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How Do I Overcome Suicidal Thoughts? Let Me Count the Ways.

Too many times in the last two and a half years I have felt suicidal, and two times I did act on it and attempted. Too many times those thoughts have haunted me, and pushed me into seriously thinking about going down that “rabbit hole” of suicidal thoughts and attempting again. No, I don’t want to die. I really, really do want to live! So what do I do to stop those thoughts from coming back, or at least to overcome them when they do return? After all, I am dealing with some heavy stuff — recovering from the trauma of childhood sexual abuse, which pulls in generalized anxiety disorder (GAD), major depression (MD), post-traumatic stress disorder (PTSD) and dissociation! So coping with this is very serious, and very important.

Well, for quite a while I have been attending a dialectical behavior therapy (DBT) group, and through it I have learned a lot of skills, especially coping skills to help deal with the daily stressors of life. DBT addresses mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. I’m starting to transfer this “head knowledge” to “heart understanding’,” meaning that some of the skills are now automatically accessible to me in everyday life, but not all of them. Yes, the DBT skills are important and very effective, however when my mind completely checks out and goes blank, and I dissociate, well there’s not much I can do to use those skills! Cognitive thinking is gone, and only limbic brain, that is “reptile brain,” is functioning. So anything I have learned is not accessible. So frustrating! Even so, I am continuing with the DBT group, because I’m really hoping that in learning the skills better, they will be more instantly available to me.

OK, what else have I tried? With my therapist’s suggestion, and using my knowledge of DBT, I have put together a “safety plan.”  This includes a list of ways to hopefully prevent triggers from happening in the first place, plus how to cope when triggers do happen. Yes, that has been helpful as well, but it doesn’t always take care of times when I hit “skills breakdown,” and I am feeling suicidal. 

Over the last several months, I have been really stressed about how many times those rotten suicidal thoughts continue to come up in my mind. It really distressed me, because no, I do not want to die! Yet those thoughts keep coming back. No, I don’t want them, but they show their ugly head again and again.

So what did I do? I had brought up many difficult and challenging topics with my therapist, but this is one I had avoided. I mustered up the courage, and I started talking to my therapist about it. Probably over about two months, I would bring it up in session with her again and again. One day, I was telling her about recent incidences where someone else was feeling suicidal. I wanted to give them support, and I needed to find the right words for them. We talked about it, then she suggested that I could write a note to help myself if I was ever in that situation again. I did. I wrote, “A Letter to Myself When I Feel Like Life Isn’t Worth Living.” This incorporates what words I need to hear when I am feeling suicidal.  Not a “recipe,” or generic formula, but what I need when I am in that terrible place of suicidal thoughts. More on this later.

A Mighty editor Sarah Schuster interviewed one of the Mighty’s contributors, Heidi Fischer, who had written a story about a “suicidal thoughts scale.” That whole concept intrigued me! I read it, and it changed the whole way I think about those kinds of thoughts. 

I knew there were times when random, stray, fleeting suicidal thoughts were going through my mind, and then they were gone. There were other times when those thoughts were a bit stronger, and would haunt me again and again. Then there were times when they would consume me, and I couldn’t think about anything else!  The former were more “passive” thoughts, the middle were kind of in-between, and the latter were more “active” thoughts with a plan, and therefore more likely to be acted upon, and more dangerous.

In a very clear, concise way Heidi outlined that yes, they are all suicidal thoughts, but they can differ in strength, intensity and intention! Plus where they are on that wonderful scale can indicate whether I act on them or not, and what kind of support I will need! This was amazingly eye-opening! It taught me that suicidal thoughts are not all the same, and they are kind of on a continuum that ranges from passing thoughts to an actual plan.

I sent the link to my therapist, including this note, “OK, I definitely don’t want to be in this place again, but… if I am… I wanted to send you this scale, because then if I’m having a bad day, we have a common language that I can communicate to you how I’m feeling. Does this work?” 

When I saw my therapist the next week, she agreed with me. We talked about it, openly and honestly. Wow, that was hard! But when we finished that session, I wasn’t feeling as fearful of those suicidal thoughts! Wow! I didn’t know that those thoughts would be less scary by just having an open and honest conversation about them! Facing them, not running away like I had been doing for quite a while!

Then, of course, a couple days later, I was having another rough day, and I called and left my therapist a message “Hi, um … I’m having those thoughts again. Last night I was at a three, and this morning I’m at a two.” Later on in the evening, I left another message, “It’s been going back and forth between a two and three all day long.” When I saw her the next week, she said that having that “common language” let her know where my mind was. She knew that yes, we should be concerned, but I wasn’t in immediate danger.  

