Managing thoughts of death
Warning: The following content addresses suicide.
Facts and figures
There are roughly 329.5 million people in the United States.
In 2020
Suicide was among the top 9 leading causes of death for people ages 10-64
Suicide was the second leading cause of death for people ages 10-14 and 25-34.
Ethnic/Racial groups with the highest suicide rates (per 100,000)
White males (25.4),
Native American/Alaska Natives (14.6),
Black males (12.6).
African American, Latino, Native American, and Asian American people who are lesbian, gay, or bisexual attempt suicide at especially high rates
In 2020, an estimated 12.2 million American adults seriously thought about suicide
3.2 million planned a suicide attempt
1.2 million attempted suicide.
**While many people have thoughts of suicide and most people do not act on these thoughts,
it is still important talk about these experiences with your therapist.**
Work with a therapist who helps you feel safe.
People experience thoughts of death or suicide in different ways. These experiences may range from thoughts of not wanting to be alive to having a plan, to attempting or completing suicide. Having thoughts of death or suicide does not make you a bad person, or a failure and is not a sign of a moral deficit. Many times, these thoughts are part of mental health struggles, and are commonly experienced when people are depressed, anxious, struggling with trauma or grief. Individuals struggling with significant medical issues, such as a terminal cancer diagnosis or degenerative health conditions may also experience these thoughts. Sometimes, people’s thoughts of death center around an existential crisis, like “why am I here and would anyone miss me if I wasn’t around?”.
It is understandable that people are apprehensive about expressing these thoughts and feelings. Stigma, shame and fear may make it difficult to express these experiences. People may also remember that therapists are mandated reporters. This means, if a person says they are a danger to themselves, a therapist may have to break confidentiality, which may result in hospitalization.
Having suicidal thoughts does not guarantee a person will be hospitalized or that the therapist will have to break confidentiality. Your therapist should be comfortable having difficult conversations with you and listening to you explore your emotional pain. Your therapist should be able to help you identify ways to manage these experiences and connect you to resources to help moderate and decrease these thoughts. Your therapist may even create a safety plan with you, identifying how to deal with these thoughts based on their severity and how to manage factors that trigger these thoughts. Your therapist will discuss with you if there are any reasons why they may feel hospitalization would be beneficial. Remember, hospitalization is only one possible way to manage suicidal thoughts. It is not the only option and often is not the first option.
The benefits of expressing these feeling.
Talking about suicidal thoughts may help prevent you from acting on these thoughts. It may help your therapist identify additional resources you may need, including community resources, crisis hotlines, an adjustment of psychotropic medications, increase the frequency of therapy sessions, group therapy or, depending on your circumstances, hospitalization. Having these conversations may benefit your therapy as it will give you additional opportunities to express yourself, practice your ability to communicate your feelings and express your needs. Talking about your suicidal thoughts will give your therapist a chance to review your progress, adjust your treatment goals, and possibly adjust their therapeutic approach. It can also help you feel less tense, feel less isolated in your experience and improve your connection with your therapist or other people in your life.
If you do not feel comfortable or safe expressing yourself to your therapist, remember, there are 329.5 million people in the United States. There are other options for people or organizations who would be willing to support you. There are other therapists who can help you.
RESOURCES:
Please consider programing the resources listed below in your phone.
If you are feeling feeling suicidal, please call 911 or go to your nearest emergency room.
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Suicide and Crisis lifeline
988 (call and text)
1888-628-9454 (Spanish)
1 (800) 273-8255
Crisis Text line
Text Save to 741 741
National Hopeline Network
(800) 784-2433
Self-Harm Hotline
(800) 366-8288
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The Trevor Project LGBTQ Crisis Hotline
1866-488-7386
Text “start” to 678678
Chat https://www.thetrevorproject.org/webchat
SAGE LGBT Elder Hotline
1-877-360-LGBT (5428)
GLBT Hotline
1 (888) 843-4564
Trans Lifeline
A 24/7 hotline available in the U.S. and Canada staffed by transgender people for transgender people.
1-877-565-8860 (United States)
1-877-330-6366 (Canada)
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Veterans
1800-273-8255 (press 1)
Text 838255
Frontline Responder Services
1-866-676-7500
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National Domestic Violence Hotline
1 (800) 799-7233
Family Violence Helpline
(800) 996-6228
Planned Parenthood Hotline
1 (800) 230-7526
The Childhelp National Child Abuse Hotline
1 (800) 422-4453
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American Association of Poison Control Centers
1 (800) 222-1222
Alcoholism & Drug Dependency Hope Line
1 (800) 622-2255
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National Crisis Line, Anorexia and Bulimia
(800) 233-4357
AIDS Crisis Line
(800) 221-7044
