Dealing with suicidal thoughts

Many people who have suicidal thoughts experience them when they are not in their usual frame of mind. This can be due to an illness, such as depression, or because of stressful events going on in their lives. Therefore these feelings are often temporary, or treatable.

What is suicide?

Suicide is the act of intentionally ending your own life.

Self-harm, on the other hand, is the act of causing oneself harm irrespective of the motive. In other words it is not necessarily done with the aim of causing one's own death. However, people who self-harm may have a higher risk of dying from suicide.

Who has suicidal thoughts?

Anyone can have suicidal thoughts.

A 2016 UK study found that 1 in 5 adults had experienced suicidal thoughts at some point in their life. About 1 in 18 adults had experienced suicidal thoughts in the past year.

A different 2017 study reported that about 1 in 9 young people aged 10-15 had experienced suicidal thoughts in the past year.

But these might be under-estimates, because many people may not want to talk about having these thoughts.

Some people think that everyone has brief, fleeting thoughts about suicide at some point in their life.

Suicidal thoughts exist on a spectrum. They can range in intensity, from thinking about what it would be like to be dead, to making a serious plan about how to die.

Whilst suicidal thoughts can happen to anyone, some groups of people are more likely to experience suicidal thoughts, such as:

• People with mental health conditions, such as depression, anxiety, PTSD or bipolar disorder.

• People who are having significant life problems, such as relationship or financial difficulties.

• People with a chronic illness.

• People who have problems with alcohol or drug misuse.

• Adolescents and young people.

• Older people.

• People who have experienced psychological trauma before, such as survivors of physical, sexual, or emotional abuse.

• People who experience discrimination, such as people from minoritised ethnic groups, and LGBTQ+ people.

Why do people have suicidal thoughts?

People often feel they want to end their lives when they can no longer bear the pain and difficulty they are in. Most often this is because they are not in their normal frame of mind. This could be because of:

• Having depression and seeing everything at its worst, or not having the energy or motivation to carry on.

• Having odd beliefs and ideas due to schizophrenia, or hearing voices.

• Something terrible having happened that they can't cope with - for example:

  • Death of a loved one.

  • Break-up of a close relationship.

  • A criminal conviction.

  • Being in prison.

  • A problem at work.

  • Redundancy.

  • Getting into debt.

  • Being abused.

• Guilt or remorse over something they have done.

• A physical illness making them unwell or giving them a lot of pain.

• Being under the influence of alcohol or mind-altering drugs.

• Feeling isolated or lonely.

But there is always another option to suicide. The cause of these feelings is something which can be treated, or a feeling which will change over time. That is why friends, family, health professionals and governments want to do everything they can to help people cope with suicidal feelings.

People with suicidal thoughts often think everyone else will be better off without them. In fact, suicide leaves devastation and guilt for others left behind. Relatives, friends and professionals are left wondering what more they could have done to help, and wishing the person who died had confided their feelings.

What can I do if I have suicidal thoughts?

If you are having thoughts about suicide, you may feel alone and that nobody can help you, or that nobody cares. This is not at all true.

If you read the section above, you will see that many of the reasons for suicidal thoughts are temporary. They can be treated or improved. Health professionals, charity organisations, families and friends may be able to help you cope with your feelings and help you work out ways to make you feel better about life.

The Government considers the prevention of suicide so important that a new strategy was launched in January 2017 focusing on the prevention of suicide and self-harm. It also intends to improve services for people bereaved by suicide and target high-risk groups.

Here are some of the many options you might consider to help you through this difficult time:

Talk to somebody

Often just sharing how you feel and being able to express yourself helps. Remember you may not be in your normal frame of mind (see section above). So feelings may be confusing and talking them through with somebody else may help you see things differently. Everyone's situation is different but people who may be able to help just by listening include:

• Close friends.

• Partners and family members.

• Your GP (see below).

• A person on a telephone or text helpline (see below for details).

• A counsellor (your GP can refer you, or you can find one via one of the self-help websites mentioned below).

Telephone helplines

Shout - Text Shout to 85258

The UK’s first free 24/7 text service for anyone in crisis anytime, anywhere. It’s a place to go if you’re struggling to cope and you need immediate help.

Samaritans - 116 123 (UK and Ireland, free to caller)

Somebody is available at the end of the phone to listen to you 24 hours a day, every day of the year. They are trained to help people understand and deal with their suicidal feelings. They have talked to many people with the same feelings, so they will not be fazed by anything you have to say. Because there is always someone there to listen to you, it is worth making a note of the number, as that phone call might be a good place to start in a crisis.

You can also email jo@samaritans.org, for a response within 24 hours.

Papyrus UK - HOPELineUK - 0800 068 41 41, or text 88247

Papyrus is a charity devoted to children and young people up to age 35 with suicidal thoughts. You can ring their helpline, HOPELineUK, to talk to a trained professional who won't judge and won't lecture - they're just there to offer support and practical advice. The lines are open 24 hours a day, every day of the year.

CALM (Campaign Against Living Miserably) - Helpline: 0800 58 58 58

The Campaign Against Living Miserably (CALM) works to prevent male suicide and offers support services for any man who is struggling or in crisis. CALM’s helpline 0800 58 58 58 and web-chat are for men in the UK who need to talk or find information and support. The services are open 5 pm–midnight daily and are free, anonymous and confidential.

