There's a difference, though, between having brief flashes of ending your life, and ruminating about it constantly and forming a plan, says Neeraj Gandotra, M.D., a psychiatrist, instructor at Johns Hopkins University School of Medicine, and the Chief Medical Officer at Delphi Behavioral Health.
More than 50 percent of people will experience some form of suicidal thoughts in their lifetime, according to Ashley Boynton, Ph.D., a therapist and suicide researcher.
Take a second to try to wrap your head around that.
There's a difference, though, between having brief flashes of ending your life, and ruminating about it constantly and forming a plan, says Neeraj Gandotra, M.D., a psychiatrist, instructor at Johns Hopkins University School of Medicine, and the Chief Medical Officer at Delphi Behavioral Health.
While the former is normal (although disturbing), the latter means you should seek help immediately, he says. Again, not everyone who considers suicide does it, but everyone who completes a suicide thought about it first, so it's super important to take these thoughts seriously, he adds.
What are the risk factors for suicidal thoughts?
Not every suicide can be predicted or anticipated but researchers have identified some risk factors that make someone more likely to experience thoughts of suicide, Gandotra says.
Devastating life circumstances
The most common risk factor is when circumstances in your life take a dramatic turn for the worse. Think: the death of a loved one, a breakup, or the loss of a job, Boynton says. But it doesn't always have to be major-any situation that causes someone to feel demoralized, guilty, or ashamed can increase the risk of these thoughts, Gandotra adds.
Mental illness
The most common medical cause of suicidal thoughts is having a mental illness like depression, anxiety disorder, bipolar disorder, schizophrenia, or anorexia, Gandotra says. Having a mental illness doesn't mean you will commit suicide but it can increase your risk, especially when you feel that something isn't right in your head but you don't know how to fix it, he adds.
Substance abuse
Drugs and booze both cause depression and are a way to self-medicate when you're depressed, causing a vicious cycle that can end in a suicide attempt, Gandotra says. "When you're in an intoxicated state, you don't exercise good judgement and you're more impulsive," he explains. It can be even more dangerous when combined with being depressed or suffering a major loss.
Suicide is the 10th leading cause of death in the U.S., according to the American Foundation for Suicide Prevention.
Hormone swings
There are three times in a woman's life when she's at a far greater risk of suicidal thoughts or completion, due mainly to hormones, Gandotra says. If you suffer from premenstrual dysphoric disorder (PMDD), have had a baby or were pregnant within the last year, or are going through menopause, pay close attention to your feelings and seek help immediately if you start thinking dark thoughts, he says.
Being part of a marginalized group
A sense of marginalization or oppression-identifying as transgender, for example-can also contribute to a sense of isolation or hopelessness. “If one senses that they are a burden to others, feels isolated and alone, or feels that they have lost hope that life will get better, this can increase risk for suicidal thoughts,” says Boynton.
A history of sexual abuse
Being the victim of sexual abuse, especially as a child, is known to increase someone's risk of suicide, Gandotra says.
A family history of suicidality
Whether it's because you learned poor coping skills from your parents, grew up with a depressed or suicidal parent, or witnessed a loved one's suicide, the sad truth is that suicide can run in families. The link may be genetic or social or a combination of both but regardless of the cause, it's important to tell your doctor if anyone in your family has attempted or completed suicide, Gandotra says.
Self-harming behaviors
Behaviors like cutting or taking an intentional overdose, with the intent to harm-but not kill-oneself are called parasuicidal behaviors. Even those these aren't a suicide attempt, they are still a risk factor for a future suicide and should be taken very seriously, Gandotra says.
For every person who completes suicide, 25 attempt it, according to the AFSP.
Race
White and Native American people have been found to have higher rates of suicide attempts and completions than black or hispanic people, Gandotra says.
Isolation
Having a tight-knit social group of friends and family, along with social responsibilities to that group, are two of the biggest factors that protect against suicidality. So people who are isolated, lonely, and have no sense of purpose are at a higher risk, Gandotra says.
How to deal with suicidal thoughts
If you find yourself overwhelmed with thoughts of dying or suicide, or you have made a plan to die by suicide (even if you don't intend to carry it out at this moment), you need to know two things, Gandotra says: First, you're not alone; and second, there are things you can do to feel better.
"The first step is to recognize you are having these thoughts and not try to ignore them or push them away as that will just cause them to fester," he explains. Once you've done that, the next step is to talk to someone, like a friend, coworker, family member, or pastor, and then call your doctor as they can help you get the appropriate treatment.
"It can definitely feel scary, but reaching out to a mental health professional is a courageous and important step, because suicidal thoughts are treatable through therapy and mental health medication," Boynton says. Most people feel relieved and connected after sharing their struggles with someone else, she adds. If reaching out to a mental health professional seems daunting, ask a trusted friend or loved one to help you find one, or contact the National Suicide Prevention Lifeline (1-800-273-8255), who can put you in touch with local resources to get help.
