How We Address the Severest Form of Depression and Anxiety: Morbid Thoughts

When Intrusive Thoughts Take a Dark Turn

February 15, 2023

No one loves me. No one cares. I've made too many big mistakes. There's no coming back from this. I've gone too far this time. There is no hope for me. There is nothing to live for.” All of these thoughts swirled continually in Christy’s head as she choked down an entire bottle of tequila. This time, she was going to end it for good. As the room began to spin she placed the gun to her head and “click!” She pulled the trigger again and again. Nothing happened. Somehow her gun had jammed. 

Christy had battled mental health issues her entire life. She actually attempted suicide a total of five times. Ultimately, after repeated failed attempts and multiple stays in inpatient psychiatric lock up units, she attended a residential Nedley Depression and Anxiety Recovery Program™. Through in-depth analysis, continual evaluation, and the consistent application of her personalized treatment plan created by Dr. Nedley and program counselors, Christy was able to get her life back and gain lasting recovery. When asked about the person she was before and the person she is now, she said, "I don't recognize that person from before." She said, "My life has transformed. I'm grateful, joyful, and at peace." And now? Whenever she is able, Christy works in the program as a nurse, helping people who are in the same place she was once in herself. She also conducts mental health education seminars and programs, compassionately bringing hope to her community.


Suicide is among the leading cause of death in the United States, with suicide rates rising each year over the last decade. Annually, nearly 14 out of every 100,000 people die by suicide.[ii] That translates to 45,979 people who died by suicide–with an average of 130 suicides occurring daily in 2020.[iii] Over 1 percent of all Americans are dying by suicide every year. Suicidal ideation has also continued to rise. During the COVID-19 pandemic in 2020, nearly 11 percent of Americans seriously considered taking their life.[iv] People who had never considered taking their own life began thinking they would be better off dead, wishing they could go to sleep and never wake up.

“For every adult who died by suicide, approximately three were hospitalized for nonfatal suicidal behaviors, nine were seen in an emergency department for suicidal ideation or behavior, 31 reported having attempted suicide in the past year, and 234 reported having seriously considered suicide. In addition, thousands more are affected by the suicides or suicide-related injuries of friends or family members.”[i]

Many individuals who attempt or commit suicide are under medical or psychiatric care, have been prescribed medication, and are undergoing counseling. Primary care physicians, such as family medicine, internal medicine, pediatricians, obstetricians, gynecologists, and psychiatrists are licensed and trained to treat and prescribe medicine and other therapies for people with depression and anxiety, with most of these medicines being prescribed by primary care physicians.[v] Often antidepressant medication increases impulsivity before improving depression. Suicide is often an impulsive act; therefore, antidepressant medications have black box warnings that state the medications can increase the risk of suicide.

Intrusive, negative, persistent thoughts; deep, unrelenting depression; and painful, overwhelming anxiety are often characterized by the deepest form of despair: morbid thoughts. Morbid thoughts are characterized by thoughts that you or someone else would be better off dead, and are often associated with being preoccupied with death or symbols of death.[i] Suicidal ideation is thinking about, or considering suicide. Someone who is actively suicidal has allowed suicidal ideations to lead them toward developing a definite plan with obtainable means to end their life immanently. If they have recently attempted to end their life, they are often still actively suicidal. Active suicidal thoughts and intentions are one indicator of severe depression and anxiety.

Typical Care for the Actively Suicidal in America

Patients who are actively suicidal need to go to their local emergency room accompanied by someone who can keep them safe until there. Once in the emergency room, they can gain access to an inpatient psychiatric hospital and be kept for at least 72 hours until they are no longer a danger to themselves. Fortunately, being actively suicidal is not a chronic state, and most likely those feelings will pass, given enough time, usually within 72 hours. In this facility, a safety plan will likely be discussed with suicidal patients. A safety plan teaches the suicidal patient alternatives and healthier ways to deal with their feelings instead of succumbing to suicidal ideation. However, very often, even though the patient is no longer actively suicidal and therefore able to be discharged from a psychiatric facility, they still have at least some morbid thoughts. It is important to know how to deal with morbid thoughts instead of resorting to suicide, but it is even better to have the morbid thoughts completely eliminated. 

