Suicide OCD vs Suicidal Thoughts

Suicidal thoughts are a significant health concern in the U.S. today. In 2008-2009, 8.3 million people over age 18, corresponding to 3.7% of adults, reported having suicidal thoughts during the previous year. Based on self-report, this is undoubtedly an underestimate as many are hesitant to admit having such thoughts.

Sometimes what appears to be suicidal ideation is actually a form of Obsessive Compulsive Disorder. There are a number of factors differentiating suicidal thoughts and suicidal obsessions, yet given the high degree of overlap, determining the scope of the problem for each individual requires a comprehensive evaluation and regular follow-up.

Suicidal Thoughts and Behavior

The seriousness of suicidal thoughts can be difficult to ascertain since sometimes they may be fleeting while other times there may be a detailed plan in place for carrying out the behavior.

In general, those intent on committing suicide will not provide any indication of their plans and deny the intention if confronted. This is one of the most traumatic aspects of successful suicides for friends and relatives of the victim – the idea that somehow they should have seen it coming despite reassurance from professionals that there was no way to know beforehand.

Most individuals with suicidal intent are actually ambivalent, wavering between wanting to live and wanting to die. Other individuals have no intention of actually dieing but make a suicidal gesture to get others attention or as a call for help.

Thus, suicidal thoughts and behavior are complex problems with a significant risk of death even when not intended.

Suicidal Obsessive Compulsive Disorder (S-OCD)

Suicidal obsessions are invasive, repetitive, unwanted thoughts of suicide that result in significant distress. While S-OCD is conceptualized as having only obsessive symptoms or as a “Pure O” type, this is a misnomer.

The disorder does include compulsions involving either mental acts or behaviors resulting from the anxiety created by the obsessions. Engaging in the compulsions allows the individual to escape the thoughts lowering the anxiety. The decreased anxiety reinforces the link between the obsessions and compulsions and maintains the disorder.

Suicidal obsessions differ from suicidal thoughts in that they do not reflect a true desire to kill oneself; in fact individuals with these obsessions often feel the opposite. They don’t want to kill themselves, typically oppose suicide on moral or religious grounds and are terrified their thoughts could inadvertently cause them to do something that results in their death.

Suicidal obsessions may be spontaneous, seeming to appear from nowhere, or triggered by various activities. The fear of them re-occurring creates secondary anxiety with attempts to identify triggers in order to avoid them soon realizing this isn’t possible.

Over time, it’s likely the frequency of these thoughts will increase until the fill much of the day with obsession, rumination over countering the suicidal thoughts, or engaging in actions to provide reassurance no suicidal behavior has occured.

Individuals who suffer from S-OCD are not ambivalent – they are opposed to committing suicide or even considering it. If suicidal plans enter their thoughts the anxiety worsens, as they fear the more detailed their thoughts become the harder they will be to resist.

Obsessions and Compulsions in S-OCD

Obsessions

Suicidal obsessions often involve the fear of losing control and being unable to resist killing themselves despite not wanting to do so. Thus, the specific thoughts usually follow the form of “What if . . . and end up killing myself before I come to my senses? The “What if. . .” part of the thought can include the following:

What if go crazy and don’t know what I’m doing . . .?
What if I don’t pay enough attention to my thoughts to avoid following them and . . .?
What if the impulse to jump of a building or cliff overwhelms me. . .?
What if I become severely depressed . . .?
What if I can’t resist the impulse to jump in front of a bus or subway . . .?
What if I’m harming myself somehow without knowing it . . .?
What if I’m purposely putting myself in harms way without realizing it . . .?
What if I can’t stop myself from driving off a bridge . . .?
What if I become so distracted by my thoughts that I can’t pay attention to what I’m doing and . . .?
What if I take a handful of pills when I think I’m just taking one or two . . .?

Compulsions

Suicidal compulsions involve maintaining control by obtaining information, making sure there’s no actual suicidal intent and/or they haven’t unknowing engaged in self harm, or manipulation of the environment. Four categories of compulsions include:

Checking

  • Mentally checking “real” intentions regarding self harm; Checking memories for any time they may have hurt themselves; Checking reasons why they wouldn’t kill themselves and any that could indicate the opposite
  • Checking actions and conversations to ensure nothing done or said indicates suicidal intent
  • Checking written items to ensure none indicate suicidal intent
  • Checking to ensure no lethal items are accessible in their home
  • Checking their body to ensure there’s no indication or self harm that occurred without their awareness

Avoidance

  • Avoidance of others who make them feel negatively about themselves or trigger a negative mood or memory
  • Avoidance of places associated with unwanted thoughts such as subway stations or high buildings
  • Avoidance of lethal items in others homes or public places
  • Avoidance of being alone so the presence of others will inhibit any suicidal impulses or stop them from acting on any impulses if they can’t resist without help
  • Avoidance of boredom or inactivity as physical and/or mental stimulation creates distraction from unwanted thoughts; Avoidance of relaxation including going to bed as they fear “letting down their guard” will allow unwanted thoughts to return
  • Avoidance of violent or scary movies to prevent the visual representation of violence from triggering unwanted thoughts; Avoidance of hearing or reading the news to prevent exposure to negative stories
  • Avoiding the ability to hurt themselves by keeping their hands in their pockets or sitting on them

Reassurance Seeking

  • Obtaining confirmation that others don’t believe the individual would kill themselves
  • Asking others to confirm the individual has never hurt themselves without remembering
  • Sharing unwanted thoughts in the hopes others will say they don’t believe this makes the individual a bad person since the thoughts don’t fit with what they know about the individual
  • Spending a lot of time on the internet researching to reassure themselves they have nothing in common with people who kill themselves

Mental Rituals

  • Ruminating about why they would never kill themselves, that they’re opposed to suicide, that they have no desire to kill themselves and that they always fight off the unwanted thoughts
  • Replacing unwanted thoughts with pleasant thoughts that contradict suicide such as future related images
  • Purposely flooding themselves with thoughts of suicide to prove such thoughts disgust them
  • Engaging in compulsive prayer or superstitious behavior that they believe will prevent them from acting out their thoughts
  • Instructing themselves to begin a task over again repeatedly until they complete the task without having any unwanted thoughts

While these compulsions may at times lower thought related anxiety, most of the time they are ineffective since they are either impossible to accomplish or alienate the individual from others in several ways.

