Suicidal thoughts

The people who helped write this resource have described some of the thoughts and feelings they had. We hope that sharing this list will help you to see that you are not alone in your feelings and thoughts. If it is too difficult to read these examples right now, please skip this section.

• I can’t cope with the pain
• I can’t see any solutions
• I don’t want to die, I just need the things that are happening to stop
• I wish I wouldn’t wake up tomorrow morning
• It’s getting too much, I’m not sure I can handle it anymore
• I don’t care if I live or die
• I can’t do this anymore
• I don’t want to be here anymore
• I wish I could disappear
• There’s no hope for the future, what’s the point in keeping on going?
• I am going to feel this bad forever and I cannot bear it any more
• I don’t want to feel this way anymore
• I have no one who loves me
• I don’t deserve to be loved
• I know there are people who love me who will be upset. But I have fought these feelings for as long as I can and I cannot continue any longer
• I feel hopeless and can’t stay here any longer, but I’m scared of dying.

How you are feeling will be unique to you. You might also be uncertain about exactly how you are feeling, and that’s okay too. Some people feel lots of different emotions at the same time. Other people experience suicidal thoughts while also being afraid for their own safety. Suicidal thoughts and feelings can last for several days or weeks. Or they can come and go, even several times in one day.

These feelings and thoughts are not your fault. There might not be a simple solution for making them stop quickly. However, there are things you can do now to keep yourself safe, and get to a point where these thoughts are not so strong. There are also some things you can do that might help you in the future.

You have already shown strength by looking for help. We encourage you to keep reading this resource. By the time you reach the end, you might have some ideas for what you can do next. Or reading it might help to distract you from your thoughts for a while.

If you think you might be in danger of harming yourself, there are some things you could do to keep yourself safe.

We know that some people have had these techniques suggested to them in the past, and reading them here might feel unhelpful. However, for some people these might be new ideas that help them to ground themselves.

Remove any items you could use to harm yourself

For example, any objects or medications. Or you can ask someone to remove them for you.

Move to a place of safety

If you are in an unsafe place, or a place where you could harm yourself, move away from that place to somewhere safer. Or ask someone to help you move to a place of safety.

Focus on ‘getting through right now’

Prioritise things which are easy to do, can be done anywhere and that you know are helpful to you. Here are some examples:

• Counting exercises - For example, counting forwards or backwards to 10 or 100.
• Calming breathing exercises - For example, box breathing. This is where you breathe in for four seconds, hold that breath for four seconds, breath out for four seconds, and hold that breath for four seconds. Repeat this until you feel calmer.
• Looking at photos that remind you of better times.
• Having your favourite hot or cold drink.
• Taking a cold or warm shower, or bath.
• Watching your favourite film, TV show or online video.
• Connecting with someone you feel comfortable to talk to in this difficult moment.
• Contacting one of the helplines at the end of this resource.
• Going to a place that feels safe or makes you feel calmer.
• If you have been viewing upsetting or triggering content on your phone, think about reducing the time you spend on your phone. You could use an app or your phone settings to limit your screen time, or ask someone else to look after your phone for a while.

This might not feel easy for you to do. Sometimes speaking to someone about how you are feeling is the hardest step.

If you are feeling extremely low or isolated, it’s understandable that you might find it difficult to think of anyone who would be able to understand you or help. Here are some options you could consider:

Someone you know

If you can, try to think of someone you know and trust.

When you see this phrase, who comes to mind? It could be:

• a friend
• a family member
• someone you work with
• a religious or community leader
• a neighbour
• someone in your community
• a health or social care professional who has been understanding in the past, or who is involved in your mental health care currently.

Think about whether you have had any conversations with people in the past where you felt understood and supported. These could be helpful people to reach out to now.

If you are worried about telling them that you are having suicidal thoughts, remember that you do not have to share everything straight away if you are not ready. Instead, you could say that you are feeling very low and need them to distract you or keep you company.

