When Suicidal Thoughts Do Not Go Away

The popular image of someone who is in danger of suicide goes like this: A person has suicidal thoughts. It’s a crisis. The person gets help, and the crisis resolves within days or weeks.

That’s the popular image, and thankfully it does happen for many people. But for others, suicidal thoughts do not go away. Their suicidal thoughts become chronic.

The pattern of chronic suicidal thoughts is similar to that of a person with any other kind of chronic condition: For some people, there are flare-ups where the condition is far worse than normal, and then the symptoms subside, but only temporarily. And for other people, the symptoms never subside. Those people live with their symptoms – in this case, suicidal thoughts – every day.

Who Is Prone to Chronic Suicidal Thoughts?

Chronic suicidal thoughts are especially common in people with borderline personality disorder, an illness characterized by unstable emotions and identity; impulsive, often self-destructive actions; and turbulent relationships. The psychiatrist Joel Paris notes that, for many people with borderline personality disorder, “suicidality becomes a way of life.”

However, chronic suicidal thoughts can occur in concert with other mental illnesses, such as recurrent episodes of depression, or with no illness at all.

Many people who regularly have suicidal thoughts have considered suicide for so long that it feels normal to them. Some have thought of suicide ever since they were young children. And some have made multiple suicide attempts, sometimes so many that they lost track long ago.

Why Chronic Suicidal Thoughts Persist

Often, intense, ongoing psychological pain fuels chronic suicidal thoughts. But even seemingly minor challenges can intensify the wish to die.

Frank King captures this dynamic well in his TedX talk, A Matter of Laugh or DeathAlthough King is a comedian, he provides this example in all seriousness:

“See, people don’t understand. Let’s say my car breaks down. I have three choices: Get it fixed, get a new one, or I could just kill myself. I know, doesn’t that sound absurd? But that thought actually pops into my head… It’s always on the menu.”

Some people say it comforts them to know they can die by suicide if ever the pain of life gets to be too much for them. The soothing nature of having an escape has led some experts to refer to “suicide fantasy as life-sustaining recourse.”

As the philosopher Friedrich Nietzsche stated, “The thought of suicide is a great consolation: by means of it one gets successfully through many a bad night.”

The Danger of Chronic Suicidal Thoughts

By Dese’Rae Lynn Stage

Even if suicidal thoughts provide some form of escapism and relief, it does not mean that chronic suicidal thoughts are harmless. The more someone thinks of suicide, the more they might get used to the idea. This can weaken their inhibitions and fears about suicide.

Also, chronic suicidal thoughts typically indicate that an unhealed wound needs healing, whether that wound arises from past trauma, mental illness, grave loss, or some other cause.

Even for people who do not view their recurrent suicidal thoughts as a problem, it certainly is better if they can come up with other escape fantasies besides death. Better yet, they can be helped to develop problem-solving abilities, coping skills, hopefulness, and reasons for living that will make the option of suicide unnecessary.

Therapy for Chronic Suicidal Thoughts

For someone with chronic suicidal ideation, therapy tends to take longer than it does for someone in an acute crisis. The goals of therapy are not only to keep a person safe, but also to help them develop the skills and resources that will weaken suicide’s allure. Dialectical behavior therapy has been effective at reducing suicide attempts and suicidal ideation in people with borderline personality disorder and chronic suicidality.

Often, it is not a realistic goal for a person with longstanding suicidal thoughts to stop thinking of suicide. Suicidal thinking has become a habit. And nobody can control what thoughts come to them, only how they respond to the thoughts.

One way for someone to respond constructively is to observe their suicidal thoughts with curiosity and detachment. Some of my therapy clients say to themselves something like, “That’s not my real self talking. That’s my depression (or stress, or post-traumatic stress, or some other condition) talking.”

Mindfulness can be especially useful. The psychologist Marsha Linehan, PhD, developed DBT, which essentially is a form of cognitive behavior therapy combined with principles from Zen Buddhism. She uses a metaphor of a train passing by: You can sit on a hill and watch the cars of the train pass, or you can jump onto one of them and get carried away by it.

When to Panic – and Not to Panic – about Chronic Suicidality

So if you know someone with chronic suicidal thoughts, you don’t need to respond as though it is an emergency every time they think of suicide. That would be a lot of emergencies. Chronic suicidal thoughts often are manageable and the person stays safe in spite of them.

Danger occurs when the suicidal thoughts have intensified to such a degree that the person is intent on acting on their suicidal thoughts within hours or days. That is an emergency.

If the person is simply having the same thoughts that they have had for many years, don’t panic. Instead, compassionately listen and empathize with the person. Ask how you can be of help. Talk with the person about resources they can use, like the National Suicide Prevention Lifeline (800-273-8255) or the Crisis Text Line (741-741). Also talk about how they can keep their environment safe, like by removing firearms from the home.

Chronic suicidal thoughts are not ideal, but they also are not a crisis if there is no intent to kill oneself soon. As odd as it sounds, the option of suicide might be the very thing that helps some people to stay alive.

Stacey Freedenthal, PhD, LCSW, is the author of “Helping the Suicidal Person: Tips and Techniques for Professionals.” This post originally appeared in slightly revised form at insurancethoughtleadership.com/understanding-person-with-suicidal-thoughts/.

Copyright 2018 by Stacey Freedenthal, PhD, LCSW. Written for SpeakingOfSuicide.com. All Rights Reserved. Photos purchased from Fotolia.com.

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  1. Annon says:

    There isn’t a day that passes where I don’t don’t think about or envisage ways to commit suicide. It could be the best day of my life and suicidal thoughts will linger. I have BPD and yes I have now become very used to having suicidal thoughts. I’m glad I’m not alone. I wish no one else felt this way however it’s comforting to know it’s not as abnormal as I thought.

  2. Natalie says:

    This really hits home with the way I have always felt. I can trace my suicidal thought back to when i was 12, and in some form I think they were there for years before too. I am 26 now and I really don’t feel like I don’t understand why I am still here. I feel most of the time like a failure for still being here, not the other way around like people would expect. I have suffered with Borderline Personality Disorder/Emotional Intensity Disorder, social anxiety, depression and from my teenage years Obsessive Compulsive Disorder. I feel like one of these would be a lot to deal with but all of them together has made me feel like I have no way around my problems. Like I am blocked at every point.
    This article sums up exactly what my thinking is towards suicide. It is always in my mind as an option. I always tell myself that if things get bad I can end my life. I also feel addicted to having it as an option. I feel like I don’t even want to contemplate having any thing that would mean that suicide wouldn’t be an option. Like I would feel trapped if I didn’t. So I have been in a constant state for years with just the constant idea of, maybe I will kill myself this time. I feel trapped by lack of wanting to break out of the chronic thoughts of suicide and I feel trapped because I haven’t went through with suicide or haven’t ended up dead. Its a really strange place to be. Borderline Personality Disorder especially can make me unable control my emotions and I can’t get control. The article is right about how I feel in those times. I can get so caught up in emotion and despair that I just want it to stop right away. It makes me erratic and not in the right mind and this is where it is really important to have something to take your mind off of it or you may up hurting yourself. I feel like I have been at this point quite a lot of times and usually my frantic state of mind stops me thinking clearly or at other times I have tried to kill myself but have ended up not being successful (for lack of a better word) due to it not being thought through entirely or it not being the most effective method. At other times I can be almost calm and calculating about it and almost numb. This is also a dangerous way to be and I even think for me personally it is when my thinking is at my most dangerous and self destructive. Because in that frame of mind I am clear about my goal and I want to be successful (again not best choice of word) in killing myself. I feel like I would be more likely to try to kill myself in the erratic heightened suicidal state, but less likely to actually end my life, but more likely to end my life with the other more numb detached way of thinking about it. Both are horrible places to be. Suicide as a thought for just about every second of everyday is such a mentally draining , soul crushing way to live. Sometimes it is there in the front of my mind and sometimes it is background noise. But it is always there. Sometimes something triggers it and sometimes I just wake up and feel I don’t want to go on. Having these thought constantly always becomes an addiction. But there has to be ways to deal with this. Because just simply having two options of either living with the pain and the constant fear and pushing through, and the other option of death, is not a way to live.

