How to cope with chronic suicidal thoughts…

People who don’t struggle with chronic suicidal thoughts sometimes imagine suicide as the type of crisis that happens in the movies.  And it can happen this way, but not for everyone.  You know the cliched scene (we’ve all seen it) someone loses their job, breaks up with their partner, makes a terrible mistake, suffers the loss of a loved one etc. and they spend a dark night contemplating ending it all.   Maybe they reach out, a friend comes over, makes them tea, stays up all night and talks them through it.  Or maybe they are taken to a hospital emergency room, where staff admits, them and they are released a few days later, on medication and thankful that they are still alive.

Yes, single episode suicidal crises happen.  They are terrifying and frightening and can be medical emergencies.  If you are struggling with this type of crisis, you are not alone.  Suicide is a permanent solution to a temporary problem.   There is help available, even though reaching out can be scary.

But what if this isn’t your experience.  What if, like me, you struggle with chronic suicidal thoughts, on and off, for decades?   What if suicidal thoughts and suicidal impulses became, during times of trauma, part of your coping mechanisms?  What if suicidal thoughts, ironically and paradoxically both threaten your life and help keep you alive?  What if it isn’t just “one long dark night”?  What if it isn’t something that a trip to the local emergency room and a short psychiatric admission can even touch?  What do people like me do when they hit a rough patch?

It’s complicated.  It’s complicated for a number of reasons.

  1. It’s very hard to even talk about suicide.  It’s not an easy subject to bring up.  I’m always afraid that people will either overreact (ie. treat it like the suicidal crisis described above and call emergency services) or under react (and ignore my disclosure or not offer support).  Let’s face it, most people aren’t comfortable talking about suicide.  If someone asks me: “How are you doing today?”  they don’t want to hear “Actually I’m dealing with suicidal thoughts at the moment, thanks for asking.”  It’s just not something I can say.
  2. If I do disclose that I’m having suicidal thoughts, most times people just sit there awkwardly.  Try to figure out if I’m joking or serious.  And then change the subject.  Meanwhile, I’m sitting there, just as awkwardly, feeling guilty for making the situation awkward and not just saying “I’m fine.”
  3. See point #1.  Talking about suicide is a societal taboo.  I’ve had these thoughts for 20+ years.  I’m still alive and I’m still finding it difficult to talk about them.  There is something about this that doesn’t quite make sense.
  4. There is an incredible amount of shame related to this societal taboo.  This means that not only do I feel suicidal, I also feel ashamed about it.  I also feel afraid about the consequences that could occur if people find out and misunderstand what chronic suicidal thinking means (aka…911 calls, police, hospitals).
  5.  Suicidal thoughts are not a “cry for help” or a “way to get attention.”  Most of the time I deal with suicidal thoughts alone and people aren’t even aware that I’m having them.  Even when I do disclose, I generally minimize how bad they are.  I try to cope by myself as much as possible.  Self harm has also been a very private thing in my life.  For something to be a “cry for help” generally other people need to actually know about it!  It would be more accurate for me to describe the suicidal thoughts as a way to gain control, the ultimate control, over an overwhelming or out of control situation in my life.  It’s also related to obsessive compulsive thinking, and in that way can be circular and very difficult to control.  Sometimes I have intrusive thoughts about suicide that are obsessive and not related to anything in particular in my life.  They are disturbing to me and they are  unwanted, arriving in my brain suddenly and then leaving.

So how do I cope with these chronic, obsessive suicidal thoughts?  I use some combination of the methods below, depending on what type of thoughts I’m having, how long they last and how severe they are.  It can be helpful to make your own “safety list” with various ideas that you can use when your suicidal thoughts make an appearance.  I suggest that you create a variety of coping ideas, because chronic thoughts of self harm are very persistent and won’t likely go away with the use of just one distraction or grounding technique.  If you are lucky enough to have a supportive partner/friend you can give them a copy of your safety list and they could help you use some of the skills in a crisis situation.  For some folks, taking medication or calling a support line can be items on their lists.

  1. Delay. Delay. Delay.
  2. Distract. Distract. Distract.
  3. Remind myself of reasons why I need to stay alive (aka my kids)
  4. Listen to nature sounds on Spotify.
  5. Get in a safe space (aka my bed, under lots of warm blankets, away from anything potentially dangerous.  This works best for the most severe thoughts when other techniques may not be safe)
  6. Take a walk outside, ideally in nature.  Breathe, move my body.
  7. Drink a hot beverage (tea, hot chocolate, coffee)
  8. Reach out to a trusted friend (I may or may not tell the person I’m struggling)
  9. Blogging (others may use journaling, art or other creative outlet)
  10. Helping others, volunteer work, helping a friend in need (this works very well for me, but caution as it can lead to burn out if this is your only coping tool)
  11. Disassociate or zone out (ensure that it is safe to do so)
  12. Pay attention to your environment.  Count things you can see, feel, touch, hear.  Ground yourself in the present moment.

If you are coping with chronic suicidal thoughts, I hope that reading this post helps you to feel a little bit less alone.  If you don’t struggle with them, I hope it helps you to understand them a little bit and maybe allows you to help others around you who might be living with them.  Many people live with suicidal thoughts for years, it’s exhausting.  So very exhausting and nothing at all like what is presented in the movies.  But it has to be better than the alternative.  So I keep trying and keep breathing!  Keep hoping that it will get easier for all of us!

How are you?

how-are-you

How are you?  How are you doing?

Fuck.   They feel like SUCH  loaded questions right now.

99% of the time people want to hear the standard answer:

I’m fine thanks, how are you?

But I can’t lie.  I’m not fine.  That being said, I know that 99% of people don’t have the time or energy to listen to how I’m really feeling.  Maybe they don’t care, maybe they are busy, maybe they don’t have spoons, maybe they are at work, maybe they were just asking to be polite.

I’ve started answering this question with:

The same.  It’s always the same.  I’m always the same.

Until I get the verdict, I’m not going to be fine.  I’m probably not going to be feeling better, and I don’t have the energy to lie about it.

I’m feeling grumpy today.  I’m feeling grumpy because I just want to cry when people ask me how I am.  I want there to be space for me to not be okay.  I want there to be space to just not function for a while.

I came home after a long day.  It’s cold outside, unseasonably cold for May.  I was shivering.  It was time to eat.  I decided to make myself grilled cheese. Comfort food.  What could be simpler?

I burnt the shit out of that sandwich.  So burnt it wasn’t even possible to scrap the black bits off the edges.  Throw it in the garbage burnt.   I wanted to burst into tears.  “You can’t even make a simple sandwich!” screamed the self critical voice in my head.  Somehow this burnt sandwich became a symbol for everything I feel isn’t going right today.

It’s difficult feeling lonely.  It’s difficult feeling like the one who is never “fine.”  I feel like I’ve been losing friends or driving people away from me because my life is complicated and I’m not always easy to be around.  I feel like I’m whining, complaining, self-absorbed, wallowing, not being grateful…lots of self criticism.  I know I’m doing the best I can.  It just never seems like enough.

