From Surviving to Living: Building a Life Worth Living
After the immediate crisis has passed and you've stabilized, the real work begins: building a life you actually want to live. This isn't about returning to how things were - that life led to a suicide attempt. This is about creating something different, something sustainable, something that makes you want to stay alive.
The Foundation: Why "Life Worth Living" Matters
DBT Concept of Life Worth Living
Dialectical Behavior Therapy teaches that recovery requires building a life worth living, not just removing suicidal thoughts.
Key principle:
- If your life feels meaningless, empty, or painful, suicidal thoughts will keep returning
- Treatment isn't just about managing symptoms - it's about changing your life
- You need reasons to live that are compelling enough to outweigh pain
What "life worth living" means:
- Not perfection or constant happiness
- A life aligned with your values
- A life with purpose and connection
- A life where good moments outweigh bad ones
- A life you choose, not just endure
Starting From Zero
After a suicide attempt, you may feel like you're starting over:
- Lost job or school progress
- Damaged relationships
- Lost sense of identity
- Don't know what you want anymore
- Everything feels different now
This is actually an opportunity: You get to intentionally build a life rather than sleepwalking through one that wasn't working.
Identifying Your Values
What Are Values?
Values are different from goals:
- Goals: Destinations ("Get a job," "Lose 20 pounds")
- Values: Directions ("Contributing meaningfully," "Taking care of my health")
Values guide your choices and give life meaning.
Common Value Areas
- Relationships: Connection, love, friendship, family
- Work/Education: Contribution, achievement, learning
- Personal Growth: Becoming who you want to be
- Health: Physical and mental wellbeing
- Creativity: Self-expression, making things
- Community: Being part of something larger
- Spirituality: Connection to something greater
- Recreation: Joy, play, enjoyment
- Nature: Connection to natural world
- Justice: Making the world better
Values Clarification Exercise
For each value area, ask yourself:
- How important is this to me? (1-10)
- How much am I currently living according to this value? (1-10)
- What's one small thing I could do to move toward this value?
Example:
- Value: Relationships/connection
- Importance: 9/10
- Currently living it: 2/10 (isolated since attempt)
- Small action: Text one friend this week
Focus on values where there's a big gap between importance and current living.
Setting Recovery Goals
Short-Term Goals (1-3 Months)
Focus on stabilization and foundation:
- Treatment consistency: Attend all therapy and psychiatry appointments
- Medication adherence: Take prescribed medications daily
- Basic self-care: Shower every other day, eat 2 meals daily, sleep schedule
- Safety skills: Use safety plan when suicidal thoughts arise
- One social connection: Regular contact with one supportive person
- One enjoyable activity weekly: Something small that brings pleasure
Medium-Term Goals (3-6 Months)
Building structure and engagement:
- Return to work/school: Full-time or part-time with accommodations
- Expand social circle: Reconnect with 2-3 friends, join support group
- Develop coping skills: Practice DBT skills, mindfulness, exercise
- Start hobby or interest: Something engaging and meaningful
- Improve living situation: If environment is toxic, work toward change
- Physical health: Establish exercise routine, address medical issues
Long-Term Goals (6-12+ Months)
Creating sustainable life:
- Values-based living: Life reflects what matters most to you
- Meaningful work: Career or volunteer work that feels purposeful
- Strong support system: Multiple sources of connection and support
- Identity beyond mental illness: See yourself as more than your diagnosis
- Resilience skills: Can weather hard times without returning to suicidality
- Helping others: Use your experience to support others
SMART Goals Framework
Make goals:
- Specific: "Exercise" → "Walk 15 minutes three times per week"
- Measurable: Can you track whether you did it?
