Q. I suffer from severe depression and take antidepressants, which have mostly stopped thoughts of suicide. My doctor told me that I need to “change the way you think” if I get a suicidal thought (which I sometimes do if I get exhausted and lose sleep). I’m not sure what that means.

A. There is a formula that says, “For every period of exhaustion there will be a corresponding period of depression.” Possible reasons for this include:

• Each brain needs its optimum amount of sleep in order to keep its chemical stew in relative balance and think clearly
• Exhaustion tends to lower levels of serotonin, which can exacerbate one’s level of depression (and females tend to have lower levels of serotonin overall as compared to males)

When you have thoughts of wanting to harm yourself in any way or to kill yourself, contact your doctor immediately, as your brain may need a different level of medication. As your doctor pointed out, however, it is also important to “change the way you think.” Thoughts are just thoughts. You can choose to hang onto them or to change them, and you can decide whether or not to take any action based upon them.

Some years ago I heard a mother give a brilliant response to her seven-year-old son, who was angry because he had missed some school outing or other. “I’m going to run away from home!” he said, stamping his little foot emphatically. “I am! I am!”

Rather than get upset, his mother had calmly replied, “I understand that is what you think right now. If you still feel the same way tomorrow, you can call your cousin Billy and ask if he wants to run away with you.” Her little boy said, “Okay,” and soon was busy playing with his Legos.

That type of processing can be helpful in adulthood, as well. When you become aware of thinking you want to harm yourself, try saying: “That’s my thought right now. It’s just a thought. It tells me that my brain wants to feel better. I choose to think of three things for which I am grateful. I’m riding my stationary bicycle for 15 minutes while I think of things for which I am grateful.”

Learning to develop a positive mind set, positive self-talk, and a positive communication style is not a Pollyanna response to life. When something bad happens, you acknowledge that it happened, decide if there is anything you need to do to mitigate the situation or repair the damage, and then think of something for which to be grateful. This can result in a number of benefits:

• Help to prevent your brain from downshifting (or help it to upshift)
• Program your subconscious mind for thoughts you want to think
• Enhance your communication with yourself
• Improve your health and wellbeing
• Increase your energy
• Increase your likelihood of success