In all likelihood, there are only a few more weeks of waiting left.  Things are going to shift in my life soon.  Potentially in major ways.  I’m so close to the end of this chapter of the journey.  I’m so close I can almost see the finish line.  I can almost reach out and touch my new life.

But it’s just out of reach.  It’s blurry and uncertain.  After 3.5 years in court and almost 14 months of waiting…a 16 month long total (and counting) trial process…it’s actually no longer possible for me to clearly visualize or imagine it being over.  I used to fantasize about getting the verdict.  Where will I be when I get the call?  Who will I tell first?  How will I feel?  What will happen from there?  So many unknowns.  In a way, waiting has become normal for me.  In another way, it has never felt normal.  I’ve never adjusted to having so little control over my own life.

It’s a unique situation.  Very few people in my life can relate.  It’s gone on for so long, very few people still have time to listen to me talk about it as much as I feel I would like to or need to.  Everyone around me is tired and frustrated too.  Nobody knows quite what to say. I understand.  It’s been a long journey.

I’m so close to the end.  But I’m not fine.  I’m burn out and I’m afraid.

What does “fully recovered” mean?

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I’ve been reflecting on what it means to be “fully recovered” from an eating disorder.

The best books I’ve read on this subject are “Life Without Ed” and “Goodbye Ed, Hello Me” by Jenni Schaefer.   These books promote the message that it is possible to be “fully recovered” from an eating disorder.  They give me hope that anorexia isn’t something I will have to struggle with for the rest of my life.   I’ve read the books at various times when I’ve felt overwhelmed or hopeless and they have always helped me stay positive.  I truly admire the author’s dedication to having a life free from ED, or in my case Ana.

But if I’m 100% honest with you, I’ve never even TRIED to be fully recovered.

I’ve been in imperfect recovery for years.  At times this has meant being at a healthy weight, but still struggling with unhealthy thoughts and habits related to food and restricting food.  At times, this has meant slipping back into controlling my body,  purposefully eating less and obsessing about taking up less space.  I know how imperfect recovery works.  It keeps me “functional” and sometimes even “looking healthy,” but inside I am never truly free.  The thing with imperfect recovery is that Ana still controls my life to varying degrees, depending on how much I’m struggling.

It’s not possible to tell by looking at a person whether or not they have an eating disorder.  Being at a “healthy” or “normal” weight means nothing.  Being at a “healthy” weight doesn’t even mean a person is medically stable or in recovery.   In my current situation, my weight is higher than it’s been in  years, but my eating disorder is causing me MORE trouble, not less.  I feel exhausted mentally and physically most of the time.

I’ve been in hospital treatment programs in the past.  Inpatient programs where I was “forced” to eat large quantities of food.  I was supervised after eating, a staff member watched me to make sure I ate all of my meals and snacks.  I followed the rules because I had to, even though I was there voluntarily, I was able to comply because it was required.

But let’s be honest.  I never attempted to be fully recovered.  I have never, in 20 years, been even willing to CONSIDER giving up Ana as a coping technique.  I’ve used it to varying degrees at various times, but I’ve never committed to letting Ana go.

I stayed in treatment until I was functionally recovered.  Until I could eat without panic and physical discomfort, until I could have the energy to get through a day, until I could think more clearly and re-engage in life.  Then I discharged myself every time.  I wanted to be healthy and eat, but I didn’t want to gain too much weight or give up my obsessive compulsive thoughts and habits.  I wanted to be in control, even of the recovery process.  I told myself I could do it by myself, I could do it my own way, I didn’t NEED the program.

I was told again and again that I needed to follow a meal plan and eat mechanically for at LEAST a year before trying things on my own.  I was told again and again that I needed to gain to my goal weight and maintain it for a year in order to recover.  I was told again and again that I needed to stop controlling food and my body in order to heal.  But what did I do?  I poured out my juice when nobody was looking.  When I got out of treatment I stopped drinking juice altogether because it was unnecessary!  I cheated in a million little ways.

When I was younger, I thought I knew better.  I thought I could do it on my own.  I thought I could let go of the horrible life threatening aspects of Ana, but hold onto the comforting habits that kept me slim.  I thought I would be happy about 10-15 pounds below my “goal weight” and that I would be medically stable.  I thought Ana and I could dance together this way forever.  I thought I could have Ana on my terms, not hers.

But I’m not a teenager anymore.  I’m pretty close to my “goal weight” now, but I feel worse physically than I have in years.  I can’t push my body the way I used to.  I get migraines, physical body pain, exhaustion and lack of patience.  I don’t dance with Ana anymore…instead we are plodding, dragging through life, in a way that has very little meaning to me.

Because I have never embraced “fully recovered,”  I have instead remained sick.  Because let’s be honest about this too, if Ana is driving, I’m sick regardless of my weight.

For a long time, imperfect recover was enough for me.  It was such an improvement, I was proud of myself.  People stopped bugging me about gaining weight.  I was able to eat most things without panic.  I was able to eat around other people.  I was able to attend social events.  I was more relaxed.

But even at the BEST of times, there were always rules, calculations.  I always felt that I deserved to eat only as much as I needed to survive each day.  Never more.  I wasn’t starving myself literally, but I was starving my soul.  I was depriving myself of more than food, I was depriving myself of joy, connection and abundance.

Recently the stress in my life has been almost more than I can bear.  I’ve been waiting for 5 months for the outcome of a year long family law trial.  I’m waiting for a stranger to decide the future of my children.   Many important aspects of my life are quite literally out of my control.

I struggle daily to accept my body at this weight.  I struggle daily feeling like I am too big, seeing parts of my body as fat, living with body distortions and hating myself.

I struggle daily with the lack of control and the waiting.

And quite honestly, I CHOSE to let Ana start driving again.  I saw it as a necessary evil, to help me keep functioning and keep moving forward through each day.  I opened the door and let Ana right back in.  I welcomed her. I almost felt happy that I had a way of modulating and distracting from the unbearable stress.

I changed a few things here, a few things there.  Nothing drastic, but small changes.  I felt okay about it.   Maybe I could lose just a few pounds.  But it isn’t really about the weight, though I might say that it is.  It’s all about feeling in control of my body and thus, my life.

Irrational.  Magical thinking.  Self-destructive.  Self-punishing.  Illogical.

But even though I’ve let Ana drive many times before, always with varying degrees of disastrous results, I STILL believe deep down inside, that she is my friend who will NEVER leave me.  I love Ana for getting me through years of sexual and emotional abuse.  I love Ana for never letting me down, for always being there.

But Ana is an abusive partner.  She isolates me.  She makes me say no to eating dinner with friends because she makes me ashamed and afraid to eat in public.  She makes me tired from restricting food.  She makes me impatient and she makes me struggle to connect with those around me.  She helps me to disassociate by numbing out through the physiological effects of semi-starvation.  Ana is abusive even when I let the door open a crack.  Ana is abusive even when I’m not emaciated.  Ana is abusive even when you see me eating.  Ana is abusive right now.

Ana tells me that I don’t deserve to eat.  That I don’t deserve to take up space.  That I’m bad or weak for needing food to survive.  Ana tells me that the high of restricting food means I’m strong.

