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.

Terminal illness (psychiatric style) aka suicide

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One of the side effects of having a chronic psychiatric illness is that you spend a lot of time in hospital, treatment and therapy groups.  One of the great aspects of this is all the amazing people I’ve had a chance to meet along my journey.  Perhaps the most tragic aspect of this story is the number of friends I’ve lost, when their mental illnesses became terminal.

I think it is time to stop saying “she committed suicide” or even “she completed suicide.”  It is more accurate to say things like “she died from chronic post-traumatic stress disorder,” or “she lost her battle with anorexia and alcohol addiction,”  or bluntly “depression killed her.”

Kirsten, Irene, Pammy Jo, Darlene, Marian, Lexi, Erin, Andrea

I will say their names so they are not forgotten.  These women ultimately did not survive the psychiatric and health care systems.   They died as a result of complicated, layered physical and mental health problems and, in many cases, social barriers and challenges as well.  Sexual, physical and emotional abuse killed some of my friends, though they died ultimately long after the abuse ended.  Many mental illnesses do not just appear out of the blue (in fact they rarely do).  I struggle to even call many of these deaths suicide.  I’d like to call some of them murder by PTSD.  If these women had not survived gender based violence or abuse within the health care system they quite likely would be alive today.

Quite simply, if my friends had not been abused I would be talking to them today instead of writing this blog post.

This afternoon I attended a memorial gathering for Lexi.  She died about 9 months ago.  She was beautiful, talented, creative young woman.

I find myself flying back, years in the past to when I experienced my first loss as a result of mental illness….

I met Darlene on 8East at South Street hospital, it was within my first few months there.  Possibly the 3rd admission.  She just slightly younger than me, perhaps 19 years old at that time.  I remember her roommate was a young woman with bulimia who was being tube fed with limited success.  I can still remember their voices laughing across the hallway.  They were listening to Nelly Furtado, Turn off the Light over and over, singing along.  Their room was full of stuffed animals.

Like me, Darlene was also a frequent flyer at South Street hospital and later at the Regional Mental Health Care London (better known by us as the LPH).   London Psychiatric Hospital.

Also like me, I believe she had also been labelled with borderline personality disorder as a result of frequent overdosing and high utilization of psychiatric services.  She was also a patient of Dr. X while at South Street.

July 23, 2002 I received a call from Darlene.  She started saying goodbye to me and I was confused.  I asked her if she was going to visit her Mom and she said no.  I quickly realized she was speaking about suicide.  I talked to her for a while and asked her permission to call 911.  She agreed.  I ended the call and send the paramedics to her house.  She was taken to the ER.  I later learned that she ate a roast beef sandwich while waiting for the doctor.  I have often wondered if that was her last meal.  A dry, cold, prepackaged hospital sandwich.  The thought breaks my heart.

She called me from a pay phone the next morning and explained she had been admitted at the LPH.  She had been chemically restrained, with an injection in her thigh and put into an observation room overnight.  She was angry and was being discharged and wanted me to come to meet her.  I took the bus across town to the hospital and the two of us took a cab to her apartment.  It was the first time I’d been there.  I had to leave her because I had an appointment to attend.  Another friend of ours stopped by and kept her company for the afternoon.  She was a young woman, about 16 years old.  The two of them went to the park and swung on the swings together.

The next day I was not able to reach Darlene by phone.  Scared, I called 911 thinking I would send the police to check on her.  The operator asked her name and my own name and then I was put on hold.  I was confused and started to feel a deep sinking sick feeling in my stomach.  After a few seconds someone else came on the phone, I assume it was  a police officer but I can’t remember.

Darlene is dead.

Sometime over the course of that phone call, or when the police officers came to my house I found out that after E went home, Darlene had returned to the Emergency Room at South Street asking for help.  She was turned away rather than being admitted.  Having had similar experiences myself, I can only imagine the staff were frustrated that she was back again so quickly.

Darlene walked a few short blocks away from the hospital and in front of a train around 8pm July 24.  She died alone, less than an hour after walking out the ER doors.  Outside of hospital staff, my friend and I were the last two people to see her alive.

This is what terminal psychiatric illness looks like.

This is the result of labeling someone borderline and attention seeking.

She was only a few days away from turning 21.  The system failed her.

After speaking with the police I drove to E’s house.  We went for a walk in the park by her house.  I had to tell this young woman, my friend, that her friend Darlene was gone.  It was one of the most difficult things I’ve ever had to do.  We sat on a rock in the park, crying and hugging each other.  I remember that a balloon floated by in the shape of Bert from Sesame Street.  It was a sunny day.

At her funeral, still in shock, we cried for our friend.  It was a strange service, her grey velvet casket sitting at the front of the room. There was no eulogy, no family members spoke.  The priest that spoke was a stranger and gave what sounded like a stock, religious speech.  He kept saying her name and it didn’t make sense to me. It was impossible to believe it was our friend who had died.  At the end of the service they played Angel by Sarah McLaughlan.  That song still makes me cry

I hope all of these women have found some comfort.  I certainly miss them.

When mental illness ends in suicide, a light goes out.  Suicide takes some of our brightest lights.  Grieving loss related to mental illness is complex and often not acknowledged openly by society.  I will write more about my own struggles with suicidal ideation, gestures and attempts.  I will write more about my friends.  The secrecy and stigma surrounding suicide needs to be broken in order to save lives.

My dear friends…

“In the arms of the angel, may you find some comfort here”