Cognitive Distortions

What are Cognitive Distortions?

And how can we try to reduce them?


“Nobody likes me.”

 “I just failed that exam. I am such a failure in life.”

“I can’t trust anyone; everyone is going to end up hurting me.”

Credit: Just Passing Time

Do these thoughts sound familiar to you?

They are all prime examples of cognitive distortions – thought patterns that can cause you to perceive yourself, others, and the world in inaccurate and negative ways!

Cognitive distortions are habitual errors in thinking and most of us experience them from time to time. Although we develop these cognitive distortions to help cope with adverse life events, these thoughts might not be rational nor healthy for us in the long-term, as they can increase the risk for anxiety, depression, and other relationship difficulties.

Understanding Cognitive Distortions: A Comprehensive Guide

The different types of cognitive distortions

There are at least 10 different types of cognitive distortions we experience. These include:

1. All-or-nothing thinking


“If I am not a total success, I am a failure.”

Also known as “polarised” or “black-and-white” thinking, all-or-nothing thinking occurs when we habitually think in extremes, viewing a situation in only two categories instead of on a continuum.

This kind of cognitive distortion is unrealistic and often unhelpful for us because most of the time, reality exists somewhere between the two extremes.

2. Catastrophizing

“I stuttered so much during the job interview, I must surely be rejected. I will never be able to get a job.”

Also called “fortune-telling”, catastrophizing involves assuming the worst when faced with uncertainties, predicting the future negatively without considering other, more likely outcomes. When we catastrophize, ordinary worries can quickly escalate.

While it is easy to dismiss catastrophizing as an over-reaction, people who have developed this cognitive distortion may have experienced repeated adverse life events, such as childhood trauma, so regularly that they have learnt to fear the worst in many situations as a coping strategy.

3. Disqualifying or discounting the positive

“I might have scored well on that exam, but that does not mean I am competent; I just got lucky.”

A negative bias in thinking, you unreasonably tell yourself that your positive experiences, achievements, or qualities do not count, explaining them away as a fluke or abnormality. When we do this often and believe that we have no control over our circumstances, this thinking can diminish our motivation and cultivate a sense of “learned helplessness”.

4. Emotional Reasoning

“I feel like a failure, therefore I must be a failure, otherwise why would I feel this way?”

Emotional reasoning is the false belief that your emotions are the truth, and they are an accurate depiction of reality, whilst ignoring or dismissing evidence that suggests the contrary. Although it is important to listen to, validate and express your emotions, it is equally crucial to judge reality based on factual evidence! This is a common cognitive distortion even amongst people without anxiety or depression.

5. Labeling

“Since she arrived late, she must be a lazy and irresponsible person.”

You put a fixed, global label on yourself or others without considering that the evidence might more reasonably lead to a less negative conclusion. This often happens when you judge and then define yourself or others based on an isolated event. The labels assigned are usually negative and extreme.

Assigning labels to others can impact how you interact with them. This, in turn, could create friction in your relationships. When you assign those labels to yourself, it can also hurt your self-esteem and confidence, leading you to feel insecure and anxious.

6. Magnification / Minimization

“Getting a mediocre evaluation just proves how inadequate I am.” -- Magnification

“Getting high marks doesn’t mean I’m smart.” -- Minimization

Have you heard the popular phrase, “Don’t make a mountain out of a molehill?” Well, there is a reason why many often do that! When you evaluate yourself, another person, or a situation, you might unreasonably magnify the negative and/or minimize the positive.

7. Mental Filter

Is the glass of water half full or half empty?

“Because I got one low rating on my evaluation [which also contained several high ratings], it means I’m not performing good enough.”

Mental filter is also known as selective abstraction when you dwell excessively on one negative detail instead of seeing the whole picture. Even if there are more positive aspects than negative in a situation or person, you focus on the negatives exclusively. Interpreting circumstances using a negative mental filter is not only inaccurate, but it can also worsen anxiety and depression symptoms. There is research that having a negative perspective of yourself and your future can cause feelings of hopelessness. These thoughts can become extreme enough to even trigger suicidal thoughts.