- Achievable: Within your current capacity
- Relevant: Moves you toward values
- Time-bound: Has a deadline or timeframe
Rebuilding Daily Structure
Why Routine Matters
- Depression thrives in chaos and unstructured time
- Routine provides external scaffolding when internal motivation is low
- Regular schedule regulates sleep and mood
- Accomplishing small routine tasks builds self-efficacy
Building a Sustainable Routine
Start with non-negotiables:
- Morning: Wake same time daily, take meds, eat something
- Afternoon: One productive activity (work, appointment, errand)
- Evening: Connection with someone, self-care activity, meds
- Night: Sleep routine, bed same time
Add gradually:
- Week 1-2: Just basics
- Week 3-4: Add one enjoyable activity
- Week 5-6: Add exercise or social contact
- Week 7-8: Add creative or productive activity
Activity Scheduling
Balance three types of activities:
- Necessary: Work, treatment, self-care, responsibilities
- Pleasurable: Things you enjoy (even if small enjoyment)
- Meaningful: Things that matter to you, align with values
All work and no play = burnout. All pleasure and no productivity = lack of purpose. Find balance.
Returning to Work or School
Deciding When You're Ready
Consider returning when:
- Symptoms are stabilized (not perfect, but manageable)
- Medications are at therapeutic levels
- Can handle basic self-care consistently
- Have outpatient treatment established
- Feel capable of managing stress without crisis
May need more time if:
- Still having frequent suicidal thoughts
- Can't complete basic daily tasks
- Substance use isn't addressed
- Medication side effects are debilitating
Accommodations Under ADA
You may be entitled to reasonable accommodations:
- Flexible schedule: For therapy appointments
- Reduced hours initially: Part-time return
- Modified duties temporarily: Less stressful assignments
- Work from home options: If feasible
- Quiet workspace: If sensory issues are factor
- Mental health days: Without having to justify
How to request:
- Contact HR or employee relations
- Provide doctor's note (doesn't have to disclose diagnosis)
- Employer cannot ask about specific condition
- Reasonable accommodations are legally required
Starting a New Job
If previous job isn't viable:
- Consider what contributed to crisis (toxic environment, wrong fit)
- Look for positions aligned with values
- Prioritize mental health-friendly workplaces
- Start part-time if possible
- Don't have to disclose mental health history
School Reentry
Accommodations for students:
- Reduced course load
- Extensions on assignments
- Excused absences for treatment
- Note-taking assistance
- Testing accommodations (extra time, separate room)
- Medical withdrawal option (may get tuition back)
Contact disability services office with documentation from your provider.
Developing Hobbies and Interests
Why This Matters
- Gives you something to look forward to
- Provides sense of identity beyond mental illness
- Creates opportunities for flow states (being fully engaged)
- Can lead to social connections
- Builds competence and self-esteem
Rediscovering What You Enjoy
If you don't know what you like anymore:
- What did you enjoy as a child?
- What makes time pass quickly?
- What would you do if money and time weren't issues?
- What do you find yourself reading or watching about?
Low-Barrier Activities to Try
Creative:
- Adult coloring books
- Photography with phone camera
- Writing (journaling, poetry, blogging)
- Music (listening, playing, creating)
- Cooking or baking
Physical:
- Walking in nature
- Yoga or gentle stretching
- Dancing in your room
- Swimming
- Gardening
Intellectual:
- Reading (fiction for escape, nonfiction for learning)
- Podcasts on topics you're curious about
- Online courses (many free)
- Puzzles or brain games
- Learning new language
Social:
- Board game groups
- Book clubs
- Volunteer opportunities
- Classes or workshops
- Online communities around interests
Behavioral Activation
Depression says: "I don't enjoy anything, so why bother?"
Truth: You have to do activities before you feel like it. Motivation follows action, not the other way around.
Strategy:
- Pick activity based on what you used to enjoy or think you might enjoy
- Commit to trying it for 15 minutes
- Do it even if you don't feel like it
- Notice if you feel even slightly better after
- Repeat regularly, even when unmotivated
Over time, capacity for enjoyment returns.
Building Social Connections
Overcoming Isolation
After a suicide attempt, many people isolate due to:
- Shame about what happened
- Not knowing what to say
- Fear of burdening others
- Depression making socialization feel impossible
- Friends pulling away out of their own discomfort
But isolation increases suicide risk. Connection is protective.
