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This is somewhat a part II of a post I wrote a few years ago (five years ago?! what is time?!) titled, “To those who feel like a burden”. Considering the last year both busted open the flood gates of mental health crises and gave an easy “excuse” to talk about mental health, it felt like the right time to revisit and share some well tested coping mechanisms. Don’t let the fact that I have a somewhat lengthy list fool you into thinking that I’m not constantly in search and need of more — please share what works for you. I promise in turn to update this post as more come to me. Finally, I want to note that I do believe in the right to die and I think it’s a powerful exercise to regularly consider why we live, what makes us feel alive, etc (this book might be interesting to read on the latter point).

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Create more words/ways of discussing

We don’t have enough words surrounding the concept of suicide. Like the story around native people in various Arctic regions and their many words for snow in some languages (there is no one language), there is power in having language to express nuance, particularly when the world around you needs the granularity communicated. With our current mental health climate in mind in the US, it is astounding to me that we’ve only expanded the pages of the DSM rather than expanding the words we have to capture and reflect how one feels. Sometime during the blurry months of 2020, I carefully skateboarded around in a SLC parking lot with dear friend of mine who is getting a PhD in critical health communication with one of a few focuses being suicide. We spent nearly an hour nerding out over this topic, wishing there were more words at our disposal. We came up with a few areas we wish had more language that I pass along to you in case it helps in expanding both your understanding of how you feel and in talking to others:

• Grey suicidality: feeling as though you’d be okay if you died but not actively planning or taking action in that direction.
• Suicide as a safety net: the idea that thinking of suicide as a backup plan/way out provides comfort and relief.
• Community suicide: building off of Durkheim’s work, the idea that feeling suicidal is not a solely internal problem but that forces in the world make some want to die more than others. Talking from this angle shifts the conversation to forces that don’t want you to be here in a way that can be validating, insightful, and more productive.
• Living as resistance: tied to the previous item, there’s great power in choosing life as a resistance to the forces that don’t want you here.

Would love to see more expansion around a spectrum of suicidal thoughts, perhaps in line with colors like “grey suicidality”.

If words feel like too much to conjure, try using emojis. I have a group texts with some lovely friends where we each have our own emoji bat signal for when we aren’t doing so well (mine is 🥴). Years ago, the phrase “there’s always breakfast and chocolate” became a mantra both for remembering the little things in life and for acknowledging how narrow and dim everything felt with another friend. Ultimately, it’s scarier to not talk about it than it is to do so. By adding words to the conversation, it can hopefully help move this sometimes mysterious, overwhelming concept without edges into a more practical and clear space for both you and your loved ones.

This section is part of why I used “attached to life” in the title as I find that’s a better umbrella phrase for what folks feel.

Create a plan (no, not that plan)

“Do you have a plan?” is such a classic question in our collective minds when talking about suicide and it’s always asked to evaluate severity of suicidal thoughts. I’ve never been asked whether I have a plan for living, only whether I have a plan to die. Over my sabbatical from work in 2019, I created a SPP aka a Suicide Prevention Plan complete with stages, specifics around how to help, last updated date, etc. I asked close friends to be a part of it, added them to the doc, and have updated it from time to time. In writing this today, I just updated the title to be a “Living Plan” as that’s truly what it is. It’s not perfect but I offer a hallowed out copy below to fill out if it’s helpful. Use it as inspiration for what you want or don’t want — just know that I encourage you to create your own and invite others into it. I’ve been shocked how people have shown up more by making things explicit and how helpful it’s been for me personally to turn to.

If you’re struggling with your own and would like to see more specifics of my personal plan, happy to share a more filled in version privately without any of my friends’ contact information. Just contact me.

Write a letter to your future self

I first wrote a letter to myself after a really bad breakup in my early 20s and found there was something uniquely helpful to read my own words. Now, from time to time, I write a letter to my future self using futureme.org and always am somehow surprised that my past self knew what my current self needed to hear. On good days, write to yourself as a way to bottle up those feelings for a rainy (or torrential downpour) day. This could either be done via a tool like futureme.org or just as a running note on your phone.

Find a therapist who specializes (if you can)

Recently, a therapist told me that there are studies showing that therapists will avoid asking about suicide, partially due to the legal liability in doing so and partially due to often being woefully undertrained in any set curriculum for how to handle suicidal folks. Having been through the process of finding a therapist who specializes in suicidal ideation and having helped others seek out the same, it’s agonizing to finally find a safe space to land yet, even then, there remains tons of fear around what can and can’t be discussed. There is a noticeable difference in finding someone with specialization and, if it’s accessible to you, I highly recommend finding one who does. I’d be remiss if I didn’t mention that the therapist I went to for suicidal ideation, while great at that specific topic, wasn’t an expert in everything else. She never could grasp surrogacy and the impact that had on me. It became almost comical with her regularly messing up which person was my mom, whether my dad “was my actual dad”, and more.

While it sucks to figure out which part of your mental health you’re going to focus on potentially to the detriment of others, I do recommend focusing in with an expert for a time. Tied to this, I’d recommend reading articles around how best to talk with a therapist as you might have more options than you realize in how to communicate how you’re doing. TL;DR: a therapist will first evaluate how serious your thoughts are and won’t immediately ship you off to the closest mental hospital.