Severe Depression and Anxiety Are Not New

Neil Nedley, MD, began practicing medicine as an internal medicine physician in 1989, with an emphasis in the difficult-to-diagnose patient and gastroenterology. As time went on, Dr. Nedley began to realize an increasing number of his patients were suffering from something other than the heart, gastrointestinal, or other bodily organ diseases he sought to treat. Many of the difficult-to-diagnose patients that were referred to Dr. Nedley with multiple physical symptoms also had depression and/or anxiety as their primary diagnosis, which was a root cause of their troubles.

By 1997, one in four of Dr. Nedley’s patients were struggling with depression or anxiety. As an internist responsible for getting to the bottom  of his patients’ challenges, Dr. Nedley committed himself to finding the root causes of depression and/or anxiety instead of only somewhat improving the symptoms with medication. Because of his ongoing study of the latest scientific research related to diseases of the mind, combined with years of clinical experience, Dr. Nedley found myriads of causes (over 100 hundred) as well as many evidence-based interventions (also over 100) to combat mental health diseases. He consistently found that when approaching mental health issues from a meticulous and comprehensive approach, the mind is able to recover, even in the most hopeless of situations. Many patients who had struggled with depression and anxiety for years under medical care, hearing from others who had found their way out of depression and anxiety, sought out care from Dr. Nedley’s outpatient clinic. Utilizing an approach similar to what is now called the community Nedley Depression and Anxiety Recovery Program™, an educational/health coaching curriculum that has helped over 10,000 people around the world experience improved emotional and mental health, Dr. Nedley began to see drastic improvements in his patients’ symptoms of depression and anxiety. 

As a result, Dr. Nedley was invited to the Lifestyle Center of America in Oklahoma to offer the first residential Nedley Depression and Anxiety Recovery Program™ (NDARP) in 2003. Over the last 20 years, the residential NDARP has conducted many successful medically supervised programs in Oklahoma, California, and Georgia with multiple teams of trained doctors, administrators, therapists, nurses, and support staff. The program is designed to leave no stone unturned in discovering why each patient is suffering from depression and anxiety and what the reasons are behind persistent morbid thoughts. Through evaluating brain biochemistry, epigenetics, hormones, nutrient levels, inflammation levels, adverse childhood experiences, current life stress, life purpose, and creating an individual plan that corrects each participant’s underlying causes, the program has been proven to produce dramatic results. The residential NDARP team is dedicated to reigniting hope and providing the tools necessary to overcome depression and anxiety. We firmly believe that no one must suffer from these mental illnesses for a lifetime, nor should they have to anticipate doing so.

How the Residential NDARP Deals With the Highest Levels of Depression and Anxiety

The residential Nedley Depression and Anxiety Recovery Program™ combines medical, therapeutic, and lifestyle practices to comprehensively combat severe, treatment-resistant depression and anxiety. By identifying the underlying causes of depression and anxiety (hits or blows to the brain), personalized treatment plans during and after the program provide each participant with a roadmap for success. During the intensive 10-day program, participants who actively engage with their treatment protocols experience dramatic results, which can be carried home for ongoing success, recovery, and transformation. 

Medication, targeted nutrient supplementation, mental health education, counseling, lifestyle interventions, and accountability can be successfully employed for severe forms of depression and anxiety, including morbid thoughts and suicidal ideation. Every residential NDARP participant is screened during the interview process for morbid thoughts, suicidal ideation, actively suicidal thoughts, of if they are a danger to themselves or others. Those who are actively suicidal or a danger are denied admission to the residential NDARP since it is a voluntary, non-lock up facility. 

Those who are admitted to the program with non-actively suicidal morbid thoughts or suicidal ideation are further evaluated by both the program physician and therapists to ascertain the best approach to mitigating these thoughts once at the program. If a participant becomes actively suicidal during their stay at the residential program, our safety plan ensures they are admitted to an appropriate emergency mental health facility that can facilitate a 72-hour hold.

