Like many pieces related to mental illness, I’ve found that self-care recommendations often address more socially acceptable symptoms — typically those that relate to anxiety and mild depression. While it is important to address those and talk about the things we can do to keep ourselves running in tip top shape. We don’t talk enough about what to do when things get scary or dangerous for yourself or loved ones.

As a person who lives with severe, debilitating and sometimes dangerous mental illness, most of my energy goes towards very basic practices necessary to keep myself alive. It’s hard to consider which yoga routine would be best for me when the predominate thought running through my mind is whether I should jump off of the balcony. It’s not a great idea to shower when I’m already thinking about picking up a razor to harm myself. We don’t talk about suicidal ideation enough. We don’t talk about delusions or psychosis — or even mania — enough.

Sometimes I experience suicidal ideation where I do feel like I can keep myself safe. It may require some help, but I feel like I can manage it. The reality is my mood changes very quickly, and I feel my emotions very intensely. Sometimes I feel bad. I mean really, really bad. With that comes a despair that I will feel like this forever. This is often when I start thinking about harming myself rather than living another moment with that feeling — even though my history dictates that the mood will always pass. Feeling hopeless, but comforted by the knowledge that the moment will pass, I’m at a point where I need to employ some temporary strategies to get me through. Over time, I have been able to recognize the importance of having systems in place to keep myself safe in those moments.

Check out some of the strategies that my loved ones and I employ below:

First let me say, if you are experiencing suicidal ideation and have a plan or don’t feel that you can keep yourself safe, please call 911. If you, like me, are terrified of the police, call someone you trust or a hotline, but please tell someone and get help. It won’t feel like this forever.

  1. Go to Bed Sometimes I can’t will the thoughts away or focus on something else long enough to actually be distracted. In this situation, I chose to go to sleep for the night if it’s late enough or take a nap with the intent of reassessing how I feel when I wake up. I often feel better and am able to think more clearly when I wake up.
  2. Change Up Your Daily Routine When I’m feeling good, I can chop onion or shave my legs without a second thought. However, when I start to feel bad, things that I could use to hurt myself trigger my impulsivity. I know that I need to change up my routine so I don’t tempt myself unnecessarily. I will opt for cereal for dinner instead of cooking myself a meal, skip my shower for that day and sleep in the living room without access to the balcony like in my bedroom.
  3. Remove Yourself from the Situation I live alone, which gives me a lot of time to get caught up in my own head. I have huge amounts of anxiety relating to crowded, public spaces and strangers, but for me it is worth it if it shifts my concentration from more harmful sentiments. Generally, I’ve found that I do better when I’m outside and in public when I feel like harming myself. If the feeling is too overwhelming I will go somewhere familiar to me — usually for a walk around the block with my dog or take him to the dog park, sometimes for a few hours. It’s helpful for me to be around other people — not necessarily interacting with anyone but just being physically in the same space — to help me keep my impulses in check.
  4. Call Your Therapist or a Hotline Sometimes I like to contact my therapist in between sessions to help me cope. It’s helpful for me to talk to someone who knows intimately about my struggles. She confirms that I am doing okay and reminds me when our next session will take place. I have a standing appointment once a week but that reminder that I will see her again soon helps strengthen my resolve.
  5. Check Yourself In To be clear, I have spent time in a residential psychiatric facility specifically for suicidal ideation. The caveat here is that I went voluntarily. I was able to control where I went and what was happening to me even though I felt like I could not control my thoughts or impulses. I came away having had a mostly positive experience; I would absolutely go back if I felt like it were to the point that I could no longer commit to keeping myself safe.

There is no shame in doing what needs to be done to keep yourself safe. Develop a game plan in order to get back to a place where you feel strong enough and in control enough to keep fighting this fight.