Find/create some mental reframes

I read the following quote in an article recently and haven’t been able to forget it:

Suicide is also surprisingly impulsive. A majority who decide to do it act within an hour, Nestadt says, and nearly a quarter act within five minutes. Not having access to a lethal weapon during that time greatly reduces the risk of death.

From the NYT’s piece on “Will The Pandemic Result in More Suicides?“

It really underscores how powerful it is to have ways to ride out the feelings. I’m a big believer in mental reframes that force you outside of your current thinking. I even regularly use them for less intense things — every time I hear an obnoxiously loud motorcycle go roaring by (hate loud noises), I tell myself it’s a wonderful lesbian living their best life and find myself inevitably smirking rather than worked up. What follows are some of my favorite mental reframes that I’ll run through:

• Think of your future self. I often think about future coffee shop conversations with a dear friend where we reflect on the past and sit in disbelief about how we made it through. I ponder what my future self will say about the current state I’m in and how much more perspective I’ll have. This gives me a future hope that I’ll make it through in one piece.
• Think of what else you’ve survived. When everything feels unbearable, I remember all the times I was able to make it through. As a friend said to me once, “Anne, you’ve been through worse. You’ve got this.”
• Get outside perspectives. Lean on those closest to you and remember your perspective is just one point of view – get others. Seek out those who can help you see outside yourself. More is fixable than you realize.
• Get a visual. I look at maps on bad days and visit/think about libraries. The vastness of the world and the lifetimes of work put into all the books in the library reminds me how little I know. It reminds me that knowing so little, I can’t be so certain about how I feel and what I think. Having truly visual representations of this idea (maps, libraries, space, etc) often helps bring me back to a more balanced reality not fully saturated in sadness and pain. There’s so much more to life than I can even conceptualize as I’ve only been on this world for so long.
• Think over time. I think about those who came before me and paved the way for me. As a queer woman, the sacrifices are many and it’s incredible to think about. We all benefit from those who sacrificed for us to be here just as a human species. Knowing their sacrifice helps me remember to love my problems dearly – they are hard fought problems for me to have.
• Use pain as a pathway to connect. When I hate how much I feel and care, I return to this: “In this world of numbness and information overload, the ability to feel, is a rare gift indeed.” – Patrick Ness. I try to remember this can be a gift and to use it to help me connect with others rather than to cause it to isolate me. We all have our burdens to bear.
• Consider what you’ll miss & take note of what you haven’t by existing. “What a wonderful thought it is that some of the best days of our lives haven’t happened yet.” I return to this quote often on tough days. I think about the people I have yet to meet who will become fast friends and who need me to stay put. I reflect on those folks in my life in the last few years whose path has somehow crossed with mine and how if I hadn’t stuck around I never would have had the chance to know them. My heart often breaks at the thought of never knowing such beautiful souls I know now and it usually gives me the chance to hope for future beautiful souls to know by not acting on my thoughts.
• Consider yourself from a friend’s point of view. I realized I wouldn’t let a friend be in my life if they talked to me the way I talk to myself. Watch what you say to yourself. Watch the stories you tell yourself. Speak kindly – treat yourself as you would a friend. Tied to this, what would you say to a friend feeling the way you do? It’s always amusing the kind of wonderful perspective I’ll offer myself when considering things from outside my own vantage point.
• Make your experience an object of study. You’re an explorer into the deep end of life that many won’t venture to. This pain could be useful to others in the future as a result. Also, understanding the biology of my brain and being has helped me come to grips with how I can somehow wait out how I feel. I recommend seeking out Andrew Solomon’s work as he approaches it an incredibly human and raw way (book, TED talk).
• Find the freedom in the alternative. There’s freedom in not being attached to life that, if captured, can be powerful in creating a life that you do feel more attached to. If I don’t care what happens, why not go to that party and see who I connect with? If I don’t care what happens, why not try that new hobby? If death is welcomed, what else can be? This is tricky to explain so if it doesn’t resonate, don’t worry.
• Push through to the other side. The earth will take me no matter what. This thought hit me mid-pandemic and mid-Winter as I was slogging through my days. For some reason, it neutralized my thoughts almost instantly: I don’t need to worry about this. The earth will take me eventually.

See the thoughts as information/a signal

Often times, when suicidal thoughts grip us, it feels so wholly overwhelming that it’s hard to take a step back to figure out the details of what might be going on. By asking for specifics of what it is you are trying to escape through death, you can both begin to listen to suicidal thoughts as signals to do something differently and to pay attention to very real needs. This is very much easier said than done and I personally find it to be most helpful when talking with a loved one. Some questions I ask myself to help in that state:

• What changes would make me less suicidal? This helps me reflect on the malleability of life and my own agency.
• What would make me more suicidal? This usually helps me discover what might be at the root of how I’m feeling and what’s pressing the gas on those intense feelings.
• What other options exist? This kicks into gear my practical brain that usually can think of at least a few things to try first.
• What about this bout of suicidal thoughts feel similar to prior bouts? Over time, thinking about this has helped me stitch together patterns and better understand these thoughts in the moment as they come up.
• Why does this particular time in my life feel completely intolerable compared to others? Once more, this usually helps inspire needed reflection.

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Hope this helps. Hope this reminds you that you aren’t alone.