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Monday, January 10, 2011

Reasons Not to Commit Suicide

One of the issues that all mental health professionals have to deal with is helping people past suicidal thoughts at times.  Life can become so painful that suicide may seem like the way out for some people.  Here are some of the things which I tell my own clients when this issue comes up.

Suicide is closely related to hopelessness and to negative thoughts about the future. Persons who commit suicide are generally convinced that there is no other way out for them. This is not true. There are better solutions to problems than suicide. If you are concerned that your depression will always be with you, then keep in mind the fact is that even severely and chronically depressed individuals can have long periods of time in which they are not bothered by depression or mood swings. Most depressions come to an end and do not go on forever.

Since hopelessness is so closely associated with suicide, it is vitally important to find a reason for hope. In this regard, it is important to avoid catastrophizing and fortune telling. The suicidal person believes that the future will be bleak and full of despair. Some examples of typical fortune telling thoughts are:
“I’ll never get over this depression.”
“I’ll never be happy again.”
“Now that I’m divorced, I’ll always be alone.”
“I’ll never find someone else that I can love or who will love me as much.”
“I’ll never find another good job. I’ll always be scraping by from now on.”

The suicidal person often anticipates that something dreadful and intolerable is about to occur. However, the future is almost never a sure thing. There is no way of knowing with certainty what is going to happen. Even if it appears fairly definite that something bad will occur, it may be that you are not just afraid of the event itself but of something which you think will follow it. For example, if you are sure that your spouse is going to get a separation, maybe what you fear most is the idea that she will take the children away and that you will never see them again. The likelihood of a separation may be almost certain; the probability of divorce may be somewhat less sure; and the chances of her taking the children away where you could never see again them are even less likely. The farther into the future a person is predicting, the more doubtful it is that their fears will actually come true.

Suicidal individuals often have the thought that others will be better off without them. “No one would miss me if I’m gone.” “I’m worth more to them dead than alive.” These are examples of the extremely distorted thinking that can occur in depression. The grief, pain, and suffering of family members after a suicide is often overlooked or discounted by the depressed person. Suicide is not a noble act. It is does not take a burden off the family--just the opposite. It is a desperately self-centered act which can burden survivors with feelings of guilt, anger, and depression for years to come. It is important to realize that underneath the selfless sounding words of “taking a burden away from the family” through suicide, the depressed person is sometimes actually very angry.



HOWEVER MUCH SUFFERING SUICIDE SAVES THE DEPRESSED PERSON, IT PUTS MUCH MORE ON THE FAMILY OF THE PERSON TO DEAL WITH.



Suicide is often more of an expression of anger than selflessness. When this is realized, then the suicidal person can find more appropriate ways of dealing with their anger.

Suicide can be thought of as a last ditch, desperate means of solving a problem. The problem usually consists of an external component (such as a legal problem or a relationship disappointment) and an internal feeling of pain. The person usually feels that all possible means of dealing with the problem have been exhausted and that there are no good alternatives left. Usually, this is not true, although it may be necessary to get help from a friend or therapist to see the alternatives which have been missed. Get someone to help you see some new solutions to problems that you have not yet been able to see. Get away from any rigid, all or nothing thinking. When persons are stuck in trying to solve a problem, they often feel that there are only one or two ways to solve it. When they feel that neither of them is working, then they tend to feel helpless and hopeless. In reality, there are often a variety of solutions to a problem. None of them may be perfect, but almost every one of them is likely to be better than suicide. Oftentimes, there may be multiple problems, which is particularly confusing to a person who is already depressed, tired, and having difficulty concentrating. A therapist can be very helpful in pulling apart the different problems and helping to find solutions for each.

Distracting Yourself Until Suicidal Thoughts Pass

Usually, suicidal thoughts don’t last for more than a few hours at a time. By remembering that such impulses usually pass, it is easier to find ways to distract yourself temporarily. If you can get past the moment, then you may change your mind about wanting to kill yourself. The first step is just to get through the night or the next few hours. Contact a friend. Then reconsider your situation. Delay acting on your suicidal thoughts. Keep your choices open. As long as you are living, you have the choice to stay alive or not to. But once you are dead, you have no choices. Give yourself the chance to change your mind. Once the crisis passes, develop a plan for how you will deal with the thoughts and impulses if they occur again.


AS LONG AS YOU ARE ALIVE, YOU HAVE OPTIONS. ONCE YOU COMMIT SUICIDE, ALL OPTIONS ARE GONE.


