Biting the bullet: CBT

[Scared_11]

Thanks for the info.

I think this is we're I went wrong today then. I was focusing in the depressive thoughts whilst alone in the house. It made me feel a lot more anxious. Because I fear that u will become majorly depressed, lose the will to live I am not sure how I would tackle this with exposure.

When I only had the thoughts of stabbing etc exposure worked realy well for me as I just held a knife an tried to convince myself to do it. It cause anxiety but that faded quite quickly an those thoughts never bothered me again.

I realy don't know how to tackle this worry.

[theharvestmouse]

Its a very complex issue, especially where the suicidal thoughts are concerned, I don't think there is any set pattern and maybe that is what makes it the unkown and all the more scary.

FOr instance there are people who kill themselves without ever really thinking about it before, and then something happening and within hours they go and do it. THen there can be someone who has been suicidal for months or years but for some reason they just never go through with it. I suppose there could be a fine line between a vague thought of suicide and just doing it, that's what scares me. What if I one day just cross that line without really controlling the feelings myself.

[Scared_11]

Yes this scares me also. It's a thought that makes me feel sick at the moment. I can't stop thinking about it and it scares me. I know I don't want to die I just want to get better. The thought that I would do that to my family sickens me.

[NoPoet]

Scared11 - what I have learned is that my fear of "going mad" through anxiety or depression and killing myself is not the same as being suicidal. There are some very complex issues going off that all interact with one another. The idea behind CBT is to ignore the symptoms and instead go for the core issues, since the core issues are what generate the symptoms.

So in your case, you would NOT be classed as suicidal. "Suicidal ideation" could best be described as imagining doing it with the intention of actually going through with it, or considering actually doing it without making an attempt - the point being you either want to do it, or are trying to make your mind up about doing it.

"Suicidal thoughts" doesn't mean that much on its own. People think that if they think of suicide, it means they are suicidal, or doomed to one day become suicidal. This is completely wrong and is not based on any kind of logic. It is an irrational fear. If you read an article about the police and imagine yourself as a criminal being pursued by the law, that doesn't make you a criminal, nor does it mean you are now fated to somehow become a criminal, nor are you suddenly being hunted by the police. So why would imagining an attempt at suicide be any different? It isn't, and this is the key to overcoming your fear of such thoughts.

Death is one thing common to all humans and it is an in-built fear we all share. If we didn't fear death, we would put our lives in danger on a regular basis and our species would not survive. However, some people suffer from a fear of death that is more intense than "normal" (normal meaning it is a fear which occasionally occurs but does not cause prolonged or undue suffering). A fear of suicide has the fear of death hiding behind it. What you probably haven't considered is how your fear that you will somehow suddenly becomes suicidal implies that you will somehow lose control of yourself. So a hidden trigger for your thoughts/fears about suicide is likely to be that you fear losing control over yourself.

You might never have thought that consciously because you're so busy suffering the fear and guilt about your thoughts of suicide. So you don't notice the hidden issues which are pulling all your strings. You then concentrate on reading about depression, reading about suicide, become hypervigilant to all mention of the subject, and you feel like you're going crazy - you believe your fears about suicide are becoming a self-fulfilling prophecy. It doesn't come true, of course, because you are not suicidal, you merely fear that you might be one day. You fear (without realising it) that you will lose control, yet you never lose control.

On the other hand, fear of suicide may simply be an expression of your fear of death. It's likely that you are experiencing symptoms of health anxiety by worrying about your mental health suddenly deteriorating to the point where you die. The fact that you fear you'll commit suicide is probably irrelevant. Your fears are of your mental health, of death (health anxiety is an expression of your fear of death), and behind it all you fear losing control.

Do you find yourself holding onto your thoughts and emotions very tightly? Are you scared your thoughts and feelings will run away with you - like if you get mad with someone who is pissing you off, you'll end up shouting and screaming and crying and being violent, then you'll suddenly become suicidal?

If so, you should strongly consider a treatment plan which will help you regain confidence about your ability to control your own destiny. You won't fear suicide anywhere NEAR as much if you know in your heart and soul that you are not suicidal and never will be. Also, since the fear of death (which is linked to health anxiety) seems to be a major point for you, you should consider discussing this with your therapist. As Dr Claire Weekes continually stresses, "Acceptance is the key" - you will never entirely lose your fear of death because it is hard-coded into you to keep you alive! You are not SUPPOSED to completely lose that fear!

God and nature and evolution determined that the best way for us to stay alive is to be conscious that we aren't immortal so we take logical and rational steps to protect ourselves. You've taken some mis-steps and you've come out of sync with your nature. That's where CBT comes in.

EDIT: Can you see how complex this whole thing becomes? The longer you have been a victim of anxiety/depression, the tougher it becomes to un-learn your bad thinking habits and replace them with new ones. The key is to gradually, through discussion, analysis and attempts at exposure therapy, find out your core fears (of which there probably won't be that many) and then attempt to address them directly, one at a time.

As for exposure therapy for depression, as you can see from this epic post you're going about it the wrong way. Instead of trying to summon up feelings of depression and overcoming them through brute force, challenge the negative core beliefs which cause the depression. "I am terrified of losing control" could be a place to start and you can work from there.

[Scared_11]

Thank you very much for taking the time to reply to my post. I have had a quick read but will read it again properly later on.

It's such a relief to hear from someone who has experience and knowledge with this particular worry. I keep telling myself that's alls this is, just a worry, a horrible 'what if?' thought. And a confusing one at that. When u feel down and these thoughts worry you, it's easy to think, 'am I actually suicidal now?'

I even called the samaritans today looking for them to feel me I was not suicidal. They didn't, they just listened to my worries. I explained about my OCD and my fears of what may be but I am sure I just made the poor guy confused as to what to say.

I know deep down that this is just linked to my fear of death, I have had health anxiety forever. And I am obsessing over it (my OCD).

Your completely right when u say I probably cling on to my emotions. I do this all the time. If I am feeling down I search for why an look for something to cheer me up as soon as possible. And if I feel happy and positive I always question why and it's not long before the negativity starts again.

I have never taken medication as I am very worried of the suicidal thoughts side effects. I am considering taking them though. I had CBT for this last year which finished in April but feel I need to go back. I feel scared my this as I feel it's too soon as I should have been better for longer. But u suppose if I need to see a therapist for the rest of my life then so be it. I know life can be better than this.

Thank you for reminding me of everything I already know, we all just need reminding sometimes.