  • They individual will realize that it’s impossible to ensure nothing potentially harmful exists in their home much less others homes or public places where they have no control.
  • While they may find nothing written indicating suicidal intent they can’t ensure they’ve checked everything assuming they wouldn’t remember doing so.
  • Asking others for reassurance can seem odd such that the individual is avoided, leading to the conclusion the avoidance is due to others not wanting to admit they believe the individual actually could commit suicide.

Reasons Suicidal Compulsions are Ineffective

It is practically impossible to prevent the obsessions from occurring with other thoughts, since obsessions can’t be predicted and generally become more frequent over time until they occur almost constantly. Therefore, the individual is already overwhelmed by the intrusive thoughts before they’re able to engage in mental strategies to counter the obsessions and anxiety.

When such strategies are effective they reinforce the relationship between the obsessions and compulsions by lowering anxiety. When they are become ineffective the individual develops worsening anxiety as well as other serious co-morbid psychological difficulties including other anxiety disorders, mood disorders and substance abuse, which is often an attempt to self medicate the thoughts away.

Research indicates that OCD will not remit without treatment. One main reason for this is that what are considered attempts to cope with the unwanted thoughts are actually compulsions and actually part of the disorder.

Suicidal Thoughts vs. Suicidal Obsessions

Distinctions between suicidal thoughts and suicidal obsessions include the following:

  • When associated with depression suicidal thoughts are ego-syntonic or congruent with the individuals thoughts and mood state. For instance, they may have suicidal thoughts related to a feeling hopeless about the future will be better or that they are worthless and don’t deserve to live.

In comparison suicidal obsessions are ego dystonic or incongruent with the individuals intentions and beliefs. Despite the thoughts they belief suicide is wrong and are opposed to any type of self harm.

  • Individuals with suicidal thoughts, even when ambivalent, will often want to act on the thoughts, whereas those with suicidal obsessions want to prevent the act, attempting to avoid or escape even the thoughts themselves.

 

Suicidal thoughts are more likely to be associated with previously reported ideation, self harm and suicide attempts compared to suicidal obsessions. Suicidal obsessions rarely result in self harm in the absence of true suicidal thoughts.

· Those who have suicidal thoughts often ruminate about methods for carrying out the act whereas individuals with suicidal obsessions ruminate about reasons why they’d never commit suicide.

While the characteristics of suicidal thoughts and suicidal obsessions may seem easily diffentiated, this is not always the case. The distinction may not be clear-cut given the large overlap between the two categories of thoughts in individuals suffering from S-OCD.

Manifestations of Suicidal Thoughts in OCD

There are several formulations of the ways in which suicidal thoughts and/or ideation are found in OCD, which help determine how best to treat the disorder.

1) The first category involves OCD with suicidal thoughts, none of which are obsessions.
This could describe a person who, for example, has contamination type OCD with symptoms that are frequent enough to interrupt normal daily functioning. The individual may feel hopeless about the problem improving and become depressed over their inability to prevent themselves from having thoughts and engaging in behavior they recognize as unreasonable. This can lead to thoughts such as “I’d be better off dead than living this way”. Thus, the thoughts are consistent with the individuals mood state, and the act of self-harm seems reasonable in light of the thoughts.

2) The next category involves OCD with suicidal thoughts that are exclusively obsessions. Such obsessions lead to the fear they may not be able to prevent themselves from committing suicide despite their opposition to self-harm. Individuals with suicidal obsessions believe that given their disgust related to self-harm that the fact they are having uncontrollable suicidal thoughts indicates underlying pathology that they can’t predict or fully understand. Yet the risk of self-harm in cases where there are only suicidal obsessions is significantly reduced compared to individuals with true suicidal ideation.

3) Some individuals who suffer from S-OCD possess both suicidal obsessions and suicidal thoughts. While this condition combines both low and high risk thought types the overall risk of the individual attempting suicide is higher than when either type of thought exists alone. This is due to the confusion resulting from the two opposing sets of thoughts.

The individual may not want to commit suicide and fights the suicidal obsessions using mental or behavioral acts to prevent inadvertent self-harm. Yet they may also be suffering from depression related to the condition and simultaneously experience actual suicidal thoughts such as “life isn’t worth living”.

These opposing belief systems can become overwhelming due to the inability to make sense of how these conflicting thought patterns can exist together. The individual may become so confused regarding the inability to define their true beliefs that they may engage in suicidal behavior impulsively.

Conclusions

It is often difficult to definitively categorize all suicidal related thoughts an individual with S-OCD may be experiencing. However, effective empirically validated treatments for S-OCD and depression with suicidal ideation exist. It is important for individuals who are experiencing any type of suicidal thoughts to work with a trained professional to treat the complete range of symptoms involving suicidal ideation and obsessions.

S-OCD often results in extreme distress, emotional pain, confusion and social alienation, whether or not actual suicidal ideation is also present. Yet the prognosis following therapy is quite good for S-OCD for each symptom pattern and almost all these individual return to a state of normal functioning whereby they can once more experience a satisfying and enjoyable quality of life.