Ana lies.  She lies like any abusive partner.  She gaslights me.  She lulls me into thinking she is caring for me while she is trying to destroy me.

Today, I am at the stage of contemplating full recovery.

When Ana drives, I eventually feel like life is not worth living.  I can’t imagine living another 20 years this way.  Half living, half dying.  I’m tired.

To me, full recovery means more than changing my eating habits.

Full recovery means letting go of giving meaning to food.  Letting go of believing my food intake or weight has anything to do with my worth.  Letting go of trying to control my body as a means to feel safe in this world.  Letting go of believing that being thin will protect me from being raped again.  Letting go of trying to disappear to stay safe or avoid hurting anyone.

Fully recovered means eating when I’m  hungry and stopping when I’m full.  Fully recovered means going out to dinner with friends, even if I ate lunch.  Fully recovered means eating lunch daily. Fully recovered means eating 3 cookies.  Fully recovered means breaking all my food rules, even drinking juice!  Measuring nothing, counting nothing, giving food no value other than nutritional.  Fully recovered means not cheating, by holding on to “just one or two habits.”   Fully recovered means committing to staying alive until my natural death.  Fully recovered means learning to like myself, then learning to love myself.  Fully recovered means reconnecting with the world, trusting myself and opening myself up to others.  Fully recovered means healing from years of abuse, by self compassion rather than self hatred. Fully recovered means accepting my natural body shape, no matter what size that turns out to be.

Fully recovered means letting go of fear.

I hope fully recovered means living with joy.  I hope that one day I will experience fully recovered and it will be wonderful.

Today, I still feel lost and stuck in survival mode. If you have tips for finding “fully recovered” please share them in the comment section below.

The Voice.

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I’ve been feeling very young recently.  I feel like Ana is around more than I am.

There is a book (which I haven’t yet read) which talks about structural disassociation and describes the experience of having an “apparently normal part” and one or more “traumatized child parts.”    My apparently normal part seems to be quiet this past few weeks and Ana, my traumatized teenage part is very loud.

Sometimes when Ana is around I do things that don’t make a lot of sense to my apparently normal part.  And my apparently normal part doesn’t make sense to Ana.

I was trying to figure out if there were any particular triggers, anniversaries or memories surfacing for me recently, ones that would bring Ana to the forefront.

Next week will be the anniversary of when I first started being abused.  It will also mark the one year anniversary of this blog!

I started reading through an old journal from 2001:  the year I first was hospitalized, the year I tried to kill myself multiple times and the year I began cutting daily, sometimes multiple times a day.

Reading the journal, my 2001 apparently normal self seems extremely young.  But even at that time, I clearly identified having  a traumatized child part.  Back then I called it healthy me and little girl me.  I also called it “the voice.”  I’ve found multiple segments where I speak about “the voice”  and I recognize what she is saying as Ana.

February 21, 2001

The sensation of hunger is not an easy one for me.  It is frightening.  Like I feel afraid of losing control of myself. And yet I know that the E.D is out of control.  It is a part of me that often deceives and betrays me.  I know that in the end, though it feels comfortable, it cannot be trusted.  The voice which tells me not to eat, tells me to cut my skin, to smash my head against a wall, to step out in front of traffic, all sorts of dangerous and hurtful things.  It speaks to me in persuasive ways.  It is a part of me and yet foreign.  My ally and my enemy.  My strength and my destruction.  But after so many years it is the way I know.  A method of ridding myself of unwanted feelings…I feel like a stranger in my own life.

I don’t know what to do to help my traumatized child part heal.  What does Ana need?

The answer that comes to my mind is love.

She needs love.  She needs acceptance.  She needs to be believed.  She needs to feel safe. She needs to be forgiven for all the years of self abuse.  She needs to forgive her own body.

But I rail against it.  My apparently normal adult self doesn’t feel capable of parenting an angry teenager.  Ultimately, she is me…both the apparently normal adult self and the traumatized child parts are me.

Even in 2001, I can read in my journal signs of this inner battle.  The battle between health and self destruction, between hope and despair.  I’ve been fighting for a long time.

I can read myself trying desperately to convince myself that my engagement was a good idea.  That I loved my partner.  That my own PTSD and issues were the root of the stress in our relationship.

March 18, 2001

I miss having him around me and yet I’m also afraid of our intimacy.  He is at the same time my motivation to get well and my trigger to feel upset.  The strong emotions I have toward him complicate and simplify my life

I can read my younger self trying to convince herself that things would be okay.  I can read between the lines that a deeper part of her knew the relationship was wrong and unhealthy.  I can read how I desperately continued hurting myself, longing to be SEEN. Truly SEEN and accepted for who I was.  I can read my self blame, self hatred and confusion.

And a good part of this fight has been internal, between parts of myself that can’t seem to make peace, forgive and start again.

South Street.

Photo credits to the London Health Sciences Centre website documenting the decommissioning and destruction of South Street Hospital.

I’ve been thinking about South Street.   It’s been completely demolished now, destroyed and decommissioned but it’s still alive in my memory.

I haven’t written many posts about being in the hospital since I started this blog almost a year ago now.  Those were first posts, the first thoughts on my mind which I wanted to share.

I think people who have never spent time on a psych ward often have a dark curiosity about what they might be like.  I find myself filled with the same morbid curiosity as I search through pictures of the abandoned South Street hospital online.  How can a place where I survived so much just be demolished?  On one hand I’m glad it is gone.  It was a horrible place!  On the other hand, I feel like it should have stood there forever as a monument to the suffering and the intensity I felt there.

What were days like as a patient at South Street?

The days varied slightly depending on which unit I was on.  There was something comforting about the meals being delivered on neatly organized trays.  In the morning you could select your choices for the following day, marking them off on a paper slip.  The selection for vegetarians was rather poor.  The food in general was awful, but they would bring me a peanut butter and jam sandwich for lunch.  I wrote in my request beside the offered choices.   In the morning there were little boxes of cereal and tiny muffins.  Breakfast was always my favourite meal.   For your first day or two, your meals are delivered directly to your room.  After that you were encouraged to eat with the other patients in a small dining room which was unlocked at meal times for this purpose. I never ate there.  I carried my tray carefully back to my room where I ate alone.  The meals arrived like clockwork at 8AM, 12PM and 5PM.  You could order ginger ale as a snack or a treat, it arrived in a paper bag with your name.   I used to order Colt diet ginger ale, but I’d use the edge of the can to hurt myself, I never drank the pop.   Dinner was the worst meal.  There were a selection of about 4 different vegan dinners that came in plastic trays, preheated.   I would peel the plastic wrap off and sample them, sometimes eating very little.   The arrival of the trays marked the passage of time through the day and the long hours after dinner stretched out, especially if you didn’t have a visitor.