Here, seven courageous women who have experienced suicidal thoughts share what helped them get through it.
"I realized I deserved love and respect."
“I was mentally, emotionally, and financially abused from around age 5 by my drug-using and mentally-ill parents, and it didn’t end until I left home at 19. I was also sexually abused by a family member of my stepfather at age 8 to 9.
“As I became an adult, I didn't get proper care to handle the pain of my childhood. Being a black woman, seeking help was quite hard. In 2010, when I was in college, I was so broken and desperately seeking validation from my grades and professors that I went extreme lengths of time with no sleep to study. Still, I felt there was no possibility I could ever achieve anything of greatness. I felt I was invaluable and worthless. I couldn’t move past the idea that I didn’t deserve life, since no one ever protected me.
“On February 21, 2010, I attempted to take my life. A friend couldn’t reach me, so she called the campus police. I was taken to the ER and then sent to the psych ward for observations. I started campus-mandated therapy, and my counselor diagnosed me with depression and post-traumatic stress disorder (PTSD).
“I had to really evaluate my life and find the good in myself. I began journaling and going to therapy to view myself in a better light. I finally got to a point where I now see myself as a woman who is deserving of love, respect, and kindness. I had a few suicidal thoughts after my incident in 2010, but when the thoughts come I realize it’s too costly to entertain them, and that thoughts are not facts.
“I believe my suicide attempt was like a rebirth. I don't have a strong support system but am slowly developing one, though relationships are not my strong point yet. To any beautiful black woman who feels this life isn’t worth it, please look in the mirror and see the gift you are to the world. I know it’s hard to see and believe in your own value, but your life lights the world. You’re worthy and you deserve love and peace.” -Christian Simone, blogger, TheChristianSimone.com, Instagram: @TheChristianSimone
"Hypnotherapy cured my depression and PTSD."
“I was 18 when my 19-year-old sister Bethany died in a car accident due to a drunk driver. My suicidal thoughts started the next year after my high school sweetheart and fiancé broke up with me and called off our wedding. I had an intense depressive episode and locked myself in my sister’s old room for a weekend. My thoughts told me I was broken in ways I would never be able to heal from, that I could never be happy, hopeful, or love again. I felt so much mental, emotional, and spiritual pain all at once, I couldn’t stand it one second longer. I wanted to not exist and just sleep peacefully forever to be free from that pain.
“That weekend, I attempted to take my life after my parents had left for work and my younger brother had gone to school. I survived because my mom had the thought (she says God told her) to leave work and go home to be with me. Paramedics said if she’d been even 10 minutes later I wouldn’t be here today.
“I began therapy but didn’t feel much better after seeing six different counselors. Some tried to explore my grief. Some prescribed medication and gave me practical tools to deal with my anger and hopeless thoughts, but they didn’t inspire me or change my feelings. Doctors and therapists believed my feelings were circumstantial and would pass with time.
“About three years after my sister’s death, my depressive thoughts worsened when I started suffering from debilitating symptoms of neurological dysfunction (seizures and problems with vision, concentration, memory, and speech). I went to the Mayo Clinic, where they diagnosed me with conversion disorder (now known as functional neurologic disorder), PTSD, and major depression disorder. Considering I had already tried traditional therapy and medications, they recommended hypnotherapy, which led me to seek the help of Jon Connelly.
“I had one session that lasted two hours and 20 minutes. During the first two hours, Connelly explained how trauma can affect a person and how it’s possible to recover from it, and he challenged how I’d been thinking. He then guided me into a very peaceful meditative-like state and repeated key phrases like, ‘The past doesn’t exist, Bethany is at peace, you can be at peace. Your mind is clearing.’ He also lead me through a guided exercise to clear the horrible images I had of my sister in a coffin and of the crash.
“Since that session, I haven’t had any of the symptoms or nightmares that I’d suffered for four and a half years. My results were unusual; research says results take six to eight sessions. Since then, I go to on average two sessions a year, and the healthier way of handling my emotions has stuck with me. (Watch Kristin’s TEDx talk.)
“During my first session, I made up my mind to train with Connelly, and two months later he began mentoring me to become a hypnotherapist. I became certified to practice within a couple of months, and the next year I opened my own practice in Seattle. I’ve seen hypnosis help relieve clients from suicidal thinking by allowing them to resolve past traumas and transform negative feelings and thought patterns into more positive ones. Hypnosis helps a person do this by getting their mind into a clear, calm, and focused state of intention to the point of becoming highly emotionally, and even physically, responsive to imagery and suggestions.
