Table 3.
Most significant flashforward image reported by bipolar group when at their most suicidal, alongside the appraisal of image and response to image
| Participant no. and diagnosis | Content of image | Appraisal of image | Response to image |
|---|---|---|---|
| 1. BP-I | Visualized harming myself with a razor | Makes me feel I'm going to die | Want to curl up in a ball and hibernate |
| 2. BP-II | I imagined hanging myself from a tree on the path I regularly take to the shops | Hope that it will end mine and my family's pain | Made me want to get on with it [suicide] |
| 3. BP-I | Image of rolling up sleeve and taking a knife or broken glass to cut wrists vertically, as there is greater chance of success | Things would be over, it would be something I could do to get release | When images were frequent would get tattoos: the pain of needles was a distraction |
| 4. BP-I | Thinking of picking up a gun and blowing my brains out | Total escape. The easiest way to die. A way of being in control when you're out of control | Made me want to get a gun |
| 5. BP-I | Taking an overdose | An end to all the rubbish. Going from turmoil to peace | Take tablets to find calm |
| 6. Cyclothymia | My family identifying my body, which has gun-shot wounds. My face is ashen-coloured | Images of family were reasons not to do it, therefore, they were unwelcome. Meant there was something to stick around for | Made me not want to do it, not use the gun, not pull the trigger |
| 7. BP-II | Sticking a gun to my head and finding the right place of my brain to hit so the first shot would kill me | I'm going to get out of this—a solution | Want to do it |
| 8. BP-I | Imagining pills all together, how to get more pills | An escape | Wanting it to happen |
| 9. BP-II | Mental image of where on my thigh I would have to stab myself to maximize my chances of hitting my femoral artery and bleeding to death | An escape route, a way out | Wanted to do it |
| 10. BP-II | Image of her children crying | Suicide is not an option | Wanted to do it but could not because of effect on family |
| 11. BP-II | Imagining self finally going to sleep | Control | I wanted to get on with it, to finish, to end and leave once and for all |
| 12. BP-II | Me with an open bottle of white tablets of different shapes and sizes | It was a way of working it through—could I put these tablets in my mouth? Could I ingest them? | Made me think suicide was not a good idea. I had a conviction I would make a mess of it |
| 13. BP-I | Slitting wrist, holding a blade by my vein and running it down and watching the blood pour out | An escape from everything | Avoid everybody, hide away and cry |
| 14. BP-I | Being in trouble with criminals. Being beaten up, tortured. This is an image I have experienced when suicidal and suffering from psychotic depression | Things will get worse, something more unbearable will happen. I won't be able to stand it | Wanted to end it all so I could get away from what I felt was my lot in life |
| 15. BP-II | I imagine picking up a knife in a kitchen, then lying slouched up against a fridge with blood everywhere | This is what I deserve. I will prove to myself that I can do this | The image motivated me to move it into reality |
| 16. BP-I | Deliberately careening off the road and crashing car | If I do this there will be no going back | Images snapped me out of the suicidal thoughts, made me want to grip the steering wheel tighter |
| 17. BP-I | Walking through a meadow at dusk, seeing myself getting into the water and then drowning | Something must be badly wrong. Concerned that might act impulsively on the image | Made me want to go into the hospital and seek some sort of shelter to keep the images at bay |
| 18. BP-I | Vivid image of a patient who I was in the hospital while cutting their wrists in the bathroom. The image had a religious quality to it | Other people had the strength of mind to commit suicide—it's not just me that feels this way | Image made me want to kill myself |
| 19. BP-I | Image of hitting head against a glass window, trying to break skull | Wanted to try and destroy the feelings of self-hatred | Image made me want to commit suicide |
| 20. BP-I | Standing on a wall of a bridge. Imagining jumping off and drowning | I will be released from all of this, all of these thoughts | Wanted to do it, but at same time wanted to fight the urge to act |
BP-I = bipolar I disorder; BP-II = bipolar II disorder.