60 thoughts on “Suicide OCD vs Suicidal Thoughts

    • Pure O OCD responds to both medication and ERP. The challenge with ERP is uncovering the compulsions, which aren’t very overt. Treatment with medication is a hit-and-miss as everyone responds differently to SSRIs.

      • Hi, Thanks for the article. If ERP is good for SOCD, why did you say it was a compulsion to fill your mind with the thoughts to prove you don’t believe them? I thought that’s what ERP was. Thanks.

        • Flooding your mind with the unwanted thoughts is indeed an ERP exercise. However, the point is to refrain from performing any compulsions whether it be checking, reassurance seeking, etc. With ERP you have to ride out the anxiety that the thoughts create without trying to counter them. Proving you don’t believe them is a form of checking.

  1. Hi how are you I’m a 30 ur old male who suffers severely from OCD,Extreme Anxiety,Panic Attacks, horrible intrusive uncontrollable suciidal thoughts please help thank you

    • Hi,

      Sorry to hear about your struggles with OCD and the other disorders you mention. It would help if you could provide additional details about whether or not you have sought professional help and any therapeutic techniques you have tried to get your conditions under control.

    • Tolerate the thoughts but don’t fight them!!
      And you have a lot of other problems too though :\
      So I think you should try seeing a therapist or psychologist or something?? Please do that; I don’t want you to suffer anymore 🙁

  2. I just wanted to comment this article.

    First, I’m feeling this article is causing more fear than necessary. I understand it’s mostly based on the article written by dr. Steve Seay about the same subject, but there are some inaccurate or poorly documented statements in your article.

    Regarding the combination of SI and SO (ideation and obsession), “life is not worth living” is not a suicidal thought. It can be experienced by everyone, and it may also be an obsessive thought (especially after reading the article), and anyway, thinking “life is not worth living” along with SO does not make you want to act on your obsessions. Suicidal thoughts are when someone specificly plan to kill themselves, fleeting thoughts about death are not suicidal thoughts.

    These thoughts are not necessarily ego-syntonic when associated with depression. Lots of depressed (and anxious) people worry if they will feel so down in the dumps that they will consider killing themselves. This is neither SI or SO, but more in the realm of health anxiety (hypochondriasis) or GAD. I have a lot of experience with this.

    People with depression may also have purely ego-dystonic suicidal thoughts..

    Obsessive thoughts do not necessarily have a “what if”-prefix.

    I also want you to document your statement about “having SI and SO together poses a higher risk than any of the thoughts alone”.

    • Hi,

      Thank you for your comment.

      You are confusing suicidal thoughts for suicidal ideation. Suicidal thoughts do not have to encompass an elaborate action plan. “Life is not worth living” can indeed be considered a suicidal thought in the right circumstances. If you are trying to split hairs over the distinction to eliminate anxiety, there is a very good chance it is nothing more than an obsessive thought.

      Depressed people who worry over being driven to suicide are not experiencing suicidal thoughts, but rather obsessions from an obsessive-compulsive spectrum disorder like the ones you mention. Suicidal thoughts absent co-morbid disorders are more likely to be ego-systonic.

      Obsessive thoughts may not explicitly take the form of a “what-if” question, but that is the general theme of OCD thoughts.

      • It is a bit confusing… but quite interesting. I’ve been hearing a lot about this being an OCD trait, so I am just starting to look in to it. Having read the article and the comments, I still can’t tell where I am in all this. I seem to actually do both… like I’ll get to the point of acting on the compulsion and then argue with myself until I am safe, but this may take several hours while on the brink of the edge – literally. I will bring this up with my providers….

  3. So what treatment plan would you recommend for the latter. I have a family member who has been diagnosed with ocd and depression. It can be very tricky. How does someone overcome obsessing about suicide when they are actually depressed. The proof that I have in believing this is the case is because, she has had ocd since 6 years old and has been battling this for this long without anyone knowing. She says she needs to be kept safe. To me, that sounds as if she is afraid she may hurt herself, just like those who obsess about hurting someone else, only difference is, she has actually thought it is a way out of her pain. I suppose it is best to alleviate the depression and then work on the ocd. Problem is, can’t seem to really eliminate the depression. Tried Prozac, luvox, lexapro, Zoloft, anafranil. Only thing that has seemed to be the best is emsam, a patch(Mao) antidepressant. She is working with a psychiatrist. Do you have any other recommendations. It’s truly so complicated. Thank you

      • Yes she seeing a psychotherapist. He seems to focus more on her depression than on her ocd. I think she is going through a extenialism crisis. She is very smart and questions her purpose and meaning in life. Her ocd focuses on the whole realm of ocd. The unpardonable sin, sex, harm, it touches just about everything. She is 15 so it makes her feel so different than her peers. She is always thinking about the the thought of suicide, not actively, but thinks of it constantly. Is there a way out of this? We’ve been in therapy for 11 months now, nothing is budging. I mean she can function, but she finds life to be overwhelming. Any other suggestions? Thanks in advance for responding.

        • (I’m not the same person who responded to you; I’m a different person)
          The thing that makes intrusive thoughts worse is the rationalizing/reassuring/checking. Tell her to tolerate the thoughts but not to check them. Tell her to not fight the thoughts, she should only just tolerate them and move on back to whatever she was doing before. That’s for the OCD part. Also cognitive behavioral therapy will help!!
          For the depression part…I don’t really know, but she should continue going to a therapist or whoever she’s going to!! And also for the medications, I guess she should just take whatever works best (you said Emsam worked for her?), if she’s gonna take medication.
          In the meanwhile, you should definitely take her out to places and stuff like that, or do activities with her, and that kind of stuff is what helps make OCD go away. Just getting the mind off things helps. 🙂

          • I suppose you could keep reminding her that there are literally thousands (if not more) of us who have identically intrusive suicidal thoughts…mothers who would never dream of leaving their children alone, grandfathers, kids. I personally just thought that everybody had suicidal ‘pictures’ like me as a child. It only became constant in my late twenties and thirties when I was told that no, not everyone had them as I had become worried that I may ‘wake up’ and have committed self harm without my consent, so went to the doctors. I honestly believe this only affects people who are highly sensitive, empathetic and genuinely nice!!!!