  3. cupcakes431 says:

    What some people don’t understand about depression is that, there isn’t a cure. It’s like I’m constantly disappointing my relatives with my depression. I don’t want to be a burden or an embarrassment to them anymore. Some give me the impression they want me to “get over” my depression like it’s just the flu. I’ve been through too much trauma in my life. Too many mistakes. Too much regret. Too much pain. Too much struggle. A lot of self loathing. Suicidal thoughts & suicide is a last option for me. I’ve been to therapy for over 8 years. I’m taking medication too. Depression seems to worsen for me year after year. I can’t wait til I die someday.

  4. Nobody says:

    Digging in the darkness of the internet, it seems there really isn’t any help for people like me.

    Sure, there’s some sympathy. I can see there are a few people who would prefer i didn’t feel as badly as i do.

    But there’s no help. And so, there’s no hope.

    The hopelessness is the worst part. It confirms the fear that there’s no reason to persist. And so there’s no reason to exist.

    Why bother? Why endure daily sadness, daily loneliness, daily mood swings, daily pain that becomes unbearable? My sadness become so overwhelming sometimes i yell out loud. But most the time it is a persistent, crippling distraction that i cannot overcome, as i try to simply hang on. I feel cursed to be miserable forever.

    I am exhausted, like I’ve been treading water for years. I am so tired, and i can see no reason to continue. I only wish someone would rescue me. Is there anyone, anywhere? God, please help me.

    • Anonymous says:

      I feel like I wrote that.

    • ASHLEY ROSE A.K.A. A.ROSE says:

      DEAR “NOBODY,”
      YOU R “SOMEBODY”.
      SOMEBODY I KNOW ALL TOO WELL.. THAT NOBODY LIVES INSIDE OF ME TOO.. EVERY LETTER OF THE WORDS U WROTE;WHEN I READ THEM THATS WHEN I REALIZED U HELPED ME REALIZE SOMEONE IN THIS WORLD LITERALLY UNDERSTANDS WHAT I GO THREW TOO..I HEAR U, I ACKNOWLEDGE THE FUCKING GUT WRENCHING SAD ,LONELY, LOST ,MISUNDERSTOOD,EMPTY, “JUST TOO DIFFERENT” FOR THIS FUCKED UP SOCIETY, I SEE AND HEAR AND FEEL ALL OF U..I WAS IN DOWNTOWN SAN JOSE,CA TODAY AND I WAS LIGHTING A CIGARETTE AND THIS GIRL WALKED BY ME AND WITH HER EYES SHE ASKED ME FOR A CIGARETTE AND AS I WENT TO REACH FOR ONE TO GIVE TO HER, SHE BURST OUT IN TEARS, THATS WHEN I REALIZED SHE HAD THAT NOBODY THAT LIVES INSIDE OF HER TOO AND I GOT OUT OF MY CAR AND HUGGED HER FOR PROBABLY 2 MINS STRAIGHT AS SHE CRIED..I DONT KNOW EXACTLY WHAT WAS WRONG WITH HER BUT I SAID IVE BEEN THAT GIRL TOO MANY TIMES IN MY LIFE TO NOT COMFORT HER

  5. Anonymous says:

    i’ve had suicidal thoughts for a long time now, i don’t know when it started but my head hurts and im tired of it. i want to reach out but feel like im just going to get rejected. suicide is the first thing that pops in head when things get too complicated

  6. Jacob says:

    I am a 17 yr old trans guy. I continually think about suicide. I was hospitalized for a week about a month ago, but it didn’t help. I’m just getting really, really tired of dealing with it. I want to reach out to people, but I’m afraid that they will get tired of me. I don’t think this pain will ever end. I have great people in my life, but at any inconvenience I think about overdosing or cutting. But there is nothing to do about it. I believe in God, so I feel guilty that I don’t just trust in them. I don’t know anymore.

    • Sierra says:

      I just came across this page because for years I’ve been having suicidal thoughts I’ve been told I have severe depression PTSD and borderline personality disorder my suicidal thoughts has gotten worse and I used to self harm and I’m afraid I’m going to relapse again in July I had a miscarriage and I feel like a monster how could I not save my own child from myself? In August I sent to the cancer center for having high platelets and it’s like a never ending waiting game on watching my white cells and red cells now, I feel like nobody hears me or understands how broken I am everyone depends on me for advice or when they need money I’m 21 years old and my life isn’t in order like it should be I wish I could be as great as my sister was and both of my parents would be proud of me, but instead it’s like I’m trying to buy their love and nothing works.

      • Jacob says:

        I don’t know you; I only know what you commented. But I am confident that you are not to blame for the loss of your child, and I’m so sorry that happened to you. Please give yourself room to mourn, but remember you are not to blame for bad things that happen to you. You can only control how you respond to those things. You can control who you surround yourself with, and the thoughts you gently acknowledge and let go or the thoughts you focus on. You are worthy of support and love and self care.

  7. nathaniel says:

    please help I am having suicide thoughts and my head hurts I have no friends everyone is just walking away from me when i’m at school life is hard and I feel like the only way people would actually care is if I was dead that is when they would cry If and only if I am just a hopeless person I don’t like life anymore people say im creepy weird and I freak everybody out well that just offends me and so yes I am alone except I have 2-3-4-5 friends. people say im always making girls uncomfortable well im in highschool see since my first day there i just keep thinking about prom and all that but my thoughts also control my actions which leads to the reason of why I’m so alone and why I want to die so bad

    • Aaron Johanningsmeier says:

      Something that might make you feel more comfortable about yourself is googling if any of your favorite music artists or people you look up to, have similar qualities to yourself or your perception of life. You change as you get older, allowing yourself to use all of your life experiences that have shaped you, even negative ones into a better realization of who you are as a person and what route you should take based on your skill set and interests. Never limit your possibilities. Always do what makes you enjoy sticking around.

  8. Sindi Muçaj says:

    I Just Need To Talk To Someone Who Understands Me I’ve Been Having Depression A lot Lately And I’m Only 9 Years Old

    • Dear God, child, may I please urge you to have the courage to confide in a trusted adult about your continuing depression. What you are going through, unfortunately, is normal for a whole lot of people. Help is available. Please talk to the school nurse, a suicide prevention hotline, a church minister, or any other adult you trust; and, yes, that hopefully includes your parents. I know. I lost my 15 year-old son to suicide.

    • Carrie Culver says:

      Im sorry . Maybe your parents or grandparents or a counselor can help you. Talk to someone you trust.

    • P Virany says:

      I would be happy to talk to you. I am a Director, and I have a website/reel at paulavirany.com. Just click on the contacts page and you will see my gmail address there. Maybe I cannot help you, but maybe I can.

  9. Anonymous says:

    My suicidal thoughts didn’t truly come till I was 19. I have never been hospitalized or anything, but have tried therapy, medication, exercise, etc. The thoughts still linger. And I’m tired of experimenting on myself with drugs. We need new creative solutions to fighting depression, or more people will be devasted by America’s poor mental health system.

    If I wasn’t so privileged I would definitely be homeless right now.

    • Anonymous says:

      Research ketamine therapy. It is working well enough that drug companies are trying to develop new, similar alternatives which work the same but can be sold at a higher price. If you are privileged, maybe someone can help you get this treatment. I would try it if i could. Good luck. I hope you make it. I hope you can find a way out of this hell.

  10. Samantha says:

    Well here I am laying in bed again, trying to talk myself out of my sadness. I had to laugh at the car comment though- thank you for that. My car really is broke down and it’s one thing in a string of events that has made me feel like a loser, hopeless.
    I was hospitalized 3 times after the birth of my youngest son nearly 3 years ago and I promised myself I wouldn’t let it get this bad. And yet, here I am. I walked outside with the intention of stepping out in front of a train but I turned away and went back home. The thought of my kids being separated from each other after the inevitable outcome of my husband being unable to take care of them is what stops me. But my life is far worse than it was 3 years ago. Eviction, loss of security,the inability of me being able to get a job or secure childcare has left me feeling very empty and useless as a mother. My children deserve better than the life I’ve given them and they deserve a mom who doesn’t feel dead inside. They didn’t ask to be born and I have failed them. I don’t see the point of going to the hospital or getting help again when I just fail over and over. I wish I knew how to fix this.

