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!

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.

It’s not for attention, it’s a serious mental illness.

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As we approach National Eating Disorders Awareness Week (Feb 1-7), I’ve been thinking a lot about my own eating disorder.  I’ve also been thinking about some of the common misconceptions there are about eating disorders.

One of the myths surrounding eating disorders, that I will discuss in this post, has two parts.  The first part is that eating disorders are  the same as dieting and are about being thin.  The second part follows, that they are about getting attention and meeting societies/media ideals of beauty.

I’ve struggled with anorexia for 20 years.  In my own experience, anorexia bears no resemblance to “normal” dieting that most people engage in at some points in their lives.  It is a serious mental illness, with severe physical and psychological impacts and side effects.   In my experience, anorexia was not about being thin, at least not at the beginning.   It certainly was not about getting attention, or competing with media ideals.  A good portion of anorexia was about disappearing, taking up as little space as possible and was fueled by intense shame and embarrassment, NOT the desire for others to notice me.

I went to, and go to, great lengths to hide my anorexia from others.  In fact, there are large aspects of my eating disorder I’ve never spoken about to anyone.  I rarely talk about it in therapy, I almost never disclose details to friends and family and I tend to keep it secret mainly due to shame and guilt and fears that others will view me as stark, raving mad…if they really knew.

After struggling with anorexia for 20 year, I have osteopenia.  This means that I have low bone density for my age.  I had low bone density before I was 30 years old. This is a common physical impact of eating disorders.  I’ve struggled with low iron levels which causes low energy, dizziness and fatigue.   As I age, I find I have less tolerance for restricting food.  I get dizzy, tired and have trouble focusing.  Symptoms I didn’t experience as a teenager.

But I’m lucky.  I have friends who have had heart attacks, passed out daily due to low potassium levels, lost all their teeth due to purging, have had broken bones due to osteoporosis and those who have lost their lives.  Eating disorders kill.  These people didn’t die because they wanted to look like the models in magazines and the stars in Hollywood.  They died because they couldn’t escape from a serious mental illness.

People who have eating disorders aren’t vain.  They aren’t making a choice.  Anorexia isn’t a lifestyle choice.  It’s a serious mental illness.  It’s often a coping reaction to experiencing abuse, trauma or extremely stressful life circumstances.

Anorexia isn’t about getting attention.  When I was at my sickest, I would rarely eat around other people.  This led to social isolation, rather than attention seeking.  I saw friends and family less, I spent a lot of time alone in my room. I would eat either before my family got up, or after they had finished in the kitchen.  I avoided social occasions where food was involved (in other words ALL social events).

I was deeply ashamed about the majority of my eating disorder behaviours.  I still am.  When I look back on those years, I feel the need to apologize to everyone I knew back then.  I want to apologize to them for making them look at 85 pound me.  A skeleton in a skirt, drifting through the halls of our high school like a shadow.  I feel embarrassed.  I know that I looked awful and that I scared a lot of people.  People who cared about me and were worried that I might die.  But quite honestly, I didn’t even really believe that I was sick.

I felt like I was living on autopilot.  I felt driven and I couldn’t stop.  I couldn’t slow down.  I didn’t exercise at the gym, but I used to walk long distances.   With the amount I was eating even daily activities were over exertions.  I had so many rituals it was amazing I could keep track of them all.  I would measure my food, eat certain foods only on certain days, eat or drink certain things only at certain times of days.  I drank a lot of coffee, tea, water and diet coke.  I drank fluids to avoid eating, but I was later told that staying hydrated was probably a good part of why I had so few negative side effects at my lowest weight.

If you had asked me, I probably wouldn’t have identified myself as someone with an eating disorder. I was confused.  I didn’t even know what I was doing or why.  All I knew was that suddenly food was my enemy and I felt that I could survive on almost nothing.   The anorexia always had an obsessive compulsive quality to it, the rituals were designed to keep me safe, not to alter my weight or physical appearance.  I was never trying to lose weight.  I was trying to control my trauma, my body and to numb out my feelings.

In the warped and bizarre world I lived in, slicing my half a banana into exactly 11 slices on my 1 cup of cereal kept me safe.  In that world, I could buy a cookie on Tuesday and Thursday only. I had to break that cookie into exactly 4 pieces which I would eat at specific times over the course of that day.

I used to go to the library sometimes after school and read books.  I remember one day my willpower failed and my hunger won. I ate my whole cookie at once.  I panicked.  Extreme panic.  I don’t know exactly what I thought was going to happen, but it was terrible and  I couldn’t undo it.  I knew from reading books that bulimia existed.  It was something I’d never explored, I never really ate more than a small amount at a time.  But somehow on that day, that cookie felt like a binge. I felt like the world was going to fall apart because I’d broken my ritual.  I went into the washroom at the library and tried desperately to make myself sick.  I wasn’t able to. I never have been able to (probably a good thing).   I remember crying and panicking and not knowing what to do.  Eventually I must have just gone home.  I remember feeling so very alone.

I’ve never told anyone about that, because of the intense shame I feel about behaving so strangely, in a way that I can objectively see makes very little sense.  This is why I don’t believe that anorexia is a cry for help, or a plea  for attention, because the majority of it happens in secret.   Sometimes I’ve been reluctant to share details about my eating disorder because I don’t want to trigger others or give people who are not in recovery ideas about behaviours.

Objectively, I can see that anorexia doesn’t make sense.  I can see that my obsessive compulsive habits, rituals, and rules don’t make sense.  I can see that they don’t make me safer or protect me. I can intellectually understand the health risks of not taking care of my body.  In my mind, I know that eating normally and being at a healthy weight would improve my mental health and that nothing bad would happen to me.

But Ana, spins a different web of lies in my head.  The fear of what could happen, the anxiety drives the OCD cycle of obsessive thoughts leading to ritualistic behaviour related to food.

I actually see Ana (my eating disorder voice) as a separate person.  I have a visual image of her in my head.  I experience her telling me things and I feel I have to listen.  She’s angry.  I know she isn’t a good friend and the majority of what she tells me (if not everything) is a lie.  But I feel some strange loyalty and attachment to her.  It’s hard to let her go.  I sometimes feel like I’d be lonely without her.

Eating disorders are serious mental illnesses.  You don’t have to fully understand my experience, in a way, I’m glad if you can’t understand it, because it means you haven’t lived through something similar.  But the stigma and myths about anorexia and other eating disorders need to be challenged.  People with eating disorders need your compassion and they need specialized, accessible and trauma informed treatment options in their own cities.  There is a woeful lack of eating disorder treatment available and people die while waiting for treatment.  Ending the stigma and increasing public education about these serious illnesses can help change this situation.