          • Oh, and sertraline helped me greatly…off it now for over 2 years but think I need to revisit them.

  4. Hi, I suffer from severe ocd for past 4 years. I have not consulted anyone yet. Please help with this. I have been brought up in lonely situation. is that a reason for this? and I loved a person but was rejected. after that, i got such thoughts intensively. what exactly is the reason?

  5. I might have just missed similar cases in the comments, but I personally struggle with an almost uncontrollable suicidal intent and I’m curious as to whether or not this would be in the same vein as S-OCD or if it’d be classified as depression?

    I’m 21 and I’ve been struggling for a while with these intrusive urges that make me unable to function socially; last year even reached the point where I couldn’t even fight away the urge and lock myself in a safe place and it resulted in about 19 stitches.

    My life has barely begun and as unhappy as I may get and no matter how many adversities I face in my life…. I’d still really like to live it and do something worthwhile with my days.

    I hope this type of comment isn’t entirely out place but I just thought I’d share and also ask, because maybe it’ll make a difference.

    • I’ll try to help you!!
      The first thing I would say is what I’ve said to like all the other people in this comment section: Don’t ever try to fight the thoughts. Don’t ever try to rationalize them, don’t do the whole checking and reassuring process. Tolerate the thought and say “lol fine” then go back to what you were doing. You obviously want to continue living. 🙂
      And your situation sounds really bad, so maybe you might need some therapy, if you can’t just do the advice I just gave you:
      Someone else in this comment section said that there’s “cognitive behavioral therapy” with an “exposure and responsive component”.
      I really suggest that you do the cognitive behavioral therapy 🙂 please

      • Hi i believe I am dealing with ocd I have been having suicidal thoughts but never acted on them its more of a fear like what if I harm my self or lose control..but before than and still sometimes i have a fear that ill Hurt myself or some one around me again i never act on it its more of a fear and thought that hunts me because its negative and I’m not a negative person I’m also a mother so it scares me to be around My daughter which makes me feel guilty then my mind says I’m a bad person and mother which I know is a lie then thats when the suicidal thoughts kick in how do i get rid of these thoughts I don’t even know where it came from but its irritating and scary i recently had surgery on my foot and most of the time I’ve been home not working due to the surgery so that did cause anxiety and depression.. I still have my job not really social right now…mostly just around my daughter..family sometimes friends but not often and I hate being alone because of these thoughts my biggest concern is being healthy around my child because I would never want her to be affected …..please help I just wanna live my life …

  6. My heart goes out to all of you with ocd who have written in.

    My 17 year old son has had harm ocd from the age of 9 and struggles daily with thoughts of wanting to end his life in spite of meds and a therapist.

    I just want to say – ocd has only 2 bits to it…if it is unwanted, repetitive and intrusive and you can’t control it then it is an obsession. However all compulsions, whether mental or physical, are behaviors that can be controlled, however automatic they may seem to be.

    So if you’re thinking “I want to die” and this is under your control, it is probably a compulsive ritual or neutralization strategy to try and reduce anxiety. Stopping it will cause anxiety to flare up in the short term but this will fade if you do not do the ritual again.

    I know its easier said than done. Please try and get help. Good luck.

    • Yeah, and the key is to not do the whole rationalizing process tbh. You just have to tolerate the thoughts and not stress about it 🙂

  7. This is a very interesting and helpful article; I’m both depressed and have ocd.
    I’m a CPA and left my employer 2 months ago due to Bullying and I’m getting
    ready for tax season to start. My depression stems from being bored and having to use some of my retirement savings to live on until I start working again. Having been devalued at work (daily for the past several years) it is easy for me to come up with thoughts of disillusionment.
    I suffer from repetitive thoughts and can really get caught up in over analyzing something in a big way. It seems with the more time I currently have on my hands the more I obsess.
    Today a stray thought passed my mind of suicide and I dismissed it; because I know things will get better and know that such thoughts could cross anyone’s mind with depression. I do look forward to finding a job and getting pass this period in my life and want to live to a ripe old age.
    My ocd wants to take hold of the thought I had this morning and really examine it.
    I believe that I just need to relax and let it go and not make an issue out of it.
    This, of course, is difficult now but the anxiety will pass.
    I believe that my situation is a combo of actually having a transient thought based on mood which I looked at rationally and dismissed and now my ocd trying to obsess about it.
    Thanks to the writer and those who have left their input.

    • John,

      When you dismiss a thought the idea is to accept it without judgement or qualification.

      You tried to rationalize the thought by telling yourself better times are ahead. The anxiety faded, but sure enough the thought crept back up later during the day. Compulsive behavior is sneaky like that.

      Next time challenge yourself to tolerate the thought and the anxiety it creates.