8. Mind Reading

“What a grim expression he has! I must have done something bad to offend him! This must be why he seemed so distant from me nowadays.”

Also known as “jumping to conclusions”, mind reading involves you believing that you know what others are thinking or feeling, while failing to consider other evidence or more likely possibilities. Then, you react to your assumption. This thinking error is often in response to a persistent thought or concern of yours.

9. Overgeneralization

“Because I felt so uncomfortable and awkward during the meeting, I don’t have what it takes to make friends. Oh no, I am destined to be alone!”

When we overgeneralize, we tend to make a negative conclusion about one event and then incorrectly apply that conclusion across other different situations in the future. Overgeneralisation is associated with Post-Traumatic Stress Disorder (PTSD) and other anxiety disorders.

10. Personalisation

“My parents are fighting again. It’s all my fault.”

One of the most common thinking errors is taking things personally when they are not connected to or caused by you at all. You might be engaging in personalisation when you blame yourself for negative circumstances that are not your fault or are beyond your control. Another instance is when you incorrectly believe you have been intentionally excluded or targeted, without considering more plausible explanations for others’ behaviours. This distortion is associated with heightened anxiety and depression.

11. “Should” and “Must” statements

“It’s unacceptable that I was late – I should always be on time.”

These imperatives are subjective ironclad rules you set for yourself and others without considering the specifics of a circumstance. You have a precise, fixed idea of how you or others should or must behave with no exceptions, and you overestimate how bad it is that these expectations are not met. Yet when circumstances change, and things do not happen the way you want them to – they really depend on many factors – you feel extremely disappointed, angry, or upset.

12. Tunnel Vision

“My life sucks. I have the worst life.”

Just like being in a dark, isolated tunnel, you only see the negative aspects of a situation when you have tunnel vision.

How to reduce cognitive distortions: A guide


Remember that it’s often not the events but your thoughts that upset you in many instances. You might not be able to change the events, but you can work on redirecting your thoughts!

What do you see these thinking errors as having in common? Does it strike you that a common thread among these distorted automatic thoughts is the failure to take in all known information and to explore realistic outcomes based on evidence? 

The good news is that cognitive distortions can be corrected over time. Here are some steps you can take if you want to change thought patterns that may not be helpful.

Steps to Identify and Challenge Distorted Thoughts

Ψ Identify the distorted thought: the first step to change

  • When you notice your self-talk is causing you anxiety or worsening your mood, you can practise mindfulness and recognise what kind of cognitive distortion is taking place.

Ψ Conduct a reality check

  • Ask yourself if your thoughts are really accurate and check if there is any existing evidence that supports or contradicts it.

Ψ Reframing the situation

  • Look for alternative explanations, objective evidence, and shades of grey to broaden your interpretations.

  • It might also be helpful to create a thought record by writing down your original thought, followed by three or four alternative explanations based on the evidence available to challenge the cognitive distortions.

  • Example: Instead of thinking “I have a miserable life since all my plans are ruined”, try reframing your thoughts to “It’s okay; it’s just a bad day, not a bad life. Plans change and I can adapt.”

Ψ Putting things in perspective

  • Even if your negative thoughts about yourself, others or the situation are accurate, ask yourself if it will still be important in the grand scheme of things, and whether it will matter a week or month from now. Chances are, they most likely won’t.

Ψ Perform a cost-benefit analysis of your thoughts

  • Behaviours are often reinforced and repeated when they are perceived to be beneficial in some way.

  • If you find yourself often engaging in cognitive distortions, you might find it helpful to analyse how your thinking patterns have helped you cope in the past. Do they invoke a sense of control in situations where you feel helpless? Or do they allow you to avoid taking responsibility or necessary risks?

