How to Find Help When you Feel Like Unaliving
What to do, where to look, and who to talk to if you are having a crisis.
First things first: you are loved. You matter. Your existence brings joy to others. I'm proud of you for reading this and trying to find help.
An intrusive thought is an unwanted, usually random, sometimes uncomfortable thought. Something that pops into your head out of nowhere. They can be violent, sexual, self depreciating, remind you of trauma, be about you or a loved one getting sick or hurt, paranoid thoughts, public embarrassment, religion related, about death, and suicidal or self harm. All of this is completely normal. Everyone has intrusive thoughts. Just because you are having intrusive thoughts, doesn't mean you are going to act on them. They may even be the opposite of how you are feeling. You are not your intrusive thoughts.
Recognizing and naming intrusive thoughts really helps if they are bothering you. Bad thought pops into your head, go: 'that's an intrusive thought.' Sometimes I call mine Karen. That's basically what they are. Little uncontrollable nagging annoyances. Though, sometimes you need to treat them like a toddler. Depends on if you feel like you need self care in that situation, or if saying 'Okay Boomer' to Karen is going to work better.
Intrusive thoughts become a problem when you get stuck on them, or they are negatively affecting your life. If they are causing you anxiety, making you feel bad, or generally just being annoying, talk to a doctor or therapist.
This is when you are having thoughts about not wanting to be alive or hurting yourself. You may also be ruminating on these sorts of thoughts. At this point you need to get therapy and consider other coping methods, like medication. You don't necessarily need to check into a mental health hospital, unless you feel like you need to. For people with depression, anxiety, PTSD, etc, this isn't abnormal. Again, at this point you need to talk to a professional.
Therapists, Psychiatrists, and Phycologists
Yep, all those are different people.
Therapists are licensed professionals trained to treat mental health conditions by communicating with a patient. Therapists can give diagnoses, but don't usually prescribe medication. Therapy is ongoing and continuous care. Again, you do not have to be having a crisis to go to therapy. You can see a therapist for any reason. If something is bothering you, it's not stupid or insignificant.
Most of what you do in therapy is just talk. It's that easy. Your therapist listens. They may ask questions, give you reassurance, or offer insight to your situation. You can also set boundaries with your therapist. I had one that asked me to look in their eyes so they knew they were serious about something. I asked them not to do that cuz I do not like eye contact. They apologized and never did it again.
A psychologist specializes in diagnosing and treating mental health conditions. They can prescribe medication. Some can also act as a therapist. Mine doesn't. It depends on the person, and where they work. There may be some health conditions they don't diagnose, like autism. They have fancier degrees than a therapist.
A psychologist specializes in the study of the mind and behavior. I would say they are a bit more on the science side of things. This is who you go to if you are trying to get a behavioral or developmental disorder diagnos, such as autism or ADHD. They have even fancier degrees than psychiatrists.
A quick note on diagnosis as an adult: it's ridiculously difficult to get an ADHD, autism, etc diagnosis as an adult, especially if you are in a minority group. There are also not that many resources out there for adults with those conditions. Having one may also be departmental to your life. Like losing social security if you get married when you are disabled. Plus. Discrimination. Whether you get one is up to you.
What if you don't like your therapist/psychiatrist/psychologist? Tell them it isn't working out and see someone else. No one will be mad at you. Set your boundaries and advocate for yourself.
In the US, insurance is messy. It's about to get messier, thanks to recent events. If you are low income, there are multiple Medicaid or Obamacare (Marketplace) plans. Find an insurance broker. They make money off commissions from selling certain insurance plans, so some of them don't charge their clients. They represent you, the client. They can help you find a policy you can afford that fits your needs. If you know you are going to need therapy, they can help you find a plan that mostly or completely covers psychiatric needs. They can also find you a plan that works with the medical professionals you are already seeing. I'm currently on Medicaid, and my therapy is completely covered. If you don't like your insurance broker, find a new one.
Unfortunately, you do need to watch out for scammers. I have had someone try to weasel out from taking my insurance. This is another reason brokers are great. They can help you figure out when something is fishy. They will advocate for you if the insurance company messes something up.
There is some wiggle room with payment when it comes to therapists. Right now, if you make below a certain amount of income, you can be on Medicaid for free. That might change in the next, oh I don't know, four years (post created in 2024.) There are low income programs that can work with you. There are also therapists or graduate students who are willing to let you pay what you can. I was able to work with a graduate student once and she only charged me $10 a session. (Loved her.) If you are in college, your campus may have free therapists or counseling services. There are also people willing to do therapy over Zoom. Betterhelp can connect you to them, though there has been some controversy with that company. You don't need to use them to find people who will do video call therapy. I've had a couple who work with me to do either in person or telehealth care.
