Ideas2Words Words2Minds Minds2Action

Well, I’ve been trying depression for a while, but that doesn’t seem to be shaking off the suicidal ideation. Seems rather obvious to you, I guess. I tried everything else, so I thought maybe depression would be just the thing. People always say, “Stop being so depressed. Stop thinking about suicide.” The two come together so often that we begin to think one requires the other.* So, harkening back to those nail-biting Sherlock Holmes mysteries read in the halcyon days of youth** (not my youth, of course, but one whose youth was spent reading Sherlock Holmes in days that must have been peaceful or enjoyable or in some other way worth harkening back), I couldn’t help but remember the advice of the sage sleuth: “We must fall back upon the old axiom that when all other contingencies fail, whatever remains, however improbable, must be the truth.” As I have already tried everything else, I thought, “what the hell, no one has tried depression yet; let’s give it a whirl.” Well, I am just barely here today to report that indeed depression is not a good antidote to suicidality.

With that in mind, I thought I’d give mirth another go. If not entirely therapeutic, it should at least be more enjoyable than spending all day in bed staring at the wall and might even win back a few friends in the process. So, consider yourself warned, the rest of this entry will be mirthful, impishly giddy, and down right silly. It may even be funny here and there—but don’t hold your breath.

To kick things off, I thought I’d dust off a limerick I wrote a while back. I don’t think it got the ovation it merited, so I am republishing it here for all to read (and applaud):

   There once was a boy full of bile,
   though he’d greet you with laughs and a smile.
       He decided one day
       he should jump in the bay,
   but his meds kept him dry for a while.

And now, a few one liners à la être suicidaire:

   A man walks into a bar. He says, “OW!”
   A suicidal man walks into a bar. He says, “OW! See! Even the bar hates me … what’s the use?!”

   Normal guy: Take my wife … please!!!
   Suicidal guy: Take my wife … she has suffered enough; she deserves better than me.

   Normal guy: I took a train once, but they made me put it back.
   Suicidal guy: I jumped in front of a train once, but someone pulled me back.

   Jack and Jill went up the hill, each with a buck and a quarter. Jill came down with $2.50; she needed the money!
   Jack and Suicidal Jill went up the hill to fetch a pail of water. Jack fell down and broke his crown, and Jill—knowing she could never live without Jack—came tumbling after.

   Normal guy: My wife hates me. The other day, I fell asleep with a cigarette in my mouth. She lit it.
   Suicidal guy: My wife hates me.

Okay, enough of that. I feel better already. Of course, it’s 5:30 in the morning, so it could be that I’m just delirious. Hey, I’ll take what I can get. Good night everybody. I hope to be as happy tomorrow, but I make no promises.

NOTES:
* - Didn’t want to interrupt the line of levity, but didn’t want to let the thought go either. Just as often as people assume a suicidal person must also be depressed, I have assumed that a depressed person (me) must also be suicidal. Talk about a dysfunctional automatic thought! “Well, I’ve been depressed all weekend, I guess it’s about time I start thinking about suicide…” Sounds stupid when you say it like that, but the thought process (sorry folks, I just can’t resist) has a mind of its own.

** - Harkening back? Halcyon days? Yeah, I know. Just thinking about Sherlock Holmes makes me conjure up words I could have only heard in my youth, moments before the speaker was severely beaten up for using such uppity words. “You think you smart, huh? Well, how smart are you now with my foot stuck in yo’ ass?! Punk ass bitch think he all smarter than me and shit…” Snap out of it, Ashley! Click those heels and get back to Kansas (with yo’ white ass)!

Well, I’m going to check myself in today.  The last couple of days have been pretty rough and I don’t know if I can make it through another lonely night.  I will talk to my doctor about doing only the partial program instead of the full day.  If you don’t hear from me for a while, you’ll know it was the latter.  And, if you don’t ever hear from me again, you’ll know I took the third option.