Someone you do not know

Sometimes it can feel easier to talk to someone you don’t know. There are many support organisations for people who are distressed, are experiencing suicidal thoughts or who self-harm. They are often run by volunteers, who are ordinary people who won't judge you.

Some well-known organisations are listed below. You can contact whichever organisation you prefer, and it is okay to contact more than one.

Samaritans
Samaritans is a charity that offers listening and support to anyone who needs it.

Shout
If you can’t say your thoughts out loud, or don't want to, you could text Shout. This is a free, confidential and 24-hour text messaging service for anyone in the UK who needs support.

CALM
CALM is a suicide prevention charity with a helpline for anyone affected by suicide or suicidal thoughts.

The things you share with these organisations are confidential. They will not share what you tell them with anyone else unless there are specific circumstances where this cannot be avoided. If you want to understand more about how these organisations manage confidentiality, you can ask them, or find out more on their websites.

Will talking help?

It can be hard to share private thoughts and feelings, but it can help you get through a difficult or distressing time. It might not feel like it right now, but whatever the reasons for your suicidal thoughts there are people who care. They will want to listen to you, help you to cope and help you to find ways to manage what you are going through.

Talking about your worries, fears or distress with someone you trust can help you to:

• feel less alone
• make things clearer in your mind
• feel more hopeful
• think about possible solutions.

If you experience intense suicidal thoughts it can be difficult to keep yourself safe. No matter how bad your suicidal thoughts are, or how long they have been going on, it is important that you get support from a healthcare professional.

You can find out more about this in the ‘getting professional help’ section below.

There are lots of reasons why people start to have suicidal thoughts. They are often linked to feeling unable to cope with an overwhelming situation. If you can understand why you have been having suicidal thoughts and feelings, this could help you to work out what kind of help you need in the longer term.

If you are feeling overwhelmed or have lost hope for the future, you might think there are no solutions or that your situation can’t change or improve. It is important to remember that there are things that can help, and there are people who want to help you.

Something difficult that is happening in your life now

Something difficult might have happened in your life, or you might be dealing with lots of smaller stressful things which have added up, causing you to feel overwhelmed.

Significant life events include:

• a bereavement
• a relationship breakdown
• bullying (online or in person)
• discrimination
• domestic violence and abuse
• losing your job
• financial worries or debt
• housing instability
• being diagnosed with a physical illness. This can feel particularly difficult if the illness is painful, life-limiting or terminal.

You might also feel as though life isn’t what you hoped or expected it would be.

Something that happened in the past

Perhaps there are things from your past that you are struggling to deal with. There are many different experiences that can make people feel that they can’t carry on, and we won’t try to list them all here. We also know that everyone reacts to experiences differently.

If something difficult happened to you in the past and you are struggling to cope with it, take a look at our coping after a traumatic event resource.

You might feel as though the things that happened to you in the past aren’t ‘bad enough’ to justify how you are feeling. Remember, if something that happened to you is making you feel suicidal, then it is bad enough.

Having a mental health condition

Not everyone with a mental health condition experiences suicidal thoughts, but some people do. If you have a mental health condition and are in touch with mental health services, reach out to the people involved in your care and tell them how you have been feeling. If you are not in touch with a mental health service, you can speak to your GP.

It might be hard at first, but explaining how you are feeling can start the journey towards you receiving the help you need.

No obvious reason

For some people, there might be no obvious reason for why they feel suicidal. If this is the case your feelings are important and valid. You are just as deserving of help and support as people who do have a specific reason.

It’s important to know that suicidal thoughts are very common. This is not to minimise how serious they are, but to reassure you that you are not alone. A huge number of people experience suicidal thoughts and get through them with the right support.

You might have made it through your suicidal thoughts on your own so far. However, you still deserve support, and there are people and services that can help you. You might feel like there is no point in getting help if you have managed on your own so far. In fact, the best time to get help is when you aren’t in crisis. If things get bad again, you will already have the tools you need to get through.

Speak to your GP

If you don’t already have mental health support, a good starting point is speaking to your GP.

