What about Suicidal Thoughts?

In his book, Cognitive Therapy and the Emotional Disorders, Aaron Beck eloquently describes his work with a young teenager who was suicidal. The young boy was alarmingly negative, and his parents and school officials were concerned about his destructive thoughts and comments. Over time, with many sessions together, Beck led the boy to talk to himself positively instead of negatively, and to meditate to calm his racing, anxious mind. The hopeless, suicidal phase passed, and he became interested in his young life again. The change happened with the reshaping of his thoughts and percep-

tions, a task that is important for a suicidal person.

What Is the Language of a Suicidal Person?

Beck describes the self-talk of one who is on the brink of self-destruction as sounding like this:

•   “There’s nothing here for me.”
•   “There’s no sense in continuing to live.”
•   “I’m a burden to those close to me.”
•   “It’s the same misery, day in and day out.”
•   “It’s stupid to go on living.”
•   “If I’m out of the picture, my parents will have more money to enjoy themselves.”
•   “It will be better for everyone if I’m just no longer here.”

The thought that others would be hurt by a suicide does not enter the mind of a suicidal person. He genuinely believes that ending his existence is a good way to solve his problems. There’s a strong desire to escape, and the suicidal person does not see other options that could alleviate the intense

difficulties. A part of depression is the range of possibilities becoming tre. mendously narrowed.

What to Do Instead?

The depressed, suicidal person needs encouragement to look at things in a different way. There may be tremendous resistance and argument, as months of negative self-talk has persuaded the individual that ending his life is the only way.

Taking a look at the negative self-talk in the previous paragraph and systematically writing, then saying out loud, sentences that state the complete opposite can start to turn the negative momentum around. It would help to have a trusted mentor, friend, or therapist to encourage the person, as depression fogs perception. The depressed person may be absolutely convinced that there is no other way.

“It would be easier for everyone if I just end it all” can become “I have personal value, and many people love me.” “There’s no future for me, and I might as well end the misery” becomes These particular problems are tem-porary. They do not define me, and the situation will pass, in time.” “It’s the same misery, day in and day out” becomes “I can find small things to enjoy and be grateful for. I am not at the mercy of my negative thinking.”

The most important thing to recognize about suicidal thoughts is that it is permissible to have a suicidal thought, but it is not all right to take action based on that thought. If you find yourself moving into the realm of making a plan for suicide, call a hotline or a professional immediately. There is always another way. It has been said that suicide is a permanent solution to a temporary situation. Whatever seems insurmountable absolutely has a solution, and it’s important to be open to others who can point out alternate avenues for thinking, feeling, and action.

Risks for Suicide

Some factors that may be present in a suicidal situation are a recent major loss, wanting to escape a terrible situation or person, someone else close to the individual recently attempting or committing suicide, drug or alcohol abuse, severe depression, family history of suicide, isolation, access to fears ending of a longterm friendship or therelationship, ora dimin-

How CBT Can Help with Depression

The nature of depression is to focus on the negative, and such a focus has the effect of amplifying unwanted symptoms. Hopelessness leads to fear, which leads to the idea that the condition will persist for the foreseeable future, if not permanently. One loses interest in life and even wonders about the appeal of continuing to live with such unbearable thoughts and emotions.

Past experiences are remembered in a negative way, and pessimism overshadows any shred of remaining optimism. Physical symptoms are exacerbated and emotional vulnerabilities become exaggerated. The physical symptoms of constipation, headaches, back and chest pain, muscle aches, insomnia, lack of appetite, and a pervasive feeling of fatigue often accompany depression.

Commonsense Actions

There are certain practical actions that are sometimes forgotten in the confusion of depression. It is tempting to look for yet another medication or another psychiatric label for the condition, when it is often the simple things that get you back on track. The following are some actions suggested by Daniel Siegel:

•   Regular exercise
•   Reasonable, balanced diet
•   Sleep
•   Avoid sugar and caffeine
•   Turn off all digital devices an hour or two before bedtime

Give Up Secondary Benefits

You may have to be very honest with yoursell about any secondary gain you might experience by holding on to depression. These things are hard to admit, but if you can, the depression will dissipate sooner. Ask yourself what will change when you are no longer depressed. Is there something that you are avoiding? Is there a next right step for your life that seems impossibly daunting, and the depression provides a refuge for the time being?

It could be something as simple as not wanting to cook or do house-work. Maybe others pitch in and care for the children if you are indisposed Are you overextended in your social, work, and volunteer commitments?

Being depressed could be easier than simply saying, “I’m going to have to turn you down on that request.” Almost no one will fault you if you are sick, but saying no requires a little more assertion.

It may or may not be necessary to find a reason for the depression, but a little detective work can turn up some kernels of truth that help you break free. If you are grieving a major loss, recognize that depression is a natural part of that process, and the phase will pass.

Use Cognitive Techniques for Depression

The important thing is to catch the negative thought, have some awareness that the thought is a choice, and create the opposite thought. For example, if you are discouraged and believe that a task is impossible and pointless, say to yourself, “I am able to do the next thing, and it will lead to good results.”

If you believe that your goals are meaningless and nothing matters any-way, say to yourself, ” have important goals that create a fulfilling life. I will take action toward my goals today.” If you are unable to do anything because of physical and psychological pain, say to yourself, “Right now I am taking a small action for my own good. I am able to take constructive, goal-directed actions.” If you are worn out from the struggles of depression, say to your-self, “Physical action creates energy. I now use my body in a positive way. It’s good for me to move around.”

Many people find that saying the new sentences out loud or writing them down has a powerful effect. One forgets that the human brain is a malleable organ, and that you can be in charge of the prevailing tone of your thinking and mood. It may take several repetitions. Some say that the positive sentences need to be written down at least ten times. Others say twenty-one times for twenty-one days. You can experiment to determine the number that seems to have a positive effect on you.