By Nancy Schimelpfening / Medically reviewed by Daniel B. Block, MD (From Very Well Mind Website)

Information presented in this article may be triggering to some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

If you have been struggling with suicidal thoughts, you are not alone. Having thoughts of wanting to take your own life is common among those dealing with severe depression. It is important to remember, however, that what you are feeling or thinking doesn’t have to translate into action.

Your life circumstances are constantly changing and your feelings will also change, no matter how hopeless it feels right now. Although it may be hard to see it when you are feeling deeply depressed, there is hope.

Depression is a treatable illness and there are many options that may help you. Even if one treatment does not help, this does not mean that another treatment won’t. In the meantime, there are steps you can follow to cope with your feelings until they pass.

Seek Professional Help

If you are not currently receiving treatment for your depression, this step could involve setting up an appointment with your family doctor or a psychiatrist to be evaluated and treated. If you are already in treatment but are struggling, your doctor will be able to help you, either by working with you to make changes in your treatment plan or by helping you to be admitted to a hospital until the crisis passes.

Treatment options for depression often involve the use of psychotherapy, medications, or a combination of both.

Psychotherapy, also known as “talk therapy,” is a first-line treatment that your doctor may recommend for your depression, either alone or in combination with an antidepressant. In studies comparing the two, psychotherapy appears to work about as well as antidepressants at helping to alleviate symptoms, although if you are feeling suicidal and need quick relief, psychotherapy alone may not be your best option.

Combining therapy with an antidepressant is probably a better choice since the two treatments together give better results than either treatment alone. Medications may afford quicker symptoms relief in combination with therapy than therapy alone, while psychotherapy can give you the tools needed to cope with your current depression and help prevent future episodes of depression.

Find Support With the 7 Best Online Help Resources for Depression

Ask a Doctor If Medication Is Right for You

Antidepressants are generally the first medical treatment that your doctor will try. If you have already tried an antidepressant without success, this does not necessarily mean that you should give up. Sometimes it’s a matter of trying a different antidepressant or finding the right combination of antidepressants.

A six-year study published in The Lancet found that approximately 60% of people had a 50% reduction in symptoms in the first two months after starting antidepressants.

While these numbers may seem low, it’s important to remember that either changing medications or adding additional ones can improve recovery rates. Don’t give up on treatment too early.

How to Know Which Antidepressant Is Right for You

Call a Suicide Hotline

Suicide hotlines and chat rooms are also important resources. They are free and can connect you with a counselor who will help you talk about your feelings in a safe environment.

Avoid Alcohol and Drugs

While it may be tempting to hide from the pain by using drugs or alcohol, this is actually a bad idea. Alcohol can intensify your feelings of sadness and hopelessness.

In addition, alcohol and drugs may lower your inhibitions, making you more likely to act on your feelings.

Work on Problem Solving

If your depression is related to a situation in your life, it may be helpful to spend some time problem-solving.

If your problem feels particularly large or difficult, focus on what “baby steps” you can take that will lead you in the direction of a solution.

As the Chinese philosopher, Lao Tzu once said, “A journey of a thousand miles begins with a single step.”

How Active Problem Solving Can Help

Make Your Environment Safe

Making your space safe could involve removing items from your home that you may feel tempted to use to hurt yourself, such as pills or guns. If removing these items from your home isn’t feasible, remove yourself from the situation by going somewhere else for a while or asking a friend or family member to help you.

Go Through Your Reasons for Living

When you are feeling bad, it’s very easy to forget all the positive things that you still have in your life. Are there people in your life who would be hurt by your death?

A beloved pet that needs your care? Maybe you have goals that you still haven’t accomplished? Whatever your reasons, take some time to think about them and acknowledge that perhaps your life means more than you think.

Seek Human Contact

Although your first inclination may be to isolate yourself in your home and avoid contact with other people, it can be helpful to do just the opposite: Go out for a walk; go shopping; seek out human contact.

It will help distract you from your thoughts and, by being in a situation where you can’t easily act on your feelings, it can help keep you from harming yourself.

Talk to Someone You Trust

Often it can be a big help just having someone to whom you can express your feelings. This person could be anyone you trust, such as a friend, relative, clergy, or therapist.

Distract Yourself

Often, coping with your suicidal feelings can be a matter of waiting until the medication kicks in or your circumstances change. While you are waiting, however, it can help for you to find ways to distract yourself from the emotional pain.

Make an agreement with yourself that just for a little while (as long as it takes to watch a movie, phone a friend, or perhaps go to work), you will not focus on your darker thoughts. As you string together these shorter periods of distraction, enough time will eventually pass for you to start feeling better.

How to Create a Suicide Safety Plan

Remind Yourself of Past Experiences

Have you been through other episodes of depression? Think back to what steps you took that helped you then and repeat them. Most importantly, remind yourself that the painful feelings eventually passed.

Consider Other Treatment Options

If you are in immediate danger of hurting yourself, you haven’t responded well to antidepressants, or there are medical reasons why antidepressants are not a good idea for you, your doctor may opt to prescribe less common treatments.

Electroconvulsive therapy (ECT), which involves applying an electrical pulse to the scalp in order to induce a seizure, works rapidly and will provide relief for about 80% of patients. Although the procedure may have undesirable side effects such as memory loss, it may be a good option for you if you need to feel better quickly.

Transcranial magnetic stimulation (TMS) involves stimulating a particular area of the brain with magnetic pulses but is less invasive than ECT and has fewer side effects. Like ECT, it’s targeted toward individuals who have not responded well to antidepressants.

Studies have found that people treated with TMS experience significant improvement in their depression symptoms. Real-world remission rates are estimated to be between 30% and 40% for those who undergo TMS.

Researchers have also found that people who had maintenance TMS were also less likely to have a relapse of depressive symptoms.

Because the patients recruited for these studies were individuals who were considered non-responders to antidepressant therapy, the results are believed to represent a percentage of patients above and beyond those who have already responded to antidepressants who could, if they don’t give up prematurely, achieve complete remission of symptoms.

Vagus nerve stimulation (VNS), which has sometimes been referred to as “a pacemaker for the brain,” is a more invasive procedure than ECT or TMS. It involves having a pulse generator surgically implanted under the skin of the chest.

One study found that those treated with VNS experienced significant improvements in overall well-being, even in cases where symptoms of depression were reduced by less than 50%.

What Is Treatment-Resistant Depression?

A Word From Verywell

If you or a loved one has severe depression, it can be a life-saving act to create a safety plan with the help of your support network. Your safety plan can help provide you with concrete steps to take to cope when your depression is at its worst and when you are having suicidal thoughts.

How to Help a Friend Who Is Feeling Suicidal