1 in 5 people experience suicidal thoughts at some point in their lives, meaning that 20% of the population have thought about suicide. This indicates a significant need for conversations about what suicidal thoughts are and how to manage them. There are some times in life when suicidal thoughts may become more prevalent or worsen. One of these times is during recovery from addiction or whilst in treatment for mental health conditions. Suicide prevention is a key component of mental health treatment and can lay the groundwork for positive change in our lives. But how do we recognise a suicidal thought, to begin with? How do we manage them, and who can we talk to during a crisis?
What are suicidal thoughts?
Suicidal thoughts can take many different forms. The term can ‘describe a range of contemplations, wishes, and preoccupations with death and suicide.’
This means that suicidal thoughts can look different from person to person. They can take any of the following forms:
- Thinking that you cannot go on like this
- Feeling hopeless
- Being in pain that you do not think will improve
- Thinking or fantasising about dying (for example, being in an accident)
- Wishing you were no longer alive
- Thinking it would be easier if you were no longer alive
- Ideas of how you may end your life
- Plans of when you may end your life
Individuals dealing with suicidal thoughts may:
- Feel lonely / isolated
- Feel numb
- Feel separate from their body
- Notice changes in eating and sleeping patterns
- Have urges to hurt yourself
- Give away belongings or money
- Prepare a will
- Feel very negatively towards yourself
Some people find that their suicidal thoughts feel ‘passive.’ This means that they may be thoughts that come and go and appear to be in the back of your mind. Others may find that these thoughts become more insistent and may find it hard to think about anything else. When speaking to a clinician, they may ask you questions to establish your level of risk. This may include:
- What specific thoughts you are having
- If you have thoughts about harming yourself
- If you have a plan
- If you have the resources to action this plan
- If you have a timeline for this plan
- If you would feel able to ask for help in crisis
Triggers and risk factors in the recovery process
We know that suicide risk is often high in individuals with mental health conditions such as depression, anxiety, personality disorders and eating disorders, and particularly among people with a dual diagnosis. We also know that suicidal thoughts can be exacerbated in times of intense stress. One of these times of stress is addiction recovery.
Recovery is a very sensitive time and can be associated with higher instances of suicidal thoughts. Individuals dealing with drug or alcohol addiction are thought to be between 10 and 14 times more likely to die by suicide.
This means it is very important to identify common risk factors and triggers present during recovery. These may include:
- Initial relapsing following a period of sobriety
- Ceasing engagement with rehab treatment and support
- Social withdrawal and isolation
- Unstable housing and financial situation
- Experiencing a big life event (grief, divorce, job loss, serious illness)
- Mixing recreational drugs and/or alcohol with prescription medications
- Ceasing use of prescription medications
- Feelings of guilt or shame
- Feeling trapped
- Feeling as though you have failed
What is important to remember is that sometimes, there is no clear trigger. Suicidal thoughts can come into our lives without a clear cause. Whatever the context, you do not have to live with suicidal thoughts. There are ways to combat them and develop routines and techniques to keep them at bay.
The importance of seeking help
All suicidal thoughts are serious. When you are dealing with these thoughts, you should speak to anyone you feel comfortable with and trust. This may include:
- A friend or family member
- A primary care worker
- A therapist
- A social worker
- A member of staff at an addiction facility
- A suicide prevention organisation
If you are in crisis, the best thing to do is always make contact with an appropriate body. Suicidal thoughts can be temporary – speaking with someone in the heat of the moment can help you stay safe until the feelings become less intense.
A list of contact numbers are available at the bottom of this page.
Developing healthy coping mechanisms
One method of alleviating suicidal thoughts is by implementing a range of healthy coping mechanisms into your day-to-day life. This means you can increase your distress tolerance and work towards emotional regulation. Examples you can try include:
- Taking a very cold shower
- Focusing on your senses through mindfulness
- Focusing on your breathing
- Writing down your thoughts and feelings
- Looking after your body (through sitting comfortably or eating and drinking where needed)
- Listening to music
- Going for a walk with someone you trust
- Engaging in a safe, non-harmful hobby
Practising self-care
When we feel very negatively towards ourselves, practising self-care cannot be easy. However, when we take the time to do something for our mind, body or soul, we may start to feel a little better than we did before. This may include showering or bathing, changing your clothing, listening to music, self-soothing with a comforting (non-alcoholic) drink, or calling a friend.
Setting realistic goals
Suicidal thoughts often come from a place of hopelessness. One way to mitigate this is to set small, achievable goals. These can be anything you want, from setting the goal to eat three times a day, calling a loved one daily, or leaving the house a specific number of times a week. You want these goals to be as specific as possible so that you can clearly identify when you have accomplished them. Doing so can improve your mood dramatically, but it can also help you tackle the feelings of hopelessness that suicidal thoughts can grow out of.
Developing a personalised safety plan
When dealing with suicidal thoughts, the best safety plan is one designed by you. This is because you are able to identify what you think may work best for you. To create your own safety plan, you can do the following:
- Think about what may trigger or worsen suicidal thoughts
- Describe what a suicidal thought may look like for you (including physical, emotional and behavioural warning signs – how might you think, feel or act when you are suicidal?)
- Describe who you can contact if you notice these warning signs
- Describe what activities you can do to keep yourself safe
- Describe what self-care activity you can do to prioritise your wellbeing
- Describe what goals you can set for yourself to make these feelings less strong
If you are experiencing suicidal thoughts, there are many people you can contact, including:
- Calling 999 (or visiting A&E) in an emergency
- Calling NHS 111 for advice
- Calling Samaritans (116 123)
- Calling Campaign Against Living Miserably (0800 58 58 58)
- Calling Papyrus (0800 068 41 41)
- Calling Childline (0800 1111)
- Calling Silence of Suicide (0808 115 1505)