OCD Subtype:
Suicidal
Suicidal or Self-Harm OCD is a subtype involving unwanted thoughts about suicide followed by anxiety and fear that you might want to hurt yourself. These thoughts are intrusive and frightening. Individuals with Suicidal OCD fear harming themselves despite having no desire to die. Because these thoughts clash with your true intentions, they can feel shocking and disturbing. The mental images or urges can be vivid and intense, but self-harm obsessions are not the same as true intention to engage in self harm.
Sometimes the fear of killing yourself becomes so strong that you feel unsafe being alone, worried you might suddenly act on the images or thoughts in your mind. This can feel overwhelming, but it’s important to know that having these thoughts does not make you more likely to act on them than anyone else. Instead, they spark waves of fear and doubt, leaving you questioning your own safety. With this subtype, it is common to also experience other mental health related obsessions about “going crazy".
In an effort to feel secure, you might find yourself checking your emotions, avoiding triggers, or seeking constant reassurance. This cycle of obsession and compulsion can make the thoughts feel even louder and more convincing. This OCD subtype is easily confused with true self harm intention, and are often misdiagnosed. Understanding the distinction between OCD and true suicidality is crucial,, as the treatment recommendations are completely different. Suicidal OCD thoughts cause significant distress, fear, doubt, and discomfort—whereas true suicidal ideation involves a desire or intent to act on those thoughts.
Suicidal OCD can show up like:
What if I drove my car off this bridge?
I don’t feel depressed, but when my mood dips, I wonder if that’s the actual state of my mental health, and if the happiness I show the rest of the time is just an act.
Does having thoughts like these mean I actually want to die?
Maybe there is a part of me that is suicidal and I just don’t want to admit it.
What if I’m going crazy?
What if I drove my car into oncoming traffic?
Maybe I’m depressed and just missing the signs.
Maybe I want to take a handful of pills.
Common Suicidal Obsessions
Fear that you could suddenly lose control and harm yourself, despite not wanting to.
Experiencing unwanted, distressing thoughts about ending your life or harming yourself.
Obsessions can show up in the form of commands or statements like “jump” or “I want to end my life.”
Concern that having these thoughts means you actually want to harm yourself or prove that you’re a danger to yourself.
Having vivid mental images of self-harm or suicide that feel intrusive and unwanted.
Common Suicidal Compulsions
Avoiding anything sharp, high places, medications, or anything that could be used to cause harm.
Constant reassurance-seeking to confirm they don’t actually want to die.
Confessing thoughts to loved ones or therapists to “make sure they’re safe.”
Googling to see if this is “normal” and if other people have experienced this.
Internally monitoring your thoughts and feelings for any sign of the feared change.
Researching online or taking online quizzes to determine your level risk of self-harm or suicide.
Fear of Suicide Is Not Suicidal Intent
If you’re terrified by the idea that you might harm yourself, it doesn’t mean you want to die—it means OCD has latched onto your worst fear. These thoughts feel urgent, convincing, and unsafe, but they are symptoms of OCD, not signs of true intent.
The path forward isn’t about proving your safety over and over—it’s about learning how to stop buying into the fear. With the right treatment, you can quiet the doubts, separate OCD from who you really are, and trust yourself again.