Recent data from the residential NDARP shows that about half of patients who are referred or self-referred to the residential program do not have morbid thoughts. Many of those with moderate to severe depression and anxiety can come with panic, fear, worry, apathy, fatigue, deep sadness, lack of focus, sleep disturbance, and physical and mental dysfunction without experiencing morbid thoughts. However, among those who do come with frequent morbid thoughts (daily or more), 88% improve to less than half to no days of morbid thoughts within 7 days. The typical patient in this most severe category leaves the program 10 days later with no morbid thoughts of any kind. 

When including all depressed and anxious patients who also have any morbid thoughts, 87% will no longer have morbid thoughts for at least 3 days before they leave the program. Depending on the cause of depression and anxiety, as well as the underlying brain biochemistry, it can take some people longer to have those thoughts eradicated. For these individuals, it is most often recommended for them to stay under the care of the program staff for an extra week to improve their brain biochemistry and thinking patterns. Among those who need the additional week, 90% of those will be able to be discharged with no morbid thoughts at all. Only 10% of those who stay the extra week (for a total of 17 days), will need even more time in the residential program to overcome their morbid thoughts. 

Our Dedication to Lasting Recovery

The residential NDARP is dedicated to finding the underlying causes of depression and anxiety and using complementary medicine and interventions to educate, equip, and motivate participants to experience lasting change. At the conclusion of each program, our team evaluates and discusses ways to continually improve on the level of care provided and how to incorporate the latest research surrounding treatment for depression and anxiety. Among those experiencing morbid thoughts, employing the tools of this program day-by-day can result in changed thoughts and outcomes. We are committed to being a part of your journey away from the despair of dark, morbid thoughts, even if your depression and anxiety is crippling. Not only can these thoughts be changed, but your entire life can be renewed and filled with purpose. Through the support of our loving, compassionate staff and your dedication to the program, you can achieve lasting recovery and experience hope and happiness in your life.

Apply for an upcoming residential program

If you or someone you know are struggling with morbid thoughts or contemplating suicide, please seek help immediately through the resources listed below.

Mental Health Resources

Learn ways to support a loved one you think may be suicidal here.

Actively suicidal:
  • National Suicide Prevention Lifeline (available 24 /7)­ Phone: 988 or Text 988; Website:
  • Local behavioral health facility
  • Emergency department
  • Police (911)
Severe depression or anxiety with or without suicidal ideation or morbid thoughts (not actively suicidal):
Mild to severe depression with or without morbid thoughts (not actively suicidal) with inability to access the residential NDARP:
Read more about Christy's story, "How I was Loved Back to Life" or watch her story on YouTube

* The community program and the residential NDARPs do not accept patients who are actively suicidal since these programs are not conducted in a lock-up facility with appropriate 24/7 staffing. Those who are actively suicidal need to go to their local emergency room, as described above.


Please contact us first before publishing this or other Nedley Health articles.


[i] CDC. (2022). Suicidal thoughts and behaviors among adults aged ≥18 years - United States, 2015–2019. Centers for Disease Control and Prevention.

[ii] Garnett, M., Curtin, S., & Stone, D. (2022). Suicide mortality in the United States, 2000–2020. 

[iii] Centers for Disease Control and Prevention. (2022). Facts about suicide. Centers for Disease Control

and Prevention.

[iv]Centers for Disease Control and Prevention. (2020). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic - United States, June 24–30, 2020. Centers for Disease Control and Prevention

[v] Smith, B. (2012). Inappropriate prescribing. Monitor on Psychology.

About the author

Neil Nedley, MD, is a practicing physician in internal medicine. He has given numerous mental and emotional health educational lectures to physicians and caregivers of all specialties for attendees to receive the top category 1 of American Medical Association continuing medical education credits. Dr. Nedley has served as an adjunct clinical professor of Medicine at Loma Linda University and has been the clinical instructor for numerous resident physicians, medical students, physician assistants, and nurse practitioners. Dr. Nedley has presented and published numerous scientific studies in the medical literature and is well known internationally as a public speaker, teacher, and author.