Dr JC Coetzee Clinical Psychologist Ponsonby & Parnell Auckland Book Sessions

Coping with Suicidal Thoughts

I’m seriously thinking about suicide. What should I do?

Clinical Psychologist, Auckland, Ponsonby & Parnell

If you find yourself contemplating suicide, it's crucial to recognise that you are not alone in experiencing such thoughts. Many individuals grapple with thoughts of suicide for various reasons, and it can be an overwhelming and frightening experience. The emotions you're likely experiencing—such as hurt, confusion, overwhelm, and hopelessness—may be accompanied by feelings of sadness, grief, anger, guilt, shame, or emptiness. In this moment, it might seem as though your situation is insurmountable, and your emotions may feel too overwhelming to handle.

It's important to understand that having thoughts of suicide does not imply that you will inevitably lose control or act on these thoughts. It doesn't make you weak or 'crazy.' Often, individuals contemplate suicide as a way to escape the intense emotional pain they are enduring. Even though the situation may feel hopeless, and you may question your ability to endure another moment of distress, there are avenues for support and ways to improve your well-being. You don't have to navigate these feelings on your own; help is available. 

How can I better understand my suicidal thoughts and feelings?

Persistent problems and enduring experiences, particularly those with a long history, can evoke feelings of hopelessness and overwhelm. In these moments, it may seem as if all options have been exhausted, leading one to contemplate suicide as a means of escaping profound emotional pain.

Individuals who contemplate suicide often perceive their challenges as insurmountable and unfixable. The emotional distress they endure can distort their thinking, making it difficult to trust, identify potential solutions, or connect with available love and support. Even in the depths of intense emotions, it's essential to remember that feelings, especially at such high intensity (e.g., grief, anger, sadness, loneliness, shame), are not permanent. Although thoughts of suicide may become overpowering, particularly under the influence of drugs or alcohol, it is crucial to refrain from using non-prescription substances, especially when feeling hopeless or considering suicide.

Common thoughts associated with suicidal ideation include believing there are no alternative options, sensing that loved ones would be better off without you, feeling that a perceived wrongdoing makes suicide the only recourse, enduring unbearable pain that seems interminable, wanting to escape suffering, expressing the desire to communicate the depth of your pain to loved ones, or harbouring thoughts of hurting or seeking revenge on others. These feelings of pain are undoubtedly real, but it's crucial to understand that hope exists.

With the assistance of professionals and the support of family and friends, you can explore the root causes of your suffering and learn how to change or manage it effectively. Understanding suicidal thoughts and feelings requires acknowledging that hurting or killing yourself is not the only option. Professionals can guide you in acquiring new skills to cope, altering your perspective on problems, enhancing your emotional resilience, improving relationships, expanding social supports, and considering medication when appropriate.

Various factors, such as mental health problems like depression or anxiety, conflicts with loved ones, and experiences of loss (e.g., break-ups, job loss, social status loss, or losing a loved one or friend), may contribute to suicidal feelings. Mental health problems are treatable, and seeking support from a doctor, counsellor, or free resources like the Antidepressant Skills Workbook can be beneficial. Conflict with loved ones, no matter how challenging, is temporary, and ending one's life is not a solution. Loss, in its various forms, can be profoundly difficult, but there are people and services available, such as the Grief Centre (0800 331 333), to help you navigate through these tough times.

Financial and legal challenges, such as overwhelming debt, gambling issues, or legal troubles, can induce significant stress. It's crucial to recognize that there are free services available to assist you in managing these difficulties. Organizations like the Credit Counselling Society (0800 377 733), the Gambling Helpline (0800 654 655), or the Community Law Centres (0800 529 529) can provide valuable support.

A lack of connection to friends and others can contribute to an increased risk of suicidal thoughts, especially if you feel isolated or unable to share your problems with anyone. Seeking professional guidance on ways to enhance social support in your life is crucial. You may feel that those around you don't fully comprehend the pain you're experiencing, and talking to a professional can help you find ways to communicate your struggles. The Social Supports wellness module at www.depression.org.nz offers ideas on improving your social connections.

