Category Archives: suicide

The Thought

As I’ve mentioned before, I’ve been doing really well these past few months. I’ve had the most emotionally vibrant period I think that I’ve ever had in my life. However, the other day, I got an abrupt reality check.

I’d had a fantastic weekend before I experienced what I’ve come to refer to as “The Thought”. Valentine’s Day was probably the best I’d ever had. My partner and I had an amazing time going out to dinner and a show, and the next day I spent some time away from home with her and her family. Life was good. Great, actually.

Then, early on Tuesday morning, I was driving home when a thought crossed my mind. “I want to swerve this car into a rock and crash. I want it all to end.” This thought seemed to come from nowhere. The weekend had been truly excellent. Then, I want to kill myself. What gives?

While the thought itself came out of the blue, it was not without warning signs. I mentioned once that trying to keep my dysthymia at bay is a little like playing Whack-A-Mole. Treating myself is like smacking a bunch of moles with mallets to keep them in their tunnels. Those moles are my dysthymia, and I keep smacking them down to keep the disease under control. Each of the moles comes out of a specific tunnel, representing the things I need to avoid to keep dysthymia at bay. Poor nutrition. Lack of exercise. Not enough “me” time. Whatever the hell’s going on chemically in my brain that requires a mallet laced with bupropion. Obviously the chemical issue has been a huge problem for me in the past, but my drugs, together with my other measures, seem pretty good at keeping that tunnel mole-free.

My ongoing nemesis throughout my life, and the tunnel from which I have the hardest time preventing moles from pouring forth, has been insomnia. I’ve never slept well in my adult life. Ever. Usually this manifested as difficulty falling asleep and inability to stay asleep once I finally did. When I did sleep through the entire night, it was not a restful sleep. I’d awaken feeling like I’d hardly slept at all.

So lately, moles have been streaming from the insomnia tunnel, although perhaps I didn’t recognize them for what they were. My sleep had been very poor the week and and half preceding the Thought. Those nights, I was getting maybe four hours of uninterrupted sleep, and then my body would wake up. The best I’d get after awaking would be intermittent snoozing. I often simply gave up at about five in the morning and got up to start my day. The night before The Thought, I was up at 3.00a in a state of panic over my lack of sleep, wondering how I was going to make it through my very busy upcoming three months. In other words, I was exhausted. Still kind of am, actually, though I’ve been catching up. I haven’t yet ascertained the reason for my lack of sleep, although I hope that my upcoming doctor appointment can help me figure it out.

Despite the lack of sleep, I still had energy. Large amounts of it, at least to me. Even with sleep deprivation, being on bupropion and treating myself correctly has given me far more energy than I had when my dysthymia acts up. So I hadn’t noticed the lack of sleep affecting me overly much.

Obviously it did, though. I wasn’t prepared for this fleeting suicidal thought; it hit me like a semi. If I’m feeling generally down, I can steel myself for the inevitable deluge of morbidity. But I wasn’t prepared this time. That short moment scared the shit out of me. I didn’t see the warning signs. Aside from my early morning fretting, I still don’t know what the warning signs were, if there were any to see at all. And that scares the shit out of me even more.

Perhaps, by allowing it to scare me as it has, I give The Thought too much power, though. Lately I’ve been listening to National Public Radio‘s fantastic new podcast Invisibilia, about the crazy parts of our brains that govern so much of what we do and who we are. In their inaugural episode, hosts Lulu Miller and Alex Spiegel use the dark thoughts that sometimes pop into our heads as a way to explore the history of psychotherapy.

The main frame of the show is a man who keeps having thoughts of wanting to violently kill his wife. That thought is used to explain how different therapy approaches try to handle the issue. Do you logically challenge the thought? Confront it directly? Push it aside as a random firing of synapses? The way the show explained these different approaches fascinated me. I’d used each of those strategies before to deal with my own dark thoughts. I’d challenge them. I’d confront them. I’d push them aside. But just like those moles, they kept popping back up.

