Trigger warning: in-depth, personal discussions of depression, chronic pain and suicide/suicidal ideation/self-harm.
I’m writing this because yesterday I spent about twenty minutes crying to my psychologist that people don’t talk about this, and because right now the only way I feel even remotely alive is through the act of using my words to do something about that. Most of the ropes I’m holding onto are fraying. This is the only one that’s even remotely sturdy, the fierce motivation I have to make the worlds unspoken real, so once again I’ll commit the crime (not a crime) of honesty if it’s the thing that keeps me breathing. (I’m a hero-rescuer type; I’m sure you noticed.) This motivation is strong and fierce, even in depression, enough that it’s so very easy to look at me and think I am not – well, my psychologist is using lovely words like ‘crisis’ – drowning in a pit brought on by chronic self-hatred and a lack of serotonin and other useful neurotransmitters that make the difference between stability and collapse.
(I could live with the self-hatred – by which I mean be functional enough to manage – if the changes to my medication didn’t send my brain chemicals way out of balance.)
This week I had to tell a GP (a new GP, because my current GP is in South Africa) that my depression is (now) such that I’m thinking about suicide and spent the evening before my appointment seriously thinking about self-harm (and then crying, because even I know that’s awful). I had to muddle through the questions about how I’d kill myself and if I thought it safe for me to leave. (I don’t know. The fact that depression makes it hard for me to make even simple decisions about what to eat or do doesn’t help. I can’t evaluate anything right now. I can’t decide anything right now.) I agreed to come back in two days’ time because she is, at least, taking that side of my depression with seriousness, but trust me, there’s nothing good about being asked to come back so soon because you’re walking that fine line of being a suicide risk. My new GP rang my psychologist, so we talked more about this in session, and all that is kind of irrelevant to the special kind of awfulness that is talking about depression, that nadir of despair, the feeling that nobody is doing anything and suicidal ideation. It’s an illness, and one that severely impairs our (my) ability to function, but it doesn’t match all the rules we’re taught in Western society about what constitutes illness, and it’s an illness that is often invisible to others or even forgotten about should we mention it: if we can get up, get dressed and leave the house, even though it is taking all the energy we possess just to do that, we must be okay, right?
It’s an illness that takes extreme courage and strength of will to fight at a time when those things are exactly what this illness attacks. I had to talk to a stranger about my thoughts on self-harm/suicide. Don’t know how awful that is? Count yourself lucky.
I’m hoping my psychologist has managed to make the case to new GP that something needs to be done about my meds. If I know something is going to happen in that regard, that’s another rope. I can tread water for a long time if I know that rescue is coming. I don’t need the meds to work right away or first shot. I just need to know that the medical professionals are prepared to do something practical and substantial that isn’t the ‘wait and see’ or the ‘we will make very slight changes and if those changes do nothing hope we can wait it out’ game, because that’s the game that breaks the soul and spirit of anyone with a chronic illness/disability. I’ve endured it with my chronic pain: in point of fact, that game so broke my soul is why a specialist, I think, put me on the medication that, now I have reduced it, has resulted in the mess that is my brain. I’ve been drowning for a few months, now. I can’t survive the wait it out game. I can’t.
Here’s the thing. It’s beyond merely difficult to say those words aloud.
My dad drives trains for a living. He has – through absolutely no fault of his own, being as he was in the cab of a train that takes time and distance to slow – killed someone who attempted suicide via train. He works with people who have done the same. He jokes about it, as do his coworkers (and my uncle, who used to drive trains). I grew up listening to these jokes. He still jokes about it in discussions with me. The good side of it, at least for Dad, is that this allows him to survive. He and his coworkers can render the horror of having been the instrument of someone’s death survivable by making it commonplace, a joke, normalised*. The bad side of it, at least for me, is that Dad’s attitude to people who commit suicide – people who force him and his coworkers to be the instruments of someone’s death, and thereby cause him and his coworkers potential anguish and grief such that it can ruin their lives – is anything but understanding or supportive. We are craven, selfish, horrible people who don’t care about the suffering we wreck on others.
(* In my novel, my character Raider responds to anything and everything traumatic with black humour; the first thing out of his mouth having witnessed his best friend’s attempted suicide is a joke about the mechanism of said suicide attempt. The second thing out of his mouth after almost killing the same best friend in an entirely unrelated incident is a joke about ruining his friend’s day. He’s actually quite empathetic when he’s not joking, which I hope makes this redeemable, but his jokes and sense of timing are horrific such that I won’t be surprised if agents or editors tell me that this is one of the many things that make this book unsuitable for mainstream publishing, aside from being a fantasy novel with a somewhat-gritty/real suicide attempt. This is how he’s survived the reality of being trans in an extremely transphobic environment: snide quips are the rope to which he clings when the world is collapsing about him. I mean him to get better over the following books, but this is the shape of his trauma, and it’s a shape I know well. Hell, my psychologist has pointed out that I have a tendency to smart-arse smiles or even laughter when talking about some seriously-unfunny things, so I’m not without this tendency myself.)
