Suicidal Intrusive Thoughts: I’m afraid I’m going to take my own life

Suicidal intrusive thoughts can be incredibly distressing for the person experiencing them. They are unwanted, repetitive thoughts (or images) around the fear of taking your own life. These occur in a person’s mind despite not wanting or intending to have them which is why they feel so alarming. 

They are a type of intrusive thought, which are often alarming and highly disturbing thoughts or images that involuntarily pop up in a person’s mind seemingly out of nowhere.

When these thoughts appear, the sufferer is left with an alarming sense of urgency to figure out why they would have these thoughts, and stop them from becoming a reality, using compulsive behaviors that offer short-term relief.

Death is so incredibly final that it is understandable for those with suicidal intrusive thoughts to take them seriously.

Allowing these thoughts to exist without exploration or ‘solving’ leaves them feeling at risk of a potential outcome that is quite literally life-ending.

But, it’s important to note that having suicidal intrusive thoughts does not necessarily mean that a person is suicidal or wants to die.

The fact that these intrusive thoughts are disturbing shows that they do not align with your values, beliefs, or morals.

As we go through this article, the main teaching we want you to take away from this is that if you struggle with Suicidal OCD there are specific science-based tools that can help you take your life back from these suicidal intrusive thoughts.

What are intrusive thoughts?

Intrusive thoughts are unwanted and disturbing thoughts, images, or impulses that occur involuntarily in a person’s mind. These thoughts can be very distressing and can cause feelings of anxiety, fear, shame, or guilt.

Intrusive thoughts are a common experience and can occur in people of all ages, genders, and backgrounds. They are often associated with anxiety disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD), but they can also occur in individuals who do not have a diagnosed mental health condition.

In fact, up to 94% of the global population experiences intrusive thoughts.

For most people who don’t have this condition, these thoughts are quickly dismissed after a few moments. But for those trapped in the OCD cycle, they become a source of extreme uncertainty, confusion, and emotional pain.

It’s important to note that having intrusive thoughts does not necessarily mean that a person wants to act on them or that they reflect the person’s true beliefs or values. 

This is why they are known as ‘intrusive’.

They are unwanted and often leave us questioning our morality and identity.

What is Suicidal OCD?

Suicidal OCD, also known as suicidal obsessive-compulsive disorder, is a type of OCD where an individual experiences intrusive and distressing thoughts, images, or urges related to suicide.

Within the context of OCD, the core obsessions revolve around taking one’s life.

Someone who suffers from this subtype does not have the desire to die. This is why those obsessions are so incredibly alarming. 

They may experience intrusive thoughts like:

“Why don’t you pick up that knife and stab yourself in the heart?”

“What if you threw yourself in front of that train?”

“You should take that entire bottle of pain tablets”

“What if you ended it all?”

These intrusive thoughts can be immensely graphic and understandably trigger high levels of uncertainty and anxiety. Thoughts may also include vivid imagery and a sense of urgency.

Our brains are constantly on the search for certainty, they do not deal well with ambiguity.

So imagine having thoughts like these – when you know that you want to live – and how mentally disruptive they can be.

Sufferers feel they cannot take the risk of letting these thoughts go unexplored because the outcome of what might happen if these thoughts became a reality is terrifying.

This is why they engage in physical and mental compulsions (anxiety-relieving rituals) in the hope to regain a sense of control.

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I’m afraid I’m going to kill myself

We understand that experiencing these intrusive thoughts is making you question everything.

They make you question your morals, your values, and your satisfaction with life.

And often people who have these fears can feel like their brain is broken and they’ll never be able to go back to the way they were before having these intrusive thoughts.

It can be so alarming that they feel like they can’t go on with their daily functioning because the extremity and repetitiveness feel so real…

It feels like they have to go and solve this problem before they can go back to daily life and engage in everyday activities like brushing their teeth or tidying the bed, and even going to work.

If you’re having thoughts like ‘I’m afraid I’m going to kill myself’ then it is possible that you have Suicidal OCD which is a highly treatable condition.

To get in touch with our OCD therapists, please click here.

What’s the difference between Suicidal OCD vs Suicidal Ideation?

To further show the difference between those who struggle with suicidal OCD versus those with suicidal ideation, we can look at intrusive thoughts versus suicidal intent.

Suicidal intrusive thoughts vs suicidal intent

Suicidal OCD and suicidal ideation are two different experiences related to suicidal thoughts and feelings.

