The “S” word (Suicide)

Suicide.  There, I’ve said it.  You can try it to.  Trust me, it won’t kill you.  Nor will it kill the person with whom you associate it.  It’s just a word.  It has no special powers beyond the specific definition it encapsulates.  We hender acceptance of the disease when we use euphemisms such as “ended it all,” “gave up,” and (my personnal favorite) “took the cowards way out.”
The same goes for “depression,” “bi-polar,” “manic depression,” “suicidal,” “attempted suicide,” “mental health hospital,” etc.  These do not need to be exchanged for “feeling down,” “moody,” “mercurial” (although, that word is kind of cool), etc.

When we give the word special power to turn down eyes and stifle conversation, we give up on communication in the most direct and honest way.  No one ever says “heart disease” with a whisper and an anxious look around the room.  Consequently, we can talk openly about heart disease without fear of killing the party or being crossed off next year’s Christmas list.  Heart disease has been normalized as has tuberculosis, broken bones, and cancer.  Indeed, even spinal meningitis doesn’t carry the social stigma associated with “depression” and “suicide.”  Let’s say the words, let’s talk about the problem, let’s discuss the social and emotional implications, let’s get it out of the closet.

Altogether now:

“Suicide” it’s not such an evil word.
“Suicide” not the worst thing I’ve ever heard.
“Suicide” can kill you like a heart attack.
“Suicide” ignore it, but it’s coming back.

“Depression” it’s just another bad disease.
“Depression” say it over till you say it with ease.
“Depression” will get you if you don’t take care.
“Depression” it’s treatable, so don’t dispair.

Keep singing this until the words roll off your tongue.  The next person who calls to check on me had better say, “Hey, I heard you were suicidal.  How’s that going?  Have you found a good doctor yet?”  Well, for now I’ll settle for “Wow, suicide.  Man, that’s tough.  So … how about them Bears?!”

Once sick, always sick

I know you are just concerned about me, but sometimes I am just going to be out of pocket.  Yes, I have disappeared before and turned up in the hospital, but the mere fact of my disappearance does not entitle you to assume the worst.  I might just be in a book store or hardware store with bad cell-phone reception.  It happens, and you know how much time I can spend in those places.  I know I’m sick, but I’m also an adult.

The Will to Recover

This is probably one of those topics that patients have considered quite deeply and one that victims may have thought about but never voiced.  I want to talk about the curious phenomenon of not really wanting to get better.  Yes, you heard (or read) me correctly: sometimes, even after a failed suicide attempt, patients find it very difficult to begin the process of recovery.

We want to be better of course, but the third phase of life is quite a bit different than the life we have been living for so long.  I know this won’t be true of everyone, but I think it is for quite a lot of us: life before now has been one of constant emotional turbulence with thoughts of suicide always near at hand, life now is consumed by thoughts of suicide–the ultimate “Get out of jail free card,” life in the future will be completely unrecognizable … maybe.

I cannot even imagine what a life free of depression, insecurity, anxiety, and suicidality would be like.  I have been sick for so long, it feels like a part of who I am–an integral piece of my personna.  In college, I had that dark, contemplative thing going.  Not exactly popular with the sorority crowd, buy something of “charm” in the tree-hugger liberal crowds with whom I ran.  It was cool in that respect.  It’s not so cool now that I have children, a mortgage and retirement looming ahead.  Shaking it though is not as easy as recognizing the need for a change.

I am also guilty of using my illness as a crutch.  How can I not, given that the crutch has become part of my body?  If I lay around in bed all Sunday, is it because I am depressed or because I didn’t want to work on those cabinets in the basement?  Difficult to say.  Probably a little bit of depression and a little bit of habit.  Perhaps laziness in the morning leading to depression in the afternoon due to being such a loser for staying in bed all morning.  (The chicken and egg conundrum is appropriate here.)

Lisa had a very good paragraph or two expounding this issue.  I couldn’t find the e-mail in which she related this idea to me, so I hope she will post them as a comment to this blog entry.

I know I haven’t done such a good job of this blog entry.  I hope to do better next time, but right now, I just can’t seem to get out of bed long enough to write for more than ten minutes at a time.

Paying Attention

I was upset last night—very upset.  On my way to the bathroom, I slipped a martini glass under a spare shirt.  I didn’t ultimately do anything with it, but when I put the glass down on the way home, my friends just assumed I stole it from the club for fun.  The truth is I had fully intended to never come out of that bathroom again, not with my blood anyway.

This morning, my friends thought it incredibly funny that I stole a glass from the club.  I was thinking to myself, “I wouldn’t have stolen it if I had remembered that I already had a knife in my pocket.”

Watch your suicidal friends very closely.  If they do something odd or inexplicable, it’s probably time to put on your thinking caps to figure out if there is any way the action could be a precursor to suicide.  Odds are pretty good that there is a “method in their madness.”

With Full Intent

In Cherished79’s excellent account of one of her suicide attempts (http://cherished79.wordpress.com/2007/07/05/suicide-the-taboo-word/), she told us her thoughts after an aborted suicide attempt: “I am berating myself. You are such a loser, can’t even get this right, why did you have to call [9-1-1], back to square one again, you had the chance, you blew it, another disappointment, a huge loser.” I thought very nearly the same thing after each of my failed or aborted suicide attempts. Not so much failure on the intervened attempts, but definitely a certain sense of loss; someone stole what was mine and now I’m trapped in hell.

“Why did I call 9-1-1?” Waking up in the hospital with charcoal stains all over my clothes, tubes sticking into me and wires of various kinds stuck to my skin, the only thing I could do was shake my head and curse myself for being such a coward. Not a coward for attempting to OD, but a coward for calling for help. TDHP will invariably say, “See, that proves the `suicide attempt’ was just a cry for help.” No, it doesn’t! It only proves that in a moment of weakness during a long night of empowerment, I failed myself. Alternatively, it was a last moment of clarity in a long night of despair. Poe-tay-toe, poe-tah-toe.

The lesson hear is that people who try to kill themselves, really do want to kill themselves. It is incredibly embarassing when they don’t succeed. So please don’t pour salt on the wound by being angry with us or, even worse, belittling us. Afterwards,we may honestly say we are relieved to still be alive, but we are just as honest when we say we wanted to die. Don’t belittle the patient in your life by saying they didn’t really try to kill themselves, that it was just a cry for help.

“F&*% you! I’ll show you it wasn’t just a cry for help just as soon as I get out of here! And next time, I’m going to do it right.”