I woke up today but didn’t want to.

The temperature in my room was warm — oppressive. The thermostat hovered somewhere around 78 degrees F.

The volume in my house was already turned up. Between my 4-year-old son and my 10-year-old daughter there was a clamor of commotion — chaos. So much noise.

And I was tired. My mind felt exhausted. My body felt fatigued.

But the real reason I didn’t want to wake up was because, to some extent, I never want to wake up. I often hope and pray that I will just disappear. Why? Because I live with bipolar disorder, anxiety disorder, and post-traumatic stress disorder (PTSD) — and one symptom of my illnesses is chronic suicidal ideations; I regularly experience suicidal thoughts.

“Suicidal ideations (or suicidal thoughts) are when someone thinks about killing themselves — with or without a plan,” says Shairi Turner, MD, MPH, the chief health officer of Crisis Text Line, a global nonprofit offering free mental health services via SMS messaging. “Sometimes these thoughts are isolated (one and done) and other times they are reoccurring.”

They arise in times of stress or when facing mental, emotional, or physical challenges.

The American Psychological Association (APA) defines “suicidal ideation” as thoughts about death, dying, or a preoccupation with killing oneself. However, the APA notes in its definition that most instances of suicidal ideation do not progress to suicide attempts, and that is the case with me.

I am 39 years old. Despite living with mental health conditions for more than two decades, I have only made two attempts. That’s because I have found ways to cope. Thanks to treatment and a lot of support, I have found ways to manage these thoughts.

For me, suicidal ideations are, in most cases fleeting — passive. They are thoughts, but they lack passion or purpose. For me, there is no intent to act.

But I want others to know that coping with recurring suicidal thoughts is an ongoing challenge I have to work at every single day: to stay, to be present, to be, and to breathe. Suicidal thoughts and ideations can differ depending on the individual. But for me, they are a struggle because they tell me I shouldn’t be here. They tell me to run, give up, and give in.

‘There’s a Tape in My Brain That Plays on Repeat and Tells Me I’m Stupid’

Of course, it’s hard to explain what goes on in my head — and the degree to which my suicidal thoughts have affected me. There is a tape in my brain that plays on repeat and said tape tells me I’m stupid. I’m dumb. I’m worthless. No one loves me. No one cares. It tells me to stop fighting. Stop trying. And it constantly berates me and puts me down.

I want to escape and disappear.

But my ideations are more than idle words. There is more to them than negative self-talk. In those moments, I imagine what the world would be like without me. I fantasize about a place and space in which I do not exist. Sometimes I consider the ways I could end my life.

Everything hurts. I feel overwhelmed, swallowed by sadness, guilt, anger, and shame.

Suicidal thoughts are rarely the result of one trigger, problem, or cause. Dr. Turner explains: “In the moment, it can be a response to an overwhelming life situation, such as a feeling that a person cannot cope with a current or impending life crisis.”

Serious mental illness, childhood trauma, and genetics can contribute to someone having suicidal thoughts, as can relationship problems, financial problems, job loss, and death of a loved one, according to the National Institutes of Health. Exposure to other forms of violence or others’ suicidal behavior can increase risk of suicidal thoughts, too.

I can relate. I am a survivor of emotional and physical abuse. I am a sexual assault survivor, a title I’ve carried since an early age. I am living with multiple mental health disorders.

‘I Get Up for (and Because of) My Kids’

I attend therapy weekly and take medication daily. With these things, and a tangible safety plan, I’m getting by.

On the days it’s harder to silence those voices in my head, I get up for (and because of) my kids.

I run, far and frequently. Exercise helps me keep the demons at bay, and I remind myself pain is temporary — this too shall pass.

I check in with a network of family and friends. This holds me accountable. It keeps me out of my head.

Some days I stay in bed with the lights off and the covers raised. Sometimes hunkering down is the only way to hold out — and on.

And when the thoughts get really bad — when things get really dark — I know it’s time to enact said safety plan. Sometimes that means reaching out to my network of healthcare providers. Other times — like last summer — it means going to the ER.

Steps to Take if You or Someone You Know Is Having Suicidal Thoughts

“If you are feeling suicidal, the number one priority becomes keeping you safe and keeping you here,” says Elena Welsh, PhD, a licensed clinical psychologist in private practice Irvine, California. “If you aren't sure what to do and feel that you can't keep yourself safe, call 911 and let them know exactly that.”

If you find out someone you know is having suicidal thoughts, you can — and should — talk to them openly and honestly. The National Alliance on Mental Illness (NAMI) recommends asking questions like: “Do you have a plan for how you would kill yourself?” and “Can I help you call your psychiatrist?” It’s important to express support and concern, but avoid raising your voice or arguing, according to NAMI.

If you are safe in the moment but are thinking about harming or killing yourself, reach out for professional support as soon as possible, as these feelings could be related to a mental health condition (either one that’s already been diagnosed or hasn’t been) that could improve with treatment, Dr. Welsh says. Regardless of whether there’s an underlying mental health condition contributing to suicidal thoughts, a mental health professional can help make sure you get the support you need.

If you’ve had suicidal thoughts, you should also develop a safety plan, or a written list of coping strategies and sources of support for use in times of crisis or when one is feeling suicidal, according to the Suicide Prevention Resource Center [pdf]. Keep it brief, easy to read, and in your own words.

I turn to my friends when I am having a tough time. I reach out and say things like “I’m not doing so well” or “I’m not okay.”

I also see my therapist more frequently. When my suicidal thoughts are particularly intense, I attend sessions twice a week.

And I know where the nearest psychiatric care facility is, just in case. I have its hours written down, along with the phone number and address.

And I fight through the thoughts and through the pain. I am worth it. Life is worth it.

If you are actively in crisis and need immediate support, call 911. You can also call the National Suicide Prevention Lifeline at 988 or text 741-741 to reach a trainer counselor with Crisis Text Line.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health.