Rebuilding Friendships
Starting with low-risk contacts:
- Text one friend: "Thinking of you, hope you're well"
- Respond to someone who reached out
- Comment on social media posts
- Accept an invitation to something low-key
- Ask someone to do specific activity with you
What to say if they ask how you are:
- "I've been going through a really hard time, but I'm getting help now"
- "I was in the hospital for a bit, but I'm doing better"
- "It's been rough, but I'm working on recovery"
- You don't owe details unless you want to share
Making New Friends
Where to meet people:
- Support groups (mental health, shared interests)
- Classes or workshops
- Volunteer organizations
- Meetup groups
- Religious or spiritual communities
- Sports or recreation leagues
- Online communities (can be stepping stone to in-person)
Quality over quantity: You don't need many friends. You need a few genuine connections.
Finding Meaning and Purpose
Beyond Just Not Being Suicidal
Recovery isn't complete when you stop wanting to die. It's complete when you start wanting to live.
Meaning can come from:
- Relationships: Deep connections with others
- Contribution: Making a difference through work, volunteer, activism
- Creation: Making art, building things, leaving something behind
- Growth: Becoming who you want to be
- Experience: Savoring beauty, joy, connection
- Spirituality: Connection to something greater than yourself
Post-Traumatic Growth
Many suicide attempt survivors report eventually experiencing growth:
- Deeper appreciation for life
- Stronger sense of personal strength
- Closer relationships
- Greater compassion for others
- New possibilities and priorities
- Spiritual or existential development
This doesn't mean the attempt was "worth it" or "good." It means humans can find meaning even in terrible experiences.
Using Your Experience to Help Others
Many survivors find profound meaning in peer support:
- Volunteer with suicide prevention organizations
- Become peer support specialist
- Share your story (when ready)
- Support others in online communities
- Advocate for mental health policy
But only when YOU'RE ready and stable. You can't pour from an empty cup.
Addressing Barriers to Recovery
Common Obstacles
Financial:
- Medical bills from hospitalization
- Lost income from time off
- Cost of ongoing treatment
- May qualify for Medicaid, financial assistance, payment plans
Environmental:
- Toxic home or work environment
- Unsafe neighborhood
- Lack of access to treatment
- May need to prioritize changing environment
Relationship:
- Abusive or unsupportive partner
- Toxic family dynamics
- Complete isolation
- May need to set boundaries or leave
Substance use:
- Using drugs or alcohol to cope
- Makes treatment less effective
- Increases impulsivity and risk
- Needs to be addressed for sustainable recovery
When Progress Stalls
If you've been trying but not improving:
- Reassess diagnosis (is it accurate?)
- Try different medication or therapy approach
- Increase intensity of treatment (IOP, PHP)
- Address co-occurring issues (trauma, substance use, medical problems)
- Consider residential treatment
- Get second opinion
Don't give up. Sometimes it takes trying multiple approaches to find what works.
Measuring Progress
What Recovery Looks Like
Not: Never having hard days or sad feelings
Is:
- Suicidal thoughts are less frequent and less intense
- You have skills to manage them when they arise
- You have reasons to live that matter to you
- You can experience joy, even if brief
- You're engaged in life rather than just surviving
- You have connections and support
- You can weather hard times without returning to crisis
Tracking Your Progress
Keep record of:
- Suicidal thought frequency and intensity
- Mood ratings
- Activities completed (self-care, social, meaningful)
- Coping skills used
- Small wins and accomplishments
On bad days, looking back at progress reminds you that you're not starting from zero.
Building Takes Time
You didn't get to the point of attempting suicide overnight. You won't build a life worth living overnight either.
This is long-term work. Some days will feel like you're moving backward. But if you keep taking small steps aligned with your values, gradually you'll build something worth staying for.
You survived for a reason. Now create a life that makes that survival feel worthwhile.