    • Don’t ever examine it, just accept it and tolerate it but don’t think about it and don’t rationalize it lol
      You’ll be fineeeee 🙂

  8. My son is 21 and has been diagnosed with OCD/GAD/possible Bi-Polar and has intrusive suicidal thoughts for example:…I should just go kill myself, I need to make a plan to kill myself..I would be better off dead…I should just go jump off a bridge and graphic images of hurting himself as well….He does not want to commit suicide and has been on medication and is receiving Cognitive Therapy……etc…These thoughts can just come out of nowhere, even if he is doing something fun and he is happy..It is like the OCD just keeps fighting back harder and harder…They just flood his brain and can last up to an hour….How is it possible to not believe them when they flood your brain and tell you to do it constantly…He uses rational behavior therapy and uses a form to dispute the thoughts and tries to add humor..That is the only thing that seems to help a bit…His Dad had OCD and did commit suicide, although he was not in therapy nor was on medication…Any other ideas that could be useful would help…Thanks

    • Trying to dispute the thoughts will only worsen their intensity and frequency. The rationalizing behavior is a compulsion that serves as negative reinforcement for the obsessive thoughts. Essentially, by trying to dispute the thoughts your son is validating them to his brain creating an even greater nuisance. Cognitive behavior therapy with an Exposure and Response Prevention component is the most suitable treatment for OCD. This treatment will help your son identify distortions in his thinking making the thoughts less anxiety provoking. The ultimate goal of therapy however is to get him to accept the uncertainty of the thoughts and tolerate the anxiety without performing compulsions. Eventually, the anxiety will level out and the thoughts will hold no power over him.

  9. Hi,
    I have been diagnosed with OCD after suffering for years with intrusive thoughts of harm towards others but I received treatment and did well for a while in terms of my OCD but I have other co-morbid mental health problems and when my OCD got better, these conditions got worse. I thought about suicide a lot but I indulged in these thoughts rather than trying to fight them off as you tend to do with OCD. I thought of different plans in my head, assessing the suitability of the different plans and even did research. I was aware that people with OCD can suffer with intrusive thoughts of suicide but I knew these weren’t intrusive thoughts as they didn’t fill me with dread like other intrusive thoughts did. It was like I was trying to talk myself into committing suicide rather than trying to convince myself I’d never do something like I would be if it were intrusive thoughts. I have a history of self harming behavior including small to moderate overdoses of pain killers. I recently decided enough was enough and that I was going to be honest and get help for the suicidal thoughts but as soon as I made that decision the doubt flooded in. I started to worry they were intrusive thoughts which held me back in seeking help. I didn’t want to kick up a fuss if it was intrusive thoughts because I already know how to deal with them. So now I’ve been in this back and forth struggle with myself trying to determine the actual risk I present to myself and whether this is genuine suicidal thoughts or OCD. I got to the point when I thought, ‘For god sake, I should kill myself and then I’ll know for sure I was definitely suicidal’. However this was very useful, it is now clear to me that I should seek help. I have made plans and even wrote notes and I know if it was intrusive thoughts doing so would cause strong anxiety and I understand that if it were OCD I wouldn’t be choosing to indulge in these thoughts or self harming. I’m going to speak to my local crisis team, so thank you for this post because it has been deeply helpful!

  10. Hi, I have been diagnosed with OCD for a little while. My OCD mostly centred around intrusive thoughts of harming other people. I received treatment and things got a lot better OCD wise but I do have other co-morbid mental health problems and they seemed to get worse as the OCD got better.

    I have always thought about suicide a lot. I’d see it everywhere but it didn’t seem to cause me distress. I think of plans in my head and it was like I was trying to convince myself to carry them out and I never once even considered it to be intrusive thoughts because it felt completely different. When I suffered from intrusive thoughts of harming other people, I tried to convince myself I was not going to do it to ease my anxiety whereas with this it was like thinking about doing it provided me with comfort. Like I say there was never a doubt in me that this wasn’t actual suicidal ideation and was instead intrusive suicidal thoughts.

    Until I was about to get help. I never doubted that I could seriously hurt myself until I decided enough was enough and that I was going to be honest about what I was struggling with and ask for help. That was when all the doubt came flooding in. I thought, ‘What if this isn’t suicidal thoughts but it’s actually intrusive thoughts but they treat it as suicidal thoughts and get me help but then me getting that help and taking up time and resources that I don’t really need leads to someone who really does need it not getting and then they die and it will be all my fault’.

    So I now it’s almost like I’m trying to convince myself that I am suicidal and that’s ridiculous because of course no one would want to feel that way but its like I do. When I’m arguing with myself about this sometimes I think, ‘Just do it, don’t get help, follow through with the plans and then you won’t have to be sure’ but part of me wants to get help and be better but I keep worrying about me reaching out will lead to someone else’s suffering.

    I’m 85% sure this is not OCD because I indulge in the thoughts and dont try to get rid of it like you usually do with ocd and i have a history of self harming.

    I just wanted to be sure before I kick up a fuss

    I was just wondering if you’d have any imput?

    Thanks

    • I’m not the person who wrote the article, but maybe I can help you
      Personally I think that you would only truly want to do suicide if you really actually hated your life…
      If you don’t truly hate your life, the suicidal thoughts are either intrusive or are just bland thoughts that keep you busy but have no effect.
      And this is important: getting help will NOT affect someone else getting help.
      Unless every help center/place in the whole entire world is booked for every single appointment time except for one, you will not be affecting someone else’s opportunity for help.
      In all seriousness, if you want to get help to figure things out, then please get it. It will not harm someone else.

  11. Let me just correct something.
    Plenty of people who were suicidal and went on to commit suicide did indicate their suicidal behaviours/thoughts before their completed suicide.

  12. I’m a 60 year old doctor previously with research interest, who had a major financial loss 2 years ago through bad advice. I feel guilt over this such that it has dominated my life, ended my career and I am now retired and spend most of every day ruminating about this and how my family future and self have been destroyed. My efforts to resolve my financial problems have got me entrenched with lawyers and complexity. I see myself self destructing despite meds, psychology and ect. I spend hours researching suicide and ruminating, reducing social contact and activity even though I know this is bad.
    Any suggestions? I don’t want to die, but suicide is looking inevitable.

