I have bipolar disorder and over the years I have had thoughts of hurting myself. This goes way back to when I was a kid and I wanted to fall down and break my leg. When I was working I would have thoughts of throwing myself down the stairs and sometimes I would run my fingernails across my wrists to see what the movement toward cutting them would feel like.

Lately, I have been having strong impulses of cutting myself with a knife. I have been afraid to do it. A week ago I laid the knife on my wrist to see if I had to go deep to cut. I didn't press because I was afraid.

I am having a really hard time right now trying to deal with my relationship which is badly wounded and there are just so many things going on. I don't want to hurt myself and I am afraid of the pain, but last night I took a knife and scraped it across my upper arm. It began to break skin and although I didn't bleed, I have a puffy red scratch that is about a half inch long.

Sometimes I think I want to stab the knife point deep into my arm. I used to think that I would never make the move to cut, but last night I did. What if I stab myself in the arm?

I feel such shame and confusion.

I went to inpatient this summer because of these thoughts and suicidal ideation. I wonder if I need to go again. I don't want to because we have a family vacation in a week and a half that I don't want to ruin for the kids.

Help.