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Do you have a suicide safety plan?

Roland

MyPTSD Pro
Do you have a suicide safety plan? If so, what is it? Did you use a template or make your own? Does anyone use an app, if so which one is recommended and why?

Most of the things I see on suicide safety things are basically things I never feel like I can use. I never want to go to call 911, go to the emergency room, or self admit to a mental hospital, because I don't have much money nor good insurance and I'm kinda afraid of the healthcare industry as a whole (I'm sorry, I'm extremely cynical, I hate society and people, I'm aware that these people are "good and help people" but I don't trust).

I have called a suicide hotline before and I found it somewhat helpful, she referred me to another hotline after understanding what I was dealing with. NAMI was much more helpful, but it's mental health resources and answers, not a crisis hotline.

I could definitely make my environment safer, last time I was suicidal I bought knives and they've been stashed in my car ever since because I don't want to ever be stuck with a dull knife again.

As far as contacting people I love and trust and are there for me, I don't like bothering people when I'm in a crisis, but also I do have people I will contact if I really need it (but only if I decide I'm not going to do it).

I'd love to hear about what others do, because I always feel like I'm in checkmate when I'm suicidal, afraid to get help, afraid to tell anyone, afraid of myself, afraid to do it, afraid not to do it.

I'm aware that this post is riddled with cognitive distortions, but that's actual things I believe and think when I'm suicidal and I really just don't want to be in that place again, but I see the threat of it spurring back up again. I'm not currently dealing with this, but the last "episode" was last March. So I know I'm not completely out of the woods yet.
 
There is a book based on IFS called Self Therapy by Jay Earley (he worked with Dick Schwartz). In the introduction he says you can do the work with a trusted friend. The main thing for that book is having someone who can listen to you talk about your parts as you discover and work with them, I think. And they say it can be a therapist, friend, minister, coach, etc.
Thank you, I'll look into it
 
I'm wanting o die so often for so long I'm quite used to just want to die and not reacting a this desire at all

When I have a peak the first thing that block me is to know for having tried multiple times I'm not able to purposely harm me. Then we'll it's the fact I'm not able to do it

So I only have to take care of the distress that comes with it and I'm used to tell the right people how I'm feeling
 
I'm wanting o die so often for so long I'm quite used to just want to die and not reacting a this desire at all

When I have a peak the first thing that block me is to know for having tried multiple times I'm not able to purposely harm me. Then we'll it's the fact I'm not able to do it

So I only have to take care of the distress that comes with it and I'm used to tell the right people how I'm feeling
That makes a lot of sense.
 
Mine escalates every year it seems
This is really useful in treatment. Recognising patterns like this? Crazy how useful they can be! As well as when to step up supports and medication, it can also help identify when you can ease off, and get back into a rhythm of stability.

So, when you say it escalates each year: is each year escalating to a particular peak? Are their stages involved in that process, or is it more sudden, like "bam, here we are back in serious terrain suddenly"? Is it related to weather patterns? Significant events (because how hard is Christmas season, right? Gah) Or is something else? (With ptsd, there's very often a something else). How long does the trough last?

And when is it easiest for you? What are the key indicators for you that you're up, or really down? Sometimes identifying what makes life really hard makes it possible to identify when those things aren't in play (like, I don't always spend 16 hours a day ruminating on..., sometimes that rumination just, like, backs off...).

I couldn't have gotten to where I am with managing my symptoms with insight just like this. It may have just been an offhand thought for you, but it was a really important one.
 
This is really useful in treatment. Recognising patterns like this? Crazy how useful they can be! As well as when to step up supports and medication, it can also help identify when you can ease off, and get back into a rhythm of stability.

So, when you say it escalates each year: is each year escalating to a particular peak? Are their stages involved in that process, or is it more sudden, like "bam, here we are back in serious terrain suddenly"? Is it related to weather patterns? Significant events (because how hard is Christmas season, right? Gah) Or is something else? (With ptsd, there's very often a something else). How long does the trough last?

And when is it easiest for you? What are the key indicators for you that you're up, or really down? Sometimes identifying what makes life really hard makes it possible to identify when those things aren't in play (like, I don't always spend 16 hours a day ruminating on..., sometimes that rumination just, like, backs off...).

I couldn't have gotten to where I am with managing my symptoms with insight just like this. It may have just been an offhand thought for you, but it was a really important one.
Thank you, that's helpful pointers. Sometimes it's hard to really identify, actually very hard. It seems like this idea that it's never going to get better, but triggered by different things. Definitely connected to March the month as two out of three episodes were in March. Yeah definitely have some analyzing to do.
 
I have one, have had for years. I keep it handy (even tho I'm not a risk atm at all), and I update it regularly.

The things that I need to keep in mind when I tweek it: it needs to reflect my pattern depression, not just what I think people should do. Knowing yourself, your risk factors, how and when SI becomes real, becomes problematic, how you personally respond to different supports (I can do this, but I'll definitely never do that) - that's gold for safety plans. It not only makes the plan genuinely helpful, but you can rely on it being a realistic support - when I pull out my plan, I know there's things on it that I will do.