  • You can also identify the potential costs are of engaging in cognitive distortions. Weighing the pros and cons of your distorted thinking might motivate you to replace them with more balanced, positive thoughts.

Ψ The role of Cognitive Behavioural Therapy (CBT)

  • What is CBT? CBT is an evidence-based psychotherapy where people learn to identify, challenge and change unhealthy thinking patterns. If you need additional guidance in identifying and altering cognitive distortions, then you may find CBT helpful.

  • CBT usually focuses on specific goals. It generally takes place for a predetermined number of sessions and may take a few weeks to a few months to see results.

  • You may consider looking for a therapist who is properly certified and trained in CBT, and ideally has experience addressing your type of thinking pattern or issue.

In summary, cognitive distortions are negative thinking patterns that impact how you see yourself and others. When our thoughts are distorted, our emotions are, too. By becoming aware and redirecting these negative thoughts, you can significantly improve your mood and quality of life.

Reach out to a mental health professional if you need additional help!

Self-forgiveness

We are human, after all


The Importance of Self-Forgiveness for Mental Well-Being

Have you ever felt guilty about something you have done in the past? You may have offended someone or hurt their feelings, made bad decisions that harmed others, or did something you knew was wrong.

Oftentimes, when we feel guilty, we may end up engaging in self-defeating behaviors, such as believing we are not worthy of love or trust, lowered self esteem or in some cases even develop affective disorders. Ruminating on feelings of guilt, anger and shame can have negative consequences on one’s mental and physical health.

Understanding why guilt and shame affect us

Feelings of guilt, anger, and shame can be very intense, which causes the nervous system to be on high alert, pumping high levels of adrenaline into our body. Sustained surges of adrenaline over an extend period of time can lead to psychological disorders such as anxiety or depression. It may also manifest in physical symptoms, such as panic attacks, chest pains, headaches, muscle tension, stomach or digestive problems.

In order to manage these negative feelings, self-forgiveness is crucial to maintaining our psychological and physical well being. But first…

What is self-forgiveness?

Self-forgiveness a positive attitudinal shift in feelings, actions and beliefs about self, following a self-perceived wrongdoing committed by the self.

However, forgiveness is not a straightforward or easy task, so what are some steps we could take?


Steps to Manage Negative Feelings Through Self-Forgiveness

Ψ Accepting Responsibility: The First Step to Self-Forgiveness


The first step is accepting responsibility. If you find yourself making excuses, rationalising or justifying your behaviour in order to make them seem more acceptable, it may be time to accept responsibility. This may include taking responsibility for the hurt you may have caused others, or actions you may have taken that you regret.

Accepting responsibility is not the same as forgetting or moving on as if nothing happened, neither is it the same as punishing yourself for your bad decisions and wallowing in shame. Accepting responsibility is about accepting what happened and showing compassion to yourself. Self-compassion means treating your self-worth as unconditional, that is giving yourself the love, care and concern you need whenever you’re going through a tough time.

It is important to understand that we are not perfect, and to be tolerant of our shortcomings because we are all human.

Ψ Understanding Guilt


Guilt is important and normal. Feeling bad about something bad we did is natural and can even helpful at times. For instance, guilt serves as motivation for us to do better next time. However, shame, which involves negative feelings about self such as feelings of worthlessness, is often associated with defensive strategies such as avoidance, denial or even physical violence. Shame may cause you to feel like you’re a bad person at the core, undermining your efforts to self-improvement or self-forgiveness. Shame-based thinking is a core belief that colors our world-view, and perpetuates self-defeating thoughts. One way we can break free from this negative pattern is by challenging your shame-based thoughts.

Some questions you can ask yourself are:

  • How do I know it’s true?

  • What proof do I have that supports this claim?

  • What experiences do I have that show that this belief is not completely true all the time?

  • Is this thought helpful or hurtful?