Medication times were another way to tell the time.  At first my nurse would come to my room to give me the selection of pills (at one time I was taking more than 11 pills a day).  After settling in, patients reported to the nursing station at set times to receive their pills.  Each pill came in a tiny sealed plastic bag, labelled with my name and patient number (I still have it memorized!).  The nurse would check my wristband carefully against the name on the plastic bags.  Then the nurse would rip them open carefully and tip the pills out into a small paper cup or into my hand.  I would get another small cup with water and the nurse would watch me swallow the pills.  Night time medication was always greatly anticipated as it marked the end of the day and the time at which it was acceptable to go to sleep for the night.  Realistically, on high doses of anti-anxiety and anti-psychotic medication I often slept during the day as well.   Floating in between high levels of anxiety and thoughts of self harm and suicide, and drugged, sluggish, words slurred together medication induced slumber.

There were no cell phones at that time, difficult to imagine!  There was a Bell payphone at the end of the hall in the TV lounge area.  There was a black leather chair you could sit in while you were on a call.  There was another payphone halfway down the hall, at the edge between the Y and Middlesex portions of the 7th floor (older and comparatively newer parts of the wing).  Talking on the phone to friends and family members was one way to pass the time.  Some patients also sat in the TV room watching whatever was on. I rarely sat there, preferring to stay in my room or in the room of a co-patient I had befriended.

If you were upset, you could ask to speak one on one with your nurse.  There was a small room attached to the nursing station where we could sit.   Sometimes the nurses would speak to me in my room.   The psychiatrist would visit once every few days.  These visits were highly anticipated.  Sometimes I would wait around the floor for hours, figuring that my Dr might check in on me.   Visits from the psychiatrist meant changes in medication, changes in privilege levels, and often discharge from the hospital.  The doctor generally just spoke to me in my room, even when the room was shared with 1-3 other people.  The level of privacy on the psych ward was very low, unless you were lucky enough to be moved to a private room.

Private rooms were highly coveted.  On the psych ward private rooms had nothing to do with the insurance coverage you had and everything to do with privileges.   When I arrived on the 7th floor I was generally in a ward room, 4 beds separated with curtains.  I didn’t mind this as long as I had one of the two beds by the window rather than one of the two beds by the door.   Patients who just arrived on the unit were placed in the ward rooms closer to the nursing station.  Aggressive or self destructive patients were placed in these rooms.  If I stayed longer, I would often be allowed to move further down the hall, further from the nursing station and closer to the exit (both literally and symbolically).   I loved the single rooms which had their own washrooms.  All the rooms had these chain link grills over the windows, but some of them did open a crack.   There were also double rooms, some of which did not have washrooms.  There was a shared shower room.  It had space for 3 people to shower or bathe at the same time, but the showers were separated by curtains.   Rumors circulated that people had completed suicide in these shower rooms and all the patients believed them.  There was also a laundry room where longer staying patients could wash their clothes.

The best part of staying at South Street was that I was generally allowed to come and go for brief periods on my own.  Sometimes I was allowed only on hospital ground, in which case I would go down to the patio at the back of the building.  This was a place where smokers could smoke and psych patients who were not allowed to leave could get some fresh air.  I would go down there with fellow patients sometimes and it was almost like an outing.  Smokers looked forward to the scheduled times we were allowed to leave the unit.

Other times I was allowed to go for short walks around the neighbourhood.   I used to walk down to the river by the hospital.  I’d walk around the streets in the area.  Sometimes I’d walk to Tim Horton’s and buy a piece of caramel coffee cake.  There was a walking path along the river to a small waterfall.  I know we sometimes though of jumping into it.  There were ducks which could be fed if you ordered extra bread with your meal.  Sometimes I walked alone, sometimes with visitors and sometimes with other patients.   I made some friends at South Street.  A few of them I still stay in touch with today.

Ironically enough, many of the patients were allowed to basically come and go as they pleased.  At night the door was locked and you needed permission from your psychiatrist to have a pass home for the evening or overnight.  Sometimes I had accompanied passes which meant my boyfriend had to sign me in and out.  Other times he would just drop me at the front entrance.   Ironically, though I was often admitted to the hospital for self harm and suicidal thoughts or attempts, I was still allowed freedom to leave the floor unaccompanied.   In reality I could have harmed myself pretty much anytime I wanted, even when in the hospital.  Sometimes I did, but other times I didn’t.

I often wonder exactly what made the hospital safer than being at home.   I think it was the thought, or the hope, or the desperate idea that it was safer which kept bringing me back there.  I was almost hypomanic and highly impulsive about self harm while I was taking anti-depressants.  I felt unsafe, I thought I’d be safer in the hospital, admitted myself then realized I felt trapped.  I was generally a voluntary patient, so I soon discharged myself and the cycle began again.  I never really felt safe anywhere.

Sometimes the hospital was a comfort.  The routines, the quiet, the break from real life.

Sometimes the hospital was terrifying, like when one of my roommates was cutting and snorting cocaine in our shared washroom.  Leaving blood and white powder traces for me to find.   Like when a patient who dressed in black and openly worshiped Satan was restrained by multiple security guards and wheeled down the hall on a gurney screaming.   Like when an old man came up behind me in the hall and placed his hands around my neck, whispering that he would kill me.  Like the blood stains on the 7th floor carpet, from where a man had been seriously injured trying to escape.

There was  tenuous grasp on order there, and we all knew it.   Sometimes people think of the psych ward as being filled with crazy people.   But in reality, I was neither more nor less crazy than the other people there.  I wasn’t psychotic, like some of them were, but I was destructive and depressed.  Everyone was there because they weren’t safe.  Our reasons were different, but the result was the same.  We all lined up for our pills.  We all ate our meals off plastic trays.  Some of us were allowed real cutlery and others only plastic.   The lines were drawn in terms of privileges, delineating various levels of “crazy.”  But in the end we were all there together.  We were all psych patients.  I see myself as being no different from the others.

Even today, over a decade later, there is a part of me that still holds that identity.  The identity of being on a psych ward, of being hospitalized against my will.  It did change me and it did shape me.  But it no longer defines me.

 

 

Meet Ana.

These pictures are of a cartoon girl called Emily Strange.  If I could draw a comic book version of Ana, she would look something like Emily Strange.

Ana isn’t just my eating disorder personified.   Ana isn’t just a nickname for anorexia.  Ana is another part of me.  I experience Ana as an angry teenage girl.  She isn’t just me as a teenager.  She has long straight black hair and very pale white skin.  She has dark eyes which are usually downcast.   Her fists clench when she is angry.  She wears hoodies, dark clothes, army boots and skirts.  She is slim and looks like she could sneak around very easily, light on her feet and quiet.  She is filled with anger and yet she doesn’t take up much obvious space.   Ana is my inner child.  Ana is my alter ego.  Ana is my eating disorder.  Ana is self harm and suicidal thoughts.  Because Ana is a scared, teenage girl.

Ana is the part of me that doesn’t trust you.

Ana is the part of me that wants everything or nothing at all.  Complete loyalty, or no friendship.

Ana is the part of me that feels like nobody believes me.   Ana doesn’t feel heard and when she is angry, she hurts me rather than expressing herself assertively.

Ana acts out, but that’s because she’s  young.  She’s probably only 14 or 15 years old.  She doesn’t have life skills.  Her anger is a mask for fears she is too afraid to share.  Her prickly exterior is a mask hiding deep vulnerability and shame.

