First up – a definition. Suicidal ideation concerns thoughts about or an unusual preoccupation with suicide. The range of suicidal ideation varies greatly from fleeting thoughts, to extensive thoughts, to detailed planning, role playing (e.g., standing on a chair with a noose), and unsuccessful attempts [Wiki].
When my ideation was at its worst, I visited my GP (this being pre-involvement of secondary mental health services). I was agitated and restless, and I spilled the beans. I had been planning and fantasising about hanging myself. I’d also been having vivid mental images of doing it, kind of like acting it out in my mind. It was overwhelming and upsetting.
It was almost like a craving to act on the urges. It felt similar to the times when I wanted a cigarette but had only empty packets. The totality of my attention was fixed on obsessing and planning the act in great detail, and it made me incredibly anxious.
The anxiety was two-fold. In one aspect it was the frantic feeling of a need not being met. I felt trapped between my desire to carry out the fantasies and my fear of actually ending my life. It was hugely unsettling.
The other side to it was more of a guilty anxiety. I was beating myself up mentally; “How could you think these things? What about all the people who love you and care about you? Your family will be devastated. Your husband will never get over it.” and so on. I knew the rational case against suicide, but knowing things intellectually doesn’t often stop the mind from wandering off on its own path.
Since then, I’ve learned better coping skills to help take my mind off the thoughts. Meditation and mindfulness have taught me to observe my thoughts and then let them go. If I’m really struggling to deal with ideation I talk to my husband or an understanding friend. Most of all, I’ve learnt that I can forgive myself for having the thoughts and that’s taken away a lot of the panic from the experience.