Suicidal Thoughts

By Kristina Randle, Ph.D., LCSW

I have found myself thinking more and more about death and dying, in particular, thoughts of wanting to end it all. A couple of things to note: It was recently the anniversary of my grandmother’s death, whom I was close to, and was taking care of her when she died (cancer). I was sexually assualted over Christmas holiday, and I have been trying to come to terms with having been abused as a child. All of that said, I am not sure if these suicidal thoughts are coming from recent events, in particular the assault, or from trying to heal from old wounds or from something else entirely. I have mentioned them rather in passing to my therapist, but I do not want to be hospitalized so I may have downplayed the thoughts. I do not have enough support in between therapy appointments (I go once a week) and feel rather isolated. I work a lot, moreso recently so I have not been able to attend church as frequently and when I am off I have not been able to do things of a social nature, that being out of my control as the only couple of friends I do things with have been ill. I do not see my work hours being able to be adjusted to be less in any reasonable time period so I feel a bit stuck. But the more and more that this goes on, the sadder I feel and the harder it is for me to function. I manage to still do well at work, but I feel horrible all the time and I really just want the pain to end. I also do not want to let my therapist down because I know she works hard to help me and I just feel more and more a burden and a bother to everyone including her. However, I do not know how much longer I can carry all of this pain. And I do not really know how to bring it up to my therapist and I worry she is going to just think I am blowing things out of proportion and to just get over it. I really need something in between therapy appointments whether from her or from someone or something else but I do not know how to get that or ask for that or find it, much less I do not even know what it is. I do not know what to do, so any advice would probably help. Thanks for reading. –Helen

A. Dear Helen, something’s got to give. You cannot continue down this life path. It’s unsustainable. Your situation has degraded to the point where you believe your only option out of this hellish experience is suicide. It is absolutely not your only option. In fact remove it as an option completely. There are other ways to correct this problem.

Your situation has become increasingly more challenging. If I were able to speak to you in person, I’d inquire about when you began to notice an increase in suicidal thoughts. Was it when your grandmother died? What exactly happened during Christmas regarding a sexual assault? Did you report this incident to the police? These are just two of the many areas that would need to be explored in great analytical depth.

Your thoughts of suicide are increasing but you’re further isolating yourself from your friends and your therapist. Do you have a pattern of shutting down when your emotional turmoil mounts?

With regard to your therapist, you must realize that it is her job to help you when you are in need. That time is now. You are not a burden to her. But she can’t help you if she is unaware of what you are experiencing. You need to be honest with her. You said that you are worried about being hospitalized because of your suicidal thoughts. Having suicidal thoughts is usually not enough to commit someone to a hospital. Most state laws require that an individual not only have suicidal thoughts but they literally have to be on the verge of hurting themselves or others. Therapists assess whether a person with suicidal thoughts has an actual plan to carry out a suicide attempt. Usually, if a person is having thoughts of suicide but has no plan to carry it out, the therapist works with that person to decrease their thoughts. Hospitalization, in such situations, is usually not the outcome.

You said that your work hours make it difficult to interact with your friends or to attend church. Are you sure you can’t temporarily cut back on your work hours? Maybe there are times when work trumps your social life but this isn’t one of them. You’re clearly suffering. You need social support now more than ever. Now is not the time to put work ahead of your well-being. Make yourself a priority. As you said it’s becoming impossible to remain productive at work when you’re not emotionally well. Your friends and attendance at church seem to provide an important level of social support that at this time you urgently need. Therefore I would strongly encourage you to consider cutting back on work and spending more with your neglected support system.

It’s time, Helen, to speak up and to be honest with your therapist. You have suffered in isolation long enough. Reach out for help from the very people who you know can help you. Your friends can help if you’d only ask. The church would help if you’d only attend. Your therapist probably would be willing to see you as often as necessary if only she knew that you needed it. Supports and resources are available all around you, Helen, but it’s up to you to access them. I very much hope that you do. Thanks for writing.

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Last reviewed: By John M. Grohol, Psy.D. on 26 Jan 2009

APA Reference
Randle, K. (2009). Suicidal Thoughts. Psych Central. Retrieved on November 23, 2014, from http://psychcentral.com/ask-the-therapist/2009/01/26/suicidal-thoughts/