Mood Disorders: Understanding Suicidal Thinking
Don’t give in to suicidal
If depression or bipolar disorder affects you or someone you care about, you know that symptoms may include feelings of hopelessness and thoughts of suicide. If such thoughts occur, it’s important to remember that they can be overcome with the right kind of care, treatment, and support.
If You Are Feeling Suicidal:
It’s very helpful to have a plan of action ready before thoughts of suicide occur.
• Learn to recognize your earliest warning signs of a suicidal episode. There are often subtle warning signs your body will give you when an episode is developing. As you learn to manage your condition, you’ll become sensitive to these signs.They are signals to treat yourself with the utmost care, instead of becoming ashamed or angry.
• Stay in contact with your doctor. Always have your doctor’s phone number with you—an office number as well as an after-hours number—and a back-up number, such as an emergency room or Suicide and Crisis Lifeline (988).
• Stay in contact with trusted friends. Develop a list with phone numbers of dependable family members and friends who can give you support during a crisis. Keep the list with you.
• Recognize symptoms for what they are. With your doctor, therapist (counselor), or trusted friends, identify the symptoms you are likely to experience when your condition is at its worst. Always remember: feelings are not facts. Suicidal feelings are not your fault; they are a symptom of your illness. They may not seem temporary, but they are. As you learn to manage your condition, you will be able to spot your warning signs sooner and get help earlier.
• Write down your thoughts. Spend a little time
each day writing down what things and people
you appreciate and value in your life and your
hopes for the future. Read what you’ve written
when you need to remind yourself why your life
• Connect with other people socially. When you are feeling suicidal, don’t be alone. Visit family and friends who are caring and understanding, even if it’s difficult. Attend support group meetings where you can meet others who understand what it’s like to live with a mood disorder.
• Avoid drugs and alcohol. Many suicides result from sudden, uncontrolled impulses. Since drugs and alcohol can make you more impulsive, it’s important to avoid them. Drugs and alcohol can also make your treatment less effective.
• Know when it’s best to go to the hospital. There may be times when your condition becomes so severe that hospitalization is the best way to protect your health and safety. Discuss this possibility and your options with your doctor and family before the need arises.
• Understand your health coverage. Know whether your insurance, HMO, Medicaid, or Medicare plan provides psychiatric hospitalization coverage and how much. Keep copies of policy numbers and important health care information in an easy-to-find place. If you don’t have insurance coverage, find out what other options you have, such as community or state-run facilities.
• Keep yourself safe. Make sure you do not have access to weapons or anything you could use to hurt yourself. Have someone hold on to your car keys when you are feeling suicidal. Get rid of all medications you are no longer taking.
• Give yourself time to get better. When you are
first treated, or when you have recently had a
severe depressive or manic episode, give yourself
time to heal. Allow yourself to take life a little
more slowly and don’t get discouraged if you
aren’t up to your previous activity and lifestyle
levels right away. With continued treatment, you
can feel better.
If You Are Worried that Someone Is Considering Suicide
Warning Signs that Someone May Be Considering Suicide
• Unbearable feelings - Depression causes some people to have powerful, extreme feelings of hopelessness, despair and self-doubt.The more intense these feelings become, and the more often they are described as unbearable, the more likely it is that the idea of suicide may enter the person’s mind.
• Taking care of affairs - Making final plans, preparing wills or life insurance, or arranging for the family’s welfare is another warning sign. The person may give away valued possessions or make reference to what others will do “after I’m gone.”
• Rehearsing suicide - Seriously discussing one or more specific suicide methods, purchasing weapons, and collecting large quantities of medication are all signs that an individual is rehearsing suicide. Even if the person’s suicidal thoughts seem to come and go, it’s important to step in early and help.
• Substance use - Addiction to alcohol and/or drugs is a treatable condition that must be addressed along with the mood disorder in order for treatment to be successful. Substance use may cause impulsive behavior and make a person more likely to act on suicidal thoughts.
• Isolation - If a person seems determined to cut off friendships and social connections, there’s a chance that the person might be experiencing serious depression and/or preparing for suicide.
• Sudden sense of calm - A person with a mood
disorder may be most likely to attempt suicide
just when he or she seems to have passed an
episode’s lowest point and be on the way to
recovery. If a person who was recently feeling
hopeless suddenly seems very calm and settled,
it may be a sign that he or she has decided on
If Someone Is Considering Suicide
Remind the person there is help and hope.
• Take the person seriously. Stay calm and let the person know you are willing to listen.
• Involve other people. Don’t try to handle the crisis alone or put yourself in danger.
• Be understanding, not judgmental. It’s important to remember if you have not experienced suicidal thoughts, it’s nearly impossible to truly understand how the person is feeling. While the idea of suicide may be unfathomable to you, remember at this time the person likely feels that it would be better than continuing to live. Remind the person that while thoughts of suicide may feel never-ending and unbearable in this moment, they can be overcome and that you and others are here to help.
• Never promise confidentiality. You may need to speak to the person’s family or doctor in order to protect the person. Secrecy can endanger your loved one’s life.
• Don’t leave the person alone, if possible. Stay
with them until you are sure he or she is in the
care of others.
It takes courage to help a person who is
considering suicide. If the person is also abusing
drugs or alcohol or is verbally or physically
abusive, helping may seem impossible. You
may have decided that you cannot tolerate this
behavior and want to keep your distance. However,
even if you keep your distance or live far away,
you can still help by informing the person’s doctor,
or another friend or family member who lives
nearby, of the person’s suicidal thoughts. People
experiencing severe depression - no matter how
unreasonable or angry they become - need help.