Clear trigger points are super helpful: when I'm thinking this..., when I'm doing this..., etc. This comes from your experience of suicidality as it plays out for you, made as specific as possible so that it requires zero brain power to determine if you need to take specific action when you're at your most unwell (because you will try and talk yourself out of doing things you need to, right?!).

Mine has 3 different levels, which reflect how my SI tends to escalate, and the interventions at each level are things that I know are my best chance at something being helpful for me.


I'd reframe this, from being a bad thing, to being a good thing. Not wanting to go to hospital is actually the healthy way to feel about hospital (and...a surprising number of people don't actually feel this way). This is how you're supposed to feel about hospital.

The trick is going to be coming to an agreement with yourself about when, irrespective of how much you don't want to go, you know the ED is necessary. And take yourself there in spite of how you feel (acting in spite of how you feel is big part of depression management, because if you feel anything at all? It's usually to not do any of those things that will help).

For me, going to the ED was the final step on my safety plan for years. And it sucks. No two ways about it. Sometimes it simply amounted to an overnight hold, which kept me alive. Sometimes it was far more dramatic and awful - that also kept me alive.

These days? I know me, and I know what I can and can't commit to in those emergency moments. I've had a lot of hospitalisations (cough...a lot!) and there's specific hospitals I won't go back to. So it's not on my plan anymore.

I now have a safe chair, and when I hit the red light on my safety plan, I sit in my safe chair with my dog, and message my pdoc about where I'm at (frankly, and with her knowing in advance about my safety plan). The deal is that I don't get out of the chair until I hear back from her about what to do next, or I can keep myself alive again. I have that as my final step now because I know that I can, and will, do that when I need to. I've slept in the chair overnight many times. It sucks. But I'm still alive.

Safety plans are the best. But they do need to be current, and reflect the realities of you, your typical symptoms, and what you actually can commit to when it comes to the crunch. If you can figure that out? It's one of the most important things a person with a history of depression and suidality will ever do as part of their recovery.
Do you have a sample of what you mean? I want to create my own though my mind is drawing sort of a blank in formulating everything you said into my own plan.
 
Yes, my suicidal part is it’s own part, too. And that makes sense about “now or never.” I am learning to be the leader of my parts instead of letting them be in control of me. It’s been a messy and uncomfortable process, but it’s working and I am getting better.

I am learning that all my parts (even the ones that feel scary and bad) serve a purpose and are trying to help me. Some of them just need to learn new strategies and gather new tools, their old ways aren’t helping anymore.

I’d be happy to answer any questions you have.


I still hold out some hope that my suicidal feelings will go away forever and never come back, but that may not happen. So I remind myself that all feelings come and go (happiness, sadness, joy, grief, arousal, numbness, suicidality…etc.). And that ALL feelings run their course. They are messengers giving me a message. I just need to listen and interpret. Not always act.

For me, with much practice, the suicidal feelings aren’t so scary anymore. They still suck…but, my suicidal part really is my friend now. Some days the feelings last a short time, sometimes a long time…but they never last forever.
@Roland thank you so much for this post. I'm at a point where I desperately need the info you asked for here on this thread and I'm so thankful for it. I hope its helped you too.

@Renly this (what you've written here) has to be one of the most reassuring things I've read to help calm me. Had an awful night. I'm really scared about my suicidality as I haven't got a plan of how to deal with it. What you have written here has taken the edge off my fear
 
@Roland thank you so much for this post. I'm at a point where I desperately need the info you asked for here on this thread and I'm so thankful for it. I hope its helped you too.

@Renly this (what you've written here) has to be one of the most reassuring things I've read to help calm me. Had an awful night. I'm really scared about my suicidality as I haven't got a plan of how to deal with it. What you have written here has taken the edge off my fear
You’re welcome! I honestly need to do some of the things from this thread. I haven’t been suicidal in two years but it’s one of those things that never **really** goes away.
 
Do you have a suicide safety plan? If so, what is it? Did you use a template or make your own? Does anyone use an app, if so which one is recommended and why?
I made my own, as it’s the end result of having spent several years actively suicidal / actively attempting to get myself killed (as well as death-wish periods, & not caring if I lived or died, … and coming out the other side in a better place than I could have known to hope for, much less work for… I created some hardline rules for myself. Because that first go? I survived by pure damn luck. Not any skill on my part.

1- If I’m going to die it HAS to be doing something useful

2- If I’m going to die I PREFER it to be in the place of someone who wants to live // and am absolutely NOT allowed to get other people killed in the process.

3- Before I’m allowed to die I have to change EVERYTHING in my life, first.


More on these in the quotes below. They’re not super well written or anything, but I’ve been trying to reply since Feb when this thread was revitalized.

And as a preamble for when I’m in ideation rather than actively suicidal? Reminding myself : If my death hurts? Die better. But if my life hurts? Live better. <<< This is one of the most frustrating and infuriating things when I can’t win for losing, but it’s a vital reminder to me that the emotional logic is completely f*cked. I can no more make my life better by dying than any other bass ackwards reverse logic fallacy. Like sick people take pills, so if I don’t take pills? I won’t get sick! Um. No.

