first reaction. In fact, these thoughts are so normal for me that I did not even think to tell my new therapist about them until recently. I only told her because I realized I needed to be able to talk about it. I need to be able to tell my full story. I cannot heal and I cannot work on rewiring my brain for more healthy pathways if I cannot tell her about the current wiring that tells me “I just want to die.”
I need to tell my therapist and my husband because they can help me trace back and ask further questions: What happened right before the thought came into your mind? Was there a trigger of sight, sound, taste, smell, story, words, actions, or situation? How can you combat that thought? What can you say to yourself when the thought arises? What do you need to do to process emotionally so you are not dissociating? What are the feelings behind that thought? How realistic are those feelings? What need do you have that is not being met? How can you meet your need in a safe and healthy way?
Just recently I have come to understand that my daily suicidal thoughts are not scary. They are my heart and brain saying: “Katie, you are miserable and scared. That must be terrible. What can we do to help you today? What do you need?” And then I can take all of that to my therapist and we can work on getting me better.
Since I have talked with my therapist about my suicidal thoughts (honestly, I think we need a different term for these types of recurring thoughts), I have felt a new kind of freedom. I have more compassion for myself as a child who was so trapped in terrible situations that she correctly saw that the only way to get out of them, at the time, was to not be here anymore. That is totally reasonable. That is also sad and scary, and it makes sense that such trauma would get ingrained in the pathways of my brain. I also have less fear of myself and more compassion for myself now. It makes sense that my brain assumes that a flight response is the only option when a situation is scary, I get overwhelmed, or I feel worthless. I am just trying to protect myself. This means I have hope; I can work with my therapist to find ways to meet my need for safety so my brain does not go straight to “I just want to die.”
Please remember that this is just my story. This is not medical advice to tell you what to do or a definitive guide as to what recurring suicidal thoughts mean. I just know that there are other people like me out there and if we want true suicide prevention, then people like me need to be able to talk about daily suicidal thoughts without fear. I can only imagine that at some point, if I never talked about it, that these thoughts could start to create new behaviors that would put me at risk for death by suicide. It is unsafe for us to not be able to talk about frequent suicidal thoughts and get the help we need.
These thoughts become so normal for us that we may think we will always have them, but I do not think that is true anymore. If we are allowed to talk about them, I think that we can have a much more joyful and healthy life.
What To Do:
First, if you feel unsure, in any way, that your thoughts will remain just thoughts, call 911, go to an emergency room, or call the National Suicide Prevention Line at 1-800-273-TALK (8255)
No matter what, always make sure a close friend or family member has the number of your mental health provider and you have signed permission for them to talk to your provider.
If you have suicidal thoughts frequently and are scared to tell your therapist, I encourage you to tell them anyway! Ask them about their policy on reporting suicidal thoughts. Ask them how they evaluate risk for suicide. How will they assess frequency and new behaviors? How will you two work together to know when your therapist should call 911? See if they understand that a change in behavior is an important indicator, not just the suicidal thoughts themselves. After you talk to them, if they feel safe to you, tell them about your thoughts- their frequency, duration, exactly what they are and what you do about them. If you do not feel safe, find a new therapist, if you can. If you cannot find a new therapist, I encourage you to tell them anyway, because it is the safe thing to do. I honestly think many more mental health professionals now understand that there is a wide spectrum of interventions for people with all different types of suicidal thoughts.