    • Anonymous says:

      Sweetheart, you clearly care about your children. If you do your best to provide for them and get by, they will remember you for that. Not what you were able to give them. You are clearly going through hard times. Just try to think how you can better your situation in the long run and chip away at it. Trust me, your kids will look back and see your efforts more than they will how comfortable you have made life for them. You sound like a good mother, and it has nothing to do with wealth. Do some research about what kind of assistance you are eligible for. It is there for you if you look for it. Hang in there!

  11. Jessica says:

    I’m 32 I’ve dealt with these suicidal thoughts my whole life and dont know why I dont act on them. They are almost just a part of my everyday life now. I’m glad to see I’m not alone. I dont talk about it to anyone because I dont want anyone worrying about me so far I’ve kept it under check. I’m not even depressed when the thoughts arise I could be having a great day and it’s just a thought almost like saying I’m hungry but instead it says you can kill yourself. I could never figure out why my mind thinks of it or what has caused it to start it’s been so long I dont even remember the first time it started. I’m an RCM and it makes me kind of relate better to my clients but I’ve never told them it just makes it easier for me to understand what they are going through

  12. Ross H says:

    It makes me feel better to know I’m not alone with these thoughts. I was begining to think I was crazier than I thought. I just can’t stop thinking this way …… it’s been happening since I was very young and I’m now 50. Thank you

  13. Billy says:

    I just recently turned 22 and I have had Suicidal thoughts ever since I was 12 I’ve become numb to the thoughts but often fear them it’s to the point were i will get them multiple times a day and I don’t know why. I have been through therapy and been on multiple anti Psychotic medicines I’m just not sure we’re to from here

  14. glen says:

    ive been thinking of suicide for many months. was looking at death images from suicides on the web few months ago..wanted to remind myself it is messy and would be painful. i dont drink dont do drugs no break ups,no lost jobs,no money woes. not sure really why but it creeps in my head every now and then about offing myself depression? not sure, married , im 52 with a 3 year old and probably the only thing keeping from doing it is my child. i have visions of the act many times today even with wife here im looking out window thinking of sticking a gun in my mouth .i’m thinking i just want to send a message to my wife or estranged family that i am not happy and i want them to change the way they think and act towards me. ive become very moody and pissed off about every thing lately too.i really hate being that way towards wife and baby. i know wife knows im pissed or unhappy whatever but i cant tell her reasons why it would lead to even more strife and send me over the edge probably. its like i want her to know that shit she does makes me unhappy but then again im going to have to piss her off to let her know how i feel and that will probably end it right there. right now alone and the means to do it i am in thought,when i do i get sad,thinking of how it could be nice ,my child,what ive worked for. sucks,makes be kinda feel like a coward for not being able to go through with it as well. wouldnt take much effort to do so. do i leave a huge mess for the wife to find and clean up?,that will teach her..leave her with those images do i do it in the woods and no one would know for months or years? go out in a blaze or go out quietly? such a coward. im sad now…thanks for letting me write this.

    • Anonymous says:

      Glen,
      I just left a post a few days ago. I relate with what you are saying very much, though my kids are older than yours. I’ve never really been satisfied with how my life was progressing, but the suicidal thoughts just started creeping in as I lose hope of anything changing as I get close to 50. Similar to how you describe, I think about the methods and scenarios also… Right now I feel safe because my parents are alive, and I couldn’t do that to them. What scares me is what will happen when they are gone. I think sometimes “what is so bad that you want to do this? You have your health, you’re not financially damaged, and if your marriage is doing it, then you can leave.” For some reason I can’t get my mind to think of the possibility of making some radical change, and I would rather die. Hang in there, man. Feel free to write back.

      [This comment was edited to abide by the site’s Comments Policy. — SF]

      • glen says:

        yeah, same old same old..gong on 3 week vacation and i really can care less, i guess it will be distraction at least. yeah the wife and baby make me happy but i am un happy when she is unhappy with me for being unhappy? make sense?if the marriage ended and away from baby lost all my stuff, that would probably be the nail in the coffin. thats probably only thing keeping from not doing it. and probably the cause of me thinking about it… yeah it sucks.i go day by day. thanks for the response,nice to know im not alone or freaking insane.

      • Aaron says:

        Both of you hit home a lot! I’m 27 and no kids or my own ‘family’and I went through a break up recently that really pushed the thoughts backs up.. even after a couple months and missing her has subsided, the loneliness presides.. but ya I’m doing well
        Compared to most people
        My age.. i make enough, own my vehicles, and have a mortgage rather than rent.. but yet.. I feel like these thoughts occur way more than friends that are in much worse states.. I only have a mom, but since I can remember I couldn’t go through with it until she’s past, couldn’t make her go through that.. it’s awful! Entertained making the ‘good bye’ letter before and never got very far.. recently googled it and found out something like 60% don’t write one and that made it that much easier.. just pick up the gun and do it and it’s done. Easy and done. Held it for quite a while.. again.. it was the thought of my mom that I couldn’t do it.. and ya, I’ve thought about doing it to cause pain to an ex, but that’s inmutare, don’t cause someone else pain, they don’t deserve it…. thanks guys! I envy your family, I don’t know the experience myself. But maybe look at the kid and the women that loves you and chose to make you a constant part of your life and know how much you matter to them…

    • Anonymous says:

      Hey.

  15. Elyce Mandich says:

    I am an LCSW at a high school and just wanted to tell you how helpful your articles are regarding suicide. Specially this one and how to ask questions about suicide. Thank you!

  16. Gary says:

    I am a male of 49, married, 1 adult child and 1 teenager. Over the past couple of years suicidal thoughts have been creeping into my mind, and now are there daily. I appear stable and rational, and in control of my life. I do not feel that way at all. Though I have a decent career and my children seem to be headed in a good direction, I feel a sense of waste, and do not like where life has taken me. I am older now and my hopes and dreams are disappearing. My wife has struggled with depression for years, and though we have a stable marriage, I think her negativity is really taking a toll on me. In addition, my children do not respect me or my wife, and I feel like I am despised by them in a way. My wife and them just have almost no relationship. When they need something they run to me. Like I have been with my parents, I always expected to have a close family relationship with my children, and it’s apparent now that is not happening. All of this may sound trite to others with real problems, but I can’t help it. I travel often, and when I sit in hotel rooms, as I am now, I think of Anthony Bourdain. I really related with his personality.
    I enjoy company and conversation, but feel very lonely. Right now I’m safe because I would never take my life while my parents are alive, and also an aunt. I don’t feel as much for my wife and children. That would really shock those who know me. I have completely lost faith in religion which has removed the fear of being punished after death for suicide. After seeing my wife have pills prescribed for depression which have terrible side effects, like turning her into a zombie and causing carelessness about everything including parenting, I don’t have much faith in professional help. I find myself turning to alcohol some evenings and weekends as a means of escape, knowing that when it wears off I will return to a clear mind. I guess I am writing this because I feel it’s my own therapy. I wish you all as many good times as you can have.

    • Chris says:

      Dear Gary, I am sorry for the way you are feeling. It really does hurt if you feel that your relationships with your children haven’t developed the way you hoped. YOU ARE NOT ALONE. when I was very lonely, I would go to the beach or for a hike. I have had some wonderful conversations there with people i have met and will never meet again. I also read a lot and try to lose myself in the characters for a while. At one point in my life, Zoloft really helped my depression, I don’t know if you have tried that or not. And it was prescribed in a way that started with a low dose and moved up until it was effective. It did not make me lethargic or anything like that. I travelled for business constantly for 7 years, and that can add to your isolation. It really takes a toll on your social life. I wonder if that is contributing to your isolation? Alcohol is also a depressant and probably isn’t helping your mood. Feel free to write to me.

      • Anonymous says:

        Hi Chris. I appreciate your kind words and advice. I do find ways to cope temporarily like you do with beach walks and hikes, but it only makes things better during the time I am doing it. Also, the alcohol seems to give me a good escape as I am never a “sad drunk”, and it always puts me in more of a cheery mood. I just want to go there too often, and am worried about the health effects and eventual dependency. I understand what you mean about the isolation while traveling, though at least I get to sit in hotel bars and speak to others sometimes who are also traveling. You know, I feel bad seeing the terrible situations others on here are in, and think I should just stop whining and find a hobby or something. 5 years ago I never thought I’d be like this. Maybe you are right about finding the right medication. As I said before, I’ve just seen my wife get dumbed down by it to the point where it affected her career and cares in life. I’m terrified of getting that way without realizing it. I suppose I need to at least talk to someone, and can always take or leave the medications.

