What can I do if I’m having thoughts about killing myself or others?

Dear Reader, 

There’s a difference between fantasizing about hurting yourself and others and carrying out those fantasies. These thoughts may be dangerous when they’re ego-syntonic, meaning they align with your beliefs and sense of self. However, if they don’t reflect your true intentions, there may be other reasons as to why they’re crossing your mind.  Speaking with a mental health professional about these intrusive thoughts and where they may come from can help lead to a proper diagnosis. 

To pinpoint where these ideas may be coming from, it may be helpful to reflect on the following questions: 

• Did these thoughts start recently? If so, when? 
• How often do you have them? 
• Are there particular people or situations that prompt these thoughts? Or are they random? 
• What emotions come with these thoughts? Do you feel angry, frustrated, disgusted, or vengeful towards a person or situation? 
• What do you do in response to these thoughts? 
• How do these thoughts affect your daily life and functioning? 
• Have you ever attempted to go through with these thoughts? If so, how? 

Answering these questions and, if you’re comfortable, sharing them with a mental health professional can help guide you to a treatment that’s tailored to your symptoms. One caveat to disclosing this information with a mental health professional is that some states have reporting requirements. Depending on where you are seeking care, health care professionals may be required to report cases in which they believe a patient may be a danger to themselves or others. For more information about this topic, you can check out the mental health professionals’ duty to warn or ask your mental health provider directly about their reporting guidelines. 

Based on what you’ve described experiencing, you might come across the term Harm Obsessive-Compulsive Disorder (OCD) in your exploration for an answer. Harm OCD is a type of OCD in which individuals experience aggressive, unwanted thoughts of harming themselves or others. Because these are intrusive thoughts, they’re often not reflective of an actual desire to carry out these actions. Instead, they stem from a fear that there’s some sub-conscious urge to actually want to perform such behaviors, like commit suicide or harm others. Those with harm OCD are often obsessed with proving to themselves or others that they’re capable of resisting these violent thoughts, driving them to engage in various compulsive behaviors. Examples of these compulsions can include actions or mental rituals, avoidant personalities, or reassurance seeking. 

If these thoughts become more frequent and long-lasting, or cause constant overwhelming fear or anxiety, it may be helpful to access emergency resources until you can connect with a mental health professional. These resources may include: 

• National Suicide Prevention Lifeline 
• Crisis Text Line 
• National Mental Health Hotline 
• The Jed Foundation 

All this to say, having thoughts about killing yourself and others can be scary, especially if you don’t want to be having them. Hopefully, this information helped to provide some clarity, and that you’re able to find help soon.