Understanding Suicidal Thoughts: Why Talking Saves Lives
Suicidal thoughts are far more common than most people realise. Research suggests that around one in five adults will experience suicidal ideation at some point in their lives. Yet we rarely talk openly about these thoughts, leaving people who experience them feeling isolated and ashamed. Understanding what suicidal thoughts are, why they occur, and why talking about them can be lifesaving is crucial for anyone experiencing crisis—and for those who care about them.
What Suicidal Ideation Actually Means
Suicidal thoughts exist on a spectrum and don't always mean someone is actively planning to end their life. Mental health professionals distinguish between different types:
Passive Suicidal Ideation Thoughts like "I wish I wasn't here anymore," "I wish I could go to sleep and not wake up," or "Everyone would be better off without me." These thoughts don't involve active planning but reflect a desire to escape overwhelming pain.
Active Suicidal Ideation Thoughts that involve considering or planning specific methods. This represents a higher level of risk and requires immediate professional support.
Suicidal Intent When someone has decided to act on suicidal thoughts and has made plans. This is a mental health emergency requiring immediate intervention.
Understanding this spectrum is important because many people experience passive thoughts during difficult times and assume this means they're "going crazy" or that they're in immediate danger. While all suicidal thoughts should be taken seriously, not all require emergency intervention. What they all do require is support, understanding, and the opportunity to talk.
Why People Experience Suicidal Thoughts
Suicidal thoughts are not a character flaw or a sign of weakness. They emerge when psychological pain becomes overwhelming and someone can't see a way forward. Several factors contribute:
Unbearable Emotional Pain Often described as "psychache," this is pain so intense that it becomes difficult to imagine continuing to feel this way. Depression, anxiety, trauma, grief, and other conditions can all create this level of distress.
Feeling Trapped When someone perceives their situation as impossible to escape or change—whether due to financial problems, relationship breakdowns, health issues, or other circumstances—suicidal thoughts can emerge as a perceived way out.
Loss of Hope Depression particularly affects our ability to imagine a better future. When someone can't see things improving, ending their life may seem like the only way to stop the pain.
Perceived Burden Many people experiencing suicidal thoughts believe others would be better off without them. This perception, while usually inaccurate, feels completely real to the person experiencing it.
Disconnection Feeling isolated, misunderstood, or disconnected from others and from life itself can contribute to suicidal thinking. Humans are social creatures, and profound loneliness is genuinely dangerous to our wellbeing.
The Neuroscience: How Crisis Affects the Brain
Understanding what happens in the brain during suicidal crisis can help reduce shame and increase compassion—both for yourself if you're experiencing this, and for others.
When someone is in acute psychological distress, the brain's prefrontal cortex—responsible for problem solving, perspective taking, and imagining the future—becomes less active. Meanwhile, the amygdala, our fear and threat detection centre, becomes hyperactive.
This neurological state literally narrows our thinking. We become less able to see options, alternatives, or solutions. We lose access to memories of times we've coped successfully before. Our ability to imagine things being different in the future is impaired. This is why suicidal crises are often described as "tunnel vision"—the person can only see one way out.
This isn't a choice or a moral failing. It's a neurological response to overwhelming distress. And importantly, it's temporary. With support, these brain states shift, and people regain access to broader thinking, problem solving, and hope.
Why Talking Helps: The Power of Externalisation
There's a common fear that talking about suicidal thoughts will somehow make them worse or "put ideas in someone's head." Research consistently shows the opposite is true. Here's why talking helps:
Externalisation Reduces Intensity When thoughts stay locked inside our heads, they can become overwhelming and all consuming. Speaking them aloud to another person helps externalise them—they become something we're experiencing rather than something we are.
Breaking Isolation Suicidal thoughts thrive in isolation. Shame keeps people silent, and silence reinforces the belief that they're alone with these feelings. Talking breaks this cycle and connects people with support.
Accessing Different Perspectives When we're in crisis, our thinking narrows dramatically. Speaking with someone else—whether a therapist, friend, or helpline counsellor—helps us access different perspectives and possibilities we genuinely can't see on our own.
Interrupting the Crisis State The act of reaching out and talking can itself interrupt the acute crisis state. It creates a pause, a moment of connection, and a slight shift in brain state that can allow other possibilities to emerge.
Accessing Practical Support Talking connects people with resources they may not have known existed—therapy, medication, crisis services, practical assistance with the problems contributing to their distress.