The National Suicide Prevention Helpline UK: 0800 689 5652

The National Suicide Prevention Helpline is for anyone struggling with their mental well-being or with thoughts of suicide. It's staffed by volunteers who provide a caring, non-judgmental ear to discuss your thoughts and feelings. Their lines are open daily from 6pm to midnight.

See your GP

Seeing your GP would be a good place to start with trying to deal with your suicidal feelings. The GP will want to know all about how you feel and why you think you might be feeling this way.

What will happen when I see a GP about suicidal thoughts?

A GP will want to ask you more about what you are feeling, to try to understand what is happening.

They will be able to check whether you have any of the signs of depression, or schizophrenia or any of the other mental health disorders mentioned above. Remember most people (but not all) with suicidal thoughts have one of these illnesses.

These can be successfully treated. For example, if you have depression, therapy or antidepressants may totally change the way you feel. After being treated, the suicidal thoughts would settle down. Also if it is a physical illness causing your thoughts, your doctor may be able to help with this, or help you cope with it better.

Having tried to establish the reason or reasons for your feelings, your GP may also be able to refer you for support or specialist help. For example, some people are helped by various different types of talking therapies.

These include counselling and cognitive behavioural therapy (CBT). CBT aims to train your brain to look at things differently and react to stressful situations in other ways. A specific type of CBT called dialectical behaviour therapy (DLT) is sometimes used. This also helps people deal with their emotions in a more positive way.

Mental health services

Alternatively, your GP may feel you need help or support from the mental health services. This is a team of psychiatrists, psychologists, psychiatric nurses and social workers who help people with mental health problems, or people who are feeling very suicidal.

If they are very concerned about the risk of suicide, the crisis team may support you intensively at home, or you may occasionally be admitted to hospital. Or they may provide less intensive support and treatment via the clinic or in your home.

Consider keeping a diary

Sometimes just letting your feelings out, instead of bottling them up, can help. If there is nobody you feel you can talk to, it may be that writing down how you feel may help. Or you may find art a better way of expressing yourself.

Look after yourself well

Try to look for positive things to make you feel better. List the good things in your life. Consider making a 'distraction box' of things you like. For example, pictures or photos you like or which remind you of happy times, a favourite CD or book or DVD. Try to eat well. Exercise regularly, as this boosts your 'happy hormones'. Pamper yourself by arranging occasions or holidays which might help cheer you up, if you can.

Look through the information on self-help websites

There are several support groups available. Their websites have information on who you can contact and what you can do to help yourself. There are also stories of others who have had similar problems.

Hospital services

As discussed above, your GP may refer you to the local specialist mental health team. The team typically consists of a psychiatrist, a psychologist, a psychiatric nurse, an occupational therapist and a social worker. Any or all of these individuals may be involved in your care.

They sometimes see you in a hospital clinic, or sometimes visit you at your home. There is usually a crisis team to offer emergency assessment, support and treatment if your feelings are particularly severe. The mental health team may be able to help by:

• Prescribing medication.

• Providing support.

• Talking treatments (see above).

• Helping with social problems such as housing and financial difficulties.

• Helping with getting you back to the practical things in everyday life.

In a crisis the local Accident and Emergency (A&E) department may be the place to go. There may be a long time to wait but the A&E doctor will talk to you and assess your suicidal feelings. That doctor may then arrange for the on-call mental health team to see you, who will decide on an action plan with you, to help you feel better.

The mental health team will then arrange regular review and follow-up, probably starting the next day. It is unlikely that you would be admitted to hospital but sometimes, in extreme cases, this may be advised.

If you have already taken an overdose or seriously harmed yourself then seek urgent help by calling 111 (or 999/112/911), or by attending your local A&E department. Remember the reasons people want to kill themselves are temporary, and life can get better.

Other tips

Remove any means of hurting yourself in case you have a strong impulse to do so. For example, give a friend or family member your medication to look after.

Avoid alcohol, as this tends to exaggerate your feelings. If you are feeling low, alcohol will tend to make this much worse. Similarly, avoid drugs which may cause 'lows' or 'downers' or paranoid feelings.

Remember suicide is permanent, whereas the feelings you are struggling with are temporary. There are ways of helping you through this horrible time.

I'm worried about someone else who is having suicidal thoughts - what can I do to help?

If you are concerned about a friend, partner or relative who is having suicidal thoughts, there is a lot you can do to help. People who are thinking of ending their lives usually feel very hopeless, so it is important to show them that somebody does care.

Listen to them

Allow them to express their feelings. This is often very helpful. You may be able to help them put their feelings in perspective. Sometimes, just having the opportunity to talk to someone can be helpful in itself. Ask questions about how they are feeling.

Offer support and show that you care

Check in on them regularly to show that you mean this. Try to direct their thoughts and activities to things and people that they enjoy and love, and help distract them from their negative feelings.

Encourage them to see their GP

You can direct them to the sources of support and treatment in the section above. If you feel they may have an illness, mental or physical, offer to go with them to see the GP if this might help. Write out the Samaritans' phone number for them and leave it somewhere they can easily find it if they need it.