Help me understand why this is happening
March 12, 2011 9:41 AM   Subscribe

Suicidal ideation under stress -- help me.

When I get under stress about anything, but especially something fairly minor that may involve letting someone down (like a scheduling conflict, being late, saying the wrong thing) -- I really freak out. I'm great in a real crisis, and I can maintain calm on the outside when I'm with others, but when I'm alone, I start:

- repeating to myself over and over "I want to die", "I'm supposed to die", "I deserve to die" ---even though I don't really believe it

- then another part of myself takes over and forces me to just move forward, make the phone call, have lunch, take a shower, etc.

- and another part of myself says very reassuring things, like "I love you", "It's going to be okay" "Yesterday was better and tomorrow probably will be too" and does CBT type stuff ("What would you say if this were someone else's problem?" "What is the worst thing that can happen?", breathing techniques for anxiety, etc.)

It's a weird cycle I go through, and what really gets me is that I don't understand it.

I think I'm better than I have been in the past, because I use CBT techniques, am reassuring, nurture myself, etc. The techniques help somewhat...

But what gets me is that I don't really understand WHY I am doing this. I think understanding why would really help me as I have a bunch of tools for dealing with it, and they do help, it always seems to come as a surprise to me when it happens. Why does part of my brain do this? Why does it jump to these thoughts?

I read the book "How I Survived When My Brain Was Trying to Kill Me" -- and it was pretty good, but didn't really help me understand why this is happening. Therapy has helped me talk about it and has offered some helpful techniques, but I would like to hear from others who do this too.

Other info: I'm healthy, young, in therapy, don't have any mental illnesses (that I know of), have never tried to commit suicide, cut myself, or anything like that.

I'm a very analytical person, the kind who learns to dance by analyzing the steps, so helping to understand why would probably be a huge help to me.

So, does anyone else here on Askme have this problem? Why do you think it happens to you? Do you use the same words or different ones? Does it happen in the same sort of situations?

Feel free to private message if you would prefer not to share publicly.

posted by carolinaherrera to Human Relations (12 answers total) 34 users marked this as a favorite
Grapevine: Someone told me once that her therapist had told her that there's a physically addictive chemical involved in thinking depressive thoughts.
posted by aniola at 9:58 AM on March 12, 2011 [1 favorite]

I have definitely had this problem, although it has never impeded functionality in an actual crisis. It happens far less frequently than it used to, thanks to medication and therapy. I don't see any mention of medication in your post, though. What's your position on that?

These days, if such a thought should occur to me, I take the moment to be gentle with myself, and think -- "oh, honey, this really is stressful, I know, I know . . ." I try to be as kind to myself as I would be to a panicking stranger.
posted by Countess Elena at 10:10 AM on March 12, 2011 [1 favorite]

I have this happen, in the same situations with pretty much the same words (except the self-comforting part, I don't do that), but I've been diagnosed with depression and have attempted suicide. I get over it by recognizing it as a symptom of the illness, telling myself not to listen to the disease, and pushing to follow through with whatever caused the hang-up. Doing what I need to in spite of how it affects me always makes me feel better. I've never been in therapy and was only briefly medicated, although while I was the thoughts abated. I pretty much assume I'll be living with these thoughts until I no longer suffer from depression, if that ever happens. It sucks, but I'm cool with it, all part of being me. I wouldn't worry if you've never been compelled to act on these thoughts.
posted by Carlotta Bananas at 10:24 AM on March 12, 2011

So, does anyone else here on Askme have this problem?
Yes, I have this problem from time to time. Less often now that I am on medication, but it does still sometimes occur.

Why do you think it happens to you?
For me, I think it is an ingrained response to certain situations and feelings where my wacky brain chemistry gets me in trouble. When I am anxious, stressed, or unhappy, my brain wants to relieve the discomfort caused by those feelings, and because of my depression and years of unmedicated response, my brain starts telling me, "It's okay, you can just kill yourself. If you're dead, it won't be a problem any more." Things like that, over and over. "Invasive thoughts" is how it is described in psychology. It sounds from your description that that's what's happening to you--the repetition, the high-intensity feelings, the inability to control the thoughts even though your rational self is all, "what the hell, dude?!"