It’s funny, I started this blog with the handle “Suicidal No More” — optimism springs eternal, or was it just sardonic word play?  Either way, I can no longer continue the masquerade.  I’m still sick.  I guess I’ll always be sick.   That points to a question always in the back of my mind: who would want to live like this for the rest of their life?  I sure as hell don’t.  Is that the disease talking? Or simply the voice of reason?  I know what my doctor would say; what would you say — you who have been in the bog?

Thank you all for reading my silly little blog.  It really has meant a lot to me.

-Ashley

WHEREAS, I would like to make this blog as close to a daily as possible; and

WHEREAS, Many of you have much experience with suicide, suicidal ideation, suicidality (both acute and chronic); and

WHEREAS, I am in a bit of a funk and am not inclined to get out of bed, let alone write something pithy and profound;

I propose that one or more of you SP (sick people) or FnF (Friends and family) or even one of TDHP (those damn healthy people) write today’s entry. Just enter it as a comment below.  And, thanks in advance for helping me keep this project going through my little “crisis of the week.”

TDHP view:

He should be getting back to work today; that’s good news.  Oh, here he goes again: “I’m sick; I’m depressed; I’m suicidal; I can’t go back to work now; I need to go to the hospital.”  He does this every time he wants to avoid doing something.  It’s time to grow up, you coward.  Why can’t he just get his meds right and start following his doctor’s advice?!

Patient’s view:

Man, I have to go to work tomorrow.  I’m so scared.  What must my co-workers think of me?  They will all be staring.  And, why shouldn’t they?  I’ve been playing hooky for seven weeks, hiding in my room feeling sorry for myself, getting smashed at the pitty party every night.  What makes me so special?  They have to deal with the same stuff I get and they don’t just skip out and leave their work for their co-workers to complete.  I’m just pathetic.  I suck.  I really never should have been born.  [hours later] F&F: Call 9-1-1! I think he’s really hurt himself this time….

Another patient’s view:

Man, I have to go to work tomorrow.  I’m so scared.  What must my co-workers think of me?  They will all be staring.  And, I know what they’ll be thinking.  “He’s been playing hooky for seven weeks, not coming to work because he feels sorry for himself, just throwing himself a pitty party every night.  What makes him so special?  We have to deal with the same stuff he does and we don’t just skip out and leave our work for our co-workers to complete.”  Yeah, well I’ll show them I haven’t been faking it.  I’ll show them I have been dealing with some really heavy shit.  They’ll see.   [hours later] F&F: Call 9-1-1! I think he’s really hurt himself this time….

This is probably one of the most frustrating questions family and friends (F&F) have when dealing with suicidal patients.  Unfortunately, the answer is not at all clear and probably different for each of us.  That’s not of much help; but, hey, no one ever said this was an easy disease.  I will try to list some of the thoughts I’ve had over the years.  If I end up contradicting earlier posts, just keep in mind that I am in a fairly good mood now, which may not have been true when I wrote the previous comments.  And, in any mood, I am full of contradictions.  (I am losing weight, but I am still large enough to contain multiples, if not multitudes.  Perhaps when I get down to 190 lbs. I’ll be of a single mind!)

There is one thing I must say emphatically before giving any useful advice (such as I might give): do not try to convince your loved one that they shouldn’t be depressed!  Spewing a list of reasons someone shouldn’t be depressed or suicidal to someone who is depressed or suicidal, will only cause anger and resentment.  Why?  For you warm and fuzzy types, acknowledging our current state of mind validates our humanity and reality (subjective though it may be) giving us the feeling that someone understands us — in particular, that our thoughts are crazy, but we are not.  For you logical folks, I’m affraid a somewhat longer-winded explanation is necessary — a very quick lesson in brain structure. 