    • Go talk to your family again, or friends, and if you can’t, then just do hobbies to keep you busy. Don’t feel bad about something that happened like years ago
      (and this is not the person who wrote the article, this is just another person :D)

  13. I’m confused… Thinking about the though is bad, not thinking is bad, trying to tell yourself you won’t do it is bad… It seems anything you can do is just bad.
    After some time I am pretty sure I have this. I feel like I want to jump out the window. I live high up, that would kill me. I worry I might fall out, jump out, I fear that I might just “dive out” the window, and I just plain fear that I will somehow end up falling. I’m fine around knives, ropes, pills, guns. I could swim in a vat of pills and I wouldn’t be afraid of suicide. Even if I was shot at by someone, chances are I would still be thinking about how I might fall out the window to my death.

    I’m so tired of this, it’s a pretty near constant in my life. Everything I experience is secondary. The thoughts of jumping/falling out of the window at at the forefront of my consciousness at all times, sometimes stronger, sometimes weaker.
    I know for a fact that if the thoughts just stop I can be happy. I would be instantly happy and fine if the thoughts just stop. But they won’t stop. They just keep going. It gets to a point where I get so angry I just think “I’m just gonna go and eat a bullet before these thoughts win and I fly. Hear that brain? You gonna force me to eat a bullet you traitorous scum! You will never win, I will never give in and jump”.

    • (This isn’t the person who wrote the article btw)
      I think I might be able to help you… What you have to do is accept the thoughts but then DON’T CHECK to reassure yourself that it’s just thoughts.
      Next time you get a thought like “What if I jump out and die??” just literally think to yourself “Lol ok” and go back to what you were doing, whether you were watching TV, listening to music, talking to someone, or whatever. DO NOT start worrying; don’t think “Well I won’t do that…it’s just OCD…but what if I jump out…well no it’s OCD…but what if I really will jump out”. That kind of thinking is what makes it all worse lol.
      I’ve had several different intrusive thoughts, they’ve been coming in phases. But when a thought comes, what I do is I simply just go back to what I was doing and let myself be distracted. Then maybe in a minute the thought will come again. Then I just think “Oh it’s a thought again” and go back to what I was doing.
      The key is to not be stressed out by your intrusive thoughts. Accept them, yes. But don’t do any of the checking stuff.
      You’ll be fine 🙂 follow my advice and remember, don’t be stressed lol 😀

  14. Hi,

    I’m 15 and early last year I got told by my school counsellor I have S-OCD and GAD. My obsession is with being on a bridge about to jump (I have really bad memories of being on a bridge and being just about to do it when someone stopped me) and now I do a really complicated, superstitious ritual every morning to see whether or not they’ll be there again if I do happen to be on that bridge that day, and when it goes ‘right’ it makes me feel so elated for about 5 minutes but it usually only goes right once every blue moon because it relies purely on chance. That’s usually the only time I feel emotion. My mother refuses to believe I have either of those but won’t take me to see a psychiatrist to confirm my s-OCD. I know the struggle everyone’s going through with their compulsions. I feel like I’m never going to get over the obsessions. It just gets worse with all the stigma and myths surrounding OCD in this day and age. Thanks so much for posting this stuff, it’s good to know exactly what I’m up against.

    • Omg listen to me, you need to stop that every-morning ritual. That is what’s making it all worse. Accept the fact that you have intrusive thoughts and DON’T do the checking process, meaning, don’t do the ritual of reassurance process. Do a hobby and when the thought comes, say ok, and go back to the hobby. Not just with hobbies actually, but with any activity or anything you’re doing 🙂 Or go out do fun stuff with your friends or something, or with your family, maybe even tell your mom to take you to maybe the zoo or a park or anywhere, and just do stuff to keep you busy. Then if the thoughts come again, just go back to what you were doing and don’t stress 🙂 you’ll be fine

  15. I am currently having obsessive and or intrusive thoughts of suicide on a daily basis and especially when alone. Therefore would like to ask if anybody has faced a similiar situation and what treatment they would recommend for my condition?

    • Hi!! I’ll say what I’ve said to many other people on this comment section: accept the thoughts, maybe even laugh at them with a smile, then don’t do the whole checking where you try to reassure yourself and stuff.
      If you’re alone or bored a lot, then find some sort of hobby, or game on your phone, or a board game, or play or listen to music, watch TV, or anythinggggg and then you’ll be busy, then when the thought comes, just say “lol good one” and return to what you were doing 🙂
      The thought might come again periodically, but it’ll drift away if you take the advice that I said. It’ll drift away and you’ll forget about it in no time, don’t worry 🙂

  16. I thank God for showing me this page at the right time. I suffer from HOCD and I think that was a blessing in disguise coz SOCD is scarier than HOCD and because I already experienced HOCD, this will be quite easy for me to handle. But I’ll just tell you what happend tonight. I was with my family and I was happy, but after we arrived home, I have problems like normal people and suddenly had the urge to cut myself. I tried(compulsive, I guess) and there was a little cut. Im outraged and scared(knees, whole body was so weak) coz I would never do this, but I actually cut myself a little. After reading this, I feel so relieved coz this is totally just like HOCD(homosexual ocd). I had suicidal thoughts, but this was the first time that I had a panic attack and suddenly had the urge to cut myself. Damn! It was so scary. I’m from the Philippines and its hard to find psychologists(I think) that will truly understand this. How can I self help? I truly believe I can handle this coz I handled my HOCD! Thanks and GOD BLESS

    • Omg yeah just use the same techniques. Like the accepting but not checking 🙂 You’ll get through it, you’ll be fine lol

  17. Hello Everyone,

    Upon reading the article and reading so many people’s replies, I feel better because I use to think that I was the only person thinking that I was completely losing my mind!!! I would have thoughts of harming myself, Family Members, Co-Workers, etc. even though I know it wasn’t something that I was capable of doing.

