Coping Skills for Suicidal Thoughts

Coping skills for suicidal thoughts are specific, learnable strategies that help you survive moments of intense pain and reduce the grip those thoughts have over time. If you are in crisis right now, contact the 988 Suicide and Crisis Lifeline by calling or texting 988 (in the U.S.), or reach the Crisis Text Line by texting HOME to 741741. Research over the past two decades has produced a range of evidence-backed approaches, from structured safety plans and distress tolerance techniques to digital tools you can carry in your pocket. None of them require you to feel hopeful first; they work precisely because they give you something concrete to do when hope feels out of reach.

Safety Planning as a Starting Point

A safety plan is a short, written document you create (ideally with a clinician, but it can also be done on your own) that lists personal warning signs, internal coping strategies, people you can contact, and professional resources to call when suicidal thoughts escalate. It is not a contract or a promise not to act. It is a set of steps arranged in order from things you try first on your own to things that involve outside help, ending with emergency services as a final step.

The strongest evidence for safety planning comes from a study of more than 1,600 patients treated in emergency departments. Those who received a safety planning intervention plus follow-up phone contact were roughly half as likely to engage in suicidal behavior over the following six months compared with patients who received standard care, with about a 45 percent reduction in suicidal acts overall.¹ The plan itself takes only about 20 to 30 minutes to put together, and you can keep it on paper, in your phone, or both. Having it written down matters because during a crisis your ability to think through options narrows dramatically. You do not want to be generating ideas in the worst moment; you want to be reading them.

Distress Tolerance and Riding the Wave

Suicidal thoughts often peak during moments of overwhelming emotional pain that feel permanent but are not. Distress tolerance skills help you survive those peaks without acting on the urge. Many of these techniques come from dialectical behavior therapy, and you do not need to be in a full DBT program to use them. A randomized trial of brief DBT skills training in suicidal patients with borderline personality disorder found significantly greater reductions in suicidal and self-injurious behaviors over 32 weeks compared with a waitlist, along with improved anger management and emotion regulation.²

Research also suggests that how well you can tolerate distress is a meaningful factor in suicide risk on its own, cutting across different mental health conditions. One study found that distress tolerance partially mediated the link between emotional symptoms and suicide risk, meaning that lower tolerance was part of the pathway connecting emotional difficulty to suicidal behavior.³ The practical upside is that distress tolerance can be trained. Some strategies that people find effective in the moment include:

Temperature change: holding ice cubes, splashing cold water on your face, or stepping outside into cold air. The physical shock activates your body’s dive reflex and redirects attention away from emotional overwhelm.
Intense exercise: even a few minutes of running, jumping jacks, or push-ups can shift your physiology enough to take the edge off an acute surge.
Paced breathing: inhaling for four counts, holding for four, exhaling for six or eight. This slows your heart rate and activates the part of your nervous system responsible for calming down.
Sensory grounding: naming five things you see, four you can touch, three you hear, two you smell, one you taste. This anchors you in the present and interrupts the spiraling quality of suicidal thinking.

These are not meant to fix the underlying problem. They are meant to get you through the next ten minutes. That is their entire job, and it is enough.

Cognitive Strategies for Changing the Narrative

Suicidal thinking tends to be accompanied by a specific set of thought patterns: hopelessness about the future, a sense that problems are unsolvable, and the belief that you are a burden to others. Cognitive therapy targets these patterns directly. In a randomized controlled trial, participants who had recently attempted suicide received therapy focused on identifying the thoughts, images, and core beliefs that were active before their attempt, then learned adaptive ways to cope with stressors including hopelessness, poor problem-solving, impaired impulse control, and social isolation.⁴

You do not need to be in formal cognitive therapy to start noticing and questioning these thoughts. When you catch yourself thinking “things will never get better,” you can ask: Is this a fact, or is this how I feel right now? Have I felt this way before and found it changed? What would I say to a friend who told me this? These are not magic phrases, and they will not make the pain disappear. But they introduce a sliver of doubt into thoughts that present themselves as certainties, and that sliver is often enough to slow down the escalation.

Researchers have also highlighted cognitive flexibility as a promising target for suicide prevention, noting that the ability to shift between different ways of thinking and coping during a crisis may reduce the rigidity that characterizes suicidal states.⁵ In plain terms, when your thinking feels locked into one conclusion (“the only way out”), practicing any kind of alternative thinking widens your mental field of vision.