For our purposes, the human brain can be roughly divided into the ancient/animal brain and the new/rational brain.  As you might guess, the animal brain controls our most basic functions, emotions, and responses — “Ug must eat, Ug envy Og for food, Ug must club Og to get food.”  (Grammar apparently wasn’t very sophisticated in Ug’s and Og’s day.)  As you might further surmise, this part of the brain is not too concerned with mitigating circumstances.  The new part of the brain, is much more nuanced — “I certainly am hungry and Mr. Og Jones has quite the bounty.  I am much stronger than Og, so I could just take his food.  But, Og trapped and prepared that food making it rightfully his.  If I simply took his food, then there would be no trust amongst neighbors and therefore no basis for a civic life, no basis for ethical behavior…”  So Og is safe because we have logic to save us from fight or flight, right?  Well, not quite. 

Here are the other facts you may not know: the animal brain is incredibly fast and tends to deal with the most urgent needs like eating; the new brain is much, much slower and tends to deal with more esoteric needs such as the meaning of life or the condition of man.  As it turns out, the newer brain is incredibly powerless against the old brain when strong emotions and the impulsive actions they drive are in question.  This is as it should be because “Tiger! Run!” really ought to win over “Why must the tiger eat meat?  What is its motivation?”

So, when you tell us, “you have nothing to be depressed about; you have food, a lovely family, a good job, a nice car, …” when we are contending with “everyone hates me and I have no reason to live, so I should club myself, …” your words just don’t have a chance.  Our subjective reality has hijacked our psyche and no amount of evidence from your absolute reality will change that.  Much better is to accept the fact of our crisis, help us through it, and only afterwards bring us back to your world of facts and statistics.  And with that, I shall begin my list:

Suggestion 0: Acknowledge how the patient feels right now and save the debate for Hanity and Colmes.

Suggestion 1: Stick to the script on the safety plan.  (Remember suggestion 0, don’t argue!  Just stick to the script.)  Don’t have the safety plan?  Then, you aren’t on the patient’s list of go to people; get over it.  If they don’t have a safety plan, then suggest they formulate one with their therapist before the next crisis comes. 

Suggestion 2: Ask the patient what you can do to help them, but don’t expect a good answer.  Then, make suggestions of things you think might help.  This will hopefully spawn a constructive conversation that, in and of itself, will be helpful and may even yield useful actions for you or the patient or both.

Suggestion 3: Don’t belittle us, don’t guilt trip us (yeah, well, it’s a verb now!), and don’t compare us to Middle-eastern Jihadists.  Suicide may be immoral and stupid in your mind, but obviously it isn’t in ours.  Appealing to our sense of guilt and shame is almost always the exact opposite of what we need to hear.  I have never thought to myself, “Gee, you’re right.  Suicide is an unforgivable sin.  What kind of a man takes the coward’s way out?  What kind of father would even consider abandoning his kids like this?  I hate myself for who I have become.  Won’t you please take this gun out of my hand?”

Suggestion 4: Be yourself, and no one else.  Be a friend that cares for us; be a family member that cares for us (rare, but it happens); just don’t try to be a savior.  You aren’t likely to save us — something only we can do — so your efforts will at best fall on deaf ears and at worst make us feel pathetic.  Save your cable t.v. psychobable for the singles bar because it will probably do more harm than good in a real situation.  (Sorry to be so blunt, but we are paying someone else $150/hr. for their years of training and education in this area; your arm chair psychology is worth … well … what we paid for it.)

Suggestion 5: Actually listen to what we have to say.  Don’t call us with your generous offer of support, then get engrossed in a football game while we are opening up to you (rare, but it happens).  Do you know the old song, “Mister Cellophane“?  Most suicidal people feel like that.  Don’t add to the problem.

I’m all out of suggestions for now.  I could think of more I suppose, but it’s 1:30 am and I am thinking about getting back to work after seven weeks off, so I’d better choose sleep over profundity.  Hopefully, we will get a lot of comments so the F&F can get a sense of what they might do to help.  We know you care, so read up and show us how much you care.

Good night everyone (that wasn’t a euphimism, so don’t get depressed).  I am looking forward to reading the comments of other silk folk and the thoughts of their F&F.  I know this is not easy for F&F — it may even be the hardest thing you ever have to do in a relationship (sexual acts not withstanding) — but you can do it.

-Ashley