Editor’s note: This story discusses suicide and suicide prevention. If you or a loved one is struggling with thoughts of suicide, call the Suicide & Crisis Lifeline by dialing 988.
It always seemed like Regina Renaye Kinney, now 41, had it all as a smart, successful businesswoman. But for years, very few people knew that she was mired in the depths of a serious depression. “I would hide through my achievements and good grades and good jobs,” she recalls. “But I was really masking. On the inside, I was miserable.” The disconnect between her inner self and what she projected to the world felt unbearable—and drove her to multiple suicide attempts over the course of several decades. “I didn’t want to be dead,” she says in retrospect. “It was just this mountain of pain and anguish and all the situational stuff that happens in life. Why does it have to be this hard?”
Thankfully, Kinney survived her attempts. But tens of thousands of Americans aren’t as lucky. An estimated 49,000 people died by suicide in 2023 in the United States (the most recent year for which data is available), and 1.5 million people attempted it. And one particular type of suicide has been the toughest for experts to know how to prevent: unplanned suicides.
Unplanned suicide is exactly what it sounds like: a person suddenly deciding to end their life. It’s also surprisingly common. A 2021 study found that 44 percent of suicide attempts happen within 10 minutes of the person making the decision to end their life. “We’ve seen these stats for decades, but it’s almost like we don’t believe them,” says Ursula Whiteside, PhD, clinical faculty in the University of Washington’s Department of Psychiatry and Behavioral Sciences and founder and CEO of the suicide prevention organization Now Matters Now. Determined to better understand and help prevent unplanned suicides, she and her research team conducted a study on the emotional state of people who have attempted them. Their findings may not only save lives; they can help anyone in a mental health crisis.
The Dangers of Emotional Fires
For the study, Whiteside and her team first talked to survivors of unplanned suicide attempts to better understand their mental state in the moment of their attempt. They interviewed 26 patients in the Kaiser Permanente health system who had reported zero suicidal thoughts on a standard mental health questionnaire (the kind given as part of a checkup), then shortly after tried to take their lives. “We wanted to get at that question of ‘How are we missing them? How can we catch them?’” Whiteside says. “One person we spoke to was like, ‘I never thought about killing myself until a few hours before I attempted,’” says Ghazaleh Shokouhaghaei, MA, the COO of Now Matters Now, who helped design, conduct, and write up the study with Whiteside. “There was never a clear plan or clear intent.”
Instead, patients described dealing with worse-than-usual stress or emotional turmoil in the weeks and months leading up to their attempt. Then, one crisis—a triggering fight with Mom, for example, or a shitty interaction with a gaslighting doctor—pushed them over the edge. Whiteside and Shokouhaghaei dubbed this state an “emotional fire”: an intense, full-body panic. Much like what Kinney experienced, it was described by patients in the study as feeling extremely overwhelmed by their emotions and unable to think clearly or logically. Instead, they’d get flooded with intense, all-or-nothing thoughts, like Everyone’s better off without me or Nothing will ever get better; there’s no way out. The pain and panic can feel so intense that it’s unbearable. And without intervention, a person will fixate on finding a way to escape that feeling, Shokouhaghaei says.
For Kinney, one such moment happened a few months ago after a series of intense stressors: a pileup of microaggressions at work, the threat of eviction, and a stay at an inpatient psychiatric center. “I just felt trapped,” she says. “There were so many things happening on the outside that I had no control over.” During this episode, Kinney says her thoughts were “swirling like a tornado,” so overwhelming that she couldn’t string words together to articulate what was happening. “I felt like I had to scratch off my skin because I felt so trapped, and it took everything in my body to not bang my head against the wall,” she says. “It was really, really scary.”
“Some of the worst things in life happen when we’re on emotional fire and we’re trying to get through it or escape pain, panic, and hopelessness,” says Whiteside. Suicide is the most extreme example. But a person in this state may also engage in self-destructive behaviors (like drinking and driving) or make rash decisions that they’ll later regret (like abruptly quitting a job, ending a relationship, or blowing up at a friend and saying unforgivable things), says Shokouhaghaei.
“As a Black woman, I have to deal with sexism, racism, and misogynoir,” says Kinney, all of which have been linked to worse mental health. “Yet oftentimes in our community, having depression or sadness or anxiety is seen as a character flaw or moral deficiency,” she adds—which she says made it harder for her to be honest about her struggles or to get help.