Suicidal ideation refers to the experience of thinking about, considering, or planning suicide. It is a symptom commonly associated with mental health conditions such as depression, anxiety, bipolar disorder, and PTSD. 

Individuals with suicidal ideation may experience a range of thoughts and feelings related to suicide, including thoughts of self-harm, thoughts of death, or feeling that life is not worth living.

Suicidal OCD, on the other hand, is a type of obsessive-compulsive disorder where a person experiences intrusive and distressing thoughts, images, or urges related to suicide. 

These thoughts conjure a plethora of negative and highly distressing emotions. People with suicidal OCD may experience a variety of repetitive unwanted and intrusive thoughts, such as imagining themselves harming or killing themselves, feeling compelled to carry out suicide-related actions, or experiencing intense anxiety, guilt, or shame related to these thoughts and urges.

While both suicidal ideation and suicidal OCD involve thoughts and feelings related to suicide, the main differentiating factor is the intention.

Those with suicidal OCD do not wish to take their lives.

Those with suicidal ideation see suicide as a potential solution to their suffering.

When qualified clinicians work on diagnosing a client with either suicidal OCD or suicidal intent, one way they do this is to determine whether the suicidal intrusive thoughts are ego-dystonic or ego-syntonic.

Those with suicidal intent have ego-syntonic thoughts about death, which means they line up with their values and their intention to take their life.

Suicidal OCD is ego-dystonic in nature which means those obsessions do not line up with their values and they are not something they want to engage with.

Why do suicidal intrusive thoughts feel so real?

When you have an intrusive thought and then your brain sets off the natural “fight or flight” response – which releases stress hormones such as cortisol and adrenaline – our brain is sending messages to our bodies that we either need to run away, fight, or freeze.

The hormones released in association with the thought can contribute to our experience of this being a real danger, in real time, that we need to solve right away.

The presence of the intrusive thought alone might not feel very real or urgent to those who don’t experience anxiety, but those who experience that fight, flight, and freeze response (FFF response) are the ones who tend to get really caught up in the content of the thought because it feels so real; our body is actually experiencing it like an imminent threat in the heat of the moment.

For example, if you had the thought, “What if I take those pills?” you might experience a racing heart, tingling in your fingers, tension in your body, and shortness of breath which will give you the sense that this is imminent and threatening. Therefore your response may be to remove the pills right away.

You may also have the thought, “What if I jump in front of that train?” and in the confusion of the moment, the urge to run away from the track can be misunderstood as an urge to jump onto the track.

When it comes to suicidal intrusive thoughts, they can feel especially real and intense because they tap into our deepest fears and anxieties which can make them difficult to ignore or dismiss.

It’s important to understand that while suicidal intrusive thoughts can feel very real and overwhelming, they do not necessarily reflect reality. 

These thoughts are a symptom of various mental health conditions, and they can be managed and treated with the help of a qualified mental health professional. With the right support and resources, it is possible to reduce the intensity and frequency of suicidal intrusive thoughts and regain a sense of control over one’s life.

Common misconceptions about suicidal intrusive thoughts

There are several misconceptions about suicidal intrusive thoughts that can lead to misunderstandings and stigmatization of individuals who experience them. 

Some common misconceptions include:

1. Suicidal intrusive thoughts mean the person is suicidal: Suicidal intrusive thoughts are ego-dystonic which means the person having these thoughts does not wish to have them and does not wish to engage in these actions.

2. People with suicidal intrusive thoughts are weak or attention-seeking: This is a harmful stereotype that can lead to shame and self-blame for individuals who experience suicidal intrusive thoughts. In reality, suicidal intrusive thoughts can affect anyone, regardless of their strength or character.

3. Suicidal intrusive thoughts are always dangerous: While suicidal thoughts should always be taken seriously, it’s important to understand that not all suicidal thoughts indicate an immediate risk of suicide. If you are experiencing suicidal thoughts that are ego-syntonic (meaning you want to harm yourself or die by suicide) please go directly to the emergency room or call a suicide hotline – 988.

4. Suicidal intrusive thoughts can be easily dismissed or ignored: Some may believe that if they know they don’t want to take their life, they should be able to be less affected by these thoughts. But the reality is, OCD thrives on these fears and it knows how to play on them to get your attention and strengthen its grip. 

Suicidal OCD is one of the many OCD subtypes that is greatly misunderstood by both sufferers and non-sufferers alike.

