How to Tell Your Therapist You're Having Suicidal Thoughts

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Understanding Suicidal Thoughts

Having thoughts of suicide or self-harm can be scary. However, these feelings are more common than many people realize. Studies show suicidal ideation affects around 4% of adults annually in the United States.

Suicidal thoughts can range from fleeting to persistent. They may include:

  • Feeling that life is not worth living
  • Wishing to go to sleep and not wake up
  • Wanting to die by suicide
  • Thinking about how to kill oneself
  • Having a specific suicide plan

If you've been experiencing any suicidal thoughts, it's important to reach out for help from a mental health professional. Being open and honest with your therapist is the first step toward getting better.

Why You Should Tell Your Therapist About Suicidal Thoughts

It can be difficult to open up about suicidal feelings. You may want to hide them out of shame, guilt, fear of consequences, or not wanting to burden others.

However, sharing these thoughts with your therapist serves several important purposes:

Ensuring Your Safety

Voicing your suicidal thoughts allows your therapist to conduct a safety assessment. This helps identify your level of risk so proper precautions can be taken if you're in imminent danger of self-harm.

Accessing Appropriate Treatment

Based on your risk level and symptoms, your therapist can recommend specific treatment plans such as therapy approaches, medications, or hospitalization to help keep you safe.

Diagnosing Any Underlying Conditions

Suicidal thoughts may stem from mental health conditions like depression, anxiety, PTSD or bipolar disorder. Discussing them aids in proper diagnosis and treatment.

Tracking Your Progress

Checking in regularly about suicidal thoughts allows your therapist to evaluate your treatment effectiveness and make adjustments as needed.

Establishing Trust

Opening up fosters trust, understanding, and communication in the therapeutic relationship. This provides a judgement-free place to process emotions.

How to Bring Up Suicidal Thoughts

Speaking up about suicidal feelings may feel uncomfortable. But your therapist is there to listen without condemnation. Here are some tips to help start the conversation:

Be Honest

Don't downplay or hide your suicidal thoughts. Be open so your therapist can understand the full situation.

Describe Specifics

Provide details like how frequent the thoughts are, how long you've had them, any plans or past attempts, and other relevant context.

List Triggers

Explain what seems to trigger or worsen your suicidal thoughts, like stressful events, mood changes, trauma memories, substance use, or relationship issues.

Share Your Feelings

Talk about the emotions you experience with suicidal thoughts like hopelessness, loneliness, guilt, emptiness, anger, anxiety, depression, self-loathing, etc.

Ask for Help

Make it clear you are bringing this up because you need help and want these thoughts and feelings to improve.

Start the Conversation

Some opening lines include: "I've been struggling with thoughts of suicide lately..." or "I need to talk about some suicidal feelings I've been having."

What to Expect From Your Therapist

Don't worry about shocking or upsetting your therapist. They are trained to respond with compassion. Here's what you can typically expect:

Non-Judgement

A good therapist will listen without criticism, embarrassment, or making you feel guilty for having suicidal thoughts.

Support

Your therapist will convey understanding, concern for your wellbeing, and a readiness to help you through this challenge.

Assessment Questions

To evaluate your risk level, your therapist will ask questions about plans, means, frequency of thoughts, past attempts, reasons for living, supports, and other factors.

Safety Planning

Collaboratively you'll develop coping strategies and supports to help manage thoughts and keep you safe when struggling.

Referrals

If needed, your therapist may refer you to a psychiatrist for medication evaluation or to an intensive treatment program.

Ongoing Support

Your therapist will work with you on a long-term basis with therapy, resources, and accountability to improve your suicidal thoughts.

Treatment Options for Suicidal Thoughts

There are many ways your therapist can help once suicidal thoughts are in the open:

Cognitive-Behavioral Therapy (CBT)

CBT helps modify negative thought and behavior patterns contributing to suicidal thinking.

Dialectical Behavior Therapy (DBT)

DBT provides distress tolerance and emotion regulation skills to cope with suicidal urges.

Medications

Antidepressants, mood stabilizers and anti-anxiety medications may be prescribed to treat underlying mental health issues.

Hospitalization

Inpatient hospitalization provides intensive care for those at immediate risk of suicide.

Support Groups

Connecting with others experiencing suicidal ideation can help reduce feelings of isolation.

Lifestyle Changes

Your therapist may encourage improvements to sleep, nutrition, exercise and social connections.

Safety Planning

Having access to crisis resources and planned coping strategies can help manage sudden suicidal urges.

Ways to Make Talking About Suicide Easier

It's natural to feel anxious discussing suicidal thoughts. Consider these tips:

Write it Down

Jotting down what you want to say can help organize your thoughts and make opening up easier.

Send an Email

If too nervous to talk face-to-face, email your therapist explaining your situation and that you need to discuss it.

Bring a Support Person

Having a trusted friend or family member at the appointment with you can help you feel more comfortable sharing.

Talk Between Appointments

If you become acutely suicidal between sessions, call your therapist's office. Help is available 24/7.

Focus on the Positives

Remember all the ways talking about this can lead to you getting help and feeling better.

Other Sources of Support

Your therapist isn't the only source of help with suicidal thoughts. You can also turn to:

  • Suicide prevention hotlines - Call 988 in the U.S.
  • Your primary care doctor
  • Psychiatrist
  • Support groups - in-person or online
  • Close friends and family
  • Spiritual leaders
  • Emergency rooms

The most important thing is reaching out to someone. With professional help and honest communication, relief from suicidal thoughts is possible.

FAQs

Why should you tell your therapist about suicidal thoughts?

Telling your therapist ensures your safety, allows access to proper treatment, aids in diagnosis, tracks progress, and builds trust.

What can you expect your therapist to do if you open up about suicide?

You can expect non-judgement, support, risk assessment, safety planning, referrals if needed, and ongoing help with treatment and resources.

What are some therapies that can help suicidal thoughts?

Cognitive behavioral therapy, dialectical behavior therapy, medications, hospitalization, support groups, and lifestyle changes may be used.

What are some tips to make talking to your therapist about suicide easier?

Writing thoughts down, emailing ahead of time, bringing a support person, calling between appointments, and focusing on the positives can help.

Where else can you get support for suicidal thoughts besides your therapist?

Hotlines, your doctor, psychiatrist, support groups, friends/family, spiritual leaders, and emergency rooms can also provide help.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.

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