“It’s been eight years and I’ve had a few moments resulting from extremely stressful circumstances where I had fleeting thoughts of wanting to be free from the pains of life, but I’ve wished to live well and feel better, not die. I remember the strategies Connelly suggested in my session, ways to manage my breathing and my thoughts to prevent myself from suffering panic attacks, rage, or depressive episodes. I focus on making sure my needs in life are being met in healthy ways.” -Kristin Rivas, certified hypnotherapist and NLP practitioner at Mind Talk Hypnosis
"My dog saved my life."
“About 12 years ago at age 30, after being been married for five years, my husband asked for a divorce. Not long after we separated, I got involved in a relationship with a married man several years older than me. After about a year and a half, I started having suicidal thoughts. I spent my days wondering if and when he would be able to see me, what my future looked like, if I would ever have kids, how was I going to afford staying in my home, and why my path in life was so different from everyone else who seemed to have it all together. I felt as if nothing was solid in my life. Sometimes, I could see nothing but a black hole and I convinced myself that no one would really miss me. This was the demon of depression talking.
"What stopped me from moving forward was my golden retriever, Shadow, who stayed by my side and loved me for me. I wasn’t sure what would happen to him if I was gone. Who would take care of him? How long before someone found me and him? Would he be hungry, need to go out? I also believe in God and couldn’t come to terms with what would happen to my soul if I did this to myself.
“Fortunately, I only had suicidal thoughts for a week or two before I finally scared myself enough that I drove myself to my primary care doctor. I told him how I was feeling and he put me on an anti-depressant, which was enough to help get me back on my feet. I didn’t do therapy or counseling, but in hindsight think that might have been a very good idea.
“A few months after I hit bottom, I met my now-husband at a work function. Six months later, we started dating. We’ve been married nine years now and have two children. When I think of Shadow, who passed away nine years ago, I remember how very important he was to me-not just as a companion but as my true lifesaver.
“I share my story occasionally because I want to remind people going through similar experiences that what they are seeing is not reality. There is a light at the end of the tunnel, even if it’s dim or not noticeable yet. If I had done something permanent all those years ago, I wouldn’t have my two beautiful kids or my loving husband. I’m so fortunate I was able to pull myself out of the depths of depression-it was scary and lonely.” -Hollie, from Pittsburgh, PA
"I realized it\'s okay not to be perfect."
“I grew up in a home where, although my parents didn’t fight, there was very little love in the home. My dad traveled a lot, we moved every couple of years, and my mom was depressed. I felt unloved. At 11, my parents sat me down and told me they were getting a divorce. I hadn't seen it coming. My world collapsed; I became depressed. I would skip school and lock myself in my room and imagine how I might kill myself, so a school counselor came to my home and spoke with me. We decided I would try to move in with my dad, but life was worse there. I hated life and hated myself.
“At 14, I tried to kill myself. It was not a cry for help; it was an attempt to end my life, which thankfully failed.
“After the suicide attempt, I saw a number of mental-health professionals. My dad and stepmom sent me to a psychiatrist, who focused on my dreams. It was not helpful. One counselor I saw had me yell and scream at him like he was my dad to get the anger out. He didn't teach me what to do with that anger. Too often, professionals I’ve worked with have discounted my struggles, just making them worse.
“At 19, I started reading the Bible and going to church. I learned that God loves me unconditionally. The church friends also accepted me for who I was. Yet I was still in the place of feeling like suicide was my only option far too many times to count. Chronic sickness and fatigue while working and raising children as a single parent was often too much to handle. I got through by writing thankfulness lists to force myself to be grateful. I shared what I was feeling with close friends and asked for their prayers. I even took myself to the ER a few times.
“Now, at the age of 51, I’ve been free of depression for about six years. Some of my responsibilities lightened, and I now have an amazing psychiatrist. I finally realized it’s okay not to be perfect; it’s part of being human. This was incredibly freeing and healing. I’ve learned that laughter really is good medicine. I celebrate progress, even if it’s baby steps. And I know self-care is enormous. So seek help if you need it. If you don't get it, keep seeking. Surround yourself with people who will support you, accept you, and love yourself for who you are.” -Cindy Girard, author, The Great Escape: Helping Someone Break Free from the Deep, Dark Dungeon of Depression
"I learned my feelings were acceptable."
“In fifth grade, I started having suicidal thoughts because I lost all my friends. I remember thinking that it's all pointless because we all just die in the end. I felt like the pain of life wasn't worth it, and I should just jump to the end. I began hurting myself and told no one. I was always in therapy for one reason or another during elementary school, but it was never the right therapist. I distrusted the people I was sent to because they rarely validated how I was feeling, so I never told them the whole story.
“In middle school I tried to kill myself. It didn't work and I didn't tell anyone. I started self-harming, too. Then, in college, I started taking stupid risks hoping it would kill me. I even researched ways to do it. That's when I really started to scare myself. When it became obvious that I was a danger to myself, my parents were told that I needed intensive help, and I was finally put into proper treatment.
