Coping with Chronic Suicidality
When we talk about suicidal ideation or thoughts, and preventing suicide; we think of intervention whether that is hospital admission, contacting suicide hotlines or speaking to a friend/family member/ care service staff. Little is said in reference to long-term management of suicidal thoughts and fantasies about suicide. So that’s what we’re going to have a chat about today.
Watch the video below:
There is a difference between being actively suicidal and having chronic, sometimes passive, suicidal fantasies and suicidal thoughts. Being actively suicidal usually means you have a plan, talk about death, give away possessions and try to distance yourself from others to avoid confrontation about what you’re doing. Chronic, passive suicidal fantasies and thoughts means that the act of suicide or the thoughts surrounding suicide are on your mind and you, for the most part, don’t want to kill yourself. That doesn’t mean to say there aren’t days or months where you do, but for the best part, they’re in your head but you don’t act on them. Chronic suicidality as it’s known in reference to being a symptom, is common in personality disorders, depression and bipolar, as well as autism and chronic pain conditions.
Chronic suicidality’s signs differ from the signs of someone being suicidal. Symptoms of chronic suicidality can be sarcasm, saying no to a lot of things, a generally flatness in their demeaner rather than sadness, tiredness, excessive sleeping, low energy and slowed thinking. People suffering from chronic suicidality can just appear ‘normal’, like they are no different from anyone else because we become adapted to living with the thoughts and fantasies.
Chronic suicidality is often overlooked, because we think suicide, we think prevention and crisis support. Whereas chronic suicidality can be a passive indifference to living with a side order of fantasising about being hit by a car or dying in your sleep. Crisis support isn’t appropriate in that case, and although psychological therapy can help, it doesn’t take it away, nor does medication. Just like suicide, there is little research into the topic, and even less research done on chronic suicidality. The same as people talk about subjects when they’ve overcome it: we see articles or news on people who have survived suicide and are helping charities or organisations that helped them through it… But with chronic suicidality, for me, it hasn’t come to an end. And I know there are people out there in the same position who have lived with it for double the length of time that I have.
It’s like living in a tornado. The eye of the tornado is relatively calm, where I sit most days. Passive thoughts and fantasising about scenarios surround me and pass just the same as thinking about what’s for dinner. But if something knocks me off balance or off my routine, such as a negative situation or if my mood decides to rocket downwards, I’m in the middle a storm and it’s hard to get out. That’s when there’s more of a risk of becoming actively suicidal, because everything becomes overwhelming and you can’t breathe.
What Can Help, What Can Hinder?
But we’re all still here, we’re all fighting to live another day despite the day-dreaming and thoughts. What can help? What can hinder? What can you do for yourself of someone else who is trying to cope with chronic suicidality?
Don’t force someone to commit to something long-term or in the future, because it’ll make them HAVE to stick around.
I have a lot of commitment issues, at work, within relationships or even just booking things in advance. And it’s not because I don’t want to commit to something, it’s because it gives me really bad anxiety thinking about whether I’ll be around to fulfil something or see it through to the end. I cope better being detached, which in itself isn’t great either because you can go to the extreme of isolating yourself, which I did for a long time. I worked for a long time trying to get the happy balance of living my life but not putting added pressure onto myself.
Committing to an event or activity might work for some people, but if they’re not keen on it, don’t force it down their throat and make them agree to it. It may cause them more anxiety and harm than good. If they’re not up for making the decision right there and then, leave them sitting on the idea.
If you’re thinking about committing to something and feel like you can’t, don’t force yourself. Don’t commit to a relationship just to make the other person happy, don’t book a holiday if it stresses you out more than it relaxes you. Sometimes in-the-moment adventures are just as good as pre-book ones. You won’t miss out.
If you’re feeling overwhelmed by the thoughts, set a timer.
This might seem a bit silly, but it works for a lot of people. Setting a timer and devoting 10 to 20 minutes to doing something can help distract you from your thoughts. Whether this be dusting your room, walking the dog, making a meal, going for a shower; anything to stop yourself from sitting thinking. Sometimes it’s easy to lose track of time when you’re going down the rabbit-hole thinking of one thing then the next.
Don’t try to achieve a life without thoughts of suicide, accept and learn to cope with it.
People tend to think of recovering and being recovered as having no thoughts or symptoms, being free of symptoms or a diagnosis. Realistically, recovery is being able to live your life despite of your illness. It’s managing to cope and having the tools to live with your illness.
Accepting chronic suicidality was part of my life was a huge step forward for me, because I always held onto hope that one day I’d wake up and the thoughts wouldn’t be there. (Realistic, huh.) Unfortunately, mental health doesn’t work like that. But in accepting that it’s part of your life, you accept that you’re going to strive on despite of it. It doesn’t mean that there won’t be any bad days or that you’re going to have days where you feel like you can’t cope, that’s going to happen. But you know that you’ve gotten through it so far, and you’re going to continue fighting it.
If you are feeling actively suicidal, there is help available. Call this number for Samaritans if you are in the UK (116 123) or call this number if you are in America for the national suicide prevention lifeline (1-800-272-8255). If you are in another country, please call your nation prevention helpline to talk to someone.
Life is worth living, tomorrow is coming, and you deserve to be there to see it.
Until next time, stay happy, stay healthy and stay positive. And remember, someone out there cares about you, so if you need help or feel like chatting, reach out.
Beth
