Suicidal OCD involves preoccupation with repetitive, intrusive thoughts and/or urges involving killing oneself and fears of losing control and accidentally acting on these thoughts. It is normal to have an occasional thought of suicide. People without OCD can accept this and move past these thoughts. People who are suicidal embrace the thoughts of suicide and think about them voluntarily.
Suicidal OCD develops when an individual becomes consumed with obsessing over these thoughts and/or urges, begins to feel anxiety, distress, doubt, confusion, or another difficult emotion because of these obsessions, and may develop some compulsive behaviours (physical or mental) to find short-term relief from these difficult emotions. Unfortunately, the obsessive doubts (e.g., “Why am I having this thought”, or “What does this thought mean?”) cannot be argued or reasoned with and it is exhausting and endless to attempt to do so.
What are the OCD symptoms?
Obsessions: The obsessions in suicidal OCD revolve around thoughts of suicide. This can involve a fear of losing control and accidentally killing oneself, a fear of becoming sad or depressed, and feeling unsafe when alone. Some examples of the intrusive thoughts associated with suicidal OCD include: “I thought about stabbing myself when I picked up the kitchen knife. Does that mean I’m suicidal?”, “I had an urge to drive into oncoming traffic. What if I’m suicidal and I don’t know?”, and “What if I’m actually suicidal, lose focus, accidentally take too much of my medication and kill myself?”. The thoughts can take an infinite number of forms and are only limited by the brains capacity to imagine.
Compulsions: To manage the anxiety and distress associated with the uncertainty of their suicidality, people with OCD seek to reduce the amount of anxiety and distress caused by these thoughts by behaving in repetitive ways that provide short-term relief. They may find themselves attempting to keep themselves safe by seeking reassurance, and/or avoiding or hiding sharp objects.
Why does it occur?
Suicidal OCD can occur when the thoughts clash with an individual’s morals or values (e.g., that life is important and meaningful). This clash can cause anxiety and distress, and the individual may attempt to suppress the thoughts, causing a rebound effect where the thoughts come back more often and more intensely. Individuals with suicidal OCD may try to find relief from the anxiety and distress by performing certain compulsions. They may find themselves stuck in a cycle of obsessing, feeling anxious or distressed, and engaging in a compulsion to relieve the anxiety or distress for the short period until the obsession returns.