I’m going to write a little about suicide now; I’m not considering it (well, I’m not considering doing it, but I am considering it as a topic, obviously, since I’m writing about it), but the hows and whyfors of suicide have been on my mind for the last few days. It’s not surprising, I suppose, given what happened with Alice, but it is a tough topic to talk about.

First, let me say that I have some understanding of how it feels to lose someone to suicide. Alice was a friend of mine, and it hurts to know that she’s gone. I don’t make friends easily, and so I like to keep the ones I have around for as long as possible, even if we aren’t always close. It’s not the same as losing a father, mother, brother, sister, son, or daughter, but I care very deeply for my friends. There’s a hole in my life now, and I don’t know how to fill it up again; I suppose time will do that, but the grief is still very fresh. 

But I also know what it is like to feel suicidal. I’ve been there twice. And it is a terrifying place to be. I don’t know what it is like for people with other mental illnesses, or people whose lives have just gotten so unbearable that they feel death is the best way to go, but I know with depression there is literally a part of my mind trying to convince me that my life is so bad, that I am so pathetic, so meaningless, so worthless, so hopeless that ending my life is the best way out. I know that people find it hard to believe that things can be so bad, and in reality, the actual parts of life probably aren’t so bad. But your mind has the ability to change the way you perceive things, and so for someone with depression, like me, a minor problem – a boss makes a minor reprimand, a bad grade, missing an appointment – seems like a monumental calamity. Have enough of those happen to you, and it just seems too painful to go on.

I have seen and heard a lot of people say that suicide is selfish – that the person trying, or succeeding, is only considering themselves, not the people they leave behind. But I can say that, in my case, and I imagine in many other cases, that’s not true. It may seem selfish to others, but for us, our brains have gotten us so convinced that life is terrible, that we are pathetic and hopeless, that we are absolutely certain that our being dead will be a blessing to the people who are left – that we mean so little, and we bring so much pain and gloom to those around us, that our loss is practically a gain. So while it may be seen as selfish, the people trying – or succeeding – to kill themselves aren’t trying to be selfish. They don’t want to leave pain and misery behind for the people who care about them – they just don’t think there will be any.

I also have heard people talk about how the victims of suicide aren’t worth grieving for, because their problems weren’t so bad – there are people who live with worse problems, and they don’t kill themselves, after all. But to those people, I say (well, here; if I met one in person, I’d probably punch them) – how do you know how bad their problems are? Granted, I know my problems, when I was considering, and trying, suicide, weren’t all the big, on the grand scheme of things. I wasn’t starving, or being tortured (not physically, anyway), or being shot at. But I felt like I had nowhere to go. Every decision I made, just made things worse. I felt so crushingly sad, so abjectly hopeless, and so wracked by emotional pain that even deciding whether or not to shower in the morning was like running a marathon with broken glass in my shoes. My problems weren’t that bad, no, but my brain made me think that they were. It hurt so much, and I felt so alone (even though I know now that I wasn’t), and I felt like there was no help, no hope. And it broke me. Luckily for me, I didn’t succeed, and I found a way to manage my illness, to make my mind behave. Many people aren’t so lucky.

So I don’t begrudge that choice. I don’t know what Alice was thinking, or how badly she felt, when she decided to end her life. But while I wish that I could change it somehow, that she was still here, that my friend was still alive, I don’t think that she did anything she didn’t feel the need to do. I’m sure she had a reason, or several reasons, and while they might not make sense to me, or anyone else, they made sense to her – and the way we perceive things is really what matters here.

Acute Care

Well, it’s been an interesting week thus far. Two friends in the hospital for mental issues is a pretty lousy deal.Obviously, it’s worse for them; I don’t mean to minimize their problems. But it is hard to sit by and watch, too, because you always want to help your friends. Well, I do, anyway.  I am glad that one of them is hopefully getting out tomorrow, though.

It’s a little odd having been suicidal in the past and now having friends in that place now. People keep worrying that having two friends in such a bad place might cause me to slip backwards. I can see how that would worry people, given my past. But I’ve had plenty of practice over the last several months; I can kind of compartmentalize that part of my mind so I don’t let my worrying about my friends take over my thoughts. So while I am sad that I have friends having such a rough period in their lives, and I worry about them, it’s not consuming everything in my head – it sometimes just seems that way because, honestly, nobody is all that interested about how I cleaned my entire apartment because I thought something smelled funny.