There are good reasons why these strategies don’t always work for me. First off, depression isn’t logical. Challenging the thoughts certainly is useful, but I’m not really in a logical state of mind when having them. The asshole is too loud, too imposing. Confronting my suicidal thoughts also is of limited use in the moment. Death isn’t something I’m fearing, it’s something I’m welcoming. What use is confronting it?

My chosen method is usually pushing aside the thoughts. Ignore them. Bury them. Distract my mind so much that it doesn’t have the opportunity to wallow in darkness. That’s where working has helped. Work has helped keep me from following through on suicide in a few ways, one of which is that it distracts me. Rather than focusing on the train wreck of my life and the morass of my mind, I focused on work. There, I had some control. There, unlike my life, I could improve things. There, I could make others happy, even if I couldn’t do so for myself. Work was my escape from The Nothing.

My reaction to The Thought was similar, although I was far more cognizant of what I was doing. The Thought was fleeting, but my fear of and focus on it was not going away. Was all that work I’ve been doing over the past several months for naught? Before I went into work, I stopped by my partner’s house. She was a rock, someone dear on whom I could focus, to remind me of the happiness of which I was capable of feeling. But we both had to go into work, so I once again forced my mind into work. I had a particularly interesting challenge on which to focus at work, a complex, fascinating one involving our Code of Conduct and a future ordinance and public forums. I threw myself into it with gusto. And it worked. The Thought fell by the wayside.

After work, I was still rattled by this minor relapse. It wasn’t something that would have phased me much before, as it was fairly common. Despite my newfound happiness and positivity, I thought I was still abundantly aware that I have an illness that likely will never go away. The Thought showed me that I must not have really believed it. Now I do. I have The Thought to thank for that. I still don’t know where The Thought came from. Perhaps it was just my dysthymia saying, “Hey, remember me? I’m still here. I can still fuck with you.” And yeah, now I know it’s going to continue fucking with me. But I’ll be ready for the little bastard next time.

The S word

I haven’t really talked about the S word other than in passing in my first post. And by “S word”, I do not mean the expletive but rather suicide. Many people are uncomfortable discussing mental illness, but bringing up suicide can bring entire conversations to a halt. Almost everyone to some degree can identify with aspects of depression; we’ve pretty much all had experiences in our lives that sent us to the depths of despair. However, few other than the mentally ill can identify with the idea wanting to kill yourself. To the degree that we are beholden to our genetics, it is a biological imperative to desire to live, which is why it takes pretty severe circumstances or a very high degree of mental perversion to even consider it. Most people have not met those conditions.

Dysthymia is often termed a “mild” depression, an adjective for which I don’t particularly care for a few reasons.

  1. “Mild” doesn’t really take dysthymia’s persistence into account. If you think of major depression and dysthymia like you’re carrying weights, major depression is like trying to carry an extremely heavy weight; it taxes your strength almost immediately. Dysthymia is more like carrying a pretty heavy weight, but carrying it for a prolonged period of time. In other words, both major depression and dysthymia can make you collapse, it’s just a matter of how long it takes.
  2. As my best friend likes to say, having an illness is not a fucking competition. The term “mild” implies something being not as serious, not as important, not as worthy of attention. Mental illnesses certainly have a degree of urgency; major depression is a much more urgent condition, as there is a more immediate risk for suicide. However, all mental illnesses are dangerous if left untreated. To my knowledge, we don’t have antibodies to fight off mental demons.
  3. Dysthymia can easily become major depression, a state known as double depression. As noted in point 1, if you’ve been carrying a heavy weight for a long time, you’re bound to collapse sometime if you don’t shed some of it. There’s a strong link between dysthymia and major depression, as noted by Harvard Medical School:

“More than half of people with dysthymia eventually have an episode of major depression, and about half of patients treated for major depression are suffering from this double depression. Many patients who recover partially from major depression also have milder symptoms that persist for years. This type of chronic depression is difficult to distinguish from dysthymia.”

This is a long-winded way of saying that, despite its generally low level of depression, dysthymia poses a suicide risk, too. This conclusion for the most part seems borne out by research.