Ana feels worthless.  Ana feels helpless.  Ana feels like punishing me is the only solution to these feelings.

Ana acts like a complete spoiled, controlling brat, when she really wants to be rescued.   She makes unreasonable rules rather than admitting she is afraid.

Ana craves safety, yet acts like she does not need protection.

Ana blames herself for being abused.   Ana feels responsible and wants to protect me by keeping me alone.  Ana tries to push people away with self harm, suicidal thoughts and eating disorder behaviours.  Ana thinks if we are smaller and take up less space we will be safer.

Ana is me.  At least she is a part of me, but I don’t know how to make peace with her, forgive her, accept her and come to a truce.  I don’t know how to integrate her, so that we become just one adult person again.  I’m not sure how to soothe this angry child inside of me.  We lack compassion for each other and for our younger selves.

I hope one day I can truly feel that Ana deserves forgiveness for hurting me.  And that she can forgive me for not protecting her.

Firsts.

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<trigger warning for graphic descriptions of self harm and eating disorder>

I’ve been thinking a lot about the “firsts” of my mental illnesses.  We all have memories of the first time we did certain things or had certain experiences, but for people who have chronic mental health struggles over a number of years, not all “firsts” are positive memories to celebrate.

When I was experiencing my “firsts” of mental illness I was a teenager.  I was 15-17 years old and I didn’t have any idea that my experiences were those of specific mental illness, let alone what those mental illnesses might be.  I thought that I was going crazy.  I thought I was the only one.  I was afraid to tell others what I was experiencing internally.  Until I was diagnosed with PTSD when I was 20 years old, most of my “firsts” made little sense to me.

The first time I experienced what would become anorexia I was about 16 years old.  I’ve written about it in another blog post.  I was physically sick and hadn’t eaten for a few days.  I felt mostly better and wanted to go to school.  I remember my mother telling me I had to eat something if I was going to school.  I took a granola bar and started walking down the street to meet my boyfriend at the time and to catch the bus.  I remember feeling light, empty and powerful.  I remember feeling the sense of white, blank emptiness that I now associate with disassociation.  I felt like I could take on the world.  I felt like I could survive without food and that I’d actually be more powerful.  I loved that feeling and I chased after it in various forms for the next 20 years.  I believe this moment is the one I chose anorexia as a coping technique for the sexual and emotional abuse I was living with.  At that time I wouldn’t have identified it as an eating disorder, nor would I have identified my relationship as sexually and emotionally abusive.  It was just a feeling I had, of realizing that disassociation was more comfortable than pain.

I remember the first and one of the few times I tried (unsuccessfully) to purge after panicking about eating.  This I described in another blog post.  I remember crying and sitting shaking on the floor of the downtown public library.  My crime?  Eating a whole cookie rather than half of one.  I remember I had been reading books about eating disorders, secretly, trying to figure out what the heck was going on.

I remember my first panic attack.  I was in Grade 12, 17 years old and extremely ill from anorexia.  I was attending school despite the fact that my weight was well under 100 pounds at close to 5’9″.  I remember feeling driven.  I remember feeling an intensity of moving forward that wouldn’t allow me to slow down or calm down.  I had to keep “doing” and trying to be perfect at everything.  I had to follow all my rules or something terrible would happen.  I remember there was one day I had a math test.  I believe it was Grade 12 Calculus or some other horrible subject.  I had been doing well in school despite my illness.  But that day somehow my brain just wouldn’t work.  I remember sitting in the classroom, the desks were arranged in rows, one in front of the other with the blackboard at the front.  I remember all the numbers and letters swimming around on the paper.  I couldn’t breathe.  I couldn’t think of how to solve the problems because everything was spinning and I felt like I was being crushed.  I felt nauseous and I realized that I was about to cry.  I remember bolting out of the room and into a stall in the girls bathroom.  I remember sitting there crying, shaking and feeling terribly upset that I couldn’t do the test.  My thoughts were racing around and I just wanted to go home.  I remember another student from the class coming in to check on me (it was a male teacher).  I remember being somehow glad she was there even though I was embarrassed.  I made up some excuse about being sick and not being able to write the test.  I think I went home.  I wouldn’t have known at the time that it was a panic attack, but it was and it was probably related to extreme lack of nutrition and just pushing myself too hard on no fuel.

I remember the first time I cut myself as a coping technique for stress.  I was about 18 years old.  I had just started taking SSRI medication for depression and anxiety after about 2 years of fighting with my parents and my doctors.  I never wanted to take medication.  I think deeply and instinctively I must have known that my mental health problems were situational, but that knowledge was too terrifying to face, so I blocked it out.  The first time I engaged in cutting I  used a pair of scissors that I kept in my bedroom.  I used to make just one small cut.  I would do it once a week in the exact same place, just under where the band of my watch lay.  So I could hide it carefully.  It was ritualistic, very controlled.  I don’t remember exactly why I started doing this.  It became part of my routine as I gained weight and somewhat normalized my eating behaviour. I needed something else to help block out the memories of the abuse.

I remember the first time I considered suicide.  I was probably about 17 years old, but I might have been 18.  I remember being at a party at a friend’s house.  Radiohead OKComputer was playing in the background.  Music I always associate with the “saddest of the sad” times.  It was raining outside.  I remember sitting on the couch looking out the back sliding door.  It was dark outside, evening.  The rain was falling really hard and there was thunder and lighting. I felt like I was in a trance.  Looking back I realize this was also an example of disassociation.  I remember feeling incredibly alone and disconnected. I was AT the party but not part of it.  I remember being at home that evening.  My bathroom had green tiles.  Small square tiles with white grout.  I remember just sitting there staring at my razor.  Thinking about cutting myself, thinking about dying and ending my life by opening up my veins.  I just sat there for a long time thinking about it.  The images of the green tiles and the emptiness of that moment are burned into my memory.

I remember my first flashback.  I was 18.5 and with my first love, my first real connection after the abuse and the severe anorexia.  I remember we were in my bedroom and we were kissing.  It was consensual and I wanted to do it.  He was lying on top of me. I think he might have been about to unbutton a piece of my clothing or something like that.  Suddenly I was crying and shaking and it wasn’t him there.  It was my ex boyfriend, who had so many times taken off or unbuttoned my clothing when I’d clearly said now.  It was him on top of me and I was afraid.  I had no idea what a flashback was, I didn’t know I had PTSD.  I just had an intense physical reaction to what was happening.  My boyfriend stopped immediately.  I remember him leaving the room briefly to give me space.  I remember feeling scared and embarrassed.  I don’t really remember the explanation I gave to him.  Some of my memories are less clear, but I think over time I had told him that my last relationship had been difficult.  I don’t think I fully understood myself at that time that it had been abusive, and that this type of reaction was a normal one for survivors.