  17. Bella says:

    Thank you for this. I’m a mom of a 17 yrs old who attempted suicide 5 times in less than 8 months. I’m a nurse but I couldn’t understand it. It was a drastic change. He was a promising athlete who was charming, well rounded, born leader, sweet kid. And all of a sudden 180 degrees change. I thought there was something traumatic might have happen.

    I’m still trying to understand so I can help him best. It difficult when sometimes it feels like we’re fighting the health care system.

    Again, thank you for this insight ❤️

  18. Channell says:

    Thanks you for caring

  19. Morag says:

    I’m 31 and I have BPD and I can remember wanting to die since I was about 9. Years of constant bullying and molestation took their toll. At this point, suicide is always option #3 no matter what happens. Even if I’m at a wedding or doing something I enjoy it is always in the back of my head. There just doesn’t seem to be a point to life anymore when the future is hopeless. I think I have felt trapped since I was 20, it just took 10 years for me to fully realize and accept it, which is probably why I’m in the horrific spot I’m in now. My friends get worried when I talk about dying but to me it’s just another choice as simple as something on a menu for dinner. I can’t even vocalize how I feel to my family because they are tired of hearing about this for so long and say if I wanted to do it I just would. Well, I will one day, I’m just not at that point yet, but I’m terrified of when that point will actually be. I have tried therapy of all kinds, the one thing I have not touched is medication but I am at the point where the urge is so strong every morning (especially at work-no one with mental illness should EVER work in a customer service position, btw) that I am almost willing to try. I just can’t see myself going through another 10 or 15 years of living like this, waking up each day and wondering if today will be the day that finally pushes me over the edge, even for stupid shit like someone yelling at me too long on the phone at work. It’s just damaging and I feel like my soul is eroded like a mountainside by snow or rain-the feelings I have are the element and one day the mountain just crumbles. It feels like I have no soul or that I’m a black hole that can’t ever be filled. I just want peace and if that means by death then I’ll do it. I don’t even want a good life or to be happy anymore, I just want this to stop.

  20. Pattie says:

    “If the person is simply having the same thoughts that they have had for many years, don’t panic. Instead, compassionately listen and empathize with the person. Ask how you can be of help. ”
    Just wanted to highlight that point, Stacey.
    This is where the mental health field has gone off track, and needs to learn to listen. I am always cautious in what I say, and yet I’ve learned how dangerous these people can be when they dont know what they are doing.
    On the positive side, when I was Oregon, the understanding of “trauma-informed care” was refreshingly noticable. I also appreciated one therapist who said, “I know I can’t save the world, and while I hope you won’t take your own life, I know I can’t stop you. ” It was her respect that I appreciated, and I think other therapists need to remember their job is to support, not to police people.

    • Gabster says:

      Well said! I’m tired of people not listening,it’s becoming more of the problem than our own suicidal tendencies..another reason why it’s worse..we know no one listens,they are policing instead of trying to help

  21. Kellen says:

    The first time I remember wanting to kill myself I was 6 years old. It was a stupid fight over something I don’t remember, but I recall standing in the kitchen with a knife at my heart thinking I would plunge it into my chest and end my life. The thought of dying never really left me though. It grew more defined as I aged, but it’s always been there. One of my biggest struggles is that so many people don’t seem to understand that this isn’t a causal effect where something’s been going badly in my life and I want to die as a result. I’ve never heard of Frank King but that quote is so perfectly accurate to my life. It’s always there, always an option. When I have a “flare up” there usually isn’t a particular reason. I’ve just felt this way for so long and my interest in living reaches a low point to where I just want to die with every fiber of my being. Even when I am on top of the world and I am so happy and content with life (especially those times, actually) I will feel an immense desire to kill myself while I’m at my best. I think the phrase “so happy I could die” is truly lost on most people, or rather that they don’t really mean it. These chronic suicidal thoughts make it so hard to express my desire to die because I struggle to convey into words that this is something I deal with everyday, and that it’s not a temporary condition. How do you describe to someone why you feel a certain way when it’s just always been there? I’ve always told people the best way thing you could compare me to is an addict of some kind, but instead of always wanting a drink, I always have thoughts of suicide nagging at me. 6 years ago when I turned 21 I tried to kill myself and was in a psych hospital. It helped tremendously, but for about two years I put all those feelings in a box and believe my mental health issues were a product of my adolescence and my still developing brain. After a few years though I was starting to break down again and went through an existential crisis. As the first time that my suicidal thoughts were forcing their return, this meant that my previous belief was in fact false. This pain would always be with me in some fashion or another. Since then I’ve gone through good and bad times, but the return of the bad was never as hard as that first time. I don’t know how to cope with this though. For the past year and a half things have started to get worse more frequently, I’ve started to develop more anxiety (previously I wouldn’t describe myself as afflicted by anxiety, only depression). I had to take a month long leave of absence last summer, I wanted to again this summer but felt that I couldn’t because of the stigmas associated with depression and suicidality. I couldn’t let my work believe this would be a recurring event every year or two. Instead though I am bottling things until I reach a point where I physically can’t. I’m on this website because today was one of those days. I have spent 90% of my day at work googling suicide related topics (I even did this on my phone, lest my work find out if I did it on my desktop computer). Today I have sobbed at my desk while biting my arm to stifle the sound. I’ve gone to the bathroom to cry because I was worried someone might come to my desk to ask me something and see the state I was in. I feel like I’m doing a tap dance on the edge of a cliff and sooner or later I’m just going to go over the side, and there won’t even be a particular reason for it. Just my generalized depression. This is a hard concept for people to understand though since most of the people I talk to think it’s like breaking your wrist, wearing a cast, then you’re fine until another issue occurs to hurt you in some way.

    • James says:

      Hi, Kellen. I have been in this state also for a long period. This past month i lost a lot, 30 year career etc.. i did not expect to be alive today. I was prepared to leave. Since i was young. Now more prevalent. Anyway, i wanted to tell you thanks for letting us know we are not alone. Email me if you want. Id like to hear from you.

  22. Vince Barbieri says:

    Thank you

    For the insight.

  23. Ffjn says:

    I don’t know how to cope anymore My suicidal thoughts have become like a coping mechanism for me and on some days they get so bad, I don’t know what to do

  24. Elizabeth Mckinney says:

    I looked this up hoping to find a solution. This has gotten so bad now that I think about suicide and fantasize about it almost hourly unless distracted. At night I can’t sleep anymore. I lay here right now at 5am trying to fall asleep obsessively fantasizing and planning suicide. The comfort of it is all that gets me to sleep. I am no longer able to leave my home because of anxiety brought on by shame and self loathing.

    Therapy would be nice if I could afford it or bring myself to leave home… But I already know I won’t listen fully. I’m a practical person and what I want are solutions to my problems not masks, tricks and bandaids.

    I don’t expect this comment to exact any effect. I simply felt compelled to post. Thank you for giving me a label to identify myself with. Knowing it exists helps me be a little stronger.

    • Marcus says:

      I read it and by the fact i did that & then felt compelled to reply – it did exact some effect. I think i know how you feel. My sadness attacks me periodically to what i believe to have the end goal of eventually killing, or worse -destroying me entirely. I am 38 and been battling this at least 20 years…. possibly even 30+ – its hard to know. I have given up being part of the outside world & know systematically i am dismantling my known existence to those outside. My car broke down & i left it where it was. My phone broke and i did not replace it. On the rare occasion the manic energy my sadness can manifest takes on the form of “positive change” – i am left disappointed and hating myself for trying due to the realisation that those who i reached out to in an effort to recharge my hope – left me disappointed. The jury has spoken & their verdict is pretty clear.
      At times i think i am doing this with the motivation of a rebirth – but when the sadness hits the realisation is that i am doing it as a precursor of my death. I keep a small piece of my existence protected to ensure i have at least some essence left for my son and a lesser extent, my wife – but thats all i have left in me now – only my love and respsonbility to them stops the self loathing completely taking control. It stuns me its not obvious to more people – perhaps it is and they don’t give a shit, who knows…

      The thing people don’t get to why people commit suicide is, being sad and depressed all the time is incredibly exhausting. Being within the sadness is so exhausting and very unfullfilling. “Faking” that you are not within the sadness to keep loved ones expectations of you consistent is even more exhausting & eventually leads you to the realisation that you are nothing by a liar and fraud to the only people who have not disowned you….. committing suicide seems a fitting end to such a problem.