I am not without suicide experience. I have never actually tried to commit suicide, but I ponder it often in my darker moments. Like many other depressed individuals, I know exactly how I would do it (slitting my wrists or, excepting that, drug overdose). Plans exist in my head for dealing with my affairs post-suicide: who would receive my meager assets, how would I make sure that my animals were taken care of, what things at work would I need to ensure someone else knew, where would I commit the act to ensure that my friends and loved ones wouldn’t be who found my body. I’d imagine this all sounds grisly and terrible to many people, but such thoughts are not uncommon among the depressed.

In my brighter times, the thought of suicide mystifies me. How could I ever consider suicide when I have such a great life and so many people who depend on me? Those specific plans I made while in the pits fade from my immediate memory. Even as I write this, though I’m having somewhat of a down day, I have no desire whatsoever to go to my grave. The brighter times also are when I protect myself against such thoughts. I do not keep razor blades in the house, nor do I sharpen my kitchen knives very finely. I do not keep large quantities of painkillers in the house, the lethal dosage amounts of which I am fully aware. Firearms are forbidden from my house. (The strong link between guns and suicide is yet another excellent reason to advocate for gun control with your legislators.) I make sure that I have social interactions at least once per day. The numbers for some particularly close friends are in my speed dial. Recently, I put the number for the National Suicide Prevention Lifeline on speed dial as well. The number is 800-273-8255. Please share it with anyone you think might be at risk.

There are a lot of reasons why I have never carried through with suicide. Recently, the most obvious reason is treatment. However, there are many others: the anguish that my friends and family would feel, the mess they’d need to clean up (despite my plans to get my affairs in order), the idea of saddling my mortgage onto my not-at-all-wealthy family.

However, in keeping with the overall theme of this blog, the major thing throughout my life that has prevented me from committing suicide is my work. The reasons above are good ones, but I guess somewhere in the back of my mind I always figured that friends and family would bounce back from my death. (I should mention that having a mortgage and significant other affairs to deal with are a relatively recent occurrence for me.) But my work was always an exception. I’ve always been deeply embedded in the places where I work. I wasn’t really indispensable; I don’t think anyone truly is. However, both others and I perceived me as such. There are always things that only I know, future plans that are only in my head, tasks at which I particularly excel. I don’t think I consciously withhold information from others; it just happens, as I imagine it does in any workplace. The thought of leaving my workplace in shambles, together with my aforementioned reasons, somehow kept me from really going through with it.

Notice that none of the reasons I mentioned have much to do with me or a sincere desire on my part to live for my own sake. That is why, to those who say that suicide is a selfish act, I say only this: fuck you. Fuck you and your ignorant judgment made with no attempt at understanding. While I can’t say they don’t exist, I have never met a depressed person who did not think of others constantly and who was not fully aware of the damage they’d leave in the wake of their suicide. The warped depressive mind is such that you truly think that both you and the rest of the world would be better off if you weren’t in it. You understand that you’ll likely hurt people, but you also think that they’ll get over it and lead better lives in your absence. Yes, this is completely illogical, but depression defies logic.

Since getting diagnosed and learning more about myself, I’ve become much better about succession planning at work and, to some degree, at home. I know this sounds strange, as it seems like I’m removing one of the reasons preventing me from committing suicide. However, I really think this is a sign that I’m in a better place. I now worry about dying in a car accident or falling off a cliff on a hike, leaving my coworkers, family, and friends high and dry. When in the depths of depression, I couldn’t care less if I die in an accident; I might actually welcome it, as it seems easier than killing myself. However, for me, with an actual desire to live came a respect for death. I realize that it could happen at any time without warning, and I want to make sure that the people I love and respect are left in the best possible position should that happen to me.

If you’ve read this far, I heartily thank you. I know that reading about suicide can be grueling and awful, particularly if you’ve lost loved ones to it. And if you’re inclined to worry about me due to the contents of this post, I greatly appreciate your concern but also assure you that you have little reason to fret. That I’m able to write about it so openly and (relatively) objectively shows that I am in a positive state of mind. Suicide is a specter that haunts the depressed constantly, but that doesn’t mean that the specter has to possess you. Its continual presence gives you even more incentive to seek treatment and to better your life.