How to Respond to Intrusive Suicidal Thoughts

I just want the pain to end.

“Madness or suicide; it’s yours to decide.” During each of the times that I was suicidally depressed, my brain was continually assailed by these words. No matter what I did, these intrusive thoughts kept telling me I had only two options: either spend the rest of my life in an institution or end it all now.

What I was experiencing were Automatic Negative Thoughts (ANTS)–involuntary thoughts that appeared out of nowhere without my consent. If you are suicidal or have been suicidal, you have no doubt been plagued by similar spontaneous suicidal thoughts.

Your thoughts might be telling you, “You’re a loser,” “You deserve to die,” or “You are not going to get better, so you might as well die now.” You might be flooded with images of harming yourself. These repetitive words and images can feel like an obsession.

The problem with such intrusive, repetitive thoughts is that they create neural pathways in the brain; they are like grooves in an LP vinyl record. Over time, their strength can increase until they become difficult to manage or eliminate.

Fortunately, there is good news. While you may not be able to prevent these thoughts from arising, you can control how you respond to them. My therapist and the counselors at an outpatient program I attended taught me some valuable techniques to manage these automatic thoughts.

  • Practice non-resistance.

    Instead of dwelling on your thoughts or fighting against them, it is better to simply observe your thoughts without latching onto them or pushing them away. I like to visualize my intrusive thoughts as clouds passing overhead or leaves drifting down a river.

    This process of observing your thoughts in a detached way is called “mindfulness meditation.” You can read about mindfulness in a number of books such as those written by Eckhart Tolle, Jon Kabot-Zinn, Thich Nhat Hanh, or you can receive recommendations from a therapist.

  • Tell yourself, “These are just thoughts.”

    You can also say:
    “Just because I have these thoughts, I don’t have to act on them.”
    “Just because I have these thoughts, it doesn’t mean they’re true.”

  • Share your thoughts with others.

    When a person is suicidally depressed, chemical imbalances inside the brain create a distorted view of their present and future circumstances. You may feel as if there is no hope, but that is your brain giving you false information. If you can share your thoughts with others, they can help you dispute these thoughts and replace them with a more hopeful view of your situation.

  • Cancel and Replace

    Say, “CANCEL! CANCEL!” out loud. Then, replace the negative thought with a more empowering one. This is based on the principle that two thoughts cannot occupy the same place in your mind at the same time. Thus, if your intrusive thought is “I’ll never get better” you can replace it with the affirmation “This too shall pass” or “I can and will survive this crisis.”

  • Hope Kit

    A hope kit is an effective way of collecting and making visual your reasons for living. Think about your reasons to stay alive and consider what items might represent them. This may include photographs, letters, song lyrics, poems, childhood toys, souvenirs, or other mementos. Place them in a container or a scrapbook that you can refer to when needed. See more about how to create a Hope Kit in my Reasons to Stay Alive page.

    • Think about the people (or pets) that you would leave behind and how they would fare.
    • Think about the good you can do for other people in the future if you stay alive.
  • Positive Distraction

    And finally, you can respond to any intrusive suicidal thoughts by using the principle of what I call positive distraction. The word “distraction” often has a bad connotation—e.g. “Jill got a ticket for distracted driving.” However, in your situation, distraction means turning your mind away from suicidal thoughts and refocusing on something positive outside of yourself. In my case, it was a tennis game.

    Many years ago, while living with my retired parents during a suicidal episode, I was able to make friends with Bob, the person who ran the pro tennis shop. Whenever he saw me obsessing about thoughts of gloom and doom, he would challenge me to a tennis game. Before I knew it, all I could think about was how to return his wicked serve. For the next two hours, my competitive drive to win the set blocked out all thoughts of suicide or self-harm.

Remember, you can learn to observe suicidal thoughts without feeling the need to act on them. Just because you have a thought or feeling doesn’t necessarily mean it’s true. What you are seeking is relief from suicidal pain. There are other ways to obtain this relief than ending your life.