How to deal with moments when you feel suicidal

Thinking about suicide can be incredibly frightening and challenging to cope with. The feeling of wanting to end your life may include deep frustration or despair, thoughts of harming yourself or suicide, and even planning how to carry it out. You can manage these moments by ensuring your safety, committing to life, seeking social support, and undergoing psychological treatment.

Seek a safe place. Ensuring your safety during moments when you're having suicidal thoughts means knowing exactly what to do. Finding a safe place will help reduce the risk of acting on these negative thoughts.

• Identify a location you can go to, such as a friend's house, a family member's home, or a therapist's office.
• You can also use a safety card to remind yourself of the place you need to go.
• If you can't reach a safe place, call your local emergency service (112) or a suicide prevention hotline.

Remove harmful items. It’s easy to be drawn to objects that could cause harm, making it difficult to resist the urge to hurt yourself.

• Remove blades or weapons from your home immediately.
• Dispose of any medications you might use to harm yourself.

Seek support from others. Feelings of isolation or loneliness can trigger thoughts of suicide. Strengthening your connection with others can help minimize suicidal thoughts and actions.

• Start by identifying someone or a center you can reach out to, including family members, friends, healthcare professionals (doctors or therapists), emergency services (112), and suicide prevention hotlines. It's best to contact family, close friends, or your therapist first (if you're safe and not planning harm).
• Consider how others can assist you, such as taking you to a hospital, talking about your feelings, comforting you, distracting you, or helping you feel better.
• A strong social support network can be crucial in reducing suicidal thoughts and actions. So, find support from loved ones during this time (if it's safe). Talk to friends, spend time with family, and surround yourself with those who care about you.
• If it feels like no one is available to help you, call a therapist or a support service, like the Hotline Tâm sự Bạn trẻ. They're trained to support individuals feeling vulnerable and can provide assistance.
• Members of the LGBTQ community, especially younger individuals, often lack strong social support networks. If this applies to you and you feel unable to seek help, consider calling ICS (Vietnam's LGBT Rights Protection and Advocacy Organization) at 08.39405140, or chat with an online counselor.

Minimize triggers. Warning signs, or triggers, are thoughts, feelings, behaviors, or situations that you can't control, and they can lead you to suicidal thoughts. Understanding your personal triggers is key to preventing suicide and finding ways to cope when they arise.

• Stress is a common precursor to suicidal thoughts. Ask yourself if you're considering suicide when you're feeling stressed or overwhelmed by the current situation.
• Identify situations that intensify suicidal thoughts and avoid them. Examples might include arguments or issues with loved ones, being alone at home, stress, feelings of depression, relationship problems, work or school challenges, and financial concerns. Try to avoid these triggers whenever possible.

Use coping skills that work for you. Part of preventing self-harm is using coping skills when you're having thoughts of harming yourself. Reflect on past methods that have worked for you and determine the best approach for managing these feelings.

• Identify ways to calm yourself and self-soothe. Suggestions include exercise, talking with friends, journaling, distractions, relaxation techniques, deep breathing, meditation, and mindfulness. Use these techniques!
• Religious or spiritual coping skills (praying, meditating, attending services, following religious traditions) can be powerful protective factors against suicide.
• Avoid using alcohol or other substances to cope, as they can increase suicidal thoughts and tendencies.

Engage in positive self-talk. Speaking kindly to yourself is a crucial tool when dealing with suicidal thoughts. You can alter your mood through your thoughts. Identify a few comforting things to say to yourself right now (especially reasons to keep living) and when you’re experiencing thoughts of self-harm in the future.

• What would you say to a friend who feels like this? You might say something reassuring like, “I know this is an incredibly tough time for you, but things will get better; these thoughts or feelings won’t be around all the time. They will pass. I’ll always be here with you right now. I love you and want you to live and be happy.”
• Some examples of positive self-talk include, “I have reasons to live. I want to be here for my family and friends. I have plans for the future and goals I still want to achieve.”
• Believing that suicide is immoral or wrong can protect you from taking your own life. If you think of suicide as a morally wrong act, remind yourself of this. You could think or say to yourself, “Suicide is wrong; morally, I oppose it, so I know I can’t do that. I need to cope with my thoughts and feelings in a way that doesn’t harm myself.”
• Trusting that you have a support system can also protect you against suicidal thoughts and actions. Remind yourself that you are loved and cared for. You might say to yourself, “I am loved. My family loves me. My friends love me. Even if I feel like they don’t love me right now, deep down I know they do. They don’t want anything bad to happen to me and would be devastated if I were hurt.”

Commit to reducing suicidal thoughts. You need to make a commitment to reduce thoughts of suicide and self-harm, regardless of any negative thoughts and feelings you may have. By fully committing to preserving your life, this goal will help you cope with stress.

• Commitment to reducing suicidal thoughts can include agreeing to: engage in positive self-talk, set and track goals, remind yourself of the positive, and identify other coping strategies for negative thoughts and feelings.
• You can write down your commitment to life. Write something like, “I commit to living my life even when things get really difficult. I commit to setting goals and achieving them. I commit to using coping skills and seeking help if I have thoughts of hurting myself.”

Set goals and track them. Having goals in life creates a sense of commitment and purpose, which can serve as a protective factor against suicidal thoughts. Goals give you something to pursue, and you can remind yourself of them whenever you feel the urge to harm yourself.

• Some examples of life goals include: career achievements, marriage, having children, and traveling the world.
• Remind yourself of your future goals. It would be a great loss if you miss out on the wonderful parts of life.

Identify the positive aspects of life. Another way to commit to life and cope with suicidal thoughts is by being mindful of the good things in your life. It helps shift your thoughts toward why you want to keep living.

• Make a list of everything you appreciate in life. This could include family, friends, Italian food, traveling, being in nature, connecting with others, playing the guitar, and music. These things can provide comfort when you're feeling suicidal.
• What do you enjoy doing? Which activities bring you the most satisfaction? Do you enjoy cooking, helping friends, or playing with your pet dog? If your circumstances allow, what would you do all day? Think about these things and make more time for them.

Seek psychological treatment. If thoughts of self-harm persist, it's essential to engage in therapy or psychological treatment. Therapists are trained to help manage suicidal thoughts and can be a critical source of support for you.

• If you don't have access to a therapist currently, consider reaching out to hospitals for a list of licensed practitioners, or research low-cost or free mental health clinics.

Build and maintain a healthy support system. Social support is crucial in coping with suicidal thoughts. Lack of such support can lead to depression and intensify suicidal feelings. If you can turn to family or other loved ones, do so. If you feel isolated, a therapist can guide you in building a supportive network.

• Talk about your thoughts with someone you feel comfortable with. If there’s no one available, you can contact a therapist or services like the Youth Hotline at 1900599830.
• Share your safety plan with others so they can be ready to assist when needed.
• Healthy relationships should not involve continuous abuse, shouting, bullying, or harm. If you’re in an abusive relationship, seek help immediately.
• A healthy support system consists of various people you can rely on, including friends, family, teachers, counselors, doctors, mental health professionals, and hotlines.

Consider medication options. Medications, especially antidepressants, can help treat symptoms of depression often associated with suicidal thoughts. However, be aware that antidepressants and other drugs might increase the risk of suicidal thoughts and actions. Always discuss potential side effects and risks with your doctor before taking any medication, whether prescribed or not.

• Consult a mental health professional regarding antidepressants or other medications to treat suicidal thoughts and behaviors.
• If you don’t have a personal doctor, consider contacting a hospital or finding a low-cost clinic in your area.