COPING WITH SUICIDAL THOUGHTS

I’m seriously thinking about suicide. What should I do?

• ·If you are thinking about suicide, you are not alone.  Many people have thoughts of suicide, for a number of reasons.  Thoughts of suicide can be very scary.  You probably feel hurt, confused, overwhelmed and hopeless about your future.  You may feel sadness, grief, anger, guilt, shame, or emptiness. You may think that nothing can be done to change your situation. Your feelings may seem like they are just too much to handle right now.
• ·It is important to know that thinking about suicide does not mean that you will lose control or act on these thoughts. Having thoughts of suicide does not mean you are weak, or ‘crazy’.
• ·Many people think about suicide because they are looking for a way to escape the pain they are feeling.  Even though your situation seems hopeless and you wonder if you can stand another minute of feeling this bad, there are ways to get through this and feel better. You don’t have to face this situation alone.

Help is available. Here are a few ideas that you can use right now:

 CALL:  1-800-SUICIDE (1-800-784-2433

How can I better understand my suicidal thoughts and feelings?

Some problems and experiences, especially those that have been around for a long time, can leave you feeling hopeless and overwhelmed. At these times, you may think that you have no options left. You may think about suicide as a way to escape intense emotional pain.

People who kill themselves often think that their problems are unbearable and can’t be fixed. They feel like nothing they have tried has or will change their situation. Their emotional pain can distort thinking so it becomes harder to trust, or to see possible solutions to problems, or to connect with available love and support. Even if it seems that you can’t stand another minute, it is important to remember that feelings (e.g., grief, anger, sadness, loneliness, shame), especially at this intense level, don’t last forever.

Sometimes thoughts of suicide can become very strong, especially if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol, particularly when you feel hopeless or are thinking about suicide.

Some of the thoughts you may be having are:

• •       believing there are no other options;
• •       sensing your family or friends would be better off without you;
• •       thinking you’ve done something so horrible that suicide is the only option;
• •       experiencing unbearable pain that feels like it will go on forever;
• •       wanting to escape your suffering;
• •       wanting to let your loved ones know how much you hurt; or
• •       wanting to hurt or get revenge on others.

Your feelings of pain are very real. However, it is important to know that there is hope. With thehelp of professionals and the support of family andfriends, you can learn about what is causing yoursuffering and how you can change or manage it.

Hurting or killing yourself are not your only options. Professionals can help you learn new skills for dealing with your pain. These might include:

• ·developing new skills to cope;
• ·seeing your problems in a new light
• ·improving your ability to handle painful emotions
• ·improving your relationships and social supports
• ·giving you medications

Some other things that may lead you to think of suicide are:

Mental health problems:

Depression or anxiety can increase feelings of suicide. Mental health problems are treatable.  Counseling or medication may help. There are also free resources that can help (e.g., the Antidepressant Skills Workbook, at www.carmha.ca).

Conflict with loved ones:

You may feel that your family or friends would be better off without you. It is important to remember that conflict with others doesn’t last forever. Ending your life is not a way to solve that conflict. We know that people who lose a loved one to suicide say that their lives are not better off.

Loss:

Many different types of loss can increase the chances you may feel suicidal: a break-up; losing a job; losing social status; or losing a loved one or friend. Knowing someone who has died by suicide can increase the chance that you think of suicide as an option. As difficult as your loss may seem, there are people and services that can help you get through difficult times, such as Griefworks BC (1-877-234-3322).

Financial/legal problems:

Financial or legal problems, such as overwhelming debt, gambling problems, or problems with the law, can be very stressful. It is important to know that there may be free services that can help you deal with financial or legal problems. These include the Credit Counselling Society (1-888-527-8999), the Problem Gambling Help Line (1-888-795-6111), or the Legal Services Society (1-866-577-2525).

Lack of connection to friends and others:

Thoughts of suicide can increase if you spend a lot of time alone, or don’t feel you can tell anyone your problems. Talk to someone, like a professional, about ways that you can increase social supports in your life. You may feel that the people that are in your life don’t understand the pain you are feeling. Talk to a professional about ways that you can let others know of the pain and unhappiness you are feeling. The Social Supports wellness module at www.heretohelp.bc.ca gives ideas for how to improve your social supports.

Drug and alcohol problems:

Using alcohol or drugs can make feelings of depression, anxiety, and thoughts about suicide worse. Drugs and alcohol can change the way you think about problems in your life. If drugs or alcohol are causing your problems, you can get information on treatment from the BC Alcohol and Drug Information and Referral Service (1-800-663-1441).

Medical problems:

Medical problems such as diabetes, thyroid problems, chronic pain, or multiple sclerosis can increase chances that you may think about suicide. Make sure you have proper medical care for health problems. Some medications can increase feelings of suicide. It is important to speak to your doctor about this. You can also get information by calling the BC Nurse Line (1-866- 215-4700) or the Living a Healthy Life with Chronic Conditions program (1-866-902-3767).

Sexual identity issues:

People who are lesbian, gay, bisexual, or transgender may have a higher risk of suicide. Confusion about sexual identity and fears of possible or real rejection from family or friends can make things worse. There is support available. Prideline (1-800-566-1170) is a peer support and information phone line. Prideline is open 7 days a week, from 7:00 p.m. to 10:00 p.m.