“I went to a lot of different programs-mostly dialectical behavioral therapy (DBT) and cognitive behavioral therapy (CBT). They taught me that it's alright to feel how I felt. That was the biggest relief. From the outside I have no reason to be depressed and I have an incredibly lucky life, so people never took me seriously and I felt guilty for feeling so bad. It was my biggest hurdle, and it was such a relief for my pain to be accepted.
“Every once in a while, usually when I'm overwhelmed with life, I'll be waiting for the train and I'll think it would be really easy to just throw myself in front of it. But I wouldn't do it. I've never gone back to that place where I'm really in danger. When I’ve had suicidal thoughts, I played a game with myself. I’d say, ‘I can always kill myself, that option isn't going anywhere,’ and decided that I should at least give myself a chance. The rule was that if I didn't feel hope in six months, I go through with it, but I had to fully throw myself into my treatment and do everything the doctors asked. I didn't need to be better, I just needed to feel hope. It's dark, but it worked.” -Anonymous from New York City
"I took things minute by minute."
“When I was 18 and had just started college and moved away from home, I started having horrible anxiety and depression. I used to wake up every morning before class and contemplate the best ways to end my life.
“Daily suicidal thoughts lasted until I was about 21. I went to a number of therapists and was diagnosed with depression and generalized anxiety disorder. I went to therapy weekly and tried a handful of different prescription anti-anxiety/depression medications. When I experienced suicidal thoughts, I’d think about how my family and friends would feel if I was no longer around. The thought of my parents finding out that I had killed myself was enough to keep me from actually going through with it. Suicide would end my sadness, but I figured it would only end up causing more sadness for the people I loved. And despite wanting to hurt myself, I didn't want to hurt them.
“I also found it helpful to take the day minute by minute. I know a lot of people say ‘take it one day at a time,’ but for someone suffering from suicidal thoughts, a day can seem like forever. So I'd tell myself if I could just survive the next 60 seconds, I'd be alright. I'd repeat that same thought process for hours. It seems ridiculous, but it was enough to keep my mind on the seconds instead of ways to try and end my life. Distractions of any kind are helpful.
“I never liked being alone in my apartment because that gave me the perfect chance to actually go through with what I'd been planning all day. I spent a lot of time just sitting in public places because I figured I couldn't actually kill myself with 75 other college students sitting around me. Starbucks was a favorite. It's a surprisingly calm atmosphere. Even if you don't have a friend or family member around to keep you company, just go somewhere public.
“I still have suicidal thoughts from time to time, but they're not all-consuming like they once were. I just try to remind myself that they'll pass and I try to keep myself occupied in the meantime by doing something I love. I cope by exercising frequently. Sometimes just going to sleep is the best solution. A good support system really helps, so I surround myself with people who understand my anxiety and depression.
“When considering suicide, it's hard to think of life ever being enjoyable again, but I promise it gets better. And some day, you'll look back on this period of life and realize how brave and strong you were for staying alive when it's the last thing you wanted to do, and you'll be so glad that you kept going.” -Allison from Minnesota
"I accepted that I needed help."
“I first had suicidal thoughts when I was 12 or 13. I felt like a burden to my friends and family, as if my existence was a hindrance to other people's lives and happiness. Many of the things bullies had said at school were magnified in my head. I started inflicting self-harm. I thought about swallowing pills with alcohol and jumping off of high bridges or into traffic, which I had heard about on TV. My first suicide attempt was around 13 or 14.
“I went in and out of therapy. But I didn't seek my own help or accept help-and decide to get better-until around 10 years later, when I was institutionalized for the third or fourth time. I was put in a psych ward against my will, and I realized the decision to get better was up to me. The thing that helped change my thinking the most was one a dear family member was having similar episodes and hospitalizations. Seeing the way she hurt herself killed me emotionally. I realized that I was doing the same thing, and perhaps she, my parents, or other people could feel that about me. It's when their words of support actually started to sink in.
“Since then I’ve had suicidal thoughts more often than I'd like to admit. I get through them by accepting they are feelings. Instead of fighting against my depression, I navigate it. Fighting it would be like swimming against a waterfall, so I go with the flow and try to exercise compassion and self-love. There are a multitude of CBT and DBT techniques I've learned to use, writing in journals of gratitude, reaching out to friends, being in nature, and ‘compassion meditation,’ which focuses on extending kindness, love, and compassion to others when I can't do it for myself.
“People will tell you to get over it. To fight harder. But when you're broken, you can't even get out of bed let alone fight against your own thoughts. And that's okay. Your thoughts and feelings have validity. They have weight and meaning and deserve recognition. Question why they are there, and if you want to continue to allow them to ruminate in your mind. Because you do have the decision to kick them out. Remember, it's okay to be hospitalized. We all need help sometimes. And accepting that is not an act of shame but an act of strength.” -Cassandra Bankson, YouTube personality