I can understand why Dad feels the way he does. Sure, he’s speaking the words that society says so cruelly and carelessly, but unlike most those words aren’t exactly thoughtless: someone else forced him to have blood on his hands, and he has to live with that. I don’t know how he feels, because he hides behind the black humour and the casualness – he is a middle-aged white straight cis man trained from childhood to bury his emotions, and bury them he does (unless he’s angry, of course, in an appropriately white straight cis hypermasculine way). I suspect that even Dad doesn’t know how he feels, and that’s how he survives, by losing touch of anything inconvenient and difficult (that is not anger, because anger is an appropriate emotion for men).
Not surprisingly, the other members of my family take Dad’s view towards people who commit suicide, so I grew up listening to any number of conversations about drivers who had fatalities that diverged into conversations about the kind of people that attempt/commit suicide. I didn’t just hear society’s ugly and erroneous lies, and I didn’t just hear them from my family (who have authority by virtue of being family); I heard them from someone who has a personal relationship to the subject. People who attempt/commit suicide are selfish, thoughtless and cruel: how dare they carry out their death in such a way that impacts others? What about their families, the people who love them? Don’t they care that they’re hurting their families?
The very things that helped Dad survive, though, are gashes to the soul of his child with depression. My soul.
(And, in this post, I’m not even starting on all the bullshit conversations I’ve overheard about medication.)
Because I can tell him, as can anyone with depression, that yes, we feel we are selfish, thoughtless and cruel thanks be to the dialogue that surrounds us, but we are in so much pain we cannot survive our lives. This is what people without depression don’t understand: that we are being asked to muddle along in a life that isn’t life. We look as though we are living, because we are good actors and because depression is an illness so invisible it takes violent screaming for anyone to see us, but we aren’t, and nobody is more acutely aware of the way in which our life is lacking in all the things that make life worth the living than we are. This perception might not be real in an objective sense – sometimes it is situational, sometimes it is because it is a fucking chemical imbalance, and I’ve now had the great ‘joy’ of experiencing suicidal ideation in both situational depression and chemical depression, which have taken me to despair in ways that are different but no less horrific – but we’re often well aware of that, too, and that awareness doesn’t help us wage the war. That awareness is a blow against us. We can barely get out of bed, never mind do any of the thousand things we need to do to be a functioning human being, but we are expected to live for other people.
We are expected to live in pain so that others feel less of it.
I don’t want to be promoting suicide in this post, and I don’t want to diminish the pain that families go through at the loss of a loved one (especially, as is common, if they did not see this lethal illness), but we are not the selfish ones.
Calling a depression sufferer selfish for being ill is an act of violence.
It is the kind of thought that drives us towards, not away from, suicide: if we are so selfish and awful, in this world that causes us so much pain, why should we take on the difficult struggle to keep breathing? Anyone who ever voices this kind of thought – and remember that it takes a lot of screaming for anyone to see depression in the first place – is placing a sharp knife in a sufferer’s hand. You are the reason we kill ourselves.
I understand why my family speak as they do, but I still despise them.
The first time, when I was living with chronic pain in a toxic work and home environment, I was afraid to attempt suicide because I feared that I wouldn’t be able to succeed – and that I would have to live with the judgement in my family’s eyes that I too was a craven, selfish, weak person who knowingly and deliberately hurt the people who loved me. I had heard my own mother, when I expressed the fact that I could not live with being in pain all the time, tell me I was exaggerating and being ridiculous: my depression and my inability to cope with my pain were ridiculous. Knowing now what I do about the likelihood of chronic pain sufferers either developing depression or having it as a preexisting condition makes me sad I ever heard those words, because there is not enough dialogue about either depression or chronic pain (which is a mental illness as much as a physical condition, in my opinion). We are not supported and not understood (which is why I wrote about Oscar the way I did in Asylum) even by the people who love us, because people who haven’t experienced chronic conditions like pain, anxiety or depression think it is somehow possible to walk into the ocean and keep breathing while the waves crest over our heads.
(The speakers don’t realise they’re heading into the ocean on a dinghy, dry, relaxed and well above the waves: if they can travel out and survive, why can’t we? Well, we don’t have a fucking dinghy, but such is the joy of invisible illnesses!)
I was suicidal, though. I couldn’t stand to live my life as it was as the person I was/am. That fear was enough motivation to get help, something that wasn’t as easy as asking my then-GP for a referral, because he was the kind of idiot who thought a depression sufferer didn’t need a psychologist, and at the time I couldn’t bring myself to say the awful words I want to kill myself, words that might have motivated him to sooner action, aloud to anyone. The fact I can, these days, is a credit to me, but an awful lot of depression sufferers with suicidal ideation, having been raised on society’s awful messages about depression and suicide, just can’t say what we’re experiencing. If we live in a world where we are discouraged from having real, meaningful dialogue about how we feel, where our true feelings brand us weak and pathetic, how are we supposed to overcome that conditioning to speak aloud those damning words even to those that might help us? Shame silences us. Medical professionals and anyone else who cares about someone suffering from mental illness need to learn to read between the lines and ask the right questions: the absence of discussion about suicidal ideation doesn’t mean the absence of suicidal ideation.
