As you may guess from the title, this post contains discussion of suicide and suicidal ideation with mentions of self harm. Anyone who is currently living with suicidal ideation or action should take great care reading this or avoid it altogether.
Methods are discussed quite plainly and if this is likely to trigger difficult thoughts for you I would recommend avoiding this post.
As always, these are my experiences and I am not claiming to be an expert nor am I qualified to properly assist those in mental crisis. My aim is simply to discuss what it’s been like for me and hopefully make people aware that discussing suicide does not need to be taboo.
I can’t stand the sound of high speed trains when they pass through a station. It reminds me of all the times I’d be at the train station before or after work knowing that ‘the next train to pass through this station does not stop here.’ Vaguely wondering if at any point I’d have the bollocks to throw myself in front of one.
Obviously, I never did. I don’t think I was ever really going to. Despite my troubling ideations by this point I’d, for the most part, come out the other side of being actively suicidal. It’s easy to forget, especially if you’ve never been there, that although you may not be an active risk suicidal ideation is extremely real, scary, and sad.
Asking the question
I get asked at every psychiatrist appointment if I’ve had thoughts of harming or killing myself. I’ve no choice but to say yes. It strikes me that perhaps even mental health professionals at times struggle to understand the nuances between active and passive suicidal thoughts. I go to great pains to explain myself, but to me suicidal ideation isn’t necessarily a marker of a declining mental state nor a reason to up my doses, call the psych ward, or write me off as a lost cause.
By now, thoughts of self harm or suicide are almost a default. If I’m having a particularly bad day, up they come. I can be so anxious that I’ll wonder if I can really go on living this way. So deeply miserable that the thought of a continued existence seems almost laughable. Sometimes it takes a lot to talk myself down. To remember that it won’t be like this every day.
In my not-so-professional opinion, suicidal ideation hangs around because I spent so long thinking about it that my brain dutifully formed those pesky neural pathways and now it’s a standard thought pattern. It doesn’t always mean I’m at risk. Usually, I’m not. Not any more.
The risk factor
There have definitely been times where I’ve been at risk. I’ve ended up in hospital either through a self harm incident, a vague attempt on my life, or simply because the thoughts were too much to bear. I apologise if I seem casual or blasé. I know this is a serious issue but when it comes to my own experiences, I’m kind of desensitised.
It’s difficult to look back on past incidents and see them as dangerous or troubling. In the back of my mind there’s still a little voice claiming that it ‘wasn’t that bad.’ It doesn’t seem it now.
Not the time I resolutely took too many paracetamol, or other times, my anti depressants. The times I affixed my dressing gown cord to a door handle and tried to choke myself. The time I, clad in pyjamas, wandered out of my flat to inspect the drop between my floor and the mezzanine below to size up the risk posed by a fall. When I dramatically self harmed but, alarmed by the blood, marched myself off at 3am for stitches. The late night Google searches for ‘exit bags’ or how much medication I’d need to finish the job. The occasions I assured myself that should I need to, I can ascend to the top floor of my building and force a window open to jump.
If this comes across as emotionless then I can understand how weird that might seem. I can’t speak for everyone, but for me they’re just things that have happened. Confusing things. Retaining certainty on whether I really was trying to take my life is more difficult as time passes. Equally, as time goes on I’m more able to understand and empathise with myself.
When experiencing these episodes, I’d be incredibly unlikely to use the term ‘suicidal’. Perhaps I didn’t want to admit it to myself. Maybe I didn’t truly understand it. I certainly didn’t want to admit it to any medical professionals, and yet my self harm incidents or weak attempts were, to use a phrase often bandied about with disdain, clearly a cry for help.
Was I a risk? Yes. Would I ever have completed an attempt? It seems unlikely. That doesn’t diminish the way I felt, though, nor the risk I posed. I was on weekly prescriptions of my anti depressant medications for years because giving me large volumes of medication was a bad idea. It would have resulted in more hospital visits, that’s for sure.
Getting a response
It seems that medically, perhaps people take you more seriously if you’ve taken action. Sometimes, anyway. For how serious it can be, the way professionals react is extremely varied. One GP many years ago was almost beside herself as I sat crying in her office. Others are more business-like. Sometimes the fact I’ve acted on thoughts has perhaps meant a different referral, a change in medicine, whatever. Others it’s been nothing, just a patch up and be on your way.
The number of times I’ve laid listlessly considering some sort of action but knowing that, should I undertake it, nothing will actually happen are far more frequent than they ought to be. Nothing changes. You aren’t suddenly whisked off for therapy and magic cures. The waiting lists are still long, professionals still woefully overstretched.