    I just literally started having these murderous, suicidal thoughts over the last month even though I now realized that I been having different strange and usual thoughts/behaviors most of my life, I was always scared of dying and thinking that I was about to have a heart attack, had a terminal illness, etc. I use to also have episodes of Tourette Syndrome when I was younger and one day I can truly say that the episodes went away or were very well controlled over time.

    I’ve had numerous panic attacks since I was an early Teenager with my worse one occuring while at work back in 2006 when I was 24 years old (I was force to quit my job). For a few years I was doing just fine until recently, these thoughts have made it hard to sleep; I also now feel uncomfortable around guns, bridges, or any other object or place that reminds me of my unwelcomed thoughts….

    Everyone, please continue to hang in there, a lot of people may not understand what we are going through but just like so many episodes throughout my life, these crazy thoughts/urges will come to past. I’ve never had any Professional Therapy and never been on any Meds, we need to pray/meditate often, laugh as much as possible, we are going to live well and live longer than we may think at this present moment.

    • When you get intrusive thoughts, just laugh at them or just accept them or think “Lol ok”, and don’t do the whole checking thing. Then also just go back to whatever you were doing. Then the intrusive thoughts will drift away and won’t come back as often. Do that, and it’ll get better, I promiseeee

  18. I’ve been suffering from this OCD for around 2 months, on and off. When I sleep less than 5 hours in a night, I face this fear that I am suicidal/that I will commit suicide. I fear that I have no desire to live. Rationalizing this further scares me horribly. Then I ask myself if I am happy with my life, and of course my gut feelings tell me no, even though my mind automatically says I have joy greater than happiness. That scares me even more. After a week of sleeping normally, however, it goes away. At most once a day I will have this thought, without anxiety at all. I no longer need to question if I am happy. I tell myself that if these thoughts come again, it’s ok, i’m totally fine. Then, if I have another night of little sleep, this happens again. I fear that I will not be able to handle it when it gets bad. However, I am on the third repetition of this cycle and it is not as bad as the first 2.

    Reading this article and the testimonials brings me great relief. I’ve asked a professional in suicide profession, and they said i’m totally, fine, I just need to not entertain these thoughts. I’m also journaling these thoughts around once a day in order to let them out. Furthermore, I try to thank God for even the little things in my life, as this helps my mindset.

    Hopefully it goes away soon, and that I can help others who suffer in the same way. It’s a tough thing to live with, yes, but it will help me to smile through adversity and focus my mind as it is overcome with time, prayer, and the aforementioned measures. It’s great to know that it’s OCD and that i’m not actually suicidal. Often the hardest parts of life make it seem all the better (although I say this with a forced smile).

      • Yes that’s the key to the thoughts going away!! 🙂
        You just have to accept them but don’t be stressed about them and don’t check them.
        I’m glad it’s getting better, and I know exactly what you mean 🙂

  19. I am a 28 year old female. I’ve had OCD and GAD for as long as I can remember. My intrusive thoughts about suicide are a mixture of wanting to just not live anymore and uncontrolled random images in my mind. They can come at any time. I feel like I could live with that alone since I have always had thoughts of death. Even before I started elementary school I didn’t want to live anymore. But now I am alone and have no one to reach out to. Nothing I can find online helps. I don’t have any friends or family to talk to. I am afraid to leave my home so I am alone constantly. My husband moved across country for a new job. I would possibly go to a hospital, but my cats and dog are here and there’s no one who could care for them in my absence. I believe they’re the only reason I’m still here to be honest. I am so lost and alone. I feel like I am just sinking deeper and deeper. I’m just at a loss. I can’t leave the house. I wait until after 1am to check my mail so no one will be out and I can only do that twice a week at most. I know I need psychiatric help, but I am so afraid to leave the house without my husband! We are still married, but I feel abandoned. Is there anyone who is in a similar situation? Any advice? I just need someone to talk to.

  20. So could ocd about killing yourself be like me saying over and over again “you should just kill yourself” and then arguing with myself to shut up cause that’s that farthest think from what I want to do. It gets worse when I’m feeling low or anxious. Then I look for the thought and start ruminating it over and over in my head. Till I start thinking maybe it’s another voice in my head tell me this. But it’s like the voice you hear when you read a book. And then I start arguing with myself of how stupid um being and then at times when I’m anxious I look for bad thoughts or make them up in my head. It’s weird. And very annoying. It didn’t start till my antidepressant started wearing off and I had that initial thought popped into my head. Then ever since coming off the meds cause I felt like the doctors kept me on for anxiety which started as panic attacks for way too long it’s been an ongoing issue while on no meds. It’s only been a little over 2 months and some people say it’s part of withdrawal cause my brain is messed up and trying to rebuild chemicals it doesn’t have now. I guess if I knew it was just ocd and not like a psychotic thing I would be better about it. It was gone for a while and then this month with my period it started again. I get freaked out cause my dad killed himself about 15 years ago. So I get scared what if I’m getting what he had. But I’m not even sure he heard voices telling him to kill himself. I think he just got depressed and did it. I really don’t want to go back on meds at this point but it’s super annoying and depressing sometimes.