Getting therapy is about what you need.
If you are forming a plan, and especially if you are gathering things to act on it, you need immediate help. Treat this like an emergency.
Learning how to prevent yourself from that last stage is one of the most important things you can do. This is why Therapy is so important. You do not need to be having a crisis to go to therapy. They are there to help you no matter where you are in life. Suffering is not a contest. If you are suffering at all, talk to a therapist. Therapy will teach you healthy coping skills, self awareness, and what to look out for so you know when things are getting bad.
Suicide hotlines are there for a reason. You can Google these. There are ones that are specific for LGBTQIA+, Military Veterans, survivors of specific trauma, and many others. In the US, you can call or text 988, and you will be connected to a licensed professional. To reiterate: you do not have to be in the worst case scenario to need to talk to someone. It's called the suicide prevention and crisis hotline. I've used one once and it was because I was spiraling the day after I got my dog, because holy shite I just made a life altering decision. If you feel like you might need to call/text them, you need to call and text them.
In the US, finding facilities and care in your insurance network is necessary for your mental health needs. Most insurance plans will have a way to search for in network mental health places and practitioners through a search engine online. Some places have what insurance they accept on their website. If all else fails, you can call the place and ask. No one is going to be offended if you do. If they are, find a different facility. Do this before things get dire.
This is the hard one: Medications. It was the scariest one for me to try. I thought they would shut off my creativity or make me behave differently. They don't. It does take a lot of time and some possibly bad side effects to find the ones that work for you. If you can have someone watching over you while this is happening, that is ideal. Medications can make suicidal thoughts worse. It's worth it when you find what works. Seriously, my anxiety off meds sits at a baseline of a 7.5.or 8 out of 10. On meds it's like, 1.5 or 2.
Make an anti-suicide plan. A plan you enact when you start to have suicidal ideation. Make it clear, give it exact steps, and tell people you love about it. Each step should be implemented as things start to get worse and worse.
Distract myself with something I like or take a nap. Or talk to a friend. Self affirmations.
Take an as needed anti-anxiety med. Tell friends or family (especially important cuz that med makes me hibernate)
Bathtub time, and/or dog time. Laying in a cold ceramic tub is physically distracting enough that it makes me focus on that. My service dog, Tarot, does the same thing with sensory grounding. What I need depends on the day. (This is usually the worst it gets.)
Contact a Prevention Helpline.
Check myself into an emergency room or psychiatric inpatient facility.
Anti-suicide plans can change. You may need to skip some steps. They should also be custom tailored for you.
If you are actively seeking a way to end your life or the lives of others, it is an emergency. Treat it as such. This is what to do to keep yourself safe:
Voluntarily Check Into a Psychiatric Inpatient Facility, or go to Emergency Room. Yes, you can go to the ER if you are suicidal. Again, this is an emergency. Treat it like one.
There are two types of check in at mental health facilities. Involuntary Admittance is when someone else checks you in, possibly without your consent. The police do this, but so can your loved ones, or, if you are underage, your parents. or guardians. Voluntary Admission is when you check yourself into a mental health facility. I've not had to do this personally. I do know you have to be evaluated, and a treatment plan will be made. Staying there will involve seeing a psychiatrist and attending therapy sessions.
You will not be forced to stay if you are not a danger to yourself or others. Yes, you will be allowed to leave.
Here are some things to expect: you can't have anything that could be used to hurt yourself or others. No shoelaces, no phone cords, no metal, etc. Different places have different policies. You may be asked to surrender your phone. It's very unlikely you are going to be strapped to a table. For people with service animals, it is possible to be at a facility with your dog, depending on the facility, and your dog's training.
I'm at the end of my knowledge on that
Find the people who will support you. Both close friends, and support groups. There are also resources out there to help you understand what you are going through. Cinema Therapy is a great channel for understanding your own mental health. They use movies to talk about things like loneliness, mid-life crisis, and stalking. You can also find channels like I have Autism. Now What? They talk about topics related to autism. I've learned a lot about myself watching her. Other stuff is out there. It's not a replacement for therapy, but it is helpful.
Remember, once again, that the universe is happier with you in it.
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