They should work with you to explore how you are feeling and what is going on in your life. They should also try to find out if there is anything that might be causing you to experience suicidal thoughts, such as:

Mental health conditions

If you have a mental health condition, getting support and treatment for this might help to improve your suicidal thoughts.

If you haven’t been diagnosed with a mental health condition, your GP might ask you to complete a screening questionnaire. This can help them to work out if you have a mental health condition that could be contributing to your suicidal thoughts.

If you are using drugs or alcohol

Your GP will want to understand if drugs or alcohol might be contributing to how you are feeling. It is important that you are honest about any substances you are using so that you can get the help you need. Alcohol can act as a depressant and lower your mood, and drugs can negatively affect your mental health.

You should never be denied support for suicidal thoughts because you are using drugs or alcohol. If you are using illegal drugs, your GP should keep this information confidential. They will not report you to the police unless you are putting other people at risk.

If something in your life is causing you distress

For example, if you have:

• recently lost your job
• been through a relationship breakdown
• experienced a bereavement
• experienced something traumatic in the past.

These things can understandably affect your mental health, which could then lead to you developing suicidal thoughts, and in some cases a mental illness.

Your GP should also share information about local emergency mental health services so you know who to contact if you need urgent help.

Psychological therapy

Your GP might refer you for psychological therapy (also known as talking therapy). This is where you speak to a professional about your feelings alone, in a group, or both.

How does psychological therapy work?

Psychological therapies can help by:

• Giving you a safe space to talk about how you are feeling. This can make a huge difference on its own.
• Helping you to understand what might have led to you developing suicidal thoughts.
• Helping you to develop coping strategies and ways to stay safe if you experience suicidal thoughts again.

You can find out more about the different types of psychological therapy in our psychotherapies and psychological treatments resource.

How can I access psychological therapy?

To access psychological therapy, ask your GP to refer you. You might be able to refer yourself depending on where you live in the UK. Speak to your GP or take a look at the NHS website to find out more about self-referral.

Unfortunately it can take a long time to access psychological therapy. How long you have to wait will depend on where you live and what is available in your area.

When you are referred for psychological therapy, you will usually be offered an assessment. This will help mental health professionals to work out which psychological therapy will be suitable for you. You will then be told what form of psychological therapy you are getting and when this will start.

Some people choose to pay for private therapy. If you decide to do this, you should ensure that your therapist has the necessary qualifications for you.

You can find an accredited psychotherapist on the UK Council for Psychotherapy (UKCP) website. You can also find accredited counsellors or psychotherapists on the British Association for Counselling and Psychotherapy (BACP) website.

Medication

There is no medication specifically designed to treat suicidal thoughts. However, if you have a mental health condition that might be contributing to your suicidal thoughts, your GP might suggest medication to treat that condition.

For example, if you have depression you might be offered an antidepressant, or if you have bipolar disorder you might be offered a mood stabiliser. This is because if your suicidal thoughts are linked to a mental health condition, treating this can help to reduce your suicidal thoughts.

There are lots of other medications that are used to treat mental health conditions,

Suicidal thoughts and antidepressants

Antidepressants can be very effective at treating depression and improving suicidal thoughts. However, some people experience increased suicidal thoughts when they first start taking antidepressants. These will usually improve in a few weeks, but if they do not, or if you are concerned, get back in touch with your GP or your mental health team.

The risk of this happening is higher in children and adolescents. Because of this, young people should be closely monitored by the person prescribing their medication. Their prescriber should ask if they are experiencing any new suicidal thoughts, or if any existing suicidal thoughts are getting worse.

It’s important that people of any age are aware of suicidal thoughts. Your prescriber should monitor you for any new or worsening suicidal thoughts when you start antidepressants or change your dose. You should let them know if you experience any of these.

You can discuss any concerns or questions you have about starting medication with your GP or prescriber. It is very important that you tell your doctor straight away if you are experiencing suicidal thoughts or feelings when taking antidepressants. They might suggest that you stop taking your antidepressant, change your dose or try a different treatment. 

