Assessing Your Thoughts
Monitor suicide risk. If you are having obsessive thoughts about death and are thinking of taking your life, reach out for help. If your thoughts of death coincide with feeling hopeless, wanting to die, thinking about ways to kill yourself, feeling like a burden to others, social isolation, or extreme mood swings, get help now. Reach out to a friend or family member, or if you’re in a crisis situation, call the ED or a suicide hotline. You can Call Emergency Services or check yourself into the Emergency Department at your local hospital. If you are in crisis, call or text the Suicide and Crisis Lifeline within the USA at 988. You can live chat online at http://www.988lifeline.org/, available 24 hours each day, 7 days each week.
Ask yourself how your thoughts make you feel. While it’s healthy to have thoughts about your mortality, ask yourself how this makes you feel. Do the thoughts make you panicky, anxious, or depressed? Do they make you feel uncomfortable? If the thoughts keep you up at night or bring you distress throughout the day, they may be maladaptive. When thoughts of death come to your awareness, does your body react? Does your heart race or do you feel cold, nauseous, or sick? These may be signals of anxiety.
Monitor how your thoughts influence behavior. Obsessive thoughts might lead to mental health issues like depression, anxiety, OCD, sleep deprivation, and maladaptive self-soothing. If your thoughts of death cause you to follow up the thought with a behavior in order to alleviate the discomfort, consider talking to a licensed mental health therapist. They'll help you explore the foundation for these pervasive thoughts and learn coping skills that may help. These self-soothing behaviors might include things like reciting prayers or religious rituals triggered by fear, excessively double (or triple) checking things like locking the doors or turning off the stove, counting, tapping, or repeating words to relieve anxiety, or collecting things and not throwing things away “just in case”.
Reflect on any recent events. Sometimes, after a death or tragedy thoughts of death may become more prevalent. Ask yourself if your thoughts are a response to the death of someone you knew or a result of a tragedy, such as a natural disaster. If so, reflect on what meaning this has to you: do you fear that a similar situation may happen to you or to your family? Do you feel angry? Hurt? Outraged? Get in touch with the emotions these thoughts are triggering. You may uncover a deep-rooted fear you may not have acknowledged, or relate back to a trauma that may be unresolved. It’s normal to feel anxious, depressed, sad, numb, or to experience lower functioning after a traumatic event. However, when the thoughts become excessive, it’s time to seek help.
Coping with Obsessive Thoughts
Refocus your attention. If your intrusive thoughts about death interrupt your normal functioning, try refocusing your mind. Do something you enjoy for 15 minutes or more, such as taking a walk, listening to music, reading, or playing a game. Find a redirection that helps you refocus your attention away from thoughts of death. Engaging in something you enjoy can help take your mind and body away from thoughts of death or any compulsions that accompany the thoughts. If you find that you feel anxious after you read the news or scroll through social media, set limits on how often you allow yourself to do those things. Try using a mindfulness practice to help yourself process these thoughts. For instance, when you find yourself thinking about death, sit with the feeling without judgment. Acknowledge it, then ask yourself questions like, "Is this just something I'm worried about, or is it a real problem? What tools do I have to deal with this?"
Revalue the thoughts. Don’t accept the thought at face value; recognize it as intrusive and as not having any inherent value or meaning. Say to yourself, “This is just my brain, and I do not need to pay attention to this thought.” By not allowing the thought to evoke a reaction, you limit the power the thought has on you. While it’s difficult to control your thoughts, you can control your reactions and responses.
Focus on what is within your control. If you fear death, you can become overwhelmed with thoughts of the fear surrounding death. Keep in mind that you cannot control every outcome, especially death, but you can put your focus more onto things that are within your control, such as prevention. Even if you find yourself feeling out of control with ongoing diseases, focus on ways to cope with long-term symptoms, like diabetes or chronic illnesses. If your family has a history of heart disease or cancer, it doesn’t mean that you will die of this disease. Instead of worrying about your outcome, focus on prevention. Live a healthy lifestyle, engage socially, eat nutritious foods, exercise, and put your attention on the things that are within your control and that decrease your overall stress.
Accept your mortality. You may be in perfect health or have a health condition that limits your life. Either way, you know that sooner or later the time will come for you to die. While death is never a comfortable topic to discuss, talk about it with people who care about you. If you know your time is coming, make arrangements with your friends and family to help alleviate any stress. Don’t be afraid to bring the topic of death up, as it can bring relief to acknowledge the inevitable and discuss it with those close to you. Reflect on your relationships and ask yourself if there’s anything you can do to bring peace to those in your life. Set things straight so that you relieve yourself of guilt and can feel complete in your life. Even if you are in strong health, it’s okay to accept your mortality and make plans for the future, for your family and your friends, such as a will or custody form. It can give you some relief knowing that a plan is in order. Also, living your life in such a way that values every person and every moment can be rewarding and enjoyable.
Make meaning of death. For some, the reality of death can help bring meaning to life by helping them consider the legacy they want to leave and the impact they want to make. It helps bring forth the reality that life is finite and not to be taken for granted. While many people associate thoughts of death with fear, sadness, or guilt, find ways to approach death with comfort—it's a natural part of life. Exploring other cultures that celebrate end of life as opposed to fear or hide it may also be helpful. Think about the things you want to accomplish or experience in your lifetime. When realizing your reality is finite, ask yourself, “What’s the wait in going after these things? Why not do them now?” You may find new ways to enjoy each moment.
Getting Help
Check yourself into the Emergency Department. If you feel like you may be an immediate threat to yourself or to other people, check yourself into the Emergency Department at your local hospital. Therapists and social workers are trained to provide crisis care and help you de-escalate your thoughts and feelings in the moment, and help you cope with similar feelings in the future. The medical team may recommend further treatment, such as going to residential care or obtaining therapy.
See a therapist. If you’re having difficulty managing the thoughts on your own or are employing maladaptive coping skills, make an appointment with a licensed mental health therapist. A therapist can help you work through your obsessive thoughts and respond to them differently. If you tend to focus on catastrophic events or exaggerated feelings of responsibility, therapy can help you respond to these thoughts in a healthy and effective way without resorting to compulsive behavior. If there are specific situations that you think about or places you avoid, therapy can help you with exposure and response to these situations, such as avoiding riding in cars or trains for fear of death.
Join a support group. A support group can help you join with other people who have similar obsessive thoughts or fears. A support group can offer encouragement, support, and friendship and can help with feelings of isolation. Ask your medical doctor or therapist if there are any local support groups that deal with obsessive thoughts.
Stay connected. Having obsessive thoughts can make you feel isolated and alone, like nobody understands. Have a solid support system of family and friends to help combat feelings of isolation and vulnerability. Allow a friend or family member to encourage you to combat obsessive thoughts or follow through with treatment. If you feel socially isolated, make new friends. Volunteering is a great way to help your community and meet new people that share similar interests as you. Volunteer at your local animal shelter or animal sanctuary, or with children or the elderly.
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