Coping With Intrusive Suicidal Thoughts
“An estimated 9.3 million adults (3.9% of the adult U.S. population) reported having suicidal thoughts in the past year.” This is based on an information sheet created by the Centers for Disease Control (CDC) from 2013 data. Considering our current pandemic, those numbers are on the rise. Unfortunately, these numbers are unlikely to change until we make some changes in how we deal with suicide and suicidal ideation as a society.
Considering ending your life is frightening. It’s frightening for you and people who care about you are, understandably, frightened if you share these thoughts with them. Of course suicidal thoughts (also referred to as suicidal ideation) are concerning, but thinking about suicide does not automatically result in suicide. The thoughts may not even lead to anything beyond a fleeting thought after a significant loss or a combination of factors.
Know Your Risk Level
Nobody has a magic formula for assessing risk of suicide 100%, but it’s helpful to keep a few things in mind if you think you or someone you love could be at serious risk of suicide:
Use SAD PERSONS to remember risk factors: S=sex (males are more likely than females to complete a suicide attempt), A=age (people under age 19 or over age 45 are most at risk,) D=depression or hopelessness, P=previous attempts or hospitalizations for psychiatric reasons, E=excessive alcohol or drug use, R=rational thinking loss, S=separated/divorced/widowed, O=organized or serious attempt, N=no social supports, S=stated future intent.
If you have a clear plan and/or have rehearsed your plan, it’s time to go to the emergency room. The same goes for someone close to you committing suicide or making a serious attempt. A history of depression, suffering from chronic pain, and being LGBTQI can also increase your risk significantly. Another factor that often plays into serious suicide attempts is a sense of being a burden to others which isn’t surprising since a common refrain of anyone considering suicide is, “Everyone would be better off without me.”
Suicide Prevention Resources
If you’re not sure that you need to go to the emergency room, contact Colorado Crisis Services. They offer help by voice and text and if they determine that you’re at serious risk, they will refer you to the emergency room.
If you go to the emergency room, don’t assume you will automatically be hospitalized. Colorado law actually calls for all individuals to be in the least restrictive treatment environment possible. The downside of this is you are at risk of being sent home when you probably should stay.
If you do go to the emergency room and get released either immediately or after a brief stay, start shopping for a therapist. If money is tight, consider applying for Medicaid or Medicare. Sliding scale services are also available through the Open Path Collective. Ask your human resources contact if your employer offers an EAP. In many cases, these programs offer 3-10 sessions at no cost to you and the provider typically needs to contact you within in a specific time-frame. Sometimes, EAPs also offer free resources to help manage life stress such as webinars, information sheets, or even community liaisons to help you access local services.
You’re Not Alone and You’re Not “Crazy”
As long as you do what you need to do to stay alive and get through this difficult time, things will get better. Really. They will. As Dr. House puts it, there’s no coming back from being dead. Oftentimes, what we’re saying when we say we want to die is we want the pain to stop. Treatment will help, and some small changes and small steps might make surprisingly large differences for you.
Don’t Go It Alone
If you have a family member, friend, or co-worker who you can stay with (yes, even with COVID,) see if it’s possible to stay with them or have them stay with you for a few days. The second-best thing is to reach out and ask someone to call you a couple of times each day or set specific times for you to call them with the understanding that if they don’t hear from you, they should call the police for a wellness check.
If you’re in therapy, let your therapist know what’s going on. I’ll share that I’ve had plenty of clients in this situation and I’ve only actually considered having one of them hospitalized. Don’t assume that your therapist is just going to ship you off to the emergency room if you share that you’ve had suicidal thoughts. A lot of people have suicidal thoughts.
Don’t Mistake Self-Harm for Suicidal Behavior
As I mentioned before, nobody has a 100% accurate test for how likely someone is to commit suicide, but a lot of people (including some mental health professionals) mistake self-harm (like cutting) for suicidal behavior. Self-harm can be risky and can lead to needing medical care if cuts are too deep or if they get infected, but typically, self-harm is an unhealthy coping mechanism that provides the person with temporary symptom relief.
If you have a friend or family member who self-harms, that’s concerning, but it doesn’t mean they’re suicidal.
I hope that this information is helpful and I welcome any thoughts or questions you have. If you have a question you would rather ask me privately, feel free to email me. I can’t provide therapy via email, but I am happy to provide information.