I remember the first time I cut myself deeply enough to need stitches.  I was 20.  I was at university.  I remember buying the craft knife at the university book store. I remember walking home.   There was  a bridge on the campus and for months I thought about jumping off it every day.  I knew that I was going to cut deeply.  It was planned and premeditated.  I remember disassociating and thinking only about the injuring.  I remember wanted to make sure it was deep enough to need stitches.  I remember walking to the hospital which was on the campus.  I walked across a field to get there.  It was May or June.  I remember the doctor stitching up the wound.  It was a medical student and I remember feeling afraid.  I remember the resident coming to check the work and commenting that the stitches were incorrectly done.  I remember wondering why the resident didn’t fix them, but I assumed that because the wound was self inflicted they thought I didn’t care about scars.  In the end that wound healed badly and caused me chronic pain until it was fixed about 7 years later by a plastic surgeon at that same hospital.   I remember feeling nothing.  I remember feeling nothing about the injury and having no emotional or physical reaction until the day I went to the health clinic to have the stitches removed. I fainted when the doctor took them out.  My body felt the trauma suddenly and all at once the disassociate wasn’t there.   From then on I always took my own stitches out so I could control the process and do it in a way that I would not feel as much pain.  The ritual of the whole thing was an important part of the process of disassociation for me.

It’s a sad list.  Really sad.  Because some of these firsts are clearly in my mind that pleasant memories I would like to remember.  The way that PTSD stores traumatic memories and erases positive ones is deeply frustrating.  Because the long term consequence of disassociation is memory loss, and rarely losing the memories I wish would disappear.

Picture was drawn in September 1999

 

 

 

Healer, Heal Thyself.

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Do you ever have the feeling that you are a complete and utter fraud?

I’ve been feeling this way recently, more than usual, as I’ve been reflecting on how little of the advice I share with others that I actually follow myself.   Am I a fraud, if I truly believe what I’m telling other people, but can’t internalize it or believe it for myself?

How is it possible that everyone around me deserves health, happiness and recovery but I somehow feel undeserving of even simple things?

Someone close to me commented on one of my scars this week.  It was a passing comment, about noticing a scar on my hand that he hadn’t noticed before.  To him it was a neutral comment, just noticing, no judgment.  I told him that scar had been there since around 2002, it wasn’t new.  That was the end of the conversation for him, but I started talking about and reflecting on the amount of harm I’ve done to myself over the past 20 years.

Until 2009, I hid all my scars, all of the time, from everyone.  Even when I was home alone I would wear long sleeves and pants.  I was so ashamed of my cuts and scars that I didn’t even want to look at them myself.  In the summer, I was perpetually hot, avoiding swimming, making excuses to stay in the air conditioning.  My life was being seriously limited by my self destruction.

From 2009 on, I gradually began experimenting with uncovering my scars.  I wore t-shirts or skirts when I was hot, and started to swim again.  I still kept a cardigan or long sleeved shirt with me at all times, so I could cover up around people who didn’t know about my habit, or for situations like interviews where I didn’t want to be judged.  I used to have so much anxiety about people seeing my scars and I would imagine all sorts of scenarios where people around me judged me as crazy.  I even thought that CAS would come to take away my  kids because if someone saw my scars they would report me as an unfit mother. Over time, I  became accustomed to uncovering my scars.  I came to a place of a bit more acceptance (plus I got tired of being hot all summer!).  This was a process and today, the only time I purposefully cover my scars is when I’m helping other women at work.  I’m afraid that my scars might trigger others, especially those who are working on their own healing.

I still feel sad though, every spring when the warm weather returns and shorts, t-shirts and summer dresses flood the shopping malls.  I feel sad because in the summer I can’t hide under my clothes.  In the warm weather, I often feel exhausted when interacting with people because I am intensely aware of the visibility of my scars.  It gets a little bit easier each summer, and I think about it less and less often, to the point where there are times that I almost forget about the scars. Almost.

I can’t really forget about them. I can’t forget about them because they represent a huge, unnameable, unspeakable history of trauma and pain.  And at some points I feel crushed by the weight of the realization that I have been my own worst abuser.

I am my own most dangerous and most unrelenting abuser.

It’s difficult to know how to even approach talking about, thinking about or grieving the trauma I’ve inflicted on myself.  It’s not something others discuss or disclose to me either.  We talk about the hurt caused by other people in our lives, the betrayals, the injuries and the abuse.  We talk about being hurt and being damaged.  But how do I start a conversation or healing process around the trauma that I perpetuated?  How do I heal from situations where I was both the abuser and the survivor, simultaneously in one person, in one experience, in one breath?

My experience of surviving sexual and emotional abuse at the hands of perpetrators, is directly linked to my “decisions” to cope by self harming in various ways.  Before I was sexually abused I didn’t have anorexia, depression, PTSD, or obsessive compulsive tendencies and I did not cut or physically harm myself in response to stress.   Before I was sexually abused, I considered myself a “normal” person.  I didn’t have a mental illness, I didn’t have dangerous coping techniques, I wasn’t a psychiatric survivor or  a survivor of violence.   When I look at my scars, I see both the abuse I survived and the abuse I perpetuated.  The scars are an ever present reminder that I have survived, but they are also like a road map of the destruction and self destruction that has woven through my adult life.

Yes, my scars tell a story, but I’m not sure it’s a story that I want to hear.  I’m not sure it’s a story that I want to tell either.

But sometimes I do want to tell my story.  That’s part of why this blog was created.  There just isn’t a lot of space in our busy, day to day lives, to talk about the story my scars tell.  The person who was with me during the majority of those years (my ex-husband) is no longer available or safe for me to contact.  I don’t have anyone to share my memories of those dark years with.  The people who know me now weren’t there with me in the emergency room while my cuts were being stitched.  The people in my life now, weren’t there with me when I tried, multiple times, to end my life.   Except for a few, the people in my day to day life, didn’t know me when I almost starved myself to death.  People see me differently now.  They see me as a whole person, a mostly well person, a successful person, a good mother, a co-worker, a friend…sometimes I feel like a fraud because I can’t, or don’t know how to, talk about these aspects of my past.

And sometimes I want to talk about them.  I really want to talk about what things were like “before.”   Before I left my ex-husband.  Before I stopped utilizing the psychiatric system.  Before I decided to stay alive.

That “before” person is still me.  I’m just not sure how to heal that “before” me and this current me simultaneously.  I’m not sure how to forgive myself, or to have sympathy or empathy for the me that wanted to die.  I’m not sure how to look at my scars without feeling sadness for the fact that I permanently disfigured my body before I turned 25.  I don’t know how to grieve my smooth, scar free skin…I barely even remember what I looked like before I started cutting.

There are days when I accept my scars.  They are a part of me, they do tell a story and they do represent survival.  But there are days when I hate them.  I hate being different.  I hate having a visible mental illness.  I hate feeling ugly.  I hate worrying about what others will think when they see them.  I hate hating myself SO much that self harm feels like a reasonable solution.

Sometimes I look back on the past and wonder what my life would be like if I’d chosen a different way of coping.  Or if I’d never been abused.  Or if I’d told someone about the abuse.   How different would my life be if I’d never picked up a blade, never wished to end it all?