Guilt, on the other hand, may help us realise that our actions were bad, but that doesn’t make you a bad person. Therefore expressing remorse is an important step in making amends.




Ψ Restoring Trust: Actions to Move Past Guilt

One way to move past your guilt is by taking actions to restore the trust lost. This is not only important when it comes to forgiveness to others, but also to yourself. Making amends to the self is about taking concrete actions to right the wrong (whether it be to others or yourself). One way we could do that is by apologizing to the party we have hurt. For an apology to be sincere, it has to:

  1. Acknowledge the hurt caused

  2. Admit that your actions were wrong

  3. Explain why you regret it

  4. Describe what you would have done differently in the future so that it does not happen again


Navigating the Journey of Self-Forgiveness

It is important to be able to recognise when you should take responsibility, versus when things are beyond your control. We should be mindful to not over attribute blame on ourselves in situations we have no control of, especially in cases of abuse, trauma or loss. Lastly, if you find yourself struggling to forgive yourself, individual counseling may help.

Remember: Bad Actions Don’t Make You a Bad Person

it merely means that you made some bad choices.

Self-forgiveness does not have a one size fits all approach, and is different for everyone.

Self-forgiveness is not easy and we may slip up at times. And that’s okay, that’s normal. Try not to beat yourself up about it. Progress is not linear nor will everything go smoothly during the first try – so try again.  So have empathy for yourself, and work towards being a better person one step at a time!

Recognising Suicide Risk

Recognising Suicide Risk, Protecting Human Lives

What are the signs associated with suicide risk?

Suicide Rates in Singapore

In Singapore, suicide is among the leading cause of death among the younger population aged 10 to 29. In fact, there has been a rising trend of suicide, with the reported figure of 397 in 2018 being a 10% increase from 2017. This figure is 2.8 times higher than the number of transport accidents in the same year.

What are the warning signs of suicide?

As concerned family and friends, we must be attuned to some of the signs associated with increased suicide risk:

Ψ Health Conditions: 

People with chronic or terminal illnesses, as well as mental health conditions, may experience a sense of hopelessness about their life and future. Hence, those with physical and mental health conditions are at a higher risk of suicide. 

Ψ Situational Stressors: 

People who are going through difficult and stressful events, such as divorce, unemployment, imprisonment, or exposure to violence and death, are at a higher risk for suicide. These events may also place the individuals at a higher risk for developing psychological disorders that could affect their perception and further heighten their suicide risk.

On top of that, people with a history of substance abuse, physical or sexual abuse, social isolation, and past suicide attempts are also at a higher risk for suicide. 

Ψ Verbal Cues: 

Regardless of what you may think about suicide threats, never take them lightly. When someone you know says that they don’t want to live anymore, it should be taken as a warning sign. 

The following are other common verbal cues associated with clinical depression and suicidal ideation to look out for: 

  • Using more first-person pronouns (e.g., I, me, myself): This is reflective of someone who is focused inwardly, which is typically observed in people with high awareness and experience of psychological pain. 

  • Using more absolute terms (e.g., always, never): People who are clinically depressed tend to hold a black-and-white (or all-or-nothing) thinking pattern, suggesting impaired judgement and reasoning. 

  • Speech characterised by guilt and self-blame, isolation and loneliness, as well as feeling tired, trapped and being a burden: When someone is experiencing a lot of pain, each day may seem like a recurrence of the one before and they can find it increasingly difficult to get by as they are unable to break out of the negative loop. 

Ψ Behavioural Signs: 

Take note if you notice someone you know starting to withdraw from others, neglect their physical appearance or lose interest in activities that they used to find pleasure in. People who have thoughts of suicide also typically give away their treasured possessions, or make a conscious effort to visit their family members and close friends out of the blue. These are common signs of suicide preparations, such as having closure or saying goodbye to loved ones. Other forms of suicide preparations include writing a will, researching on suicide methods, or writing a suicide note. 