Do you use the same words or different ones?
I also have experience with CBT techniques. When I feel this way, I first try to figure out the trigger. Like I said, I'm medicated now, so if I'm having invasive thoughts, it's out of the ordinary. If I can identify a trigger, like PMS or that glass of wine I had last night, then I can better tell myself that these thoughts are a result of my wacky brain chemistry, and they're not "real." It allows me to push them to the background more easily. I know that they'll pass as PMS fades or as my body processes out the alcohol. If I can't identify a trigger, and I'm just feeling crappy, I tell myself that it's okay to feel this way for a little while, but acting on it is not all right. I tell my husband I'm feeling bad so he can keep an eye on me. I get some sleep, some exercise, and I have some cookies :) I tell myself "this will pass, you're not a bad person, you're doing your best, if you die, you'll miss (thing x that I'm looking forward to), you can always just run away to a tropical island (technically true, if not logistically so). Those things help ground me and minimize my catastrophic thinking, which the invasive suicidal thoughts are a part of.

Does it happen in the same sort of situations?
Like I mentioned above, this will happen to me sometimes right before my period (I am not on hormonal birth control, so I do tend to have mood shifts). Also, to my dismay, I can't really drink alcohol at all anymore. It used to just be no drinking-to-the-point-of-drunkenness, but the older I get (or maybe the more my tolerance drops now that I don't drink much), the more sensitive I am. Now I have to carefully consider even a glass of wine or a cocktail. The booze thing is, I think, a function of my depression (alcohol being a depressant) and the medication I'm on. Sometimes it just...happens. I'm still working on that with my doctor.

So my main point is that it doesn't really seem like there's a one-size-fits-all explanation for exactly why you or anyone have these thoughts. And my explanation is based solely on personal anecdotes and my layman's knowledge of psychology. It's a good idea to keep on with your CBT techniques; I truly believe that they are the best way to work through and past thoughts like this. You may not be able to use them as a pre-emptive strike, but it's a really good sign that you can recognize when you need them and then proceed. Maybe try to keep an eye on situations that precede these thoughts and change how you get into them or how you respond to them in an attempt to lessen your suicidal self-talk. It would be great if you could find a good doctor to help you work on these issues--objectivity is important.

Sorry this is so long; your question is one I often ponder myself and it's my hope that my thought processes can help you a tiny bit.
posted by Fui Non Sum at 10:27 AM on March 12, 2011 [4 favorites]

I do this - in similar and in other circumstances. I have done this for as far back as I can remember, like elementary school. (I have other brain tics I think are connected, like I can remember quite minor incidents where I did something wrong or said something mean to someone - out of nowhere, vivid as the moment it happened, and I experience incredible shame and guilt over it - often things no one else involved probably even remembers!) I am better about it now than I used to be. It gets much worse in a depressive episode, and it's much easier to ignore when I'm doing okay.

I'm also analytical. My personal theory is that it's sort of an OCD thing. For me it's a guilt reaction - I feel bad and then I suppose my brain kicks into thinking if only I feel so very guilty enough inside maybe it will balance out; a form of expiation. It's obsessive - I dwell on it to ridiculous lengths; it's compulsive - I keep circling back to it. I think maybe what happens is that when you feel so bad it doesn't work to feel just a little bad; you really have to prove how bad it is - so bad - so dramatically bad you want to die. See, I'm sincerely really feeling very awful now! And because this script is so powerfully negative and so emotional it's very hard to unhook it as an automatic response.

Viewing it like that helps me not credit it too much when it starts, because I know it's just a learned script at this point - a weird brain malfunction. (It's bad if I'm depressed though because I can't be dispassionate enough about it when my thinking is badly disordered.) I also find doing something to relieve the guilt, something visible, by directly apologizing, talking about it and expressing how bad I feel, doing something to make up for it, or if I can't, doing some "random act of kindness" thing out in the world helps to quiet the thoughts some. Avoiding it makes it worse.
posted by flex at 10:39 AM on March 12, 2011 [5 favorites]

repeating to myself over and over "I want to die", "I'm supposed to die", "I deserve to die" ---even though I don't really believe it

It sounds to me like this is a case of intrusive thoughts, not suidical ideation.
posted by Wordwoman at 11:56 AM on March 12, 2011

I agree with Wordwoman, this sounds like intrusive thoughts vs. suicidal ideation.

I do this with "I should die" when I'm under an unusual amount of stress, and with "I need to lose weight" pretty much all the time (I don't believe either of these things). I figured it was just a pretty typical part of being human - like occasional twitches or shivers.