      • A.ROSE says:

        I’m 32. Im seriously at a loss for words on how much I identify with u,u hit the nail on the head. Only someone that suffers as we do could describe it as u did but for those that will not ever understand the dark pain we go through they should read ur comment.

  25. Dorothy Lawson says:

    Thank you! I often have Suicidal Thoughts. I have been diagnosed with anxiety/depression. My symptoms present as sadness. I cry, sometimes hysterically. When it’s bad I might say *I want to die”. Was worried about saying that too much, after all, I don”t take any action of any kind, no follow up.

  26. Jane mastro says:

    You mention that words are critical to the discussion about diseases that cause many suicides.For the past 30 years that I have been speaking on that topic. I stopped using the term MENTAL ILLNESS decades ago and use the term Brain disease because I believe it to be more accurate. MENTAL ILLNESS simply has too much inaccurate baggage associated with it. It doesn’t readily incorporate all that medical model psychiatry has taught us and is illustrated via Pet scans etc.
    It is no surprise to me that a drug like ketamine that can halt the pain of a migraine is also effective with refractory depression.
    Jhmastro

  27. Anonymous says:

    Your article mentions psychological pain..yet PET SCANS have shown that people with severe depression experience very real physical pain.
    Further discussions about this are important regardless of the fact that we may not understand it.

  28. Jane says:

    What I don’t read much about is the intense physical pain caused by refractory depression…it feels like it is pouring out of every pore….it never stops….one lives with it 24/7….it makes waking hours a nightmare and prevents one from getting much needed sleep. It is the worse pain I have ever experienced…and it responds to no normal methods of dealing with pain…not to hot baths.. pain killers.. or massage. Apparently ketamine successfully stops the pain…but how very few of us can afford IV ketamine.

    My hope is that a more affordable method is developed to administer ketamine…nose sprays..
    Lozenges…but for those of us in the USA even those would no doubt be too costly. How long can one wait when physical pain is your constant companion.??

  29. cindy brawner says:

    What stuck in my mind was “suicide is always in on the menu”. I get a reprieve from suicidal thinking just to have it come around again, this is real upsetting because each time I think it is over. Maybe one day it will totally leave me.

  30. Ben says:

    A supposedly suicidal person who calls a crisis line is ambivalent about his decision. On the other hand, a person who truly wants to die will not call a crisis line, or say or do anything that would lead others to lock him up. Given this, the whole idea of so-called Safety Contracts seems nonsensical.

    A friend of mine (PhD in Clinical Psych) is professor emeritus in psychiatry at an internally renowned university. He told me that, in his first decade or two of practice, he used to employ Safety Contracts, but then he finally realized that Safety Contracts don’t work for the very reason I mentioned in my opening paragraph. Now, he no longer uses contracts. He said that some four decades of practice have helped him understand that, if a client wants to commit suicide, he cannot stop him.

  31. A.Rose says:

    Who is prone to chronic suicidal thoughts, when I read people with BPD MY eyes stopped reading and i started sobbing I’ve known I’ve had BPD for years now im always looking for comfort and answers anyway I can to help ease my emotional and psychological pain. I googled when thoughts of suicide go on too long is it even a feeling anymore, its my state of being how the Fuck dose someone deal with that. That’s insanity .im the classic can’t medicate I’ve tried every treatment and therapy there is I’ve done it the right way wrong was by the book way the half assed way the same .to most im sounding negative im not being negative im saying the facts of my truth

    • Anonymous says:

      Every weekend for me its like clock work

    • David Crichton says:

      I think there are probably quite a lot of us like this, but there is no way forwards, although plenty of people will take your money for talking.
      I’ve had an idea about developing a website which would be organised along research based lines and include comments and actions from people like us who at present don’t seem to feature anywhere, but we do need help and perhaps we can develop our own system.
      Certainly writing down some positives each day and throwing away some negatives.

      anyone interested in helping me??

    • David Crichton says:

      DBT is supposed to be the way forwards for you . It does seem like Dr Linehan’s fortune though as she has developed a big organisation around it. There is a book and many groups. Have you tried it?

      • Stacey Freedenthal, PhD, LCSW says:

        David,

        I don’t understand your implied judgment about Dr. Linehan’s “fortune” around having developed an organization around DBT. Isn’t that the case of any treatment that has evidence of effectiveness – that the professionals who developed it try to disseminate it so that people can be helped? The same is true of other mental health treatments such as cognitive behavior therapy, acceptance and commitment therapy, and more, but it also extends into treatments for conditions that are not psychiatric.

        Based on other comments you’ve left on this site, it seems you also believe that professionals should not receive money for their work helping suicidal people. Is that correct? If so, is there a reason why people who develop or provide treatments to suicidal individuals should not be compensated for their contribution, time, and expertise?

    • Morag says:

      I feel exactly the same as you do.

  32. David Crichton says:

    I have now been living with chronic suicidal thoughts almost every waking minute for the past 6 years. This has meant I can’t think about anything else or really do much else’
    I have had serious cycle accidents try to do exercise to distract and the doctors now have nothing left to try for me I’ve had numerous meds, some which nearly killed me with side effects of pulmonary embolus and a stroke. They are now so worried that I am seen every day ( and have been for 7 months now)
    Admission will be shameful and make me worse.
    And now I have been arrested for my internet attempts to throw away thoughts and I have been convicted for texting someone who I thought could help me.
    From a national level athlete and high profile doctor I have become a disabled shamed person.
    Life is now terrible and my family have had enough of me

    • Mary says:

      I do not know that your family has had enough of you, and I hope you might consider that is depression talking, but I am stricken by your story and your chronic suicidal thoughts so resonate with another former national athlete and high profile doctor with children that I am married to…that I am compelled to beg you to use your training to consider if there is any way to destigmatize what is becoming an ever growing crisis in health care delivery. You probably don’t have the bandwidth to take this up, but you are not alone. Any thought helps.

      • David Crichton says:

        Dear Mary

        I would be very keen to learn of anything that you and your partner have found helpful

        I am getting worse despite the fact that my court case is now over and the media have stopped their terribe stories about me
        I am complaining about the line the media have taken and the little note they made of my acquital , but still being convicted for asking for help seems very unjust

  33. No says:

    I been thinking of suicide for years. Why would i call a hotline? Not looking for attention just want to die

    • Pattie says:

      To No: I agree. I dont even relate to the way this is framed.
      I dont find this life worth living, and yet, i feel like theres a reason for it, so i get what i can learn from it. To portray it as a “simple option” or an escape cheapens the contemplation of life and death.
      If im ready to die, im not going to call someone to try to talk me out of it. Its not an impulse that i cant control.

      • Regina says:

        I am 47 and had my first thought of suicide at age 7 and everyday after if you do not have it you can’t even begin to understand and that’s ok I would never wish this on my worst enemy..oh wait.. I am my worst enemy haha..

      • A.ROSE says:

        Oh Regina no truer words ever spoken about the subject.That’s what so many people in this life r ignorant and blind to… If this is not something u suffer and struggle with there is no possible way to understand it, and ur right that is OK…. Most people go through there whole life without thinking about suicide let alone making a true attempt and not just a cry for help, when that thought and agonizing struggle of suicide becomes your normal state of being that is what gets misunderstood. People like us need a different kinda help and I do not know what that is if such a thing even exists…

  34. Joe Doe says:

    More people die each year by suicide than by car accidents. SC alone has over 1000 traffic deaths/year..

    But funding to help those of us who struggle has been cut year after year for decades.

    I am disabled, can’t work, divorced, live in parents attic and will be homeless once they are gone. I’m 47yo, associates and Bachelors. Worked 60-80 hrs/week for almost 20 years. I have taken handfuls of pills many times over the years, drove my car into a tree a year ago and think about suicide 24/7. ITS NOT A CHOICE, I CAN’T WILL IT AWAY, AN 800 NUMBER IS NO HELP. I’ve seen dozens of psychiatrists and counselors, tried over 20 medications but nothing helps. Rich and famous ppl take their lives and they don’t have half the problems I do.
    EVERYWHERE I TURN, THE SOLUTION IS TO CALL AN 800 NUMBER.
    I’ll bet my life that even a presidential suicide won’t spur funding and REAL help for the millions suffering this problem.
    Death to the 99% is what the 1% live for.
    I WELCOME an end to this world. Bring the nukes!