Understanding suicidal ideation and suicide attempts

Numerous studies have found that: 

  1. Most individuals who have suicidal ideation have mixed feelings about suicide; and 

  2. They may seek help before a suicide attempt. 

As such, we are able to intervene before a suicide attempt is made.

How Do I Help Someone Who Is Suicidal? 

Contrary to popular belief, talking about suicide will not increase suicidal thoughts, or put the thought of suicide in their heads. In fact, speaking about suicide helps individuals know that there are people who are concerned about them, and who would want to support and help. 

Granted, many of us are uncomfortable with the topic of suicide and we may not know how best to start a conversation about it. How then can you help someone who is suicidal?

Here are some helpful tips when talking about suicide: 

  • Invite the troubled individual to talk about their difficulties and listen without judgement. Withhold the urge to problem-solve or give quick solutions. Remember, they are not looking for advice.

  • Check on what the troubled individual have been doing to cope, and what resources they have available. 

  • Ask directly: “Are you having thoughts of suicide?” 

    • If they are, encourage them to seek immediate help. For example, they can contact the 24-hr suicide hotline provided by the Samaritans of Singapore (SOS). 

    • If they are not, do still encourage them to seek help from professionals, such as counsellors or psychologists. Offer your support by sourcing for suitable services together, or even accompanying them for their appointments. 

Singapore’s decision to decriminalise suicide attempt from 1 January 2020 was widely applauded as a move to support, rather than prosecute, people who are so overwhelmed by their difficulties that they attempt suicide. Indeed, when it comes to suicide prevention, much can be done to promote mental health awareness and encourage help-seeking. We can start by doing our part to support the people around us, and helping to protect the precious lives of those we love. 

Psychological Impacts of COVID-19 on the Elderly

The government announced on 10 March 2020 that it was suspending activities for seniors for 14 days, affecting some 290,000 participants. Current projections suggest that our fight against COVID-19 will be a long one, and suspensions like these form part of the measures necessary to slow and contain the spread of COVID-19.

Although necessary, suspending communal activities presents our seniors with unique challenges, especially to their mental health. While a 14-day suspension may not result in the mental health issues brought about by isolation or loneliness, without knowing when our fight against the virus ends, we must be able to talk frankly about the impacts of our measures on our seniors.

The immediate impact of a suspension of activities on seniors is the fear of isolation or loneliness. Isolation or loneliness is a subjective concept and immensely personal in nature; seniors may view the temporary suspension of communal activities or the occasional loneliness as a form of isolation, even though they may in fact continue to have access to their family and friends. No matter the reality, their subjective reality is enough to trigger the detrimental effects of isolation.

There is a strong link between isolation and morbidity.

Morbidity is a term used by mental and other health professionals to describe illness or disease. In fact, isolation is used as one of the risk factors in predicting the development of morbidity. The detrimental effects of isolation are even more pronounced in seniors, where the protective factors of employment, access to technology, and strong social support networks, do not generally exist. By contrast, seniors are often associated with risk factors such as frailty and neurodegenerative disorders, or the lack of strong social support networks.

Sustained isolation brings about increased levels of stress and emotional distress, which in turn puts physical and mental strains on the body. Specific examples of illnesses and diseases that are associated with isolation include depression, Alzheimer’s disease, heart disease, including high blood pressure, and a general decline in cognitive functioning. One longitudinal study in Singapore found that isolation was associated with a greater risk of death in Singapore and was more predictive of mortality than even living arrangements or social networks. With more than 41,000 seniors above the age of 65 living alone in Singapore in 2015, we must take care that we do not mitigate an immediate crisis by substituting it for a longer term one. The number of seniors above the age of 65 living alone is projected to increase to 83,000 by 2030.

