6 Ways to Deal With Suicidal Thoughts, According to Experts

Suicidal thoughts are relatively common. According to the Centers for Disease Control and Prevention (CDC), 3.9% of Americans have thought — or will think — about suicide in any given year. And I would know. I have dealt with passive ideations for years. It is a symptom of my illness. I am one in 9 million. But there is help.

When you or a loved one is in the middle of a crisis, it can be hard to know what to do. We spoke with mental health experts who offered some guidance on how to support someone experiencing suicidal thoughts. There is hope, and there are several things you can do to combat suicidal thoughts.

Here are six suggestions, according to the experts.

1. Determine whether your thoughts are passive or active.

The first step is to evaluate where you are on the spectrum to determine if your suicidal thoughts are passive or active. Of course, understanding the difference may seem difficult; however, Dr. Gail Saltz — an associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell School of Medicine and the host of the “Personology” podcast from iHeart Media — offered a simple explanation.

“If a person is passively suicidal they are thinking about suicide but not planning to act on it, i.e. they have thought like ‘I wish I wouldn’t wake up tomorrow.’ However, those with active thoughts have a desire and a plan, i.e. ‘I want to kill myself and I have an idea how I’d do that.’”

Still unsure? Check out this suicidality scale. 

2. Seek outpatient therapy or medical intervention.

If your suicidal thoughts are passive, Dr. Saltz suggested speaking with a medical professional as soon as possible. “You should seek an outpatient evaluation and treatment from a mental health care provider who is experienced in treating major depression, anxiety disorders and other mood disorders.”

However, if your thoughts are active and you have considered a plan, have the means or thought through when you would die by suicide, your approach should be more aggressive.

“You should seek an urgent evaluation and treatment if you have an active thought, a plan and feel at risk of self-harm,” Saltz said. “You may also want to go to the emergency room to be evaluated.”

3. Make a safety plan.

If you have regular suicidal ideations or if you are currently feeling suicidal you can (and should) make a crisis plan, or a suicide safety plan.

“I suggest that folks have a safety plan. This is not just a ‘what-to-do-if-I’m-suicidal’ safety plan but one that helps people know what to do at different levels of distress,” Dr. Taslim Alani-Verjee, a licensed psychologist and the founder and director Silm Centre for Mental Health, explained.

“If, for example, you are feeling restless and/or agitated you may want to call a friend, listen to music, go for a walk, or play with a pet. Being open and active helps. This plan, however, should include varying levels and should have tangible steps to take if suicidal thoughts increase or intensity, including but not limited to holding an ice cube, eating a sour candy, calling a helpline, and/or going to the hospital.”

Not sure where to begin? Speak with your therapist, psychologist or psychiatrist about how you can make a suicide safety plan.

4. Avoid activities and substances that exacerbate distress.

While knowing who to contact and when is important, there are other tangible steps you can (and should) take to combat anxiety, depression and suicidal thoughts. Dr. Lindsay Israel, a board-certified psychiatrist and the chief medical officer of Success TMS, told The Mighty avoiding certain substances is imperative.

“Avoid drinking alcohol or using illicit drugs, as this can worsen the suicidal thoughts as well as negatively impact judgment and the ability to inhibit yourself from acting impulsively.”

You should also try to avoid thoughts and activities that may make you feel worse, though this isn’t always easy.

“Stay away from anything that brings up bad memories too, as you may feel more sad, angry, guilty, ashamed, or anything else that will worsen the suicidality,” Dr. Patricia Celan, a postgraduate psychiatry resident at Dalhousie University in Canada, explained. And avoid being alone, if possible.

“Avoid keeping these thoughts and feelings to yourself,” Saltz said, “as sharing with others is relieving and helps you feel less alone and get help.”

5. Create safety at home. 

If you have a history of suicidal thoughts, it’s helpful to make sure your home is a place of safety. Especially if you have considered a plan or means for suicide, remove any of the means from your home. Enlist help when you need it.

“Remove any items which can be used to carry out a suicide attempt,” Saltz explained. “If said items are in your house and if you have a plan, ask a loved one to help you remove them immediately.”

6. Contact a crisis intervention helpline or hotline.

While contacting a crisis helpline may sound scary, suicide prevention hotlines are designed to save lives — not criticize or judge them.

“It is always appropriate to contact a suicide prevention/crisis hotline if you are having suicidal thoughts,” Clarissa Harwell — a licensed clinical social worker — explained. “No thought is too silly, unimportant or small.”

If you or someone you know is in crisis, you should call the National Suicide Prevention Lifeline at 1-800-273-8255, The Trevor Project at 1-866-488-7386, or reach Crisis Text Line by texting “START” to 741741. You can also head to your nearest emergency room or call 911.