Issues related to drug and alcohol use can exacerbate feelings of depression, anxiety, and suicidal thoughts. Substance use can alter your perspective on life's challenges. If drugs or alcohol are contributing to your problems, information on treatment options is available from the Alcohol and Drug Helpline (0800 787 797). Seeking support for substance use issues is an important step toward improving your overall well-being.

Medical issues such as diabetes, thyroid problems, chronic pain, or multiple sclerosis can elevate the likelihood of contemplating suicide. Ensuring proper medical care for these health concerns is crucial. Some medications may increase feelings of suicide, making it important to discuss these concerns with your doctor. For additional information and support, you can contact the Healthline (0800 611 116) or explore resources provided by the Living a Healthy Life with Chronic Conditions program (0800 600 725).

Sexual identity issues can contribute to an elevated risk of suicide, particularly for individuals who identify as lesbian, gay, bisexual, or transgender. Confusion surrounding sexual identity and fears of potential rejection from family or friends can exacerbate these challenges. Fortunately, support is available through OutLine (0800 688 5463), a peer support and information phone line. 

What else can I do to decrease thoughts of suicide?

Engage in Problem-Solving: It is always beneficial to explore alternative solutions rather than considering suicide as an option. Begin by creating a list of all the challenges you are currently facing in your life. Next, compile a list of potential solutions for each problem. Seeking assistance from someone you trust can also be valuable in this process. Addressing one or two smaller problems can effectively alleviate immediate feelings of suicide, allowing you to think more clearly. Once you have gained clarity, you can then tackle larger issues.

For practical guidance and resources on problem-solving and fostering healthy thinking, you can visit www.depression.org.nz. Online platforms provide worksheets and tools to assist you in navigating challenges and developing effective problem-solving strategies.

Here are some examples of common problems along with ideas for solutions:

For a Depressed Mood: 

  • Reach out to 1737, a helpline in New Zealand, for emotional support, short-term problem-solving, and referrals for longer-term assistance.

  • Consult your family doctor to explore treatment options, such as medications, adjustments to current medications, or addressing potential undiagnosed illnesses.

  • Prioritize self-care by ensuring adequate rest, regular exercise, consistent meals, and spending time with friends.

In Case of the End of a Relationship: 

  • Share your feelings of pain with friends, and consider seeking their support.

  • Connect with a crisis line or counsellor for professional assistance during this challenging time.

  • Explore joining a social group in New Zealand to build new connections and find support within a community setting.

Consider the reasons to embrace life: Individuals contemplating suicide often yearn to escape their pain, yet their desire is not always an inclination towards death. During periods of emotional lowliness, it becomes easy to fixate on negative aspects of life, potentially leading to viewing suicide as the sole option. To counteract this, begin actively contemplating the various reasons you have for living. Whether it's nurturing relationships with loved ones, the companionship of cherished pets, religious beliefs, personal goals and dreams, or responsibilities to others, these factors can serve as compelling reasons to continue living and act as deterrents to acting on suicidal thoughts. Compile a list of these reasons and keep them accessible. In moments of emotional distress, revisit this list to remind yourself of the meaningful aspects that provide purpose and support.

Recall effective strategies from the past: Many individuals have encountered thoughts of suicide previously. Reflect on the strategies that proved helpful in overcoming similar challenges in the past. Some examples include having faith in the belief that time provides healing, reaching out to friends and family, seeking professional assistance, participating in support groups, adhering to a safety plan, engaging in enjoyable activities, avoiding isolation, maintaining a journal, and abstaining from alcohol or drugs.

Engage in open conversations with a trusted friend, family member, or professional: Expressing your feelings to someone you trust is crucial. Sometimes, simply talking about your emotions can provide relief. Be transparent about all your thoughts, including any suicide plans you may have. Many individuals express relief after sharing their feelings with someone else, and this act of communication can significantly alleviate the sense of isolation.