However, our seniors do not merely face the feelings of isolation or loneliness. As much remains unknown about COVID-19, there is also a general anxiety among the population, including seniors, about its prognosis and mortality rates. In the face of escalating case numbers and fatalities amidst the widespread media coverage on COVID-19 especially among the vulnerable and the elderly, given that much remains unknown about the novel coronavirus, it is inevitable that fears of dying and death are stoked. And when combined with the effects of isolation or loneliness and being unable to externalise their anxieties, the anxieties and isolation become more pronounced.

To cope with their anxiety and low mood, our seniors may develop unhealthy coping behaviours such as excessive smoking or drinking, maintain a poor diet, or experience a decline in exercise or physical activity.

These behaviours are unhelpful and contribute to other long-term health issues, and they tend to persist even after the period of isolation is over. We must therefore continue to keep an eye out for our seniors, given especially that no one can accurately predict how COVID-19 will continue to impact us.

However, it is not easy to design alternative activities to allow our seniors to continue to feel engaged outside of their usual social settings. Seniors hold on very dearly to their sense of independence and freedom, to the extent that some seniors may choose to live by themselves or away from their families. These seniors tend to form strong external social networks, and the communities that they participate in become an integral part of their identity and serves as a powerful protective factor against the detrimental effects of isolation.

It is important to remember that many seniors take part in community activities as a way to cope with their unique set of circumstances in the first place. In recognition of the role that strong social networks play in combating depression and isolation, many of these activities were specifically designed to promote “gotong royong” or a sense of community.

It is commendable that extensive efforts have been made to extend these activities to all our seniors, given that strong social networks have been found to be effective in reducing symptoms of depression. Seniors who were engaged in social activities were associated with positive health outcomes were more likely to be happier, live longer, and experience fulfilment. Furthermore, social activity also slows cognitive and physical decline. Like muscles in our body, our cognitive functions gradually weaken if it is not put to regular use. Retirees who had more social interaction and engagement through some form of work involvement or volunteering reported better cognitive performance, fewer depressive symptoms and overall better mental health and life satisfaction compared to those who did not.Other studies have also found that socialisation was associated with a delay in memory loss, cognitive impairment and reduced the risk of dementia.

Returning to the impact of the suspension of activities for seniors, the potential loneliness or isolation experienced from the suspension of a single routine activity cannot be considered “in isolation”. A change in a single key activity is a significant deviation that might impact on all their other activities for the day. For example, seniors typically structure their entire day around these activities that take place at the same place or activity centre, involving the usual suspects (i.e. their friends). While some seniors might be able to adapt or find substitutes for their routine activities, there will be many who find it difficult to give up routines that were honed through years of practice. Without a routine activity to “anchor” their day, seniors may not be able to plan or follow through on activities for the rest of their day,even if those activities have nothing to do with the routine activity.

One strategy is to give our seniors a sense of purpose;

that they are very much an important tool in Singapore’s fight against COVID-19. Providing seniors with accessible and regular updates on our fight against COVID-19 and empowering each senior with an individual action plan are useful measures that can help mitigate their sense of loss from the suspension of activities. For example, seniors could be appointed as COVID-19 ambassadors responsible for disseminating information on COVID-19 to their social networks, and to check-in regularly with other seniors to address or escalate any health or other concerns to the authorities. These informal social network models tap on existing social media and chat platforms and are already effectively employed in our armed forces to boost camaraderie and reduce AWOL numbers. Seniors can continue to engage one another in small coffeeshop groups,alleviating some of the impact from the suspensions. This approach is preferable to the usual prescriptive approaches of encouraging seniors to “look on the bright side”, as emotional regulation is a finite resource that is scarce in the battle against COVID-19 without an end date in sight.

Seniors should also be encouraged to maintain the non-affected portions of their daily routine. The gap created by the suspension of activities should be positively reframed as an opportunity to try new activities or crafts such as baking, gardening, mah-jong, reading or other individual activities that the person has always wanted to try. There are plenty of options available if seniors can be persuaded to perceive the gap as a welcomed development.