What else can I do to decrease thoughts of suicide?

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 with in your life.  Second, make a list of all the solutions you can think of to those problems. 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 (www.carmha.ca) or at www.heretohelp.bc.

Some examples of common problems and ideas for solutions are:

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. 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. Write down your reasons for living.  Remind yourself of them when you are feeling low.

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.

Talk to a trusted friend, family member, or professional: It is important to speak to someoneyou trust about how you feel. Sometimes justtalking about how you feel can help. It is importantto be open about all of your thoughts. If you havea suicide plan, it is important to tell someone whatyour plan is. People often say they are relieved thatthey shared how they felt with someone. Talking can help you feel less alone.

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.

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.

How can I decrease chances that I will feel suicidal in the future?

Get professional support:  You can get help and referrals from your doctor or from referral lines listed on the following page. If the first referral doesn’t work for you, ask for another.

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.

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; or
• •       decrease or stop using alcohol or drugs, as these can make feelings of depression and suicide worse.

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 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.

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 bed time;
• •       have planned activities in your day, such as going for a walk or going to the gym; or
• •       continue to go to work or school.

Do things 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 suicide thoughts can help, even if it’s for a short time.

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.

What can I do to learn more?

Useful Phone Numbers (24 hrs/day, 7 days/week)

• ·1-800-SUICIDE (1-800-784-2433)
• ·BC Nurse Line: 1-866-215-4700 (TTY deaf/hearing impaired number: 1-866-889-4700)
• ·BC Mental Health Information Line: 1-800-661-2121
• ·BC Alcohol and Drug Information and Referral Service: 1-800-663-1441
• ·Problem Gambling Help Line: 1-888-795-6111

Other Useful Phone Numbers

• ·Credit Counselling Society: 1-888-527-8999
• ·Mood Disorders Association of BC: 604-873-0103
• ·Early Psychosis Intervention Program: 1-866-870-7847
• ·Griefworks BC: 1-877-234-3322
• ·Legal Services Society: 1-866-577-2525
• ·SAFER (Suicide Attempt Follow-up, Education and Research): 604-675-3985
• ·Vancouver Crisis Centre: 1-866-661-3311

Useful Websites

• ·Anxiety Disorders Association of BC: www.anxietybc.com
• ·BC Schizophrenia Society: www.bcss.org
• ·Canadian Mental Health Association – BC Division: www.cmha.bc.ca
• ·Early Psychosis Intervention Program: www.psychosissucks.ca
• ·BC Partners for Mental Health and Addictions Information: www.heretohelp.bc.ca
• ·Mood Disorders Association of BC: www.mdabc.ca
• ·Youth Support: www.youthinbc.com

Books

• ·Arena, J. (1995). Step Back From the Exit: 45 Reasons to Say No to Suicide. Milwaukee, WI: Zebulon Press.
• ·Bilsker, D., & Paterson, R. (2005). Antidepressant Skills Workbook. Vancouver, B.C.: Centre for Applied Research in Mental Health and Addiction. Free download at: www.carmha.ca.
• ·Blauner, S. R. (2002). How I Stayed Alive When My Brain Was Trying to Kill Me: One Person’s Guide to Suicide Prevention. New York, NY: William Morrow.
• ·Chabot, J. A. (1997). A New Lease on Life: Facing the World After a Suicide Attempt. Minneapolis, MN: Fairview Press.
• ·Cobain, B. (1998). When Nothing Matters Anymore: a Survival Guide for Depressed Teens. Minneapolis,
• ·MN: Free Spirit Publishing Inc.
• ·Conroy, D. L. (1991). Out of the Nightmare: Recovery From Depression and Suicidal Pain. New York, NY: New Liberty Press.
• ·Quinnett, P. G. (1995). Suicide: the Forever Decision. For Those Thinking About Suicide, and For Those Who Know, Love, or Counsel Them. New York, NY: The Crossroad Publishing Company.

Copies of this document can be downloaded at no cost from the B.C. Ministry of Health, Mental Health and Addiction website

Centre for Applied Research in Mental Health and Addiction website (www.carmha.ca) or from the Consortium for Organizational Mental Health (COMH) website (http://www.sfu.ca/search.html?q=suicide)

My Safety Plan

1. Do the following activities to calm/comfort myself:

2. Remind myself of my reasons for living:

3. Call someone:

4. Go somewhere I am safe:

5. Go to the Emergency Room at the nearest hospital.

6. If I feel that I can’t get to the hospital safely, call 911 and request transportation to the hospital. They will send someone to transport me safely.

If you have thoughts of hurting yourself, start at Step 1. Go through each step until you are safe. Remember: Suicidal thoughts can be very strong. It may seem they will last forever. With support and time, these thoughts will usually pass. When they pass, you can put energy into sorting out problems that have contributed to you feeling so badly. The hopelessness you may feel now will not last forever. It is important to reach out for help and support. You can get through this difficult time. Since it can be hard

to focus and think clearly when you feel suicidal, please copy this and put in places where you can easily use it, such as your purse, wallet or by the phone.