Obtaining Help and Social Support

Don’t isolate yourself. It is vital to garner social support. It’s time to call in your favors from people. This is no time to be independent and strong and to try to go it alone. Suicidal thoughts and actions are often triggered by the loss of a relationship. If you have lost a person through divorce or death, then your needs for companionship are likely to be greater. You may be feeling intense loneliness. Ask for help. Set up a support network of individuals who understand your feelings and who agree ahead of time to be supportive.

If there is a family crisis behind your urges to kill yourself, it may be helpful to turn to the member of the family who is most stable, supportive, and calm for help. Let that relative know that you have a problem and what it is. See if there is something they can do tho help you through the crisis.

If you feel that you are facing overwhelming demands that you cannot possibly fulfill or carry out by yourself, ask for help from others. If your family is not willing to provide the support that you need, there are people who will be glad to help you, such as local telephone hot lines, depression support groups, church groups, friends, a therapist, a minister, and others.

Form a strong relationship with your therapist. They are there to help you. If you feel that you need more frequent sessions with your therapist, ask for them. If your therapist does not seem to give you the amount or kind of support that you need, discuss that issue in your therapy session. Find out what the rules are about contacting them in a crisis. However, don’t stop at finding out what the therapist’s guidelines are.

Making a Contract

Make a contract with a friend or family member to stay alive. Have a firm agreement to call them and to see them before hurting yourself. Some persons are leery of making such a contract. They feel that they are giving away their freedom to someone else. Two things need to be said about this. First, you are not giving away your freedom. You are preserving it. As already mentioned, dead people are not free; only living people are free. Secondly, if you cannot make an indefinite contract, make a contract for a limited period of time--a month, two weeks, or even one week. That way you are not committing yourself “forever.”

Create a contract between you and your therapist that you will not harm yourself before coming in for another session. (It is not enough only to contract that you will wait until talking with them on the phone).

Avoiding Alcohol and Drugs

Avoid substance use because it increases the chances of following through on suicidal thoughts. Drugs and alcohol impair judgement and lower a person’s inhibitions. Moreover, alcohol and many drugs are depressants. If you need a medication to help you feel better, get a prescription for an antidepressant or anti-anxiety medication from a physician. However, make sure that the doctor knows that you are suicidal so that she can prescribe one which cannot be used to harm yourself.

Give Away Any Means of Suicide

Make it harder for you to kill yourself on a whim or an impulse. Give any lethal medications or weapons that might be used to hurt yourself to someone else. Get rid of all guns in the house. Don’t leave temptation lying around. You may even need to avoid driving at times if you find yourself having the impulse to wreck your car.

The Two “Yous”

There are in reality two ”you’s”. There is the suicidal you in the present, and then there is the you in the future that will be glad to be alive. Your therapist and friends are trying to keep you alive because they know the future “you” will be happy to still be living. Not all of your personality wants to commit suicide. The fact that you are still alive to read this means that a part of you has not wanted to die and has kept you alive up to this point. Remember that suicide is a permanent solution to a temporary problem.

4 comments:

Deanna said...

Thank you for posting this. I came across it tonight and it couldn't have come at better timing. Thank you.

Jp said...

I like your post, however I disagree with your last statement. I have been comptemplating suicide for years and the only reason I haven't is for friends and family. I still don't want to live. Therefore the me in the future is actually not happy. I honestly wish I did it a long time ago because I have now talked about it with a few people and I am afraid it would make them feel guilty for not helping me more.

Surgeon In My Dreams said...

I've had treatment resistant depression for 6 years and have been treated for depression since 1992. The ONLY reasons I am still here are my dog; my daughter; my granddaughters and my elderly parents. I used to say as soon as my parents pass I would be gone, but now my grandchildren are teenagers and would understand what I had done. Knowing I would let all these people down just adds more pressure. I'm afraid one day that pressure will overcome the other pressure...I don't want to be known as a quitter or give anyone a reason to be ashamed of me. but I'm so tired of hurting. The medications stop working after a year or 2 and we're back to square one. I am already on some not so common meds because the "easy" stuff stopped working long ago. I'm on 3 now. Three pills every day just to feel semi-normal.

Robert What? said...

Thanks for the article. On the outside I would appear to most people as a high functioning and successful entrepreneur. But the diagnosed major depression has left me struggling mightily the last few years trying to find reasons to not self terminate. As others have onserved it is often physically palpable. There was one serious attempt a few years ago. As you pointed out the suffering you bequeath to your loved ones is devastating. I know it would be to my sister most of all. Maybe even to my son in his own way. Thoughts like that are the only things that have stayed my hand. Not any hope or expectation that life will get better. Your point about distraction is critical.