There is also a role for family and friends to play. Seniors who were previously very independent and mobile may develop feelings of isolation or loneliness now that they are unable to engage in their usual social activities. They must recognise the enhanced impact that COVID-19 has on seniors, and wherever possible increase the number of engagements with their senior family members or friend. Engagement may take the form of phone or video calls, visits, or small-group activities to keep our seniors socially active. This form of social interaction will go a long way in assuring our seniors that they are still cared for, and they can reach out for emotional or other support during their time of need. This will help to prevent and reduce negative feelings and thoughts that might arise from loneliness or isolation.If the feelings of isolation or loneliness persist, it is advisable to seek help from a mental health professional.

Lastly, we should remind our seniors that it is normal to feel distressed or isolated during this period. We should also ostensibly acknowledge that our seniors are making an important sacrifice and contribution to Singapore’s fight against COVID-19. Their sacrifice, together with our front-line workers and healthcare professionals, will keep us and our loved ones safe.

Back to All Notes

After a (suicide) Attempt

After an Attempt

Surviving a Suicide Attempt

A suicide attempt is extremely traumatic.

Survivors feel disorientated, lost, not knowing where and how to go from here on. Others may feel intense waves of fear, sadness or anger. Some, after experiencing these waves, become seemingly emotionless. Numb. It is natural to have such feelings and thoughts.

Here is a list of steps to follow after a suicide attempt:

Inform

Call a loved one or trusted friend right away.

Our ability to actively care for ourselves are greatly affected by the circumstances that give rise to the attempt in the first place. Having survived the attempt, this ability is further compromised. Which means that you are going to need support. Reach out immediately.

After informing, go to the nearest hospital or medical clinic to seek medical attention. Even if the attempt does not result in you suffering from any physical injury however minor, you should still seek medical attention.

What to do at the Hospital or Clinic

Knowing what to expect greatly reduces the anxiety that comes with waiting in a busy medical facility.

Firstly, emergency staff are trained to assess and manage any injuries requiring immediate medical attention. This is known as triage. After treating these injuries, they will then arrange for a mental health professional to meet and have a chat with you about your mental health status. This may include questions on your mood, the presence of recent major stressors, and any concerns with your daily functioning. This is really just to assess your mental state and look for any further risks that you may be facing.

Occasionally, the hospital may require a detailed review by doctors with different specialisations. Depending whether such doctor(s) are on hand, you may be warded for further observation or admitted into a ward.

Reaching out to your Tribe (my what?)

We often do not realise how many members of our tribe (your family, friends, colleagues, peers - anyone who is a part of your larger network) actually do care about our safety and well-being. Even if you don’t ordinarily consider them to be part of your support network.

It’s common for people to worry over what to say to others after the attempt. You may want to start a conversation only after you feel comfortable enough to share about your experience, and even then, you can control how much you want to share. Confiding in a support group that you trust and feel connected to helps you process the experience and suicidal thoughts, or make these thoughts easier to manage if they return.

Going forward

You may find it helpful to write down thoughts and helpful tips to make your transition period easier (“journalling”, for example). These include things like knowing what you can do to make it easier to cope with things in the days following your discharge from the hospital, knowing who in your social support network you can reach out to, and most importantly, having a plan for dealing with suicidal thoughts should they come up again.

Things can change for the better if you allow it to.

Most importantly, seek support from a mental health or counselling professional if you feel suicidal. They will work together with you to create a safety plan or finding ways to cope. Things can change for the better if you allow it to.

Managing Anxiety, Stressors and Worries

We all experience anxiety, stressors and worries of one form or another.

Here are some helpful psychological strategies that have been tested and found to be effective for many.

A. Mindfulness – Observing non-judgmentally

When confronted with environmental stressors, our emotional reactions arise naturally. And we usually occlude the facts as they are. But that is rarely helpful.  

First, observe nonjudgmentally and take stock of what is actually happening around you. 

