Intrusive thoughts about dying

Death is a natural part of life, but for many of us, it’s an uncomfortable thought. There’s a lot of uncertainty around death (where do we go and, crucially, will we be reunited with our childhood pets?) and thinking about it can trigger worries about how much time we have left, or the circumstances and events that could lead to us dying.

Thinking about death isn't unusual - everyone wonders about their own mortality from time to time (who hasn’t been kept awake at night imagining the end?). However, if your thoughts become persistent and out of control, to the point that they’re disrupting your life, it might be time to dig deeper into why this is happening and look at how you can support yourself.

What are intrusive thoughts?

Intrusive thoughts are unwanted thoughts that pop into your head unexpectedly. They can be related to any number of things and the subject varies from person to person, but they’re often repetitive,with the same kind of thoughts cropping up again and again. Intrusive thoughts can be in the form of images, sounds or statements, and they can be seriously disturbing and distressing.

If you have intrusive thoughts about dying, you might:

●      Worry about what will happen when you die

●      Worry about how and when you will die

●      Worry about the deaths of your loved ones

●      Imagine yourself dying in specific scenarios, for instance a car accident

●      Imagine yourself dead

●      Imagine taking your own life

Is it normal to think about dying all the time?

Most of us think about death occasionally, but there are certain points in our lives when we might think about dying more often, like when someone we love is very unwell or if they pass away. These kinds of events can trigger thoughts about our own death, or fears about other people in our lives dying too.

However, repetitive thoughts about death can also be a sign of a mental health issue, like depression, anxiety or post traumatic stress disorder (PTSD). A lot of the time, thinking about dying doesn’t mean that you want to end your life, but, if these thoughts are accompanied by a wish to die, they could be suicidal ideation.

What is suicidal ideation?

Suicidal ideation is when someone has thoughts about taking their own life. These thoughts can be passive or active and there’s a big difference between the two.

Passive suicidal ideation:

Passive suicidal ideation is where you have thoughts about dying or ‘unaliving’ yourself, but you don’t intend to act on them. These thoughts might be fleeting or they might be a constant hum in the background.

Sometimes, passive suicidal thoughts can happen when we’re processing something sad, unsettling or difficult. This is because when our brains are faced with unpleasant emotions, they look for a way to avoid or escape them, and one way to do this is to stop living. It’s not the most helpful solution but it’s a normal response to a hard situation.

Just because you’re not going to act on thoughts of suicide, doesn’t mean that they’re not deeply upsetting or concerning. They can also be a sign that you’re struggling with a wider mental health issue.

Active suicidal ideation:

Active suicidal ideation is where you are having thoughts about ending your life and you intend to act on them. You will either be making a plan about how to carry this out, or already have one in place.

If you are planning to take your own life,  it’s important that you get immediate emergency help from a medical  professional by calling 111 or 999.

Why do I think about death or dying all the time?

●     Severe depression

Thoughts about dying or suicide can be a symptom of depression. Depression is a mood disorder that affects how you think, feel and behave. It can cause you to feel extremely sad, low, and hopeless, triggering thoughts like ‘I don’t want to be here anymore’ and ‘I just want this to be over’.

●     Grief

When we go through a significant loss, like the death of a loved one, it’s normal to experience grief. Grief is complex and personal to each of us; it can bring on many different emotional and physical symptoms, including thoughts about death and dying.

●     Intrusive or obsessive thoughts

If you have frequent thoughts about death and suicide, you might be experiencing intrusive thoughts. Intrusive thoughts can happen to anyone and almost everyone will have them at some point, but if they’re persistent, they can be a sign of a mental health disorder, like PTSD,anxiety disorders or obsessive compulsive disorder (OCD).

●      Death anxiety

Death anxiety, or than atophobia, is an extreme fear of death and the process of dying. This type of anxiety can centre around your own death or the death of a loved one. As with other phobias, you might go out of your way to avoid any mention of death, like films where people die, or avoid situations that you worry could lead to death, like driving or flying in an aeroplane.

●     Trauma

If you’ve experienced a traumatic event where your life or safety has been threatened, this can make you feel very aware of your mortality, and you might have thoughts about death and dying. Sometimes,trauma develops into PTSD, where you might relive your trauma through flashbacks or uncontrollable thoughts about the event.

Dan, a cognitive behavioural therapist at ieso says...

If you experiencing persistent thoughts about death, know that these thoughts, while distressing, are often a symptom of underlying anxiety, depression, or even past trauma. Cognitive Behavioural Therapy is an evidence based approach which helps to provide an understanding of these thoughts, challenge unhelpful patterns, and develop coping strategies to regain a sense of control and peace. Remember, you don't have to navigate these difficult feelings alone, and seeking support is a sign of strength.

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When to seek help

If your thoughts about dying are out ofcontrol and having a negative impact on your life, it might be time to make an appointment with your GP to have a mental health assessment. They’ll be able to advise you on ways that you can manage your symptoms and discuss treatment options.

If you’re in crisis and you need urgent support, call 999 or go to your nearest A&E. If you need someone to speak to now, you can call the Samaritans helpline for free, 24 hours a day, 365 days a year. The number is 116 123.

ieso offers online cognitive behavioural therapy (CBT) for a range of mental health issues. Our service is confidential and flexible with appointments that fit around you. Find out more.