I guess that ability to compartmentalize is due to the skills learned in treatment. I don’t even notice I’m doing it most of the time, and there are probably other things I don’t notice myself doing, either. Not all of the skills learned have become so easy; I still have a lot of trouble relaxing, and I only remember to try to meditate or use a breathing exercise about half the time. Sometimes this results in my jaw hurting from clenching it so often. But still, it shows that at least some of the things learned in treatment I have not only remembered, but made a part of my life.

I’m glad that at least one of my friends is not suicidal anymore, and is (hopefully) well on the way to getting the help she needs. She’s a great person, and deserves better than she has been getting. I hope the other is on her way to feeling better, as well, and that she can finally take some time to relax.

One of the worst things I’ve seen in the last few days has really been the state of general psychiatric care. Now, I don’t mean specialized private treatment centers like Menninger, but rather the places that mental patients come to know as acute care facilities. They are where people who admit themselves (or are forcibly admitted) for being a danger to themselves or others go after the ER is done with them. Some of them are private, and some of them are done by the hospital the ER is a part of, but they are almost universally unpleasant places, in my experience.

Mental patients of all types get placed in the same area, so you may have people who are delusional and violent  patients alongside people with crippling anxiety – which is a bad match, as you might imagine. It can get messy really quick. Alongside a bad mix of patients, add in a staff that tends to be very jaded and uncaring – at my last acute care center, a social worker for a group on community reintegration said she hadn’t bothered to prepare, so she just put The Blind Side on and left until the end of the group. My friend had to file several grievances against the nurses and the psychiatrist at her current facility to get them to even pay attention to her. The facilities are often pretty badly worn out, too, and can be pretty humiliating.

It’s even more sad that these are, essentially, standard emergency care facilities for people with mental illness. If cancer patients were treated this badly, there would be a national outcry, but because mental illnesses aren’t things that can be seen on X-rays or detected by blood tests, they get treated badly. Having visited one friend several times, and probably visiting the other at least once or twice, it gives me a whole new level of appreciation for places like the Menninger Clinic – which is impressive, concerning how much esteem I already hold Menninger in.

Every treatment center in the country – hell, the world – for mental illness ought to be as good as Menninger.

Back In Action

After a couple days off there, to deal with some personal issues (like having to go back to St. Louis to get a temporary driver’s license so I can drive around Texas legally), I am back. And it seems like times are tough for a lot of people. It’s hard to watch, because I’ve been there, on both sides, and it is neither easy nor enjoyable.

I have one friend who is currently in a mental hospital (well, technically an ‘acute care facility’, but yeah, a mental hospital), and another who is going there tonight, both because of suicidal ideation. I have a third who tends to ride the line pretty close on that one, though she seems to have gotten a little better. Another girl I know has been suicidal within the past two weeks, and while she seems to have improved, there’s no telling if it is a long-term improvement or not. And those are just the people I know who are suicidal or close to it; there are several others with serious problems that just don’t quite reach this level.

It’s a lot to handle, both for them and for me; I hate watching friends go through this kind of thing, because I wish I could do more to help, and at the same time I know I need to retain some sort of distance from it because I don’t want to be pulled in. It would be terrible if, in trying to help a suicidal friend, I got too close and started on that road again myself. So I have a real need for boundaries there, but it does frustrate me that I can’t do more.

I’m also feeling very conflicted about a woman; I like her a lot, and I would like to see if there’s more to it than that, but at the same time she is in a pretty dark place and I don’t want to put any more pressure on her than there already is. I keep worrying I’ll say something stupid to give myself away when we talk, and I’m just really not sure what to do. It’s not an area where I have a lot of experience, so I’m very much kind of flailing around in the dark.