A safety plan is a tool that you can use to stay safe if you have suicidal thoughts. You might also find one helpful if you self-harm.

A safety plan stores simple information in a step-by-step guide that can help you stay safe when you experience intense feelings. It can help to interrupt your suicidal thoughts or plans, and stop things spiralling out of control.

When should I make a safety plan?

It can be difficult to think clearly at times of distress or crisis. It can be easier to make a safety plan when you are not in crisis, so you can prepare for the difficult times before they happen. However, you can make one at any time.

Which safety plan should I use?

There are many different types of safety plan. Your GP or mental health service will probably have a template they can give you.

A safety plan will work best if you choose what to include in it, and ideally the plan should be developed with the support of a healthcare professional. If this isn’t possible, the Staying Safe website can guide you through creating a safety plan on your own or with someone you trust.

What should my safety plan cover?

Here we cover some of the common things included in safety plans. Not every safety plan will include all of the sections below. If yours does not, you could always add in anything you would find helpful.

We have also included some useful ideas suggested by people who have experienced suicidal thoughts.

Things to help you right now

These are things that can get you through the next few minutes:

• Activities which help you to feel calmer or find hope, such as:
  • Reminders of positive things, such as photos of people, pets or special places.
  • Listening to music that boosts your mood, and reduces or distracts you from your distress.
  • Connecting with a friend, in person or by email, text or social media.
• The ‘five things’ mindfulness method. To do this, try to identify:
  • five things you can see
  • four things you can touch
  • three things you can hear
  • two things you can smell
  • one thing you can taste.
• Taking a warm or cold shower, or running your hands under cold water.

Ways to make yourself safer

• Removing anything that you could use to harm yourself, such as any objects or medications.
• Going somewhere you feel safer. This could be with someone you trust or, if you prefer, you could go alone to a quiet place.
• Thinking about ways to make yourself safer in the future. This might mean:
  • Reducing the amount of medication you keep in your home. You could also ask a partner, friend or family member to keep your medication for you until you feel safe enough to be responsible for it again.
  • If you self-harm, thinking about ways to reduce harm. For example, keeping bandages and other first aid supplies on hand, and ensuring anything you use to self-harm is clean and sterilised.

Calming activities

• Listening to upbeat music, or music that is meaningful to you.
• Breathing exercises, meditation or yoga.
• Writing down your feelings in a diary or journal. You could also write your feelings down in a letter to yourself or someone you trust. Remember, you don’t have to send it.
• Thinking about a special place, a happy memory or a future event you’re looking forward to.
• Making a ‘self soothe box’. Fill a box (such as a shoebox) with things that soothe or distract you. For example:
  • fidget toys
  • shower gels, candles or perfumes – anything that has a smell that helps you to feel calm and comforted, or takes you back to a ‘happy place’ or positive memory
  • soft pieces of fabric
  • sour sweets or salty snacks – these can help to overwhelm your senses and distract you from your thoughts
  • things associated with happy memories, like photographs or postcards.

Distracting activities

These are activities that distract you from distressing feelings, such as:

• Things that keep you busy. For example:
  • exercise
  • cooking
  • knitting
  • chores
  • drawing
  • painting
  • interacting with someone in person, or via email, text or social media.
• Things that keep your mind busy – for example, listening to music, doing a crossword, puzzle or brainteaser, or watching a TV show, film or online video.

Contacts for support

Include details of people you can contact for support in your safety plan.

• Day-to-day support – These are people who you can contact for day-to-day support, such as friends, family or people in your community. You might not necessarily discuss self‑harm or suicide with these people.
• Support if you are distressed or thinking about self‑harm or suicide – Try to think of one or two people who you are close to and trust, who you can speak to about these difficult feelings. You might want to agree with them ahead of time that you will reach out to them if you are in crisis. You could also include details of specialist support, such as helpline numbers or the contact details of mental health professionals.
• Urgent and crisis support – These are services that you can call if you are in a crisis. For example:
  • Suicide and self‑harm prevention 24‑hour helplines or websites. You can find these in the ‘speaking to someone’ section of this resource.
  • Local healthcare support, including your GP and NHS 111 mental health services.
  • Emergency NHS crisis support.