How to Extinguish an Emotional Fire
These moments are dangerous, but Whiteside says you can survive them without being burned. She and her team developed a three-step process based on dialectical behavior therapy (DBT) techniques called “Stop, Drop, and Roll,” a nod to the fire safety protocol that they hope will help people remember what to do even when in a full panic. Everyone, not just people experiencing suicidal thoughts, can benefit from Stop, Drop, and Roll, Whiteside emphasizes. “People who need this skill are ones who are just so completely overwhelmed, or they’re so anxious they can’t even function or operate,” she says. “These are the steps to get through a crisis without the situation getting worse than it already is.”
1. STOP
Stop making any major decisions, and wait 24 to 48 hours until you’re out of crisis mode.
How it helps: The “emotional fire” state is not logical or rational, says Shokouhaghaei. Giving yourself a firm stop allows you time to come down and ensure that a decision isn’t based only on the intense emotions you’re currently feeling, she explains. Having a clear set of instructions (Don’t do anything major for the next day, no matter what!) also reassures a panicky brain looking for a way out, adds Whiteside.
2. DROP
Drop your body temperature by plunging your face in ice water and holding your breath for up to 30-second intervals or by taking a cold shower. Even drinking a big glass of cold water can help some people calm down, Whiteside says.
How it helps: This simple intervention is enormously effective at activating your parasympathetic nervous system, restoring calm to your body by lowering your heart rate and cortisol levels. Think of it as a software reboot for your nervous system, says Shokouhaghaei, to help make your emotions less intense (and take the dangerous edge off the moment). If cold is not your thing, or you’ve gotten to the point where you feel like you just don’t care anymore, Whiteside says going to sleep can help, too.
3. ROLL
Roll your eyes toward eye contact with someone and ask them to distract you.
How it helps: Eye contact is really powerful, Whiteside says. “It’s one of the strongest stimuli we have; it really grabs our attention.” In a crisis moment, it forces you to get out of your own head and connect with someone else. (Even FaceTiming with your long-distance bestie, getting on eye level with your dog, or looking at a picture of your grandma can help.) Then ask that person to distract you. “That’s one of the most useful things when you’re trying to just focus on getting through the next five or 10 minutes,” she says.
When the Smoke Has Cleared
“Stop, Drop, and Roll” isn’t a solution to one’s emotional problems. It’s a way to get someone safely to the other side of a crisis. “To understand what caused the emotional fire in the first place, and to build tools for long-term safety and healing, you need more support,” says Shokouhaghaei. That could mean booking an appointment ASAP with your therapist (or finally finding a therapist in the first place); joining a peer support group for depression, anxiety, or other issues you’re facing; or, if needed, checking into a hospital or in-patient clinic. (Not sure where to start? Now Matters Now offers free online support groups and a resource library with coping strategies and other important mental health skills. Whiteside also recommends the peer groups run by the Wildflower Alliance.)
“Peer support groups are super important to me,” Kinney adds. She first joined one during a previous hospitalization several years ago. “I’m seeing all these other people in different bodies, shapes, and sizes, and I can totally relate to them,” she says. “I just find so much comfort and safety in a group.” It helped her so much, in fact, that she started Mindful + Melanated, a mental health community and resource for Black women, in 2019.
Whiteside hopes to pilot a public health initiative at the state or county level to raise awareness of the “Stop, Drop, and Roll” framework. “These coping skills have been around forever, but packaging them in this specific way is different,” she says. “People just need to know what to do in those moments.” That starts with knowing that these moments can happen to anyone. “It’s okay to feel your feelings,” Kinney says. “That was something that took me years to understand.” And hopefully, with a new tool to extinguish emotional fires, more people will be able to get through their worst, most difficult, or most dire crises unscathed.
Jessie Van Amburg is a health journalist with over a decade of experience covering mental and reproductive health for some of the top media brands in the country, including SELF, Well+Good, Glamour, Women’s Health, TIME, and Wondermind. She lives in Beacon, NY with her husband and cats, and is passionate about ’90s television shows, climate justice community organizing, and the Real Housewives of Beverly Hills.