Our greatest ally in recovery is education and knowledge. 

When clients come to us, this is where we begin. Our greatest ally in recovery is education and knowledge. As clinicians, we first spend a lot of time educating our clients so they feel prepped and capable to navigate the treatment process. When you understand the science of your intrusive thoughts, you’ll then recognize how you’re going to change their life for the better.

How to manage suicidal intrusive thoughts

Managing suicidal intrusive thoughts can be challenging, but there are several strategies that you can use to help yourself. 

Here are some top tips to help manage suicidal intrusive thoughts:

1. Seek professional help: If you are experiencing suicidal intrusive thoughts, it’s important to seek help from a specialized mental health professional. It is important that you see a professional who is trained in OCD and Exposure Response Prevention so they can provide support and guidance for managing your symptoms and developing coping strategies.

2. Practice self-care: Taking care of yourself can help reduce stress and anxiety, which can in turn help manage suicidal intrusive thoughts. This may include getting enough sleep, eating a healthy diet, exercising regularly, and engaging in activities that bring you joy.

3. Change your response to your thoughts: In OCD, it is integral to identify our relationship with these thoughts and change our response to something more helpful. For example, if you have a thought like “These suicidal intrusive thoughts must mean something about me” you might instead say “While these thoughts are distressing, these are just thoughts and not facts.”

4. Practice mindfulness: Mindfulness practices, such as awareness training and meditation, can help you become more aware of your thoughts and emotions without judgment. This can help you better manage your thoughts and reduce the intensity of intrusive thoughts.

5. Accept and redirect: A key component of recovery is being able to accept your intrusive thoughts without trying to suppress them or engage in behaviors to reduce your uncertainty. When they arise, notice them, accept them, and then carry on with your day as you usually would had you not had those intrusive thoughts.

Remember that managing suicidal intrusive thoughts takes time and effort, and it’s important to be patient and compassionate with yourself. 

Treatment for suicidal intrusive thoughts

The most effective treatment for suicidal intrusive thoughts is Cognitive Behavioral Therapy (CBT) with Exposure Response Prevention (ERP).

This remains the gold standard treatment for all OCD subtypes and has proven to yield an incredibly high success rate.

Throughout treatment, we’re looking to change your relationship and response to those intrusive thoughts and resist the urge to engage in compulsions.

By doing this, you not only decrease the validity of these thoughts (and therefore reduce the intensity of the fear they induce) but you teach your brain that you are capable of managing the anxiety and uncertainty without the use of compulsive behaviors.

Working with an OCD specialist, they will begin treatment by educating you on the nuances of OCD so you can begin with a baseline of knowledge that will help support you when you begin to put your treatment plan into practice.

Then, you will work together to create a hierarchy of exposures that feel manageable, so you can begin to break the OCD cycle.

Other modalities are used to effectively support this treatment including ACT (Acceptance & Commitment Therapy) and Mindfulness so that you can use all the tools available to you to make a full recovery.

1:1 Private Therapy

Suicidal intrusive thoughts sit within a group of obsessions that are truly terrifying.

When clients come to us, they’re often crushed under an immense weight of guilt and shame for having these thoughts. They may say, “What would that do to my family?” or “How selfish am I for even considering it?” or “What would my friends think if they knew?”

And so, opening up to a qualified specialist can feel like a big step.

When you approach our team you will be welcomed with understanding and compassion.

You will be partnered with a highly trained professional who is invested in your recovery and will not judge you for having these thoughts.

Although it may feel scary to begin the recovery process, our clients never regret starting. They only regret not starting sooner.

Because the truth is…

OCD is highly treatable and the longer you stay stuck, feeding the cycle, the worse it gets.

It takes a great deal of courage, but the sooner you reach out and take the first step toward recovery, the sooner you will take your life back from OCD.

If you’re based in California or Arizona, please submit an initial intake form here.

We would love to support you.

Online program

If private therapy isn’t currently an option for you, OCD specialist Kimberley Quinlan has created an affordable online program called ERP SCHOOL that is accessible to everyone.

You will learn the exact tools and techniques given to those in a private therapy setting, and you will understand how to apply them to your specific intrusive thoughts and compulsions.

By the end of the program, you will have the knowledge and understanding to stop letting your suicidal intrusive thoughts ruin your life and resist the urge to do compulsions that keep you trapped in the OCD Cycle.

Join ERP SCHOOL here.