Trigger Warning: Some of the themes relating to suicide in this article may be triggering

I was 17 and still at school when I first experienced a slide over a number of weeks into depression, then deeper down to a point where my thinking became fixated on self-destruction. In this state, my mind seemed to focus exclusively on ways to take my life with an exhausting drip, drip, drip of repetitive suicidal thoughts. I was recovering from my first manic episode that had thrown my academic life into disarray. During the depressive episode that followed the mania, I had no psychological tools to manage suicidal thoughts. I concentrated on salvaging my A-levels and in time was lucky that the extreme negative thought patterns subsided, despite a level of residual depression that lingered for several years. 

Now though, I have developed protective thought patterns that enable me to beat suicidal thoughts almost before they start. When I was grappling with bipolar in the early noughties, I found a psychotherapist who specialised in Neuro-Linguistic Programming (NLP), a branch of Cognitive Behavioural Therapy (CBT). A few sessions of NLP helped me establish a greater awareness of my inner voice and observe the way my mind told me all sorts of unhelpful messages. Developing an ability to spot self-sabotaging thought patterns, and to consider alternative ways to appraise myself and the world around me, helped me significantly.

I have used the techniques to develop a suicide prevention toolkit, which I apply whenever I spot the early warning signs of a depressive episode. If you are supporting someone who’s spiralling with suicidal thinking, it’s important to first advise them to see a GP or their psychiatrist, and/or to call a helpline. This toolbox may also be useful to help stop negative thought patterns in their tracks…

The anti-depression spanner set

This consists of all the practical things I do to turn around a developing depressive episode – increasing exercise, coming off alcohol and coffee, telling my wife and trusted friends/colleagues that I'm at risk, and ensuring adequate but not excessive sleep. I apply the CBT techniques I have learned and pay more attention to my mental 'monitoring programme' that observes my thoughts and challenges irrational perceptions. Fresh air, sunlight and a good diet are key.

The hammer of experience

People who make an attempt to take their own life run a significant risk of completing on the second and future attempts. But this is where a key protective thought pattern can be helpful. I tell myself that I survived last time, so this state-of-mind is temporary and will pass. I've managed to get out of the hole before and will be able to do it again. Explaining this to someone who is suicidal is tough and they are unlikely to comprehend easily. Their mind may be telling them that a perceived catastrophe or situation they are facing is final and can't be solved, and that the only logical way to deal with it is self-destruction. They may believe they will always feel this bad. If done sensitively, however, it is possible to plant the kernel of an idea of the eventual transitory nature of these thoughts. 

The screwdriver of positive memories

I list the positive things that have happened since I was last feeling suicidal – what would I have missed if I'd gone through with it? When I first applied this thinking, it was things like becoming an uncle, making some new friends and learning salsa dancing, all of which I would have missed. Between each episode, there will be a number of positive memories, so extending that to imagine all the good things I would inevitably miss in the future is another useful tool.

The pliers of blessings

Someone experiencing suicidal thoughts may feel that they have exhausted all their resources, that they have nothing to count on. But, even in what appears to be a desperate situation, it is possible to count your blessings. For example, ‘I have water’, ‘I know where my next meal is coming from’, ‘my shoes are keeping my feet dry’, and so on. Suicidal thoughts can stem from an underestimation of the resources we have at our disposal, so listing what we have can be helpful. You may not be able to convince someone in the moment, but you may be able to establish the seed of a positive thought. 

The electric drill of other people's grief

Thinking how people would react to my suicide is helpful. In the past, I have pictured the despair and grief that my family and friends would experience. It was hard to think of putting them through that pain and enough to make me think twice. Now I am married, the thought of my wife having to cope is unthinkable. Sometimes people who are suicidal feel that the world would be better off without them. They may believe they have created a catastrophic situation and their friends and relatives would benefit from them not existing anymore. It can be helpful to point out that this thought pattern is not borne out by reality.

The monkey-wrench of meaning

I have found self-help books useful in the past and one I often recommend is 'Man's Search for Meaning' by Victor Frankl. He built a career in psychiatry having survived life in a concentration camp. He observed that some of his fellow prisoners had been more resilient than others and concluded that the difference was because they had found meaning in their lives despite the obvious horror of their surroundings. Volunteering to help others, and the sense of purpose that comes with it, has a very distinct benefit and can be extremely useful in rebuilding self-esteem. Helping others with suicidal thoughts has helped me find meaning in the experiences I have been through. 

The chisel of a compassionate listener

Having a friend or relative on your side can be extremely helpful. If someone tells you they are experiencing suicidal thoughts, I would suggest listening to them. Don’t panic. Let them explain to you how they are feeling and try not to judge. Although the thoughts are irrational, what they are thinking feels real to them and it will take time to get out of that mode of thinking. The most powerful message to try to convey, in my opinion, is that these thoughts will pass. You can also signpost to support either through a GP, local mental health crisis service or through the third sector with phone lines and online information provided by Sane, Samaritans, Mind and Bipolar UK.

This is an abridged version of a longer article published on the Bipolar UK website in May 2020. 

if you or anyone you know have been affected by the issues raised in this post, you can access help and support via our crisis help page