Living with Suicidal OCD

What’s going on?

It’s perfectly natural for people to have occasional thoughts of suicide. You might picture yourself driving your car off a bridge, jumping in front of an oncoming train, overdosing on drugs, or slicing your arm with a knife. However, for some OCD sufferers, suicidal thoughts turn into obsessions. You become so worried about killing yourself, that you feel unsafe when you’re alone. You worry that you’ll act on the images in your head at any moment. This thought can be incredibly debilitating. It’s important to remember that you’re no more likely to act on your thoughts than anyone else.

Common Suicidal OCD obsessions:

• Fear that you’ll commit suicide.
• Constantly thinking about the ways you’ll commit suicide.
• Fear of becoming depressed, which could lead to suicide.

Common Suicidal OCD compulsions:

• Excessive reflection: You’re constantly trying to determine if you’ll act on your thoughts.
• Seeking answers: You’re desperate to find answers to your thoughts.
• Research: You often look up stories about people who committed suicide and ruminate on what happened.

Common misconceptions about Suicidal OCD:

• OCD only comes in one, general type. Subsets like Suicidal OCD don’t exist.
• The idea of having the thought means you’re more likely to act on it. This is totally untrue.
• Suicidal thoughts are premeditated and intentional.

How Do I Know it’s OCD?

Everyone gets intrusive thoughts, but having them doesn’t mean you have OCD. For some people, they can be debilitating and have a serious impact on day-to-day life. No matter how hard you try, they won’t go away. Unfortunately, many Suicidal OCD sufferers are misdiagnosed by clinicians who don’t understand OCD. When this happens, the clinician may suggest hospitalization for the sufferer’s safety, which can have a negative impact on treatment.

Everyday examples:

• You have a fear of becoming depressed and feel compelled to commit suicide.
• You have thoughts of sticking your hand in a blender and turning it on.
• You’re afraid of using a curling iron and accidentally disfiguring your face, which might later compel you to commit suicide over your looks.

How can my family help with my Suicidal OCD?

Suicidal OCD is identified by the level of distress that you have around a suicidal thought. It’s pronounced and ongoing. Family members and loved ones can take comfort in knowing that you’re actually obsessed with saving yourself, not harming yourself. In many ways, the disorder is a contradiction. Having family and friends encourage you to try therapy is incredibly important. 

Is Recovery Possible for Me?

Yes! The standard treatment for sufferers of Suicidal OCD is Exposure Response Prevention Therapy (ERP). ERP is when you voluntarily expose yourself to the source of your fear over and over and over again, without acting out any compulsion to neutralize or stop the fear. By repeatedly facing something you’re afraid of, you force your brain to recognize how irrational it is.

Examples of ERP:

• You may be asked to think of suicidal thoughts or ways in which you could commit suicide. By purposely coming up with these associations, you’re training your brain to assign no meaning to them.

There are other treatment options as well. Mindfulness-based Cognitive Behavioral Therapy, also known as CBT, teaches people to identify, understand and change negative thinking patterns and behaviors. Patients are taught problem-solving skills during therapy lessons and then instructed to practice them on their own time in order to build positive habits.

Can medication help?

Medication can help alongside ERP, but it shouldn’t replace it. Doctors should always be consulted before considering medicinal options.

The main family of medicines used to treat OCD are known as Selective Serotonin Reuptake Inhibitors, or SSRIs. SSRIs enhance your natural serotonin activity and are used to treat major depressive disorders and anxiety conditions. Examples include Lexapro, Prozac, Paxil and Zoloft. 

What is the goal of therapy?

Some people with Suicidal OCD recover completely through ERP. But for many, their obsessions never fully go away. Recovery has more to do with managing the condition, than it does with eliminating it. However, that doesn’t mean you can’t lead a healthy, happy life. By prioritizing treatment and positive lifestyle habits, sufferers often gain confidence and freedom. Even if some anxiety is still present by the end of therapy, you’ll no longer feel debilitated by the condition. You can leave the house, hop on the subway, or have a sad day without worrying you will end your life.

If you suffer from OCD, you have a severe anxiety disorder. But it can be treated. Start by getting educated and making healthy living choices. Then find a clinical psychologist in your area who specializes in OCD and Exposure Response Prevention (ERP).