The climb continues
The weirdest thing about attempts or ideations is that life goes on. When you thought about it being finite, it continues. You wake up. Again and again. Everyone else’s life carries on like nothing happened, except perhaps those near and dear to you. It can be disappointing, alienating, or eye-opening. I can’t say I’ve ever experienced a sudden, ‘Ah, but now I want to be alive! I yearn for the zest of life!’ following any ideations or otherwise.
It’s more like, ‘Well, that happened. Now I have to keep climbing the same fucking mountain I was on before but this time I’m further down‘.
Suicidal ideation or action is not selfish. It’s a last straw. The weight of prolonged suffering, a complete inability to see a different way out. Sometimes, things keep us here. We keep ourselves here. Sometimes we’re not so lucky.
It’s difficult to describe exactly what it feels like to be suicidal, because by that point it can be hard to feel anything at all. Whereas now I can reason with myself that things won’t be like this forever, crisis point is different. It’s neither a rational nor reasonable place. It’s cold. It’s dark. Lonely. Scary. Exhausting. There is no heavier weight than that of being alive, trapped in what feels like a void of emptiness.
I won’t do myself or anyone the disservice of trying to decide whether passive or active suicidal thoughts are worse. I’ve experienced both. The frightening thing about being actively suicidal is the risk. It’s the darkness, the inability to see light. A future.
What’s scary about passive suicidal ideation is that if it lingers too long I’m arguably better prepared now to make an attempt. I can get out of bed, out of my home. Sometimes being bed bound by my own depression has been miraculous. For the most part, though, even now I can have fleeting thoughts of self harm and know full well that I can’t be bothered to do anything about it.
Being more able to function comes with a cost. I remember one mental health professional telling me that as people start to get better the risk of completing a suicide can be greater. I’ve my inherent laziness to thank for my safety, as well as several well-planned changes to what we keep in our household.
No large quantities of medication. No disposable razors. Even our cheap kitchen knives are mercifully dull, suited only to their purpose of chopping vegetables. I’m back on monthly prescriptions and handling it well, but that can change the moment I feel uncomfortable.
As usual I’m not sure what point I’m trying to make, but I keep myself safe. I have to. I don’t know how long I’ll have to take precautions, to occasionally deal with the intrusion of suicidal ideation. Like any other symptom of mental ill health, it has to be managed.
The ridiculous to the banal
It’s not always breaking point. Sometimes it’s a lot more mundane than that. I’m not ashamed of it now, and in fact speaking about it is my greatest defence. Saying it out loud removes it from my head a little. It takes the wind out of its sails. If I had a cold and started to get a fever, I’d say something. Just like that, this is a symptom of illness. There’s no reason I shouldn’t say anything.
I don’t need to keep it a secret, to harbour it. Sometimes I feel suicidal or have suicidal thoughts and that is okay. No, it’s not ideal. Nor is it fun or something I’d like to deal with every day, but it happens. It’s not my intention to diminish anyone’s suffering by talking so matter-of-factly. I believe that we shouldn’t be afraid or ashamed to talk about these things.
Yes, I understand how hard that is when you’re in the deepest pits of despair. The harsh reality is when you’re actively suicidal you don’t want to tell anyone because they’re going to try to stop you. The last thing you want is someone coming in with any form of concern, love, or care because that’s what you’ve finally convinced yourself no longer exists.
Removing the shame
I hope that anyone who makes it out of those pits takes some small crumb of comfort from my words. Maybe it won’t go away forever, maybe it will. Anyone who deals with these intrusions is not alone. Just as with most conditions, there are ways to manage it. To keep yourself safe. Talking about it is just a small part of that.
It gets better. Maybe it gets bad again, too. Our power comes from the conversations we share, the help we seek, the changes we make. The more we talk, the more we understand. Suicidal thoughts and actions are nothing to be ashamed of. I’m not ashamed of the scars left by the surgery I had on my leg. Nor am I ashamed of the scars on my arms from self harm.
I’m not ashamed of the period pains I’m currently experiencing. Nor am I ashamed that sometimes, as a symptom of my illness and even during the road to recovery, my brain takes me down dark paths. Neither should you be, and I hope someday everyone realises that.
Guilt tripping someone who is or has been suicidal is not the answer. Why would I suddenly feel better because you think I’m selfish, Brenda? Get to fuck.
Listening with an open mind and a willingness to help is crucial. I’m functioning. I work, I socialise, I have relationships. Sometimes I still think about suicide or even feel that it’s a solid option for me. One size doesn’t fit all. It’s nuanced, it’s tiring, frightening. Your judgement does not and will not help anyone. Your understanding might.
Suicide isn’t a dirty word. Don’t be afraid to ask someone if they’re contemplating it. It could be a conversation that saves a life.
You can access a brief and totally free course on how to have a conversation about suicide at Zero Suicide Alliance. This training is really helpful in highlighting the importance of talking about suicide.