Considering Suicide?

Considering suicide: Don't let despair obscure other options
MayoClinic, April 15, 2004

Depression and hopelessness can cloud your thinking, and you may consider taking your own life. Learn about healthy coping strategies to get through a crisis.

When life doesn't seem worth living anymore or your problems seem insurmountable, you may think that the only way to find relief is through suicide.

You might not believe it, but you do have other options, options to stay alive and feel better about your life. Maybe you think you've already tried them all and now you've had enough. Or maybe you think your family and friends would be better off without you.

It's OK to feel bad, but try to separate your emotions from your actions for the moment. Realize that depression, other mental disorders or long-lasting despair can distort your perceptions and impair your ability to make sound decisions. Suicidal feelings are the result of treatable illnesses. So, try to act as if there are other options, even if you may not see them right now.

No, it probably won't be easy. You may not feel better overnight. Eventually, though, the sense of hopelessness can lift. You can find support, appropriate treatment and reasons for living.

When you need immediate help
If you're considering suicide right now and have the means available, contact someone for help. The best choice is to call 911 or your local emergency services number.

If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:
-Contact a family member or friend.
-Contact a doctor, mental health professional or other health care professional.
-Contact a minister, spiritual leader or someone in your faith community.
-Go to your local hospital emergency room.
-Call a crisis center or hot line.

Crisis centers or suicide hotlines are often listed in the front of your phone book or on the Internet. They offer trained counselors, usually volunteers, who can help you through an immediate crisis. Some crisis centers with an Internet presence offer e-mail contact, but remember that responses may not be as prompt as with telephone support.

Talking to someone about your feelings, connecting with them, can help relieve the burden of despair and isolation, even temporarily. It may help you shift perspective and more clearly see your other options.

Daily coping strategies
You may struggle with suicidal feelings frequently, perhaps many times a day. Develop a strategy to cope with those feelings in a healthy way. Consider asking a doctor, family member or friend to help create a strategy tailored to your specific situation.

It may mean doing things you don't feel like doing, such as talking to friends when you'd rather hole up in your bedroom all day with the curtains drawn, or going to the hospital for a mental health evaluation. But stick to your strategy, especially when you're in the grips of despair and hopelessness.

As part of your strategy, consider these measures:
-Keep a list of contact names and numbers readily available, including doctors, therapists and crisis centers.
-If your suicide plans include taking an overdose, give your medications to someone who can safeguard them for you and help you take them appropriately.
-Rid your home of knives, guns, razors or other weapons you may consider using for self-destructive purposes.
-Schedule daily activities for yourself that have brought you even small pleasure in the past, such as taking a walk, listening to music, watching a funny movie, knitting or visiting a museum. If they no longer bring you at least a modicum of joy, however, try something different, particularly if these familiar activities induce painful reminders.
-Get together with others, even if you don't feel like it, to prevent isolation.
Avoid drug and alcohol use. Rather than numb painful feelings, alcohol and drugs can increase the likelihood of harming yourself by making you more impulsive, more open to giving in to self-destructive or despairing thoughts.
-Write about your thoughts and feelings. Remember to also write about the things in your life that you value and appreciate, no matter how small they may seem to you.

Some organizations recommend creating a "plan for life" or similar plan of action that you can refer to when you are considering suicide or are in a crisis. This is a checklist of activities or actions you promise yourself to take in order to keep yourself alive or stay on course with treatment. For instance, it may stipulate that you contact certain people when you begin considering suicide. It may also include commitments to take medication appropriately, attend treatment sessions or appointments, and to remind yourself that your life is valuable even if you don't feel it is.

Also, consider creating a list of specific activities to try when you're feeling suicidal or just feeling bad. The key is to engage in self-soothing for a range of negative feelings, not just when you reach the point of suicidal thoughts. Make sure they're activities that would normally offer enjoyment and that can help comfort you, not cause additional stress. Then, do each item on your list until you feel like you can go on living. It can include such things as:
-Practicing deep-breathing exercises
-Playing an instrument
-Taking a hot bath
-Eating your favorite food
-Writing in a journal
-Going for a walk
-Contacting family, friends or other trusted confidantes

Even if the immediate crisis passes, consult a doctor or mental health professional, or seek help through an emergency room if your area isn't served by mental health professionals. They can help make sure you're getting appropriate treatment. Medication and psychotherapy, either individual or group, are often effective treatments for depression, anxiety, substance abuse and other mental disorders, and they can help you feel better about yourself and your life. Although you may not want to consider psychiatric hospitalization, it can help protect you and give medication and psychotherapy a chance to work more effectively.

Seeing beyond the despair
The despair and hopelessness you feel as you consider suicide may be the side effects of illnesses that can be treated. These emotions can be so overpowering that they cloud your judgment and lead you to believe that taking your own life is the best, or only, option.

But even people with long-standing suicidal thoughts can learn to manage them and to develop a more satisfying life through effective coping strategies. Take an active role in saving your own life, just as you would help someone else. Enlisting others for support can help you see that you have other options and give you hope about the future. Suicide isn't a solution, it's an ending.