    • Stacey Freedenthal, PhD, LCSW says:

      Joe Doe,

      The suffering you’re experiencing sounds awful, and it sounds like hotlines are not helpful to you. I do have other resources listed at http://www.speakingofsuicide.com/resources/#immediatehelp that aren’t 1-800 numbers. Maybe one will be useful.

      Also the following posts might be of interest:

      “What Stops You From Killing Yourself?”

      “Like Clouds Before the Sun”: Mindfulness and Suicidal Thoughts

      Talking Back to Suicidal Thoughts

      If you’ve encountered resources that have helped get you through difficult nights, please feel free to share them here.

    • Lost hope says:

      Wow! The last comment was June 11, 2018 and with very few responses. Plus the responses offer no help or guidance only references to someone or something else. Mr. Joe Doe, you and I are very similar in our experiences of life, and in my case with death as well. I have spent my whole life with death and despair all around me. Chronic suicidal thoughts and thoughts of (SDV) are a constant companion. I have been trying to obtain assistance for many years but it seems all the mental health community wants to do is lock you up for 10 days and throw medications at you. In my case, there are very few people who have experienced what I have to during my life, therefore it is extremely difficult to find anyone to understand. If you find someone they are not accessible, either due to cost, insurance or work schedule. Then add fear of being locked up and loosing some of the rights you have always had just adds to it. When it comes to mental health issues, complaints and treatments it is trial and error. I have yet to find a so called mental health professional who has a clue of what they are doing. I have seen and been involved in too many suicides to count as well as countless other traumatic events and there is just no one out there to talk to about it. This leaves you feeling alone, useless, antisocial, meaningless, confused, very afraid, hyper-vigilant and concerned for yourself and the few people you do know, but are not friends because you do not have any, that at some point in time, under the right circumstance you will go through with it. Then that act will mentally cause great mental pain, anguish and guilt for the people that just may care.

    • Lee says:

      I’ve been suicidal most all my life in and out of therapy so many times only to find it comes back and I’m sick of fighting it just ready to let it take its course

  35. suicide girl says:

    i have thought of killing myself and its hard to stop thinking like this my boyfriend told me that if i kill myself he will die to be with me. I have to think about my little sister because i’m all the family she has and if i’m gone she will have no one and i don’t want to do that to her but its hard i have to work deal with school pay the bills and i’m just 16 and girls picking on me non stop. i’ve even tried to kill my self already and i cant handle the stress and all. if u know a way to help me out please tell me.

    • Stacey Freedenthal, PhD, LCSW says:

      Suicide Girl,

      Please talk to an adult about how you’re feeling and ask them for help. It could be a teacher at school, or your boyfriend’s mom, or someone else you know.

      Or you could go to a hospital emergency room and tell them you are having suicidal thoughts and have attempted suicide already. You might not be admitted to the hospital, but the doctor could help you get set up with a therapist or psychiatrist who could help you.

      You also can text the Crisis Text Line at any time at 741-741, or call the National Suicide Prevention Lifeline at 800.273.8255.

      And if you feel in immediate danger of acting on your suicidal thoughts, you can always call 911.

      Thank you for asking for help here. I hope this information helps you.

    • Ryan says:

      Suicide girl from reading your comment, you are dealing with alot of stress, the girls picking on you seems like a major problem. My question is what is the major problem that is causing you thoughts of killing yourself the stress of having alot of burdens to deal with or the girls picking on you. Since you are 16 the picking on you will stop once you graduate. Are you overweight and thats why they pick on you, if so you can cut out most sugar and get on the low carb diet. You are beautiful to many peoples eyes so don’t let this small time in your life be the deciding factor in your suicidal thoughts. Your boyfriend seems like he loves you very much so do your best to improve your life and cling on to your boyfriend because he seems to love you alot. School is a very cruel place and once you’re out do your best to stay as good as you can and love yourself and others the most you can. Hang in there and take care of yourself first. Lots of love Ryan

  36. Ryan says:

    This will be one of last post for a while. I will make a comment
    about what you said at the end of your article Stacey “the option
    of suicide might be the very thing that helps some people to stay alive” Yes that is 100 percent true for my situation and maybe others.

    The option of suicide is one of the only things I feel I have control
    over. I actually feel happiness that I am in control of taking my
    own life. The fear that someone else will be able to take my life
    is one of the greatest fears I have.

  37. Ryan says:

    I have witnessed, experienced and second hand experienced murders, stabbings. shootings, rape, suicide, sexual abuse, jail and prison violence, watched people shoot up heroin and meth under the bridge when I was a kid, Experienced extreme domestic violence exposed to lots of pornography as a child, beatings by groups of male and female friends from high school because I was fat and not tough. I used to hit myself in the face with all my force with my fist and an aluminum baseball bat to see how much I can take.

    I put cigarettes out on my my legs and hold my hands on the stove as long as I can. I also stab myself in the thigh with 2-3 inch long knives (that hurts really bad). I put my 22 rifle in my mouth and in my mind felt the bullet go though my jaw out the side of my head, at the same time I almost ate a whole bottle of extra strength tylenol to destroy my liver, that is when I admitted my self to the ER.

    Most men are violent creatures and unlike women we are more able and look to physically kill or intimitate each other easily. I watch people that follow me home all the time I avoid people since I was mugged and beaten many times by both men and women just by walking down the wrong side of the street at night as a kid. I have had police show up to my house many times to ask me about crimes I never commited such as being a fugitive or harboring a fugitive, breaking into cars and shooting peoples tail lights out, all of these things turned out to be they got the wrong house.

    I am at the point where I don’t have the strength to defend myself the most I can do is shake my head and say no or just finally give in if the stress was too much, since I can’t deal at all with stress anymore.

    When you feel like that there is no hope because it hurts to walk, you have a hard time breathing, you have heart failure, like I do, your children are a burden (I envy you because I have none i’ll be 40 in June), you lost a loved one (that one can be tough I lost 30 people I cared about to suicide, cancer or heart attacks), you lost your home, job, are depressed or whatever the problem is, when are you ready to end your life that is the most frightening thing that will ever happen in a persons life, the thought of not being on this Earth any longer and buried in the dirt not knowing if there is an after life of not since no one has died and come back can make the feeling at the moment of suicide frightening.

  38. cristal says:

    suicide thoughts in my opinion do not go away. Once you have thought of it once, it will come back more and more for as long as you allow it to happen.

    • Ryan says:

      90 percent of what you said is true except for the last part “as long as you allow it to happen” sometimes it happens to us, allowing is not involved or as a reoccurring nightmare of thoughts that were never invoked.

  39. Kate says:

    I’ve been lost in depression for the last 7-8 months but the last 2 I’ve had suicidal thoughts every day. Nothing I do seems to stop them. There are times they are so strong I’ve had to pull over the car, cry and just ride out the urge. None of this is normal for me, there’s no end in sight. I did promise a friend to try therapy for the first time and I’ve been to a couple of appointments, but due to scheduling, I’m not set to see her again for 3 weeks. I’m not sure how or when to bring this up and I’m worried 3 weeks seems like forever.

    • Cory says:

      I hear you on the suicidal ideology as I have had those thoughts for many years on and off. I was diagnosed as having Major Depression Disorder with anxiety. I have had at least 8 suicide attempts in the last year where I acted on them and just ended up in emergency for the night except for a one week stay in the hospital last year. I have managed to push through some thoughts last time I wanted to commit suicide. I often think of suicide as my only way out of certain situations because right now I can’t see myself as having any kind of future. I graduated from college 2 yrs ago can’t find a job in the field. I’m getting older and at my age it is difficult to get someone to hire me because of age. I have a case manager and peer support worker but the feelings I get of suicidal ideology are so strong sometimes that it is very difficult for me to deal with them. I wish I didn’t have mental illness it only complicates so many things in me life. Sometimes I think it would just be better if I weren’t here and then I wouldn’t feel like a burden to anyone.