(We are suffering depression because we have endured hell or because our brain chemicals are fucked up. Enduring hell is a good way to end up with fucked-up brain chemicals. There’s nothing weak about that.)
You could call the fact I still wanted to please my family a good thing – or perhaps that was the part of me that wanted to live. Save that, of course, if my parents didn’t have horrible ideas about depression and suicide I might have gotten help months if not years sooner. I might have been able to tell them that I was drowning. I surely would have spent less time afraid to get help. I survived that time because I found myself a good psychologist (thanks, universe) and some awesome friends online supported me; things worked out for me in that I got out of the situation that was making me so ill, but that period is most notable by the things that went unsaid. I told my parents I was suffering depression, but I never mentioned the fact I was suicidal.
(I’m still not telling them, but that’s also because I’ve learnt in the intervening years that I can’t trust my parents with my medical history. It’s more dangerous for me to tell them than it is for me to live on my own. My psychologist knows this.)
Today, I am feeling suicidal (and self-harming) because I want to live.
I want to be able to do things. I want to not be beaten down by my self-loathing and helplessness and guilt. I want to be stable enough that I can do the work with my psychologist on putting my life back together. I want to be able to write and create and hold a job and function in the world. I want to be like I was twelve months ago when I could do so many things and thrive in the chaos. I don’t want, at any point in time, to kill myself, but I also know that I can’t endure my headspace as it is. I can’t endure the flatness, the inability to make decisions, the continual crying jags, the misery, the struggle to move my body, the impossibility that is doing anything useful, the way my life has spiralled out of my control, the way my list of things I need to do is so overwhelming just thinking about it makes me break down in tears. That’s why all I can think about is attempting suicide and/or self-harm, because that’s my desperate scream to the world: I am ill, so do something to help me. Throw me a rope because it’s cruel and unnecessary to make me live like this. Throw me a rope because I don’t want to get to a point where I’m attempting suicide out of a dead-certain seriousness that there’s no point to living. Throw me a rope while I still feel that there’s a reason or two, even if there’s only scarce few of them that I can see right now, that living is worthwhile.
In a world where people don’t see my illness, suicide and self-harm are just about the only tools I have to make the people with the ability to prescribe medication sit up and take me seriously as someone in need of that fucking rope. It’s easy to brush anything else aside, to decide that waiting or tiny increases are appropriate, to ask me to be patient. I’ve seen countless medical professionals do nothing when it comes to my conditions, because they too are raised in a world where mental health isn’t quite as real an illness as something tangible. Even though I’m inventing nothing about my current thoughts/feelings on suicide and self-harm (in ways that won’t actually kill me but demonstrate the depth of my misery and seriousness to professionals), it’s too easy to be seen as only manipulative (attention-seeking, perhaps) instead of the life-affirming cry for help it in fact is. I don’t feel good about it. That didn’t stop me from wading in yesterday and telling a stranger that I’ve been thinking about hurting/killing myself (and how), because I need to look after myself, and part of that means doing what I can to be taken seriously (as a depression sufferer in desperate need of having my medication sorted out). No maybes, no soft-steps, no denials.
Right now I’m not selfish, awful, weak, heartless or thoughtless (indeed, the amount of thought I have given to all this renders this last quite the opposite). I’m trying to save my life. My feelings on self-harm and suicide are telling me, incredibly clearly, that I can’t live the way I am. It’s not that I don’t want to. I can’t. Right now I know my life isn’t objectively or even subjectively terrible, but I’m struggling with it, and that means I need people to take action in the matter of my medication (so I can take action in everything else). I hate the fact that I feel awful about talking the way I did. I hate the shame. I hate that acting to save my life carries with it such stigma, fear and horribleness. I hate that standing up and fighting for my right to have my condition managed means I have to remember everything my family ever said while saying such awful-leaden words to a stranger – and leads to doubt that I am in fact ridiculous, exaggerating or ‘not really’ suicidal.
Saving my own life shouldn’t carry with it any of those associated thoughts or emotions. It shouldn’t be a shameful experience.
I don’t want to encourage suicide – quite the contrary – but I do want to encourage dialogue about it that looks at it as something less an expression of wanting to die (escape, surrender, give up) and more as an expression of a desperate, profound need to live a life with joy, freedom, meaning and/or a proper balance of neurotransmitters … in a world where we are often not seen, heard or understood no matter how much we wave and scream.
I don’t want to die.
I want, so very desperately, to be alive.