Mental ill-health affects around a quarter of the worlds population- one in four of us can be diagnosed, at some time in our lives, with a clinical psychiatric illness.This does not count even more frequent experiences like grief or trauma that the majority of us will go through. Most of those clinical diagnoses are of depression, the most common of all mental illnesses, which is experienced by around one in five humans. We should all be aware of what can be done to help ourselves and others. More frequently felt, though, are the emotions and thoughts that can occur prior to the development of, or instead of, depression- the prodromal ideas. As a mental health professional I come into regular contact with people who experience clear ideas about ending their own lives. But what is more frequently experienced are the thoughts written below- ideas that explore non-existence, the “what if” ideas, the “will it be painful” thoughts and so on- and these are thoughts that are rarely recognised as being risky. They ARE risky, they are worthy of note, they should set alarm bells ringing. These thoughts can be the pre-cursor to suicidal actions and should be actively addressed as soon as they occur. Consider:
Just because you are not depressed it doesn’t mean you are not at risk of taking your own life- it is a myth that only depressed people do this.
You may not be actively considering to take your life but you may wonder what it might be like for others if you are not around any more.
You might be thinking about the least painful ways of doing it and you may have formulated a plan- how, where and when, how to get your finances and domestic issues in order beforehand, whether to write letters.
You may not be thinking straight- are you weighing it up while drinking, smoking a joint, after a bad day at work, after an arguement? It may be hard to see things in anything other than black and white terms but real life, unencumbered by such sadnesses, has many shades of many colours. If you only see black and white or all-or-nothing, an alarm bell should ring in the back of your mind.
Ultimatum words (“I always fail” or “no-one is ever kind to me”) should sound alarm bells.
You feel unworthy of kindness or love, you feel you don’t deserve it. This is more about how you see yourself and not how others see you.
Feeling lonely is not the same as being unwanted.
Your everyday life may not be seriously affected by your thoughts but this doesn’t mean there isn’t a problem that needs addressing. Don’t wait until your job suffers or until you can’t have fun anymore or a rift is growing between you and your chidren.
Distancing yourself from friends and loved ones isn’t always “getting older” or “just being middle-aged”.
Maybe you don’t have an overwhelming sadness but maybe you are more irritated or agitated or anxious than usual.
You may feel bad about yourself- how you look, say, or how you interact- but is this really true or just your perception? Get an honest opinion from someone else.
Do you have evidence that ending your life is the right thing to do? It is easy to jump to conclusions without proof. Remember this phrase as a mantra- don't confuse thoughts with facts.
You may feel there is no alternative way of looking at your life and personal situation. How might you feel on a different day, week or month?
Asking yourself metaphorical questions is rarely useful and usually provides no pragmatic answers.
Does suicide hold potential as a real, tangible answer? Reconsider your position if suicide appears valid.
Unattainable perfection and blaming yourself for something that is not your fault are common reasons to find it hard to see a way through. Be honest with yourself and your relationships.
Maybe taking your life feels as if you would be back in control again? Reality is different- it is empowering to let go of things that are out of your control and it is empowering to be in control of your life, not your death. Start small, it all helps.
Are there things happening in your life that are so unbearable that suicide appears the best way out? There are always other ways. Always.
Are you stuck? Are you grieving? Are you traumatised? This is not an end- this is inertia, this is grief, this is trauma. These are normal reactions to common human experiences. It is distressing, of course, but survivable and is treatable and is something that you can go through and come out the other side.
If any of the above is familiar this is what you can do:
- Tell someone, anyone. You will immediately feel at least a little better.
- You do not have to act on these thoughts. With time they will pass.
- Make an agreement with someone that you will contact them, day or night, if things become unbearable.
- Distance yourself from means of suicide. Ask someone to look after those tablets for a while, to look after your car keys and your whisky.
- Formal support is near- your GP, the local Community Mental Health Team (CMHT), the CMHT in Casualty at your nearest hospital, counselling services, the Samaritans/ telephone support services, etc.
- Avoid doing things you find difficult until you are feeling a little better.
- Develop a temporary routine for a brief period- a written schedule to stick to no matter what happens (always include movement, fresh food and at least 30 minutes of enjoyable activity).
- Reduce or stop taking alcohol or drugs (these massively increase the risk of suicidal actions).
- Deep breathing exercises, visualising a safe space, meditation, calming activities.
- Always know that a positive end is in sight, free from distress, and is acheivable.
- You will always get through adversity.
- Look for helpers, there are always there (even if it doesn’t feel like it).
- Be as kind to yourself as you would be to someone else. Be as kind to yourself as you would want someone to be to you.
- Allow yourself to be at peace. You have earned the right.
- Know that everything passes.