What Happens in Crisis Therapy
If you're experiencing suicidal thoughts and seek therapy, here's what you can expect:
No Judgment Your therapist understands that suicidal thoughts are a response to overwhelming pain, not a character flaw. They won't be shocked, judgmental, or try to talk you out of your feelings.
Collaborative Safety Planning Your therapist will work with you to develop a safety plan—identifying warning signs, coping strategies, people you can reach out to, and steps to take if you feel at immediate risk. This isn't about forcing you to promise you won't hurt yourself; it's about collaboratively identifying what might help keep you safe.
Understanding the Context Therapy explores what's contributing to your suicidal thoughts—the circumstances, feelings, and experiences that have led to this point. Understanding the context is crucial for addressing the underlying issues.
Immediate and Longer Term Support While managing immediate risk is important, effective crisis therapy also addresses the longer term factors contributing to your distress. This might involve treating depression or other mental health conditions, working through trauma, developing coping skills, or making practical changes to your circumstances.
Respect for Your Autonomy Good crisis therapy balances keeping you safe with respecting your autonomy. Your therapist wants to work with you, not control you. They'll only involve others or break confidentiality if they believe you're at immediate serious risk, and they'll discuss this with you whenever possible.
Immediate Resources If You're in Crisis
If you're experiencing suicidal thoughts right now, please reach out for support:
Samaritans: 116 123 (24/7) A free, confidential listening service. You don't have to be suicidal to call—they're there for anyone who needs to talk.
Crisis Text Line: Text SHOUT to 85258 (24/7) Free text support for anyone in crisis, providing confidential support via text message.
Your GP If you have a GP, they can provide urgent support, prescribe medication if appropriate, and refer you to mental health services.
NHS 111 (Option 2 for Mental Health) 24/7 mental health crisis support and advice.
Accident and Emergency If you're in immediate danger, go to your nearest A&E department or call 999.
These services exist because suicidal crises are medical emergencies, not signs of failure. Using them is appropriate and important.
Long Term Support: Addressing the Underlying Pain
While crisis intervention is crucial, the goal is to address the pain that led to suicidal thoughts in the first place. This is where ongoing therapy becomes vital.
Therapy helps people:
Treat underlying mental health conditions like depression and anxiety
Process trauma that may be contributing to current distress
Develop healthier coping mechanisms for managing difficult emotions
Address practical problems contributing to feeling trapped
Rebuild connection and meaning in their lives
Challenge the thoughts and beliefs that maintain hopelessness
Recovery isn't linear. There may be setbacks along the way. But with consistent support, most people who experience suicidal crises go on to live fulfilling lives and feel grateful they survived. The pain that once felt permanent often becomes manageable with time, support, and appropriate treatment.
Warning Signs to Watch For
If you're concerned about yourself or someone else, these warning signs suggest someone may be at increased risk:
Talking about wanting to die or feeling hopeless
Researching methods or making preparations
Withdrawing from relationships and activities
Giving away possessions
Saying goodbye in unusual ways
Increased substance use
Extreme mood swings
Expressing feeling trapped or being a burden
Changes in sleeping or eating patterns
If you notice these signs in yourself or someone else, don't wait for the situation to become more serious. Reach out for support now.
How Pause Wellbeing Supports People in Crisis
At Pause Wellbeing, our therapists are trained to work with people experiencing suicidal thoughts and mental health crises. We provide:
Immediate assessment and safety planning
Evidence based therapeutic approaches for treating underlying conditions
Compassionate, non judgemental support
Collaborative treatment planning that respects your autonomy
Coordination with other services when beneficial
Flexible appointment options including urgent availability
We understand that reaching out during crisis takes courage. Our therapists are here to provide the professional, compassionate support you need to navigate this difficult time.
Reaching Out is Strength, Not Weakness
If there's one message to take from this article, it's this: experiencing suicidal thoughts doesn't make you weak, broken, or beyond help. These thoughts are a sign of immense pain, and that pain can be treated.
Reaching out for support—whether to a therapist, doctor, helpline, or trusted friend—is an act of strength and self preservation. It's choosing to give yourself the chance for things to improve, even when you can't currently imagine how.
You deserve support. You deserve compassion. You deserve the opportunity to discover that the pain you're experiencing now, as unbearable as it feels, can change.
If You're Struggling, Please Reach Out
If you're experiencing suicidal thoughts or supporting someone who is, please contact Pause Wellbeing. Our experienced therapists across Liverpool, Leeds, and London are here to help.
Crisis doesn't have to be faced alone. The simple act of reaching out and talking can be the first step toward feeling different. We're here when you're ready.
Contact Pause Wellbeing today for confidential, compassionate support.