What helps me is to dismiss the thought, as one does during meditation. It's not giving me any useful information, so I ignore it. I think analyzing it would just stress me more and reinforce the cycle. I tried learning more about body acceptance when the weight thoughts were bothering me, and I've done CBT-based exercises for other stuff, and neither seemed to change the frequency of my intrusive thoughts (but they did help me stop caring about them).
posted by momus_window at 12:39 PM on March 12, 2011

i'm with flex - 100%, at least for me. you're not the only one.

my thoughts don't get quite as dark, but i definitely get more stressed by minor things like you describe - even though i'm absolutely the person you want in a crisis. very big things i manage with ease and sometimes the dumbest things will render me helpless.

the things that set me off are usually very emotionally charged, but otherwise benign ... something horrible a family member says or does; flared up health issues; minor financial hiccups. is that the same with you? is it possibly just a really severe anxiety response?

can you identify a common thread? is it with certain friends or family members? obviously, a therapist is your first line of defense. but i've learned to manage better knowing that xxx sets me off and my first course of action should be a) calling a specific friend who knows the history b) doing nothing for a few hours until i get my wits back c) writing a letter i don't send.

especially with intrusive thoughts, it helps me to give myself time to meltdown before acting. "it's just a panic attack, take a deep breath" is what i say to myself. perhaps you could practice substituting that.
posted by crankyrogalsky at 1:22 PM on March 12, 2011

Internal family systems therapy describes what you have going on quite well, and in the very language that you have used: you have a part of you that's ashamed (possibly due to prior trauma), and other parts of you that step up to defend yourself from that shame, though maybe in ways that prevent you from ever resolving the trauma. Self-Therapy is a clear and well-written introduction.
posted by shivohum at 2:09 PM on March 12, 2011 [1 favorite]

Nthing that it sounds like intrusive thoughts - especially since even when you get them, you don't really believe them. I sometimes get those thoughts, either under times of intense stress or when there's something dangerous nearby (like, if I'm on a balcony several stories up).

What's helped me is telling myself that they're just thoughts, just my brain automatically leaping to the most horrible conclusion. I don't have to listen to them, and I don't have to do something because my brain acknowledges that it's possible. Sometimes I dissect the scenario: death would hurt, and it's irreversible, and besides, it would take effort on my part to climb over the balcony railing or whatever, and I know I'm not going to bother with that.

I am actually absolutely fucking terrified of death, and I wonder if the intrusive thoughts are maybe some unconscious way I deal with that fear, or a sign that maybe I'm not dealing with it in the best way I can.
posted by Metroid Baby at 6:30 PM on March 12, 2011

I do this exact thing. The first thought gives a sense of relief - "there is a way out of this situation, I am not trapped, I don't have to feel anxious or bad" and going to such an extreme allows another part of me to say "if someone looked at this objectively, he/she would be shocked at how seriously I am taking this, and this means I am not a bad person for having made the mistake in the first place, and should forgive myself for small mistakes." Its a kind of self-punishment and forgiveness thing, in part. But for me it also involves OCD, and I take medication.
I, too get these thoughts when I think I have let someone else down, so the way I deal with it is to say "when I see the person, I will apologize" or some other concrete plan of action to relieve my stress. It helps a little.
Also, this happens much more often when I am stressed out in other parts of my life, and little mistakes feel overwhelming.
Hope this helps.
posted by Shebear at 6:28 AM on March 13, 2011 [1 favorite]

I totally understand what you're going through. I get the same sorts/types- of "it's too much- I can't deal" thoughts. Thoughts where- well, dying is the only realistic way out. But it lasts for a second. And as soon as I think it, I realize and know that it's not going to happen- I'm not going to, or do I have any real intention to- do harm to myself. What the thought is, I think- is overwhem. Overstimulated. Like, an information overload on my brain and sensitivities. So much that it's just the place that I go to in order to deal. Like, sometimes, when I have alot on my mind, as I'm driving on the highway I'll think to myself- omg, I can drive right into the meidan and flip out and kill myself....And then I'll just as quick go- hey insane girl, nice. You need to calm the f- down because you're obviously overhelmed and feeling overhwhelmed. And I don't. I don't do anything of the sort that would be regarded as insane. But that doesn't mean the thought hasn't crossed my mind.

I think officially, that would be categorized as Generalized Anxiety Disorder. Which I have. But in reality, what it means is that we freak out easy. But we don't do anything crazy because we actually have a grip. To the outside world. But inside, sometimes, we're a whirling dervish of anxiety. I don't know how other people do it. But I've tried to convince a shrink or two over my time, about my insanity- and using something like this as a prime example of my irresponsibility and general need for a team of doctors to diagnose and cure me- and all I get back is- ahhhh. You're pretty normal. We all get those things. You're not actually doing it. Insane is when you don't know the difference. So, I don't know what else to say except, join the club?
posted by Fenshwee at 5:09 PM on April 3, 2011 [1 favorite]

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