It’s an interesting dilemma, because there are some parts of my survivor self that I like and I wouldn’t want to change.  If I hadn’t had these experiences I would have chosen a different career path.  I wouldn’t have had my children at a young age.  I wouldn’t be as passionate about social justice and advocacy.  I wouldn’t know the majority of my current friends.

My life would be very different.  I don’t even want to change the past.  It did make me the person I am today and I’m okay with that.   What I do want to change is how much I still judge myself, berate myself and hate myself for my past choices.  I want to learn to do more than accept my scars.  I want to do more than tolerate my body, in an uneasy, fragile truce.

Intellectually, I know that I deserve more than surviving.  Intellectually, I know that a deeper level of healing is possible.  I’ve seen people around me heal and recover from unimaginable horrors.  I’ve seen people build a sense of self confidence from the rubble of their lives.  I know it is possible and that self-love and self acceptance are attainable goals.

But emotionally, I just don’t feel it.  And that makes me sad, and maybe right now, the first step in healing self-hatred is just simply grieving the loss of that 15 year old healthy self.

 Note: The illustration was drawn by me around 2004

 

Everything in my life was preparing me for this.

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January 5, 2016

A night I will never forget.

One symptom of obsessive compulsive disorders is strange intrusive thoughts that are worrying or scary, but not particularly realistic or likely to happen.  I have quite a number of these strange thoughts, which I rarely share with others.  I worry that people will think I’m crazy or bizarre, and I feel ashamed or embarrassed to admit them.   One of my OCD recurring thoughts involves a terrible fear that while I’m driving someone will step out in front of my car, or push someone in front of my car, or a car around me.  Essentially, that I will unintentionally kill someone with my car or witness someone being hit by a car and dying.

I think of it whenever I drive and I’m often quite vigilant, keeping an eye on pedestrians and looking carefully at people on curbs, bicycles and around blind corners.  Generally this level of hyper vigilance is unpleasant, stressful and unnecessary.  I get startled easily when I drive, especially when my PTSD is triggered. I’m very alert, and in reality,  I’m a very safe driver.

That night, my OCD saved a life.

I was supposed to be at a work meeting, but instead I was driving down a busy road in the city where I live.  It was dark, rush hour, and I was heading to a meeting with my lawyer.  I was driving over a bridge which crosses over a railway track when I saw the thing my OCD brain had been looking for for years.

There was a young woman standing on the edge of the railing.  Clinging onto it, in a shaky, desperate way.  A young woman about to jump to potential death.  A young suicidal woman.

I slammed on the brakes, ignoring the traffic, jumped out of the car into the cold winter night and walked very slowly towards the young woman.

My internal dialogue went something like this:

If this woman jumps to her death you are going to witness it.  You are going to be traumatized and you are going to be impacted by witnessing her death.  This is going to be awful.   But you have to try to help her, you can’t do nothing.  You have all the skills you need to help her.  You have the training, you have the work experience, you have the life experience, you are the only one here and this is the only chance she has.  You have to try. You can do this.”

All that happened in the split second it took for me to walk closer enough to speak to her.

She was crying, shaking, trembling and balanced just barely on the railing.  Sometimes holding on, sometimes standing up and trying to let go. I spoke to her gently.  I told her I wasn’t going to call the police.  I told her I was a support worker and that I just wanted to talk to her.  I asked her to step down off the railing just for a moment to talk to me.  I reassured her that I wasn’t going to call anyone or do anything, just talk to her.  I told her my name, I told her where I worked.

She got down from the railing and back onto the railing a few times.  I kept talking to her gently and reassuring her.   Eventually I was standing quite close to her.  I told her that I’d felt suicidal before, that I was sorry she felt SO bad that she wanted to hurt herself, I reminded her that I just wanted to talk to her.   I have no idea how much time went by, but I think it was only a matter of minutes.

Finally she got down and turned towards me.

“I’m cold” she said.

And I knew I’d made the connection.  The immediate danger was over.   We both breathed.  I asked her if she would come with me into my car so we could talk and I could drive her off the bridge.    We walked to the car and as I got into the drivers seat the world reappeared.  I was suddenly aware that my car was blocking a lane of traffic, cars were honking and passing and drivers were annoyed.  I had tuned it out completely and was only aware of the young woman.

I also became aware that literally not one of those cars had stopped, offered to help or called for help.  I felt the desperation of that poor woman, knowing that nobody in the world cared about her.

We sat in the car for a second, shivering and I could see her panic again.

“I’m not supposed to get into the car with strangers”

Luckily, I had my business card and a pamphlet from my workplace in the front seat.  I reassured her that I was just trying to help her and I just wanted to drive her off the bridge so we could talk.  She agreed and we drove down to a gas station which was just a moment away.

We talked for a little while.  I told her a little bit about myself, the work I do helping abused women.  I asked her if what was making her so upset that day had anything to do with that and she nodded.  I asked her if she’d felt that way before and she said yes.  I asked her if there was anywhere I could take her, a friend’s house, the hospital and she said  maybe just to the mall nearby where she could catch the bus.

I could tell the immediacy of the crisis had passed for her.  She seemed exhausted.

I drove her to the parking lot of the mall and we talked a little more.  I invited her to call my organization for help anytime in the future.  I thanked her for trusting me and for coming down from the bridge.  Before she got out of the car she told me:

“If you had been a man, I would have jumped.  If you had called the police I would have jumped”

She thanked me for saving her. I asked her if she would tell me her name.   She said she wasn’t in the habit of getting into the car with people she doesn’t know.  I told her under the circumstances I thought it was the lesser of two evils.  We both laughed for a moment, she hugged me, told me her first name, and then she was gone.

The second the door of the car shut I burst into tears.  My whole body was shaking.  The reaction of shock hit me once she left, and all the fear, tension and emotion of the past 45 minutes washed over me.

But I wasn’t just crying for that young woman.  I knew that I couldn’t control what might happen to her after she left my car.  I knew I’d done my best and that my best had been enough.

I was crying for Darlene, for Irene, for Lexi…and for my dearest Marian.

Why was I there, at that moment, on a bridge with this complete stranger?  But I didn’t get to say goodbye to so many of the friends I loved?

I felt an amazing sense of love and wonder at having saved a life, amazement at the randomness that I was there at that exact time, and that it was me and not someone else.  It didn’t seem random at all.  It seemed like everything that had happened to me in my life had lead me to that exact moment.  Trained me and given me the exact skills I needed to talk that woman off the ledge.   It felt like a moment of spirituality, connection and higher power.

But my sense of wonder in saving that young woman, didn’t erase the sorrow that I wasn’t there to save my friends.  Or even to say goodbye.  They are gone now, but I hope that woman from the bridge is still okay.

September 10 -World Suicide Prevention Day

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On this day I remember the friends I have lost to suicide.  I think of the friends I know who are suicide survivors.  I think about the service users I work with who struggle with suicidal thoughts.  I think about what it means to be a suicide survivor.

I am a suicide survivor.