  21. I can’t begin to explain the magnitude of clarity brought upon by this article. After over 35 years of NEVER consudering self-harm, I’ve now been obsessed with suicidal thoughts for three years after a mishap with my anxiety medication. Long story short: an inexperienced nurse insisted that ALL patients who improperly discontinue medication (which I had) attempt and usually succeed at committing suicide. Being extremely OCD, I took her exaggeration as the ultimate truth and sent myself into a tailspin! I, in turn, was convinced that I would suicide despite my better efforts; getting back on meds, going to intensive therapy sessions, avoiding being alone, even trashing alllll of our kitchen knives. After three years and many life changes, I’ve much improved but was still in disbelief of such a morbid obsession. Until this article, I was not aware of S-OCD and am thrilled to realize I’m not alone and that, with proper care, our lives can return to normal. Very very many blessing to you, friend.

  22. I’ve been reading these posts and they have also brought me a measure of relief. I have S-OCD and have had it off and on for years in episodic fits and starts. Usually it hits when I’m going through a very stressful time filled with change. Lately it’s come back really bad and it is definitely tough. Like most here, rationally, I know I want to live because well I just do. I’m married and have a child, great parents, and a pretty good life. I’ve gotten to do a lot. But the OCD tells me all kinds of things that sometimes confuse me and, of course, scare the hell out of me. The thing is, I know that if I wanted to commit suicide I wouldn’t feel scared or all this anxiety that I feel. I would probably feel at peace with it. All that said, there’s just no way I can allow myself to do it, regardless of what I’m thinking. I actually like my life, which is why the thoughts are all the more confounding. Sure, I’m prone to depression at times but it’s often unrelated to my OCD and I never feel suicidal when I’m just down in the dumps. The OCD is totally different animal. Anyways, to everyone here, don’t lose hope. Don’t give up. If you think you’re actually suicidal, call someone, tell someone, go to the hospital. There are many people who have recovered from depression, even famous people like Owen Wilson. For me, I know I have only one life here on earth and I want to make the most of it. In short, f*ck OCD.

  23. Okay, so I’ve been having a ton of suicidal “flashes” just randomly throughout the day for 2 years now. (I also have major chronic depression). And I never understood why I had them because I don’t WANT to die but my thoughts show me countless ways how to. I was wondering, how do you tell a counselor that you are having intrusive thoughts about suicide but you don’t want to actually do it? Will they try and suggest that I go to a mental hospital? I don’t know how to tell another person that I am having suicidal thoughts that repeat over and over again until I complete a task or anything that has to do with “completing” something. I don’t want to be diagnosed with S-OCD but I also want help and see if I have this because I’ve never read anything so close to what I am experiencing.

    • You won’t need to tell them – they will be able to identify through their line of questioning that you have OCD. Based on your description, this definitely sounds like nothing more than anxiety.

  24. Hello, as of 2 weeks now I’ve been dealing with thoughts and images of suicide. I’ve been diagnosed with depression before but I’ve never had an episode or felt so low that suicide was an option. I’m against it and just thinking about it scared me a lot! Well about 3 years ago I was having intrusive thoughts of harming or killing my family/friends, and it terrifies me. I was dealing with it on my and honestly for about a year I managed to overcome it by acknowledging it but never giving it credibility. This year for 5 months I was dealing with HIV/AIDS ocd (I got checked twice btw) and turned out clean. But as of now, I had a nightmare in which I killed myself and for some reason it just stuck with me and never left. My anxiety has been spiking with it ever since. I don’t think about ways of killing myself but I fear that I’ll get so low or that I’m fooling myself and should kill myself. I focus on other things and it goes away but not for long. Does this mean I’m truely suicidal??? Or it’s my Pure O playing tricks on me?

    • I felt tons of relief while reading this site, it provided a lot of insight and comfort on what I’m dealing with. Before coming here, I went to one site that kind of caused my anxiety to flare up. Basically they said if you have depression and are dealing with suicidal obsessions chances are you are suicidal and need a mental health professional. I’ve been diagnosed with Depression and PTSD when I was younger. But I never considered suicide before, nor was I in a depressive state for a long time. Recently I found out that I had a lot of symptoms in common with that of OCD mainly Pure O. Ive dealt the Harming/killing theme and managed to get through it. It’s recently that I had a nightmare where I killed myself and ever since I couldn’t shake it off. The thought of suicide scares me and I don’t have images of my death or jumping out of Windows or off bridges. But I’m scared I’ll get so low or lose control and feel that it’s my only way out. Is this OCD tricking me or is it really suicidal thoughts?
      Please get back to me and tell me what you recommend

  25. Hello! I having the same trouble.. i have those thoughts but i am 300% sure that i don’t want to do it and there is no reason for me to do it.
    It’s kind of weird.
    I know i have OCD and i got treated.
    sometimes those ideas came back , of course it’s not easy to control them..
    any recommendation?

  26. Will someone please tell me what to do. I’m embarrassed to tell anyone about this but I have struggled with this for as long as I can remember. Finally I googled “disorder non-stop suicidal thoughts” and now I’m here. I’m not going to kill myself but I know my life would be better if I wasn’t constantly thinking about jumping off a bridge, hanging myself, shooting myself. It’s constant.

  27. columbia university in nyc conducts a study on OCD I beleive. I think it’s free and anyone suffering OCD can participate. Hope this helps. Don’t forget…. this too shall pass, your bad thoughts will not last forever, they are temporary, they will go away. Accept them at the moment, don’t fight them and refocus on a positive thoughts. Good luck and stay hopeful, nothing is impossible, God loves us all!

  28. I am just ruminating on a phrase that would cause me harm it’s hard to get it out of my head overwealms me and didn’t allow me to sleep. It came out of nowhere last night due to many high stressors in my life. I am not thinking of hurting myself but with an anxiety disorder this repetative thought process gets tiresome because you camt just bypass it. Any suggestion here…

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