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I'm so sorry that you are going through this. I am so glad that you are still here though.

It may help to make a list of reasons to live for times where you do have suicidal impulses. You can read it and remind yourself of all of the reasons you have to stay alive. It can even be small things, like being here to enjoy a nice sunset or a spring day. Of course, add big things too like your family and how they would feel, but make sure you have reasons to live that are yours as well, and for you.

There's something called the TIP skill that was taught to me for when you're in crisis, whether it's self harm or suicide. One thing it suggests is changing your body temperature quickly, such as through taking a really cold shower or ice pack. It gives your body a reset, plus physical sensations. It also suggest intense exercise, such as going for a run. If you aren't able to do that, even a walk is better than nothing. Paced breathing teaches us to take slow, deep breaths and breathe meaningfully. Sometimes when we're under a lot of stress or having extreme thoughts we either hyperventilate or hold our breath, so this is one way to bring yourself back. Another thing you can do is progressive muscle relaxation. The point of the TIP skill is that you are in a "skills breakdown point," where other alternatives or skills may not work. The TIP skill brings the distress level down so you can then focus on different alternatives or solutions.

Do you think it would help to reduce your means a little bit? I know it's hard when you need things like medications but maybe put them in a safe or somewhere where you'd have to go out of your way to get to them. That way, it's more deliberate and it gives you time to stop and think before you act.

This is a link to a crisis safety plan. It may be something to look into doing, either by yourself or with your psychotherapist. Basically it helps you because you write down warning signs that a crisis/distress may start to take place, and helps you think of things you can do or who you can talk to when things start to get rough.

Distraction can also help in the moment. Find activities that you can do that take up your time, even if it's just reading or video games. Maybe find somewhere to volunteer so you feel good about yourself. Think about a time where you weren't in distress and remind yourself that you can go back to this, that the distress won't last forever. Allow yourself to feel different emotions. It doesn't have to mean that you listen to a sad song or watch a sad movie. It can even be watching a comedy, or even a horror movie if that's something you're into and if it wouldn't be more triggering in the moment. Push the thought to the side for a while. You can also do something like count to ten, one hundred, etc, count the number of a certain thing in the room (ie how many green things can you see?), or list 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. Play with different sensations.

Also find ways to self-soothe in the moment, even if it's just curling up with your softest blanket and a cup of hot cocoa or tea.

Things are so tough right now, but I know you can get through the distress and come out better for it. Make sure you are honest with your psychotherapist and the person who prescribes your medication. I know it's scary to do this, but your safety is of the utmost importance. You can even write it in the form of a letter of that is more helpful to you.

You've got this!