If you are having suicidal thoughts...

It is important to ask for help.

It is important to ask for help.

Many people feel deeply ashamed of having such thoughts, and are unwilling to tell others about them. This type of thinking can be due to depression, which is both physical and psychological in origin. With a broken leg, you would have no problem asking for help because in our culture, it is appropriate to get help with obvious physical problems. However, there is significant stigma associated with mental disorder, and we fear the humiliation of exposure. Although depression has physical correlates, they are not visible. People may also stigmatise themselves. Depressed people have difficulty remembering positive things, which happen in their lives, and instead tend to focus on negative or painful experiences. Self-esteem plummets, and people often believe that they are not worthy of receiving help, or even not entitled to receive help, others are more deserving.

Denial also happens. It isn't something which people deliberately do. It is an unconscious defence mechanism which comes into play as a way of protecting ourselves from painful or frightening experiences. Facing the seriousness of depression is potentially both painful and frightening. It takes courage to realistically look at ourselves and acknowledge our concerns and problems.

One of the results of depressed and suicidal thinking is isolation. You may find you want to be alone, or have contact with fewer people than usual. You probably feel more tired than usual, or perhaps more anxious. Chances are you feel as though no-one could possibly understand what you are experiencing, so even if you are with others, you still feel alone. You probably don't want to share your suicidal thoughts with other people, perhaps believing that to do so would be useless, or that your situation is hopeless, and that there is no future for you. Depression impairs the way you think and limits you from being able to see the bigger picture. If your thinking is off balance, then your judgement is also impaired. You can't trust it, as you normally could when you are well. It is really important that you get help from someone you trust.

Who can help?

Make sure that the people you enlist to help you are people who know how to help. Tell the person/s that you are having suicidal thoughts. It is not useful to tell someone that you are thinking of or planning suicide, and then asking them to keep the information confidential from, say, your doctor, health care provider or the police. This can cause great anguish, and it places them in a double bind. On the other hand, it is appropriate and very sensible to ask them not to gossip about you, and not to tell anyone else who doesn't need to know.

Your GP might be a good person to start with. If you don't feel comfortable telling that doctor, find another one.

You may have a friend or partner you could tell, perhaps a clergyman or spiritual director. A counsellor or psychotherapist should be able to help you or at least point you in the right direction. Call Lifeline on 131 114, or if you are aged 5-18 years, Kids Helpline on 1800 55 1800, both of which are available 24 hours a day, 7 days a week. Or you might prefer to call another counselling service. SANE Australia provides a free and confidential Helpline on 1800 688 382 Monday to Friday 9am - 5pm EST. In South Australia, staff at ACIS, a free community mental health service can be contacted on on 131 465. You can also go to the Emergency Department of any public hospital and get help.

What can I do?

Firstly, don't trust those suicidal thoughts. They can be very seductive, luring you into false beliefs. They are the product of the physical effects of depression in body and mind. Notice how they discourage you from getting help from others, how they isolate you, and how they trick you and lure you into believing that everything is hopeless, and that there is no future. These thoughts are not accurate; and once your depression begins to lift, you will have a very different view of the world. In fact, you will probably look back at this time and wonder at how the depression distorted your thinking.

Remember, the one thing that we can be absolutely assured of in this world is change. Nothing stays the same. Your suicidal thoughts will pass. Just consider how many different thoughts you have had today, and how many you must have had in your lifetime. You are not your thoughts. Thinking is something which you do, and which you respond to.

You might notice that your suicidal thoughts tend to come in waves. Knowing this, you may find it possible to "surf" those waves in your thinking, being aware that they will subside. Perhaps you have noticed that they are worse at a particular time of the day. Some people find that they get worse at night, while others may find it worse first thing in the morning. Suicide is usually something done privately, so it makes good sense to be with other people at the bad times. If you can't think of anyone to ask to be with you, go somewhere where there are other people, such as shopping centres, movies etc. If you can't do this, use the phone. Call a friend, or perhaps someone else, as listed above.

Making your environment safer is also a wise idea. For example, if your thoughts are around shooting yourself, make sure that you don't have access to firearms. If you are thinking about overdosing, dispose of any pills that you don't need, and ask someone else to look after the medications that you do need to take. You need to practise being self-aware, and to respond appropriately if you don't feel safe. Understandably, people find suicidal thoughts to be intolerable, and often try to self-medicate with street drugs, over-the-counter medications, or alcohol. This can actually place you at an even greater risk so it is best to avoid them. When people are intoxicated with drugs or alcohol, their impulse control becomes impaired.

It's like driving a car downhill without any brakes. It might be alright, but the chances of an accident are much higher. Drugs and alcohol reduce our ability to control our impulses and resist harming ourselves. It might be alright, but the odds of staying safe are greatly reduced. I have occasionally heard people tell me that they feel better while they are under the influence of substances, but it is only a very short term solution to a much larger problem. In fact, the substances can make the suicidal ideation worse in the emotional crash that comes with the hangover next day. These in themselves increase the risks to you, apart from all the other problems associated with high-risk behaviours.

One of the worst and most dangerous beliefs a person can have is that others would be better off if they were dead. If you believe this, it is a red-flag situation, and you need to get professional help now. It is never the case that others are better off if someone suicides. From personal experience, I can assure you that suicides have devastating effects upon everyone who is left behind. Many of the consequences are unforseeable. They profoundly affect those people closest to the one who has died, for the rest of their lives. Furthermore, suicides have a ripple effect outwards, into the wider community.

Try to be both patient and gentle with yourself. Don't give up. Don't set yourself up for failure, either. Focus on applying these strategies skilfully and, with help, you can recover from this illness. When your body and mind are back in balance again, the suicidal thinking will loosen it's grip and fade away. In fact, you will probably be amazed at the distance you have travelled, and the improvement in your mood. This takes time, however, and you need to stay alive if you are to achieve the journey. Remember, things will change.

Posted on 20 August 2005 in - Library - Anxiety and Depression - Human Condition

Viv Cheesman

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