Hope Boxes and Personal Reminders

A hope box is a collection of items, images, and reminders that connect you to reasons for living. The original concept was a physical box containing photographs, letters, meaningful objects, and lists of things worth sticking around for. A digital version, the Virtual Hope Box smartphone app developed for veterans, was tested in a randomized controlled trial. Users reported significantly greater ability to cope with unpleasant emotions and thoughts compared with a control group at both three and twelve weeks.⁶

The app did not directly reduce suicidal ideation in that trial, but follow-up research revealed something interesting about how it works. A study examining the mechanism found that gains in coping self-efficacy among app users were associated with decreases in the severity of suicidal ideation over time.⁷ In other words, it was not that the box magically erased dark thoughts. It built your confidence that you could handle them, and that confidence gradually weakened the thoughts themselves. You can create your own version without the app: a folder on your phone with photos of people you love, screenshots of texts that made you laugh, a playlist that shifts your mood, or a note you wrote on a good day about why life matters to you.

Tackling the “I’m a Burden” Belief

One of the most painful and dangerous thoughts that accompanies suicidal ideation is the belief that the people around you would be better off without you. Researchers call this perceived burdensomeness, and it occupies a central role in several theories of why people move from thinking about suicide to acting on those thoughts.⁸ Reducing this belief appears to meaningfully reduce suicidal thinking. A study found that interventions tailored at decreasing perceived burdensomeness were significantly effective in reducing suicidal thoughts, and that treatment-driven reductions in burdensomeness mediated declines in suicidal ideation.⁹

Among veterans receiving treatment for post-traumatic stress, reductions in suicidal ideation were linked specifically to reductions in perceived burdensomeness rather than to changes in feelings of belonging or social connectedness.¹⁰ This is a useful finding because it suggests that directly challenging the burden narrative (not just increasing social contact, but specifically addressing the belief that you are a weight on others) is one of the most effective levers for lowering suicide risk. If you find yourself thinking “they’d be better off,” it is worth recognizing that this thought is a known feature of the suicidal state itself. It feels like insight, but it is a symptom.

Self-Compassion Practices

Harsh self-criticism and self-blame often intensify suicidal thinking. Self-compassion practices work against this by training you to respond to your own suffering with the same kindness you would offer someone else. A study of patients with chronic lung disease found that self-compassion training significantly reduced suicidal thoughts, with a large effect size.¹¹ While that study focused on a specific medical population, research in broader groups points in the same direction. An online loving-kindness meditation intervention among college students significantly improved self-compassion and reduced suicidal ideation compared with a control group.¹²

You do not need a formal meditation practice to apply self-compassion. When you notice self-attacking thoughts (“I’m pathetic for feeling this way,” “I can’t even handle normal life”), try replacing them with what you would say to a friend in the same position. Even silently saying “this is really hard, and it makes sense that I’m struggling” can create a small shift. The goal is not to feel better instantly. It is to stop making the pain worse by adding shame on top of it.

Sleep and Suicidal Thoughts

Poor sleep and suicidal ideation have a tighter relationship than most people realize. Insomnia does not just coexist with depression and anxiety; it independently worsens suicidal thinking. A systematic review and meta-analysis found that psychotherapeutic sleep interventions produced a small but significant reduction in suicidal ideation.¹³

A more specific trial looked at adding a sleep medication (zolpidem-CR) to antidepressant treatment in depressed outpatients with insomnia and suicidal ideation. The overall results were mixed, but one finding stood out: reductions in suicidal ideation were significantly linked to improvements in insomnia, and the benefit was greatest for patients with the most severe sleep problems.¹⁴ If you are experiencing suicidal thoughts and also sleeping badly, treating the sleep problem is not a detour from addressing the suicidal thoughts. It may be one of the most direct routes. Basic sleep hygiene (a consistent bedtime, no screens in the hour before sleep, keeping your room dark and cool) and cognitive behavioral therapy for insomnia are both worth pursuing.