Include information about how you will contact these people or services. For example, in person, by text or by phone. For services you may want to include what times these are available, and any alternative phone numbers. It's also a good idea to list these people and services in the order you would contact them.

Warning signs

When someone has suicidal thoughts, their words and actions can sometimes give clues to people around them that they may be at risk of harming themselves. However sometimes people don’t have any warning signs, or their warning signs are not obvious to others. This is especially likely when someone is experiencing suicidal thoughts for the first time.

If you are unsure whether or not you have warning signs, you can skip this section. However, if you have had suicidal thoughts in the past, and if you or others you trust can identify your warning signs, then you can include these here. Completing this section can support you and your loved ones to take earlier action, helping you to stay safer.

Things that make you feel worse

These are sometimes called distress triggers. They are things that cause distress or make your distress worse.

If possible, try to identify anything that makes your distress worse, and think about ways to reduce these triggers or avoid them. You might also want to make a plan around how you can reduce the impact of these triggers. For example, organising more support around difficult times like anniversaries or upsetting dates.

If you have had suicidal thoughts in the past, but aren’t currently experiencing them, you might be wondering what this means for the future. It can be really scary not knowing whether these feelings could come up again.

You might not be able to guarantee what will happen in the future. However, you can try to prepare so that you will be in the strongest position possible if these thoughts and feelings do return. Suicidal thoughts can be very frightening, and a safety plan can help take that fear away.

One of the patient representatives who helped to write this resource has shared some thoughts of support here:

“You’ve shown tremendous strength, resilience, and an ability to cope. It might be difficult, but you can do this.” Eshan

Coping with ongoing thoughts of suicide

It is possible that even if you stop feeling suicidal, thoughts of suicide might return in the future. Or you might continue to experience them, but less intensely. There are things you can do to support yourself and to ensure you have support from others if this does happen.

Getting help for things you are finding difficult

If your suicidal thoughts have been made worse by particular things, think about what support might be helpful to you.

For example, if you are struggling to cope with difficult experiences you had in the past, you might find psychological therapy helpful. Or if you are under financial stress, you might want to look into what financial support is available to you.

Learning more about your suicidal thoughts

This might mean learning:

• when your suicidal thoughts are more likely to happen
• what helps if you do have suicidal thoughts
• techniques for tolerating suicidal thoughts.

You might not be able to completely control your thoughts, but with the right support and skills you can get better at controlling how you act on them. It might be difficult at first, so try to be patient with yourself.

Try to notice and write down when your thoughts of suicide aren’t present or feel less strong. If these thoughts come back in the future, you will be able to remind yourself that things have improved in the past and will improve again.

Putting support in place

Use what you have learned about your suicidal thoughts to ensure you have support available if these thoughts come up. As well as writing a safety plan, it is important to have people in your life who you can be honest with about when things are getting difficult.

You might also find it helpful to get peer support. Peer support is where people with similar experiences spend time together and offer each other support. Speak to your GP or another health professional about whether there are any peer support opportunities available near you. 

Many people who experience suicidal thoughts feel worried about asking for help. Below are some common concerns, and some things to consider if you have similar concerns.

Nothing will be able to make me feel better

It’s understandable to feel this way if you have tried things in the past that haven’t worked, or if you have been feeling this way for a long time. However, you might not be aware of all the available support options out there for you.

It’s the role of the professionals involved in your care to suggest treatments they think will help you the most. It may take time, but there is a strong chance that eventually you will find something that works for you.