I can’t speak to the experiences of other people who have survived suicide attempts, but I would like to share my own thoughts.  I think there are a lot of myths out there related to surviving suicide, how to help people who are suicidal and why people attempt or complete suicide.   It’s a taboo subject, one that people skirt around.  Sometimes the mere mention of suicide can silence a room, create uncomfortable looks and make those around you ill at ease.  I think this is mainly due fear.  It’s almost like people think that suicide is contagious.

I rarely talk about my experiences as a suicide survivor.  There seems to be a tacit agreement that it is not a suitable conversation topic.  Even in therapy there is the worry that talking about suicide will lead to unwanted consequences, trips to the hospital, worrying others, making others think that you are “crazy” or “unstable.”

Here are some of the myths surrounding suicide that I’d like to dispel.  These are my own thoughts and I don’t claim to speak for everyone who has these experiences.

  1. Suicidal thoughts and suicide attempts are impulsive reactions and pass quickly.
  2. Talking about suicide means that someone is not serious and is not really at risk
  3. Suicide attempts are always a “cry for help” and the person doesn’t want to die
  4. People who survive suicide attempts are grateful to be alive and recover quickly
  5. Talking about suicide will just “give someone ideas” and it will increase their risk
  6. The best way to help someone who is suicidal is to call 911 or take them to hospital
  7. If someone is habitualy suicidal, the experience is normal for them and they don’t feel afraid or need support.

Realities

  1. I’ve struggled with suicidal thoughts on an ongoing basis since I was 17 years old.  That’s almost 20 years.  My suicidal thoughts can sometimes be impulsive, but in my experience they are usually long lasting, persistent and even obsessive in nature.  I wouldn’t even like to hazard a guess as to the number of hours I’ve spent planning ways to die and thinking about ending my life.  In my experience, the impulsive thoughts are the most dangerous and the scariest, but the chronic obsessing about suicide is more exhausting and creates  a sense of hopelessness.   Many people struggle with suicidal thoughts over a long period of time, just because they don’t act on it or don’t talk about it, does not mean they are not at risk.
  2. I hear this a lot.  “If she is willing to talk about her suicide plan it means she isn’t serious and she really wants help.”  This is a dangerous assumption.  Every person is different, every situation is different.  Some of the times I tried to kill myself I didn’t tell anyone, I didn’t talk about it before hand, there wasn’t an opportunity to intervene.  Other times I spoke about it to many people, I asked for help, I went to the hospital without harming myself, and I often found that I was not believed or taken seriously.   It was incredibly frustrating because when I went to the hospital AFTER harming myself the doctors were angry that I didn’t “ask for help.”  When I went without harming myself, they assumed I was safe and rational and did not need help.  It was a vicious unhealthy cycle.  In my opinion, if someone is talking about suicide you should listen and you should take it seriously.  Many people who complete suicide have talked about their thoughts prior to taking the final step.  On the other hand, if someone never talks about suicide we can’t assume they are not at risk.
  3. Suicide attempts are not always a cry for help.  Sometimes the suicide survivor really did want to die and their attempt failed.  Suicide attempts are not a way to seek attention.  They are not a way to control or manipulate people.
  4. When I attempted suicide and survived, I was not grateful.  I felt like a failure.  I felt worthless and ashamed.  I felt like I couldn’t do anything right.  I felt ill and I had physical effects from harming myself.  I felt alone and I felt stigma. Even today, years later I regularly wish I had died years ago when I attempted.   Not all suicide survivors are happy to be alive.  We don’t all wake up the next day, thankful for a second chance.  It’s also common to be happy to be alive sometimes and wish you had died at other times.  The recovery process can take a long time and will last far longer than the short time someone might spend in the hospital or away from work/school.
  5. Talking to someone who you think may be suicidal will not increase their risk.  It’s far more risky to stay silent, not ask the questions, not check in with someone.  If you are concerned about someone you care about, I recommend asking them directly if they have thoughts of harming themselves, ending their lives, or wishing they were not alive.  Ask them if they feel like a burden, ask them about what connections they have in their lives, ask them if they feel hopeless.  It’s better to know the answers, then to assume someone is not suicidal.  Sometimes a suicidal person feels like nobody cares about them, and staying silent could reinforce that belief.  I can’t even remember the number of times that I was stopped from harming myself by receiving a phone call from a friend, or a connection with someone around me.  Connection is the opposite of depression.  Asking someone about suicidal thoughts is not easy, but losing them to suicide will be harder.
  6. Calling 911 or taking someone to the hospital is not always the best way to help a suicidal person.  Sometimes involving the police, ambulance or hospital can escalate a situation.  Sometimes it can destroy the trust you have with that person.  In many situations it can be helpful to give the suicidal person choices and options.  Thank them for opening up to you.  Ask them what they feel would be most helpful.  In my experience, suicidal feelings are often linked to feeling out of control and overwhelmed.  Taking away choices from someone or punishing them for suicidal thoughts can add to feelings of powerlessness.  Offering choices can be an antidote.  Maybe the person wants company, maybe they don’t.  Maybe they just want a chance to talk about their suicidal feelings without being judged.  Maybe they do need medical intervention, maybe you can take them to the hospital and stay with them.  If someone is suicidal and impaired by drugs and alcohol, or has access to lethal methods such as a gun, you may have fewer options.   But calling 911 without somoene’s permission should be a last resort.  Hospitals don’t even always admit someone who is suicidal.   I’ve been in the ER, highly suicidal and at huge risk, and just sent home.  I’ve been told “she isn’t psychotic so  she can go home, she isn’t at risk.”  I’ve often felt WORSE after unpleasant and unhelpful interactions in the ER.  It’s a myth that hospitals always help suicidal people.  Consider all your options and include the suicidal person in decision making as much as possible.  Also make sure you take care of yourself.  You are not responsible for saving anyone.
  7.  People like me, who struggle with suicidal thoughts on a chronic basis, still get scared.  Feeling suicidal is a scary thing.  It doesn’t matter that I’ve felt this way hundreds of times before.  I’m afraid.  I always worry that I will become impulsive and make bad choices.  I always feel afraid of telling someone, afraid of their reaction, afraid of the stigma.  Afraid people will think I shouldn’t be working, parenting, left alone etc.  If you know someone who chronically talks about suicide or habitually harms themselves, don’t give up on them.  Don’t assume they don’t want to get better.   Suicidal thoughts and self harm behaviours can be a coping mechanism for many survivors of violence.  Sometimes thinking about harming myself feels like the only way I can have control in an out of control and scary world.  Suicidal people need and deserve compassion.  Never underestimate how much good you can do by just non-judgmentally acknowledging someone’s struggle:  “Those thoughts sound very scary, you must feel pretty overwhelmed right now, I’m sorry you are struggling, what can I do to help?”

 

I miss my friends who completed suicide, but they are not cowards.  They are some of the bravest, most beautiful people I have ever known.  Suicide survivors are all around us.  We are regular people, living regular lives.  Suicide isn’t just something that happens to “crazy” people.  It can happen to anyone.  Breaking down the stigma helps everyone.  I think about suicide on a regular basis, but I still have an ordinary, productive life.  If you struggle with suicidal thoughts, or have lost someone to suicide, you are not alone and you should not be ashamed.  Be good to yourself, I’m happy you are alive.