Life is just a bowl of cherries. I’m sure you’ve heard that one before. A nice thought, right?

But as all of us humans know, life isn’t quite that way. And living with a chronic condition is certainly no bowl of cherries. With some great days, some good days, some not-so-good days, and some bad days.

Sometimes those bad days can feel awful. So awful, in fact, that you may at times wonder how you can keep going. Or if you even want to keep going.

And that can lead to thoughts about the S-word. Suicide.

I sometimes hear that word from my clients. And I see it in posts from members here on this site. I have to admit that each time I hear or read a reference to suicide, I feel my heart beating a little bit faster.

Suicide is a scary word. Mental health professionals don’t like to use that word, either. So we often use the phrase “self-harm.”

Whatever you call it, the meaning is the same: doing something to bring about the end of your own life.

It’s been my experience that people consider suicide because they feel helpless and hopeless. The symptoms of their chronic condition may be overwhelming. Their treatment regimen may not be working as well as it needs to be. Their self-care routine may make them feel like they are stuck on a treadmill.

Clients who are contemplating suicide often talk about how the ways they have coped with these challenges in the past don’t seem to be working anymore. Or they are being faced with new challenges that they feel unprepared to cope with. In other words, they feel as if they have hit a wall. They describe overwhelming feelings of disappointment, frustration, anger, and fear that have built up over time. Along with being tired of struggling with it all.

I have to ask: How are things going for you?

If you are having thoughts of self-harm, I first want to reassure you that having those thoughts doesn’t mean that you are destined to follow through on them.

Things may feel really awful right now. But no matter what you are dealing with, no matter how you feel emotionally, physically or spiritually, there is help – and hope – for you.

Here’s what you can do:

Put it off. Suicidal thoughts often pass after a period of time. So if you are having these thoughts, tell yourself you will take a couple of days to get some perspective on your life, to consider your options, and to get some support. And also keep in mind that you can take actions that will help these feelings pass more quickly. You can get through this.

Check your meds. Some medications can have emotional side effects, which you may not have been aware of. For some medications, or combinations of medications, the emotional side effects can be profound. And here’s something else to think about: If your meds aren’t working as well as they need to, or if your compliance is off track, your condition may also be affecting your emotions. This is definitely worth a conversation with your physician – as soon as possible.

While you’re at it, have a talk about anything in your treatment plan that’s not working. Feeling helpless and hopeless can also be a sign that your approach to treating your condition, and taking care of yourself, may be due for an update. Some adjustments may be in order.

Stay hopeful. You are not alone in having thoughts about ending your life. Others have felt this way too. And they found their way out of the despair you may be feeling right now. Don’t give up hope.

Stay healthy. Watch what you eat. Avoid self-medication through alcohol and drugs. Get rest. When you aren’t at your best physically, you are that much more susceptible to feeling overwhelmed.

Remove the means to hurting yourself. If you have actually come to the point of thinking about how you might commit suicide, then remove the means of suicide from your environment. That might mean asking someone to holding on to any pills you might have stocked up on, or removing sharp instruments from your house.

Stay involved in your life. Even though you don’t feel like it. Do the things you normally do in your daily life. Like going to work, keeping your house clean, and staying active in your other normal activities. Don’t wait until you feel like it. Do it and let the feelings catch up. Schedule yourself. Ask people to hold you accountable.

Do things that make you happy. I know this sounds pretty hard right now. But think of the things you do that bring joy to your life. The simple things, like taking a walk, listening to music, watching favorite shows on TV. Do this to remind yourself that life can be good.

Get support. Spend time with friends and family members who can listen to how you’re feeling, do an activity with you, or even just sit and be quiet together. Keep supportive people around you.

Don’t judge yourself. Self-talk like “I shouldn’t be feeling this way” or “I must be a weak person” doesn’t help. In fact, that kind of self-talk can make you feel less able to cope. Negative thoughts can be automatic. When they pop into your mind, you don’t have to believe them. Instead, tell yourself “I am going through a rough time. But that doesn’t mean I’m weak” or “I’m struggling right now. It’s normal to feel pretty bad.”

Make plans for the future. Tonight, tomorrow, later this week, next month … If you can make plans with others, then that’s even better.

Remember: This is treatable. The stress of living with a chronic condition can be causing your thoughts about ending your life. But these thoughts can also be caused by undiagnosed mental illness. Either way, one of the bravest things you can do is to admit you can’t do it on your own and seek help.

So reach out. There is no better time than right now to connect with a mental health professional. If you have health insurance, you can call your provider and ask for a referral to therapists in your network. Some companies will assist you with a clinical emergency. You can go on their website. Or check with local community resources. You can also get in touch with your physician and ask to be referred for help.

But don’t wait. Sometimes it can take a few days, or longer, to get an appointment with a mental health professional. So also consider hotlines as well as local emergency resources.

Call a national helpline. Here are two national numbers to call: 1-800-273-TALK (8255) or 1-800-SUICIDE (784-2433). And you can find more resources, including international resources, on www.suicide.org.

Or get immediate help. Call 911 or report to your local emergency room. Let them know you are having thoughts of harming yourself. Personnel are trained to give you the help you need.

I know you are hurting. And you may also be feeling like there’s no way out. But you are not without options. Reach out for help. Don’t go through this alone!

More from Dr. Gary:
Keeping a Journal: The Joys and the Benefits
You and Your Relationships: A Positive Perspective on Negative People
When the Diagnosis Is Terminal. Eleven Steps Toward Coping … and Hope