    • Ryan says:

      Kate yeah therapist now seem to see their clients once a month it used to be back in the 80’s and 90’s that therapist would allow to see their clients once a week. Don’t be sad that you pulled over to cry your mind is trying to vent it is normal and quite healthly it’s like self therapy. take care and lots of Love, Ryan

  40. This is my first time visiting your blog and I am glad to have found you. It will help me as a psychologist to keep this issue in the forefront. I also teach DBT skills group to people in a private practice setting. Tamara Suttle informed me of this blog so I have her and you to thank for being here.

    • Stacey Freedenthal, PhD, LCSW says:

      Loren,

      Thank you for visiting my blog. DBT is good for people with chronic suicidal thoughts, so I’m glad you found your way to this spot.

      It’s apt that Tamara Suttle led you here, because the site would not exist without her. I took her wonderful online workshop, BlogStart for Therapists, and she was basically an expert midwife. 🙂

    • David Crichton says:

      I think DBT skills has been greatly hyped by Marsha Linehan as a typical American major income generator, with biased research, which seems to ignore the fact that it is most widely used in USA and yet the suicide rates are increasing there more than most places in the world
      In reality every suicide is different and there is no panacea for helping prevent deaths
      All the charities have an approach which is kind but no evidence of success

      • Stacey Freedenthal, PhD, LCSW says:

        David,

        I don’t think it’s fair to say that the United States’ increasing rates of suicide are evidence that DBT doesn’t work. Very few people in the U.S. receive DBT, and of those who do, research shows that, on average, they experience less suicidal behavior than those who receive “treatment as usual.” I also haven’t seen any evidence that Dr. Linehan’s research is biased. Have you? She and her research team actually employ randomized controlled trials, which are considered the “gold standard” for obtaining valid research results.

        I do agree with you though that there is no “panacea” for helping to prevent suicide. Different things work for different people, and sadly, some people do not receive anything that helps them. (That doesn’t necessarily mean that nothing could help them, only that they haven’t encountered it.) Suicide is a complex social and medical phenomenon without a single cause or cure.

      • david says:

        The research she has done has greatly increased her status and income I would exepect, but there is NO evidence that introducing her programs into a new area has ever reduced the number of suicides in the area. All manner of assumptions are made in her research papers, which are clearly biased I feel ( I was a research lead)

      • david says:

        The research she has done has greatly increased her status and income I would expect, but there is NO evidence that introducing her programs into a new area has ever reduced the number of suicides in the area. All manner of assumptions are made in her research papers, which are clearly biased I feel ( I was a research lead)

      • Stacey Freedenthal, PhD, LCSW says:

        David,

        I think the concept of ecological fallacy applies here. Unless we’re talking about a massive public health intervention (e.g, fluoridation of water to prevent caries), there’s no reason to think that introducing a therapeutic approach that only a small number of people receive would lower the suicide rates for everyone. Nor can we assume that people who died by suicide in that area received her intervention. I’ll add that no intervention is 100% effective. People with diabetes who use insulin still can die of diabetes.

        I feel strongly about this because I believe Dr. Linehan is a truly excellent intervention researcher whose work provides a model for others to follow.

  41. Milestiba says:

    I am at a total loss. My latest “flare up” has seemed to span the length of almost nine months. Everyone has there own theory (which they are more than happy to share with me) of what I “really” believe or “really” feel after I explain exactly what I believe or feel and… well, I am fed up with it.

    I was going to kill myself (or at least give it one more “college try”) in June… on my 40th birthday. It didn’t happen. Everyone… again with the “everyone” (that is worse than the infamous “they” who will do Lord only knows if “they” ever find out)… I have talked to gleans their own true understanding of why I am really still alive when I tell them my actual answer. Now, I no longer want to kill myself for the reasons I originally had… I just am so exhausted and furious hearing what people determine is “really” the case. And I am tired of lying so they will leave me alone. Why can’t anyone listen to me, believe me, and really help me?

    I don’t expect anything out of life anymore. The only person that I ever thought really loved me because of how they showed it ended up utterly destroying my life. She was supposed to be my therapist. We got spun into the most codependent, volitile, emotionally charged relationship (which I later found out she chose to continue even when she came under investigation of the Board of Psych) and when I got browbeat into reporting her… well, her family retaliated hard – which was easy as politically and legally connected as they were. No matter how many times I disclose this to new counselors… it seems to cause problems that I have issues in therapy and keep up tons of defenses and walls.

    Anyway, I am alive only because one person has demanded it. You may think family, close friend, lover, spouse, child…? Nope. A crisis counselor I clicked with and developed an attachment to in the course of recurrent calls and talks. I am alive because of a voice on the phone. Due to my disorder… I have not been able to determine to whom I will develop an attachment. I can only recognize it and choose what to do following that. But based on how damaging some recent past attachments have been when I revealed them, I don’t much anymore. I did try to tell this person and others, but everyone tells me that the truth is I, myself, want to live and I am fighting extremely hard and yadda yadda. But lying around being horribly, utterly depressed while continuing to breathe doesn’t take much effort. Calling and dealing with her awful colleagues who long ago wrote me off and trying to tell them what is going on takes effort – especially when they hang up, or are dismissive, or tell me things that are argumentative, or all the other awful things they put me through because I promised I would call before irreparable harm is done or before I attempt to die by suicide again. If her colleagues leave me wishing I had just killed myself, I am to wait and try another day to see if she is in. Personally, I don’t want to live. I have no hope of ever getting better. My life – despite hard, intense effort to build back up – has progressively gotten worse over the last 13 years or so. But there is this unexplainable attachment. I am compelled to do absolutely anything requested by such individuals. It used to get me into trouble because others would ask for something and couldn’t get it the way they saw so-and-so get me to do something.

    I think the root of why comes from being raised by a woman who received no treatment for her paranoid schizophrenia and my family saw the effects living with her was having even as I was a young child, but chose to do nothing because they were scared. Someone thought it was a good idea to confirm this when I was an adult. They left me there to live with a woman whose rages made the wrath of God in the Old Testament seem like something that would be most welcome. Child Protection did nothing because there were no bruises, so the laws twenty something years ago stated that I was not abused due to a sense of physical marks. And I was left in a place where only my mother and I lived for years going to bed every night wondering if she would lose it tonight and kill me before she realized it. I swung like a pendulum between wanting her to just get it over with and desperately wanting someone to step in and save me. Too many professionals made it personal and tried to save me. They broke rules, demanded their own secrets with me and actually made things worse. This all I disclose in attempts to get help and counseling, but to no avail end up with a huge mess and misunderstanding.

    So I have a voice. A voice that demands I must stay alive even though the quality of my life is akin to a corpse. And that voice belongs to a real person who gets to go home to her family and friends and gets to enjoy whatever life has brought her through her hard efforts. I will never get to meet that person. Details of her personal struggles and triumphs will never be discovered. In order for that to happen, she’d have to become unprofessional and then I would suffer worse in the end. No, all I will have is a voice. Until there is another connection or attachment that I build. But, I don’t even want to leave my house. Conversations above and beyond ordering food or chatting with the cashier at the grocery store are way too much to deal with now. No contact with people means no new connections.

    Of course, if I choose not to call and don’t have contact with the voice, the attachment might fade and the next time I step out to attempt suicide, I won’t care what that voice wants. If only I had not already had the conversation about how even putting myself into the conditions where suicide becomes more probable is in its own essence… choosing to attempt suicide.

    I feel held hostage in this world. People care less and less about the quality of my life and many times in an effort to just make sure I am at least alive, the result is that my quality lessons. Sometimes quite dramatically.

    Maybe I truly do have a Russian soul. Because I think all this belief that a change is “just around the corner” is just bollocks.

    I almost bought this book to send it to the voice. I love this blog. I like the directness, the honesty, the willingness to engage in tough debate on a tougher topic than most. But I had included a message that our contract is null and void. That was a BPD impulse. So I cancelled it. Maybe one day I can find a counselor whom I get to see in person and this book can be a way to get some good talking going. One day… IF I keep choosing to breathe, live, or more accurately… if I continue to just barely exist.

    All that to say… I love the blog. Here I find some solace and if you’ve read this whole thing, I believe it has been established that I definitely need solace. So, thank you.