I was also starting to try to find my own words to use when I’m in that moment. While I really value her examples, I thought that using my own language of what I might say to myself was essential to making it work for me.

The next thing Heidi talked about was trying to figure out what my support people need to know, so basically to “update” my safety plan.  Then people can give me the best support that I will need in that moment.  That’s been a little harder, and I think I’ve got it figured out.

Remember when I said I wrote “A Letter to Myself When I Feel Like Life Isn’t Worth Living“? Who would have thought that less than a week after I published it that I would need to use it to save my own life?  To get me out of that “rabbit hole” of suicidal thoughts? 

So here is another letter to myself, affirming that yes, life is definitely worth living! 

*****

Dear Self,

OK, it happened… already!! Like seriously? It’s like when you pray for patience, what does God do but put situations in front of you that require tons of fucking patience!

So it was barely one week ago that you wrote this letter, and you had to rely on it so you didn’t go “down the rabbit hole”! Those suicidal thoughts were happening again, at least passively. Then your friend mentioned meds, and where did your fucking mind go? To taking enough so you wouldn’t feel the pain anymore! You fought the urge, and went over to lie down on the sofa, but it didn’t help. You pounded your head, but it just made your head hurt even more — a monstrous headache!

You were holding your breath, no, catching your breath, you couldn’t get any air! You felt like you were choking! A random thought about one to six came to mind, but it was just one to six, nothing else, no other words with it. Then you figured out what the numbers meant. You said something to your friend about it, that you were feeling a three or four … meaning a three or four on that suicidal thoughts scale.

Then suddenly you thought about your “Letter to Myself.” You asked your friend to read it. As she read it to you, you were able to catch your breath.  Then your breathing slowed a little. You were then comforted by your own words! Words that you had so recently penned for yourself! Who’d have thought you would need them so soon?

As she finished reading them, you realize that yes, those were the exact words you needed to hear. You lay there for a moment, realizing the magnitude of what had just happened! One week ago, after many weeks of pushing through, and fighting suicidal thoughts, you had found the right words to help yourself out of this sticky pickle of a situation! Hallelujah!

As you lay there for another moment, a smile slowly came over you. You went over to the tablet, where your friends were on Zoom, and made sure that both of them were there, and said, “Can I tell you something?” You paused while they said, “Yes,” then continued (with a smile breaking over your face), “Wasn’t that awesome what I wrote?” They laughed and agreed, and said that, “your cute apple cheeks turned pink.”

You felt joy that this creative challenge that your therapist had given you only a couple weeks before really, truly paid off! Not only were you able to get out of that dark, scary place — but you did it using your own words! Yes, someone read the words to you, but they were your words. Your words. Now it wasn’t that the “Letter to Myself” was awesome in and of itself, it’s that those were the words that you needed to hear in that moment! And truthfully, that’s the part that’s really awesome!

Yours Truly

Self

*****

So why am I telling you about this situation?  Well, it illustrates very well what I really want to share with you. There are things that you can do to help prevent those suicidal thoughts from happening. There are also things that you can do if and when they do happen!

So this is one question my therapist almost always asks me when I’ve gone through something as challenging as this: “So what did you learn from this?” Yep, it was challenging, but I am now learning that yes, I can start relying on myself. Yeah, I may need a nudge, or a little boost now and then, but these things are starting to hit home in my own head a little more often.

Oh, and my therapist said she is going to send the Suicidality Thoughts Scale to her colleagues! I guess she really does think of it as really important! I do too. 

*****

So this is my challenge to you!

Have you ever been in this terrifying place?

Did you know what to do?

Did anyone near you, or your support people, know what to do?

So I’ve talked about DBT skills, and attending a DBT group; having an open and honest conversation about suicidal thoughts with your therapist; writing a letter to yourself about what you need to get yourself out of this predicament; and using the suicidal thoughts scale, and maybe making up your own language for it. Please know that all of these things were integral in bringing me to where I am right now. I don’t think any one of them would’ve brought me to this place on its own.

Do any of these ideas resonate with you?

If not, talk to your therapist, your support system, your friends! They may have thoughts and ideas too! Don’t be afraid to start having the conversation! This is too important.

If any of these ideas do resonate with you, please choose one, or all of them, and do it! Don’t wait! Your life may literally be on the line! You are important. You are loved. You matter. 

And do you know what? Even though I don’t personally know you, you matter to me! Life is worth living for!

And yes, I will be here waiting for you, with another story on my heart, in my mind and from my soul!