That’s why I developed my suicide plan to account for my own self… and the headspace I actually get into, instead of whatever headspace I’m “supposed” to be in, want to be in, think I might whatever.

My whole plan is basically one big damn delaying action… that gives me the possibility of surviving by pulling up out of being suicidal… whilst taking into account my own shit.

Part of that plan below highlights the me stuff (it’s not the whole plan, nor all of my suicide rules).

1- If I’m going to die it HAS to be doing something useful
2- If I’m going to die I PREFER it to be in the place of someone who wants to live // and am absolutely NOT allowed to get other people killed in the process.
3- Before I’m allowed to die I have to change EVERYTHING in my life, first.

1A- I wanna eat my gun? So f*cking what? I also WANT a helluva lot of other things. Wanting something, isn’t enough. If I’m serious? Then there’s none of this childish instant gratification nonsense allowed, but serious action to be taken. It cuts out the I have something like half a molecule of Impulse control on a good day. If I hadn’t spent years and years being suicidal and decades grinding on impulse control, this wouldn’t matter none, but as I’ve done both? Wanting to die isn’t enough. I could kill myself 6 different ways just walking across most rooms. <<< The caveat here, is grief. There are a few situations (like my kid dying) where I know me well enough to know that surviving the first few days of overwhelming grief would require sedatives &/or 8 point restraints. But if I manage to get past that first wave of unadulterated pain/insanity? I have to die doing something useful. >>> Same token, it’s not useful to “cheat” and stand up in the middle of a firefight, or disregard universal precautions during a hemorrhagic fever. Just because I’m somewhere I COULD be useful, doesn’t mean I can puss out, and die uselessly.

2A- Preferring it to be in the place of someone who wants to live means I’m -probably- heading to the 3rd world. Because? Target rich environment.

3A- This one has kept me breathing an alarming number of times. Because if I’m not even willing to walk away from my life for a few months, much less forever? Pfft.

^^^
All of this, and more, is because I know my own mind. So there’s no one better to play chess against, ya know? Other people’s arguments may make sense in myriad ways… but it’s my OWN arguments that carry the most weight.


If you're willing to die... Are you willing to go to the Caribbean?

I know that might seem like a bizarre question. And feel free to spin a globe and pick any other point on it.

Long standing rule in my own life, I'm not allowed to kill myself before I change everything first. If I'm done, if I'm truly & really done & have lost and want out, then I pack a bag -or not, but from long experience, bags are useful- and change everything. I usually start with the seasons. Winter? Time to head to the tropics or the other hemisphere, for summertime. Summer? Then it's time to head to somewhere with snow. That effectively shortens my "WTF am I going to go???" down to only half the planet. Now that I've narrowed my search that much? I just keep adding conditions to change, or shrug & say screw it, and and just wing it. The next train, plane, boat... Whatever... Wherever.

Being flat broke &/or homeless isn't really an obstacle. If I cannot fund my own "I'm out!" then I get someone to pay me to go or send me. Whether that's as ships crew, or an unpaid volunteer position (think Habitat for Humanity) that they manage the logistics (and even set you up with a website to collect donations to fund your trip).

If I'm NOT willing to change everything? (But my house, cat, job, etc.!!! :eek: I can't just...) then that's a mighty huge wake up call. Because all those things go away if I'm DEAD, too! >.< That's one of those... I don't want to die... I want to stop hurting. Which has a different solution. If I'm trying to save what's left of my life here&now, that's not something fixed by suicide. The opposite. Suicide doesn't in any way fix or help my life. Suicide is just where my head goes.
 
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3- Before I’m allowed to die I have to change EVERYTHING in my life, first.
I like this... I have a similar rule, that I'd almost forgotten, but this has reminded me.

Mine is/ was "I'm not allowed to die until I've spent every last cent that I have on my bank account and overdrawn every available $ on my bank account in the attempt to improve my life so that it's worth living".

I choose to view money as = a tool to achieve certain outcomes.

So, if I've not exhausted every option that money presents - from buying myself an ice-cream, to getting a new hair-cut, to moving overseas, to whatever... then opting out doesn't count.

I've had one very deeply meaningful experience re attempting suicide in my early 20s... It was my first attempt and thankfully, I chose a slow method... slow enough for me to cathartically sob for hours about it all and to get to a deeply numbed, peaceful, spiritual state from hours of bawling my eyes out in a raw and authentic way... It made me break off the suicide attempt and I promised myself that before I throw my life away, what I will do is CHANGE it radically, in everyway possible, including walking out of the house where I was living with just a single bag and the clothes on my back and never looking back again, come what may.

It made me realise that I (and I think many/ most? other people) when they say they no longer want to live... what they mean is they no longer want to live THIS life...

So that means, by changing your life... radically changing it... you're getting rid of THIS life and swapping it for another, more liveable one.
 
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