If you feel that you are a danger to yourself in this moment, please call the national suicide prevention lifeline by using a telephone to dial 988 or 800-273-8255. You can visit their website for a live chat by clicking here.
Strategies for Overcoming Depression and Suicidal Thoughts
Cognitive Behavioral Therapy (CBT) uses a short term, goal oriented perspective focused on identifying, challenging and altering damaging patterns of thinking, maladaptive attitudes, and internally held beliefs that exacerbate symptoms. Once such patterns of thought are identified, CBT offers a time constrained, structured strategy to replace them with more constructive thoughts which then encourage more constructive behaviors (Potter, 2020). For access to a free version of CBT, click here.
Similar to CBT, Interpersonal Therapy (IPT) works by supporting us as we identify the difficulties we are having within our important personal relationships and develop coping strategies to resolve them. Difficulties may include role transitions, role conflicts, and the enhancement of social skills (Weiner, 2010). This strategy offers a highly structured, time-limited and practical approach to current interpersonal events (including disputes and processing grief), with the goal of improving communication, expressing ourselves meaningfully, and renegotiating the roles we take on (Potter, 2020).
Another strategy related to IPT to consider is assertiveness training. This approach focuses on how we express ourselves when we are trying to get our needs met. Instead of being aggressive (ruthlessly seeking what we want without considering the needs of others) or passive (avoiding conflict to the point of sacrificing our own happiness), we instead develop our assertive voice. One where we express our thoughts, desires and opinions in an effort to meet our needs, without sacrificing the needs of others (Pearson, 2019).
CBT, IPT and antidepressant medications have all been shown to be equally as effective in the long term treatment of depression. 50% to 65% of individuals surveyed reported a significant reduction in depressive symptoms after using one of these treatment options (Weiner, 2010).
Depression can also be managed effectively through the identification and development of protective factors that help maintain an elevated mood. These include connectedness to our friends, family and community, access to mental health care and healthy coping strategies (Potter, 2020). For access to a list of ways to positively cope with stressors, click here.
The development of problem solving strategies, life skills, direct communication and internal/external resources like resiliency also serves to insulate us from depression. As does getting an adequate amount of sleep, and reducing the amount of smoking we engage in (Pearson, 2019). For more information on resiliency and how it can insulate us from depression, click here.
A specific diet has been recommended for those experiencing the physical changes caused by depression. To prevent inflammation, it is recommended that we avoiding sugar, saturated fats and refined or highly processed foods. Diets high in fruits, vegetables, beans, whole grains and fish offer access to nutrients that have protect factors, including omega-3 fatty acids, folic acid, vitamin D, selenium and calcium (Pearson, 2019).
Engaging in physicality, specifically mind/body connectedness and movement, has been shown to offer protective effects (Pearson, 2019). For more insight into physicality strategies, click here.
Light therapy (using a broad spectrum light for at least 30 minutes a day) has been shown to reduce the symptoms of certain forms of depression (Pearson, 2019).
There is also a proven psychological benefit connected to a belief in a higher power, an afterlife, and fate. These beliefs are thought to create a sense of meaning around events, offer comfort in times of illness and crisis, and provide guidance when we are unsure of how to move past difficult moments in life in a way that aligns with our morals and values. Additionally, spirituality can increase our access to social support systems that can help us during hardship (Potter, 2020).
If we feel a worsening level of depression and suicidal thoughts are beginning to form, the first step is to ensure personal safety. This means removing weapons or medications from our environment, or removing ourselves from unsafe places or people. We need to reach out immediately to those who we feel safe around and trust, and seek professional medical treatment. If we cannot cope with thoughts of self-harm, it is imperative that we call one of the following crisis lines immediately (MFMER, 2018):
National Suicide Prevention Lifeline
- Call 800-273-8255
- TTY users please use your preferred relay service or dial 711 then 1-800-273-8255
Nacional de Prevención del Suicidio
- Telephono 888-628-9454
Crisis Text Line
- Text NAMI or HOME to 741-741
Strategies for Anger, Aggression and Homicidal Thoughts
When instances of anger arise, we need to postpone any and all conversation until we have a chance to reflect on what specifically is causing our anger. We will benefit from removing ourselves from the situation and thinking about something soothing or repeat a calming word (APA, 2019).
It is recommended that we engage in deep breathing. This is a technique recommended for managing all forms of intense emotion, as it allows us to take a step back from the upsetting stimuli, catch our breath and self-soothe. This is accomplished by focusing our energy on slow, deep, even inhalation and exhalation (Pearson, 2019). To start, breathe in deeply while counting to four. Imagine filling the stomach with our breath, allowing our abdomen to expand on inhale. Next, we hold our breath for four seconds. Then we exhale for four seconds. Do this at least five times in a row before moving on to the next task. Consider playing music with a slow beat, and breathing to the rhythm (Pearson, 2020).
We can take a walk or do something physical to expel the increase in energy (APA, 2019). For a list of ideas regarding mind/body interconnectedness and movement, click here.
We should take a step back from our anger and ask ourselves if we have a physical need (food, water, sleep, hygiene) that may be causing the anger (APA, 2019). For more information on how to assess physiological needs, click here.
We can work to accept our emotions as a natural part of life and make a conscious effort to avoid the desire to place blame (BHC, 2021). We can consider what outcome we are hoping for, if our sense of anger is proportional to the situation, and what options we have access to that may help to resolve the conflict (APA, 2019).
Certain behavioral exercises may help reduce the number of angry instances and the severity of the anger response. One such technique is exposure and response prevention therapy (Weiner, 2010) which is available by clicking here.
Cognitive approaches focus on identifying and restructuring automatic or dysfunctional thoughts, unreasonable beliefs, and hostile attributions while increasing social skills related to problem solving and interpersonal relationships (Weiner, 2010). For access to cognitive behavioral therapy methodologies, click here.
Emotional regulation is the ability to control how our emotions fluctuate over time and how those emotions are expressed. This ability is heavily influenced by the context of our environment, our culture and our personality traits (Potter, 2020). Those successful at self-regulation are able to control both how they experience their emotions as well as the physical manifestations of emotion, even at the height of a trigger (Wheeler, 2022). For more information on emotional regulation, click here.
Developing positive coping mechanisms can help insulate us from negative thoughts and emotions, allowing us to become more adaptable to the stressors of life (Weiner, 2010). For more information on adaptive strategies, click here.
If these above strategies are not helping, and we still feel that we are a danger to others, additional safe guards can be implemented. First, we must enlist the help of those we trust by communicating the reality of the situation to them. We can ask them to advocate on our behalf to reduce or remove the stressors that are causing anger, and we can work with them to seek out and accept support (Merrill, 2013).
Next, we can make a commitment to safety by removing tools of harm (guns, knives, other weapons, medications) from the home. We then write down a plan for safety that details how we will respond to intense feelings of anger. Include who we will reach out to, where we will go and what actions we can take that have helped us in the past. We can create structure for our time to reduce the amount of time spent in anger and increase time spent using outlets to diffuse intense emotions (Merrill, 2013).
If we are still struggling with intense anger and ideas of directing aggression toward ourselves or others, we need to reach out to a skilled mental health care professional. There are therapies and medications available that can alleviate these feelings and move us toward long term recovery (Merrill, 2013).