What are you thinking about?
Is it about the future, past or present?
Do you think it is affecting how you are feeling? 
What is going through our minds when we feel anxious, low or stressed? 

When we start to notice and be aware of our thoughts, we’ll be able to start identifying what might be contributing to our distress.

Doing this non-judgmentally means not reacting to our observations or thoughts (and/or the emotions attached to it) but rather simply letting the observations and resulting thoughts and emotions arise and being aware of its presence in our mind.

B. Mindfulness – Mindful Breathing. 

While mindfulness is a practice that helps us to not get swept away on a wave of our unhelpful or negative thoughts, people may find it difficult to observe their thoughts and emotions without reacting to them. 

Let’s try this simple exercise:  

  1. Breathe in and out.

  2. Maintain your usual breathing rhythms without being overly conscious about the preciseness of each breath. 

  3. Let your lungs expand and fill as you inhale, and contract as you exhale. 

  4. Bring your attention to each inhalation and exhalation through your nose.

  5. As you continue to watch your breath, remind yourself that each breath grounds you in the present moment. 

You are fully present in this moment of being. 

Now ask yourself, what is happening, and how are you feeling or thinking about that situation. 

C. Schedule “Worry” Time

First, identify all the tasks or items that are within your “sphere of influence”; essentially, matters that you can do something about. You may not always be able to control or determine the outcome, but you can take steps to influence or alter the outcome. 

Identify what needs to be done and complete those tasks. You’ll start to feel a whole lot better once you make a checklist and tick them off. Then tell yourself this: “there are always going to be things that are not within my influence (your “sphere of concern”)”. 

Here is how both spheres look like:   

 
 

I am going to allow myself to worry about it, for no more than 10 minutes. But after these 10 minutes, I shall leave my worries for my tomorrow self to grapple with” (or similar words… but you get the idea).

This tool has been found to be clinically effective in managing worries by freeing up your “head space” for important, relaxing or fun activities.

D. Challenge unhelpful thoughts. 

If you still feel a lingering worry after your scheduled worry time, you may want to directly address or challenge these persistent thoughts. Persistent thoughts might include: 

Catastrophising: “The world is going to end”, “I’ll definitely get the virus if I go out”, “My boss hates my presentation and I am going to get sacked” 

Filtering: Only focusing on the negative parts of the situation but not the positive aspects. During a pandemic for example, “being at home is like prison”, rather than “being at home is keeping me and everyone else safe”. 

Some ways to challenge such thoughts are to ask yourself: is that the only, and the whole truth? Are there other perspectives that I should consider? Am I constantly making reference to a state of perfection that does not exist? Am I worrying too much about how things should be instead of embracing and dealing with things as they are? This leads us to our next tip… 

E. Acceptance

Remember your sphere of concern? 

There will be many concerns that we cannot change or challenge successfully. These thoughts will usually keep us in a bubble of constant worry and anxiety instead of helping us deal with the situation. Issues within our sphere of concern that we might not be able to successful challenge include the social distancing and circuit breaker measures that will be with us for a period of time to limit the spread of the virus. But fretting about this situation will only result in more distress, anxiety or stress. Acceptance does not mean that you approve of or like the situation you find yourself in. What it means is that you have decided to embrace and acknowledge what is happening.

You have come to terms with the situation being what it is – no more, and no less – and you are no longer actively struggling or resisting the fact of its occurrence. 

 

F. Look after your Body

Yes, this means regular exercise, eating balanced meals, avoiding alcohol and drugs, and sleeping well.

 
 

There is a ton of research about the mind-body connection, it is not a myth!

How you feel emotionally and mentally can affect your physical health, and vice versa. The best demonstration of how your mental health and physical health are closely related is seen with burnout. When you’re pushed beyond your limits and putting too much stress on yourself, you experience burnout in forms of headaches, migraines, bowel issues and so on. 

At the same time, this also has implications on your motivation levels, your cognitive functioning, and may even make you easily irritated or emotional.