I also want to find more to do with myself. I have my friends here, and they’re great, and I love spending time with them. And I have several groups I go to on a regular basis, and they’ve been very helpful in keeping me on an even keel. But I think a job is something I need not just for money, but also to give my life more structure. I don’t like having all this time to myself; I’m not getting depressed, but it can be a bit boring at times. At the same time, the job market has not been very kind to me; I’ve only gotten one response in over a month, and that was to turn me down. It doesn’t help that I just keep getting pressure from certain parties who mention it over and over, as if they think I don’t realize how important it is.

So, my life will continue to be interesting for at least a while longer, it seems. Maybe I’ll find something else I like to do or try – I mean, I’ve already tried mushrooms on pizza, rock-climbing, pool workouts, and manicures, so I’m open to new things. Maybe something really cool will happen. Failing that, at least I’ll have things to talk about here, because there is no shortage of things on my mind.

Ain’t Painless

I’ve dealt with depression for a long time. I mean, I was diagnosed so long ago that my depression is almost old enough to go to high school. But aside from the fact that depression  makes you feel like crap, all the time, and even with treatment and medication you still feel kind of lousy a lot, one of the worst roads depression can lead you down is the road to suicide. And, unlike the song lyric, suicide isn’t painless.

Suicide is one of those things that nobody wants to think about, but that a lot of people end up thinking about seriously – according to the CDC, in 2010 38,364 suicides were reported – it was the 10th highest cause of death in the country. And depression makes it often a particularly tempting way out. Depression makes you feel so terrible, like nothing will ever get any better, like the world will be better off without you, like everything hurts. I should know, I’ve tried it twice.

One of the things that those of us who think about suicide never really think about seriously is how our deaths will affect those people who care for us. At least for people with depression, it is because we are so convinced of our own worthlessness, of the fact that we won’t and can’t amount o anything, and that we are just terrible human beings that we think that people who care about us will be better off if we’re gone. It seems crazy to think about it now, but it is how it works out in our heads. 

It’s not true, though. I can only begin to think about what my family and friends went through after I tried to kill myself, twice. After my first try, I was so zombified on medication and electro-convulsive therapy to see the expressions of shock and anguish on their faces, even when my friends flew from across the country to come see me. For my second attempt the looks on the faces of my family were all too clear to me; I could hear how my friends felt in their voices over the phone. Even though my feeling powerless was part of why I tried to end my life, part of my treatment was realizing that I have real power over my friends and family through my actions. It was a hard pill to swallow.

Now I have friends who are in that dark area of their lives. Two of them, in fact; they both mentioned thinking about it today (today being Sunday, 9/8, not Monday, 9/9). If I was a therapist, I would be bound to report this to someone, but I’m not, so their identities will remain secret, because I know they are both very afraid of being sent back to hospitals. But now I don’t feel powerless because I want to end my life, but rather because I have friends stuck in a terrible place and I don’t know what can be done to help them.

Like I said, I’m not a therapist. All I am is a person who has been in that dark place, and was lucky enough to survive it twice. Now I’m in a much better place in my life, but it took a long, long time to get here. It’s not easy watching someone you care about on the road to suicide. I am probably not the only person here who is watching someone else go through this, or is going through it themselves. It’s hard to know what can help at a time like this, but I thought I would try and provide some tools, anyway.

Active Listening – one of the things suicidal people (well, me, anyway) have a problem with is people not listening to them, or always trying to solve their problems when what they really want is someone to listen to them and hear what they’re saying. Active listening is a tool for that.

IS PATH WARM? – this is a mnemonic device used to help assess the condition of someone who may be suicidal. Mnemonics are a big part of the skills and tools we are taught in the various treatment groups, so this may be helpful for people who think someone they are close to is suicidal.

American Association of Suicidology – “AAS is a membership organization for all those involved in suicide prevention and intervention, or touched by suicide. AAS is a leader in the advancement of scientific and programmatic efforts in suicide prevention through research, education and training, the development of standards and resources, and survivor support services.”

American Foundation for Suicide Prevention – “… is the nation’s leading organization bringing together people across communities and backgrounds to understand and prevent suicide, and to help heal the pain it causes. Individuals, families, and communities who have been personally touched by suicide are the moving force behind everything we do.”

I don’t want to lose my friends. Please, just tell me, what can I do?