On Suicidal Ideation

Family and friends, what follows below is a guest post from my husband, Weston, who occasionally contributes his essays and personal reflections here. I hope you, like me, are inspired by his words. — Matt

“You’re not crazy” is all it took for my therapist to say for me to cover my face and sob. I had just opened up to her about my chronic suicidal ideation more than I had to anybody else, or any clinician at least. I finally let her know that yes, sometimes I do wonder how I would do it.

Suicidal ideation is described by the Cleveland Clinic (2024) as, “when you think about, consider or feel preoccupied with the idea of death and suicide. These thoughts may come and go or be extremely distracting.”

I find this definition of suicidal ideation, more commonly referred to as suicidal thoughts, to be helpful and relevant to my own experience.

The reason I have not shared this huge part of my mental illness is that I haven’t quite come to understand it yet in its totality as I have my panic, anxiety, and depression. I have also lived in fear of others’ reactions — especially that of my mental health care providers. I was scared that I would certainly be involuntarily committed.

Now that I have become much more aggressive in addressing my mental health challenges, I’m ready to put up a fight. Part of that fight is to empower myself with authenticity. I must engage in that action of acceptance and let other people in on my struggle. What if someone living with suicidal ideation finds this and feels heard for the first time? What if this message makes a single person understand suicidality and mental health a bit more?

I don’t need to have finished my graduate degree in order to know that even a person with a “mild” major depressive episode has likely considered the idea of not being alive in some capacity. I think maybe even more people than we know have had a suicidal thought or two, fleeting or not. I mean, to have major depressive disorder and to have recently gone through a “moderate” episode and to not expect some suicidal thoughts seems silly, even aside from my history of ideation.

Suicidality is a very tricky topic for reasons already mentioned, along with not wanting to plant ideas into others’ heads or trigger any existing depressive or suicidal thoughts. This is simply my lived experience and a therapeutic release to share and write. My thesis may be muddy and this piece half-baked, but I deem it necessary.

Learning and using dialectical behavioral therapy (DBT) skills has been a game changer, as I am finding techniques to prevent the suicidal ideation that I experience from causing emotional distress. I now have a better grasp on my suicidal thoughts since the onset of them in my mid-teens. How I subjectively summarize DBT is that it says: “yeah, your deck of cards is shit, here’s how you play your best hand.”

The key there is that I feel the use of DBT has identified the distorted cognition and effectively accepts that it is there. This, in turn, allows me to intervene better and stop my intrusive suicidal thoughts from distressing me.

My suicidal thoughts never progress past being just thoughts. They, however, are incredibly distracting. I am also preoccupied for some reason with the idea of my own death. Before I started learning DBT skills in earnest, these thoughts would distress me greatly. Now they don’t seem so formidable since I can name them and tell them to kick rocks.

I can only provide suggestions as I have no license or certification that allows me to diagnose or treat mental health disorders. If you live with suicidal ideation, I recommend finding the correct level of care for yourself first. There are outpatient and residential options. I recommend finding a therapist or program that focuses on DBT practices. I finally recommend that you let your thoughts remain just that: thoughts — as the taking of one’s own life only transfers the pain to another. Find your peace no matter how far you have to go or no matter how patient you have to be. There are people out here who actually care and will listen.

I have heard some people refer to their suicidality as being either “active” or in “remission.” I suppose this could be helpful to some. My narrative is that, last night I made Food Lion brand meatballs and watched Boogie Nights with my husband after a morning of engaging in distress tolerance due to suicidal ideation. It doesn’t sound ideal, but it is a world of difference compared to being stuck in a whirlpool of suicidal thoughts all day, every day. Things do get better with patience if you have the courage to change.

Today I will practice the action of patience with myself, and be gentle with myself in learning that I do belong here in this world. I do have the right to and deserve to take up space. I will be listened to and heard, primarily by my own self in saying that I am not crazy. Let’s pull up a chair to the table of life, sit down, take a beat, and lean into self-trust and self-worth.

Featured image by Polina Zimmerman, via Pexels