    • Stacey Freedenthal, PhD, LCSW says:

      Milestiba,

      I did indeed read the whole thing, and I hope fervently that you get more solace. Your description of what you’ve gone through, both as a child and more recently, is heartbreaking. I’m grateful that you connected with the voice – and the person who possesses it – on the phone. I hope that there are other voices for you to connect with, too, whether in person, on the phone, online, or wherever. I hope that you will keep trying even though your efforts have too often been met with pain or betrayal.

      You’re also a great writer. Have you thought of writing for TheMighty.com? Here’s a link for more information: https://themighty.com/submit-a-story/

      And if you need numbers or information about more places where there might be someone you connect with, please check out the site’s Resources Page.

      Finally, thank you for your kind words about the blog. I’m grateful that it gives you some solace.

      Please feel free to drop back in and let us know how you’re doing.

  42. Patti says:

    I think you are totally off base with your ‘theories’ about chronic suicidal thoughts. I’m not the only one who thinks life is overrated, and look forward to it being done. In my early confrontation with the decision to live or die, I just couldn’t believe it was random and meaningless, theres got to be more to why we’re here. So, I don’t think humans are capable of making a choice of that magnitude. It compelled me to make life the best it can be, if I’m going to be alive. And I have. But I’m always looking forward to getting it over with.
    I don’t have BPD, I DO have lifelong depression, I don’t make attempts, but I have reached a point where I truly feel like there isn’t any hope. I just wish It would end, someone shoot me, cancer, etc. I’ve done my part for years, I’m tired of the effort it takes.

    • Stacey Freedenthal, PhD, LCSW says:

      Patti,

      Thanks for sharing. What you have to say is very important, and I’m sorry that life has been so meaningless for you.

      I’d love to hear more about why the theories in this post are “totally off base,” because what you wrote here seems pretty consistent with what’s written in the post. Is it that you think it’s off base to attest that people can learn to cope better and develop reasons for living?

      Whatever the case, I hope you will check out Speaking of Suicide’s Resources page for people who have suicidal thoughts. It’s possible that one of the resources listed there could be of help to you.

  43. Randall P. Robinson says:

    In her marvelously insightful book, My Bright Shining Star: A Mother’s True Story of Brilliance, Love & Suicide, the late Rhonda Sellers Elkins (who, herself, died of suicide), made the poignant decision to publish the suicide note of her daughter, Kaitlyn, who perished, also of suicide, less than a year-and-a-half earlier. I had actually encouraged Rhonda to include it for publication in her book since I felt that it gave incredible insights into the mind of a chronically and persistently depressed suicidal person. It remains, in my judgment, the most beautiful, insightful, and eloquent suicide letter ever penned.

    In her departure letter, Kaitlyn, an intellectually gifted high school valedictorian and then 23 year-old student in her third year of medical school at Wake Forest University, wrote, inter alia, “I am so dreadfully sorry for the unimaginable pain and hurt that I have caused you by taking my life. I am sorry for hiding from you that I was so deeply sad. I am sorry for not letting you know that I felt like I simply no longer wanted to live my life. I am sorry that I didn’t let you in on the perpetual despair I lived in. Depression is nothing new to me, I can’t remember a time in my life in which I didn’t feel like I was barely treading water. I never told you how pervasive it was because I wanted to protect you from it, and I wanted to protect myself from it. But I have finally decided that I’d rather just not exist. I have found myself happy on occasion, and I have had many pleasurable things in my life, but mostly I feel overwhelmingly sad and exhausted from the weight of it. I would just rather not endure it any longer. I would have died years ago, but I couldn’t bring myself to cause you such sadness and heartache. I still can’t bear to think of the hurt this brings you, but I just can’t go on.”

    Elsewhere, in the same note, she continued, “I know I had such a seemingly bright future, and I know I would have been such a successful doctor and wife and mother. But all I have ever desperately wished for is to not feel like not existing would be preferable to being who I am and living the life I live. But that’s never been true. And that’s deeply sad and horrible and possibly terribly unfair. But that is how I feel and how I’ve felt for longer than I can remember. It may be inadequate and it may not justify my action, but it is the best explanation I have.

    I hope you will forgive me. I hope you can be happy again. I hope you can find the strength to endure this burden I‘ve placed upon you. And I hope you will never doubt how much I love you.”

    Kaitlyn’s last written words are a powerful testimony evidencing the thoughts and mind processes of a person who has struggled with chronic and persistent suicidal thoughts. As a society, we must redouble our efforts to make it easier for those who suffer from chronic suicidal thoughts to express their inner turmoil and make it known to others so that, as you say, Dr. Freedenthal, “they can be helped to develop problem-solving abilities, coping skills, hopefulness, and reasons for living that will make the option of suicide unnecessary.”

    • mic says:

      “As a society, we must redouble our efforts to make it easier for those who suffer from chronic suicidal thoughts to express their inner turmoil and make it known to others so that, as you say, Dr. Freedenthal, “they can be helped to develop problem-solving abilities, coping skills, hopefulness, and reasons for living that will make the option of suicide unnecessary.”

      And make it easier for them to just die, if the person feels that such would be the best course of action for them. Not every case of suicidal ideation can be solved in the way that you’ve described, and people deserve to have the right to exerise autonomy over their own existence.

  44. Nightsong says:

    I’m glad you mentioned that chronic thoughts of suicide aren’t always from Borderline Personality Disorder. In my experience, being mislabeled with BPD led to a reluctance to hospitalize me even when the thoughts were so intense & unbearable that I legitimately could not keep myself safe. For the extensive amount of time that I’ve been coping with suicidal thoughts, Al’s ChronicSuicideSupport.com forum has been invaluable in being able to talk about how I’m feeling when things are difficult.

    Yes, the option of suicide can sometimes be the only way to survive- when things seem so out of control and you can’t make anything better, at least you’re in control (ish) of suicide…

    I’m not sure if I’ve already shared this with you, but I gave a sermon at my church about my journey with depression & suicide that you may be interested in: https://www.youtube.com/watch?v=AftiXHnDu2U&t=4s

  45. Michael Hutton says:

    I was told by a doctor even though I talked about suicide I would never do it and they told me just keep taking your antidepressants you will be fine regardless to whether I will or not the thoughts are still there however I have stopped taking my meds as my dumb doctor has put me on Sertraline 100mg, which the side effect causes my heart to speed up this would be fine if I was not on beta blockers for my heart to slow down

    • Janice Taylor says:

      Oh my Gosh Michael Hutton how on earth can a doctor put you on medications with contra indications that one makes your heart to speed up whilst another to slow it down, do some doctors know what they are doing. There are some anti depressants that do not speed your heart up and it may well be worth your while to change your doctor and go on to something that will help with depression, as being totally without any treatment for depression might not be a good idea unless you are sure the depression is not a problem anymore which for most of us it is a chronic condition especially when suicidal thoughts have been a lifetime habit, I have had suicidal thoughts all my life and been on anti depressants since I was 24, I am 62 now and I have researched all these subjects to do with medications and depression etc. Anyway this is just my 10 cents worth, and I hope you get the help you deserve. from Janice

  46. Al Jones says:

    Well, Stacey it took you long enough to get to this entry! 🙂
    I love Frank Kings comment because it’s a natural for me. Now I know where I got that, I’ve used it myself a few times.
    Oddly I’ve heard this from several people – the Suicide Prevention Hotline doesn’t know how to work with those of us who have decided that suicide is an option. One person I know who was getting stressed was asked if they could hold for a few minutes while the hotline took care of a emergency.
    And, on that note, I like this article and will, of course, point my forum members to it, so I think you can expect more input from them.

    • Stacey Freedenthal, PhD, LCSW says:

      Thanks, Al! You also might be interested in taking a look at my book. I write about the need for professionals to validate the wish to die, to acknowledge that suicide is an option, to encourage acceptance and observation of suicidal thoughts, to not engage in a power struggle, etc. – all actions that likely would be a welcome change for many people with chronic suicidal thoughts.

      I look forward to hearing from your forum members at chronicsuicidesupport.com.

      • elean says:

        I want to say that people who consider this as an end to their suffering should not be judged.
        No one has any idea what is in their mind, body, soul. Usually very few know how that person feels and dismiss it.
        So don’t judge!!!!

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