How to cope with suicidal thoughts and feelings

The ultimate tragedy of mood disorders is suicide. Suicide is a double disaster. Not only does it prematurely end a life, it wreaks havoc on the lives of those left behind. Devastated survivors can be traumatized by feelings of grief, guilt, anger, resentment, and confusion. "There was no time to say good-bye," and "Perhaps I could have done more," are examples of comments that are made by shell-shocked friends and relatives. Moreover, the stigma surrounding suicide makes it very difficult for family members to talk about what has happened.

By far the major cause of suicide is untreated depression. According to the National Institute of Mental Health, 15 percent of those afflicted with a major depressive disorder and who are not treated (or who fail to respond to treatment) will end their lives by suicide. (This is 35 times the normal suicide rate.) People with serious illnesses such as cancer and heart disease do not kill themselves in large numbers; depressed people do.

Many theories exist that attempt to explain the motivation for suicide. Freud postulated a death instinct. Others have suggested that humans are endowed with "a drive to destruction." But to anyone who has experienced the suicidal pain of depression, the explanation is so simple, so self-evident, that it requires neither psychiatric nor psychological jargon. Death is chosen because suffering is so acute, so agonizing, so intolerable, that there comes a time-depending on the individual's tolerance for pain and the available support-that ceasing to suffer becomes the most important thing. This "aggregate pain model" of suicide is supported by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the official diagnostic resource of the mental health profession. In it's section on major depression, the manual says:

The most serious consequence of a major depressive disorder is attempted or completed suicide. Motivations for suicide may include a desire to give up in the face of perceived insurmountable obstacles or an intense wish to end an excruciatingly painful emotional state that is perceived by the person to be without end.

Suicide has been defined as a "permanent solution to a temporary problem." For the person caught in the black hole of depression, however, there is nothing temporary about the hell he or she is experiencing. The resulting sense of hopelessness is the major trigger for suicidal thoughts, feelings and attempts. This hopelessness includes:

no hope for the future.
no hope that things will ever change.
no hope that I will ever be well or stable.
no hope that I will be able to meet my goals in life
(or even have goals).
no hope that the pain will ever stop.
no hope that I can do anything to change it.

When the psyche is assailed by this level of read more