Seek treatment for mental health issues: It's essential to seek treatment for depression, anxiety, and alcohol or drug-related problems. Consulting with your family doctor may not suffice; consider reaching out to mental health specialists such as psychologists or psychiatrists. Your doctor can provide referrals, or you can learn how to find a specialist from the referral lines listed on the last page. If you are already undergoing treatment, communicate openly if your current treatment plan is not yielding the desired results.

Counteract negative feelings with opposing actions: When grappling with suicidal thoughts, consider adopting actions contrary to your current emotional state. For instance, if you feel inclined to isolate yourself when experiencing depression, intentionally reaching out to others can help alleviate those feelings of despair.

How can I decrease chances that I will feel suicidal in the future?

Seek professional assistance: Obtain support and referrals from your doctor or the referral lines provided on the subsequent page. If the initial referral does not meet your needs, don't hesitate to request an alternative recommendation.

Identify high-risk triggers or situations: Reflect on the circumstances or factors that intensify your feelings of despair and thoughts of suicide. Endeavor to steer clear of these situations. For instance, if socializing at a bar with friends exacerbates your depression, consider avoiding such environments or socializing with friends who consume alcohol.

Prioritise self-care: Taking diligent care of yourself is vital for improving your well-being. Ensure you: • maintain a healthy diet; • engage in daily exercise; • achieve a restful night's sleep; and • reduce or cease the use of alcohol or drugs, as they can exacerbate feelings of depression and suicide.

Adhere to prescribed medications: If you are on prescription medications, it's crucial to take them as directed by your doctor. Communicate any concerns about the medication's effectiveness or side effects promptly. If you've recently started antidepressants, be aware that the resolution of depression symptoms occurs at different rates. Physical symptoms like energy or sleep may improve first, while mood improvement might be delayed. If you experience worsening symptoms, consult your doctor promptly.

Establish structure and routine: Maintain a consistent routine to the best of your ability, even when your emotions feel overwhelming. Consider the following tips to introduce structure into your daily life:

  • Wake up at a regular time.

  • Establish a consistent bedtime.

  • Incorporate planned activities into your day, such as going for a walk or visiting the gym.

  • Continue attending work or school.

Engage in activities you enjoy: When experiencing intense lows, participate in activities that bring you joy. Even if very few things currently provide pleasure, recall activities you used to enjoy during times when you didn't feel as depressed or suicidal. Engaging in these activities, even if they don't bring immediate enjoyment, can offer a respite from suicidal thoughts, if only for a short period.

Contemplate personal goals: Reflect on personal goals you aspire to achieve or have pursued in the past. Examples include reading a particular book, traveling, acquiring a pet, relocating, learning a new hobby, volunteering, returning to school, or starting a family. Identifying and focusing on personal goals can contribute to a sense of purpose and motivation.

What else can I do? 

Mental health resources, websites, and helplines in New Zealand:

  1. Lifeline Aotearoa:Helpline: 0800 543 354Textline: HELP (4357)Website: www.lifeline.org.nz

  2. Mental Health Foundation:Website: www.mentalhealth.org.nz

  3. Depression.org.nz:Website: www.depression.org.nz

  4. 1737, Need to Talk:Helpline: 1737 (free call or text)Website: www.1737.org.nz

  5. Healthline:Helpline: 0800 611 116Website: www.health.govt.nz/your-health/services-and-support/health-care-services/healthline

  6. Youthline:Helpline: 0800 376 633Free Text: 234Website: www.youthline.co.nz

  7. Samaritans:Helpline: 0800 726 666Email: jo@samaritans.org.nzWebsite: www.samaritans.org.nz

  8. Anxiety New Zealand Trust:Helpline: 0800 ANXIETY (0800 269 4389)Website: www.anxiety.org.nz

  9. OUTLine New Zealand:Helpline: 0800 OUTLINE (0800 688 5463)Website: www.outline.org.nz

  10. The Lowdown:Text: 5626Website: www.thelowdown.co.nz

These resources provide a range of support, information, and helpline services to individuals in New Zealand dealing with mental health challenges. If you or someone you know is in crisis, please reach out to the appropriate helpline or seek professional help.