Managing Suicidal Thoughts: How to prevent them in the future

By Dr. Joti Samra, CEO & Founder of the Psychological Health & Safety (PH&S) Clinic and MyWorkplaceHealth

Managing Suicidal Thoughts: How to prevent them in the future
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Suicidal ideation, plans and attempts are common: conservatively, 1 out of 10 adults will consider suicide as an option at some point in their life. Despite how common suicide thoughts are, there are effective, evidence-based approaches to managing suicidal thoughts and reducing their frequency in the future.

Managing Suicidal Thoughts

1. Problem-solve: It is always helpful to think of ways other than suicide that you can solve your problems. First, make a list of all the problems you are dealing within your life. Second, make a list of all the solutions you can think of for those problems. You can ask someone you trust to help you with this. Dealing with 1 or 2 small problems can help to put an end to immediate feelings of suicide. Once you are thinking more clearly, you can tackle other bigger problems. You can find worksheets on Problem-Solving and Healthy Thinking in the Antidepressant Skills Workbook. 
2. Think of reasons for living: Most people who think about suicide want to escape their pain, but they do not always want to die. When you feel low, it’s easy to stay focused on things that are negative and upsetting in your life. This makes it easy to think of suicide as the only option. Start thinking about some reasons you have for living. For example, many people have relationships with loved ones, pets they love, religion, goals, and dreams, or responsibilities to others in their life that give them reasons to live and prevent them from acting on their suicidal thoughts. Think of all of the reasons you have for living. Write them down. Remind yourself of them when you are feeling low.
3. Remember things that have helped in the past: Many people have had thoughts of suicide before. Think of some of the things that helped you feel better when you faced the same types of problems in the past. Some examples are: having faith and trust that time always helps; reaching out to friends and family; seeing a professional; going to a support group; following a safety plan; doing something you enjoy; not being alone; keeping a journal; or not drinking or using drugs. 
4. Talk to a trusted friend, family member, or professional: It is important to speak to someone you trust about how you feel. Sometimes just talking about how you feel can help. It is important to be open about all of your thoughts. If you have a suicide plan, it is important to tell someone what your plan is. People often say they are relieved that they shared how they felt with someone. Talking can help you feel less alone. 
5. Do the opposite of how you feel: When you have thoughts of suicide, it can be helpful to do the opposite of how you feel. For example, when people feel depressed they usually want to be alone. Doing the opposite, for example getting in touch with others, can help with feelings of depression.

Preventing Suicidal Thoughts

But, what can we do to decrease the chances of feeling suicidal in the future?

1 - Get treatment for mental health problems: It is important to get treatment for depression, anxiety, and alcohol and drug problems. Just seeing your family doctor may not be enough. It can help to see a mental health specialist, such as a psychologist or a psychiatrist. You can get referrals from your doctor or learn how to find a specialist from one of the referral lines listed on the last page. If you are already receiving treatment, speak up if your treatment plan is not working.

2 - Identify high-risk triggers or situations: Think about the situations or factors that increase your feelings of despair and thoughts of suicide. Work to avoid those situations. For example, going to a bar and drinking with friends may increase feelings of depression. If this is a trigger for you, avoid going to a bar or seeing friends who drink.

3 - Self-care: Taking good care of yourself is important to feel better. It is important to do the following: 

• Eat a healthy diet
• Get some exercise every day
• Get a good night’s sleep
• Decrease or stop using alcohol or drugs, as these can make feelings of depression and suicide worse 

4 - Follow through with prescribed medications: If you take prescription medications, it is important to make sure you take them as your doctor directed. Speak to your doctor if medications aren’t working or if side effects are causing you problems. If you have just begun taking antidepressants, it is important to know that the symptoms of depression resolve at different rates. Physical symptoms such as energy or sleep may improve first. Improvement in mood may be delayed. Speak to your doctor if you are feeling worse.

5 - Structure and routine: Keep a regular routine as much as possible, even when your feelings seem out of control. Here are some tips for creating structure in your life: 

• Wake up at a regular time
• Have a regular bedtime
• Have planned activities in your day, such as going for a walk or going to the gym
• Continue to go to work or school

6 - Do things you enjoy: When you are feeling very low, do an activity you enjoy. You may find that very few things bring you pleasure. Think of things you used to enjoy doing at times you didn’t feel so depressed or suicidal. Do these things, even if they don’t bring you enjoyment right now. Giving yourself a break from suicidal thoughts can help, even if it’s for a short time. 

7 - Think of personal goals: Think of personal goals you have for yourself, or that you’ve had in the past. Some examples are: to read a particular book; travel; get a pet; move to another place; learn a new hobby; volunteer; go back to school; or start a family.

Final Thoughts

If you’ve been feeling suicidal know that you’re not alone. And just because you’ve felt suicidal doesn’t mean those thoughts will last forever. Taking small steps toward improving your mental wellness can help to prevent suicidal thoughts from returning. And remember there is help if you need it.

If you or someone you love is at immediate risk of suicide, call 9-1-1.