Here is one person’s experience of seeking help for obsessive-compulsive disorder and suicidal thoughts:

“I was experiencing severe OCD. It took up most of the hours in my day, washing my hands and showering. I felt I had no control over the OCD. I didn’t think something like cognitive behavioural therapy would help with something so serious. However, I was willing to try anything at that point, and after giving it a go, my OCD significantly reduced. Once I completed the CBT treatment for the OCD, this notably reduced the suicidal thoughts I was experiencing.”

No one will understand my feelings

It’s true that no one but you will ever truly understand how you are feeling. But professionals are trained to do their best to understand you and the bigger picture of your life. They will use their training, experience and clinical guidelines to inform how they help you.

I might have a negative experience when I ask for help

Unfortunately we can’t guarantee that everything will go well when you ask for help. You might find that not everyone understands how you’re feeling, and not all services you reach out to will be helpful.

However, we can guarantee that there is help available, and that there are people who want to help you to get better, so please keep trying.

I might get in trouble

Suicidal thoughts are not a crime, and neither is suicide itself. Speaking to someone will not get you into trouble. It will allow professionals to put appropriate support in place for you to help you recover.

I might get sectioned

You might be worried that if you tell a healthcare professional that you are feeling suicidal, you will be admitted to hospital. Or you might worry that if you refuse you will be detained (or sectioned) under the Mental Health Act. This is a possibility, but there are many other things that will be considered before this happens.

Mental health services do all they can to support people in the community. Being detained under the Mental Health Act is always a last resort for managing someone who is in a state of mental distress.

You can find out more about this in our resource on being sectioned in England and Wales. You can also read out about sectioning in Scotland and Northern Ireland. It is important to remember that even if you are sectioned, you should always be involved in the decisions made about your care if you are able to do so.

Suicide is against my religion or is taboo in my culture, so I don’t know how to ask for help

People from every religion, culture and country experience suicidal thoughts.

Some people find that their religious or cultural background gives them the skills to cope with suicidal thoughts. For some people their religion or faith helps them not to act on their suicidal thoughts. However, even if someone’s faith is very important to them, it might not be enough on its own and they may still need professional support. 

For others, if their religion or culture is opposed to suicide this can make their feelings harder to handle. It can also make it harder to talk about suicidal thoughts and seek help.

If your religion or culture are important to you, you might find it helpful to get support from a faith or community leader. Or you might find it more helpful to get support from people who do not share your faith or are not a part of your community. Getting advice from different people and places can help to give you more perspectives and ideas about how to cope.

You can find out more in our spirituality and mental health resource.

Support lines

You can contact the following organisations if you need to speak to someone:

• Samaritans – Samaritans offers listening and support to people in times of need. They are open 24 hours a day, 7 days a week.
• Shout – Shout is a free, confidential text messaging service for anyone in the UK who needs support. They are open 24 hours a day, 7 days a week.
• Childline – Childline is a free, confidential support service for people under the age of 19. They are open 24 hours a day, 7 days a week.
• SANEline - SANEline is a national mental health helpline that offers specialist emotional support, guidance and information to anyone affected by mental illness. You can find SANEline’s opening hours on their website.

Charities

• Campaign Against Living Miserably (CALM) – A charity focused on suicide prevention that offers resources for people struggling, and a helpline.
• The International Association for Suicide Prevention – The IASP has a database where you can find suicide support services in your country.

Websites and apps

• Staying Safe – This website offers resources to support people who are experiencing thoughts of self-harm or suicide, including an online safety plan template with tried and tested suggestions.
• Stay Alive – This website and free app has information and support functions for people who are experiencing suicidal thoughts.

This information was produced by the Royal College of Psychiatrists’ Public Engagement Editorial Board (PEEB). It reflects the best available evidence at the time of writing.

Clinical experts: Dr Alys Cole-King, Dr Sanjukta Das and Dr Nisha Shah

Experts by experience: Jan Giles, Melinda King and Eshan Vadgama

The experts by experience who helped to develop this resource are people who have experienced suicidal thoughts in the past, or who have supported a loved one experiencing suicidal thoughts.

Full references available on request.