Crisis Lines and Text-Based Support

Sometimes what you need is not a technique but a human being at the other end of the line. Crisis services have expanded well beyond phone calls. The Crisis Text Line, for example, connects you with a trained counselor via text message. An evaluation found that by the end of a text-based conversation, close to 90 percent of suicidal texters described the exchange as helpful, and roughly half reported feeling less suicidal.¹⁵

It is worth being honest about the limitations. A review of the broader crisis line evidence noted that research has primarily focused on short-term improvements in distress and user satisfaction, and that longer-term outcome data remains limited.¹⁶ Crisis lines are best understood as a bridge. They get you through the acute moment. What they are unlikely to do on their own is resolve the underlying drivers of suicidal thinking. Pairing crisis support with ongoing therapy or other coping strategies makes the most sense.

Reducing Access to Lethal Means

This is not a psychological technique, but it is one of the most effective actions you can take during a period of suicidal thinking: make it harder to act on the thoughts. This is sometimes called lethal means restriction, and it involves putting distance (literal, physical distance) between yourself and the methods you might use. Locking up firearms and giving the key to someone else, reducing the supply of medications in your home, or even choosing a different route so you do not pass a location you associate with suicidal planning. A systematic review identified lethal means restriction as a viable prevention strategy, noting that the approach depends on clear communication about risks between health-care providers and individuals at risk.¹⁷

Many people resist this step because it feels like an admission that they cannot trust themselves. Reframing helps: it is not about trusting yourself less; it is about recognizing that suicidal crises are time-limited and that small barriers buy time. A large proportion of suicide attempts are impulsive, occurring within minutes to an hour of the decision. Anything that adds even a few minutes of delay between the impulse and access to a lethal method saves lives.

Digital Tools and Apps

Smartphones have created new possibilities for coping in real time. Beyond the Virtual Hope Box described earlier, researchers are developing apps that use momentary assessments (brief check-ins throughout the day) to track mood fluctuations and deliver targeted coping suggestions when risk indicators rise. One such app, called Emma, was studied as a tool for ecological momentary assessment and personalized micro-interventions. Researchers described these fine-grained digital tools as promising for suicide prevention because they allow action at multiple levels through targeted, scalable, and contextualized support.¹⁸

The advantage of app-based tools is that they are available at 3 a.m. on a Saturday when your therapist is asleep and your friends are unavailable. The limitation is that most of these apps are still early in their evidence base, and none replace professional care for someone with serious or persistent suicidal ideation. Think of them as one layer in a broader strategy, not a standalone solution.

Peer Support and Shared Experience

There is something uniquely powerful about hearing from someone who has been where you are and survived. Peer-based interventions for suicide prevention have been explored in various formats, from group programs to one-on-one peer mentoring. A scoping review highlighted a group-based intervention for people experiencing first-time suicidal ideation that focused on problem-solving and emotional coping skills. The group was effective in promoting self-esteem and stress management while reducing suicidal ideation.¹⁹ Peer support works partly because it counters isolation and partly because it provides living proof that suicidal crises can be survived. If formal peer programs are unavailable to you, even a single honest conversation with someone who has experienced similar darkness can reduce the feeling that you are uniquely broken.

Cultural Context and Coping

Coping strategies are not one-size-fits-all, and culture shapes which approaches feel natural and effective. A study of African American female college students found that Africultural coping strategies, meaning culturally specific ways of managing stress rooted in African American cultural identity, emerged as a significant predictor of suicidal ideation and attempts, with cultural engagement acting as a buffer against suicidal behavior.²⁰ Spiritual practices, community connection, and culturally grounded identity work may all function as coping mechanisms that standard clinical models undercount. If mainstream therapeutic techniques feel disconnected from your experience, seeking out culturally responsive providers or community-based resources is a valid path and not a lesser one.

What Family and Friends Can Do

If someone you care about is having suicidal thoughts, your instinct to help is right, but the specifics matter. A structured suicide care education program for family caregivers produced lasting improvements in participants’ ability to seek assistance from professional resources and in their overall capacity to support suicidal relatives, with benefits persisting at 12 months.²¹ You do not need a formal training program to be helpful, but a few principles are consistent across the research. Ask directly about suicidal thoughts; asking does not plant the idea. Listen without rushing to fix. Help the person create or use their safety plan. Assist with practical steps like securing firearms or medications. Follow up after a crisis, because the days and weeks immediately after a hospitalization or acute episode carry elevated risk. And take care of yourself, because supporting a suicidal person is genuinely exhausting and you cannot sustain it if you burn out.