Tag Archives: suicide

Do reach out

CW suicide, suicidal ideation.

I imagine a different conversation.

Not the real one where you told me

How uncomfortable it would feel

To bear that much responsibility.

The conversation after the event

You have with some other person.

If only she had told us how she felt

Or reached out before it was too late.

I’m ok at the moment – I find it very hard to talk about when I’m not. Part of why I’ve had so many terrible bouts with suicidal ideation is that there were other things going on that were genuinely much more urgent than the deteriorating state of my mental health.

The evidence is finally piling up to demonstrate that depression isn’t caused by having unbalanced brain chemistry, it’s caused by distress, trauma, stress, burnout… It happens for reasons. There’s a lot that I’m working on, but there are also things I need help with. I’ve never asked for help without being deeply anxious that I would be a nuisance, or putting too much pressure on the other person. It’s loaded, asking for help to get out of something that makes you feel suicidal. I try to be easy to say no to.

But it’s a hard thing, trying to make it easy to say no when what I’m asking for is help with not wanting to die. Needing to be worth the difficulty and the discomfort. Needing to be someone it would be worth enduring discomfort for, to be someone whose life is worth saving.

If you’re on the other side of this with someone you care about… if you are scared and you feel like it’s too much pressure, that may be true. You may be facing a too-heavy load. But it may be lighter than the load of losing someone this way. I know people who have lost people to suicide. The haunting question of ‘could I have saved them’ is a terrible thing to live with. If they asked you for help, then they thought you could keep them alive, or give them a reason to keep themselves alive.

The immensity and drama of someone being suicidal can make it all too easy to imagine that what you have to do in face of that must surely also be immense and dramatic. It probably isn’t. Can you help a person feel like they have some worth? Can you express care enough that they might be able to imagine the world won’t be better with them gone from it? When you’re at those edges, small things can be life saving. To be needed – a bit, valued – slightly, good enough for someone, important to someone… 

Perhaps the scariest thing to accept is that a small action from you – some small kindness, some well considered words, some supportive action – might be the difference between life and death for someone else. Your slightest comment has the power to save or destroy another human being. That’s true whether you acknowledge it or not and regardless of whether you act deliberately based on knowing that. To know that of yourself, to accept the power and the responsibility, is to become someone who can save lives, and make life worth living for other people.

Staying Alive

CW suicide

I can’t remember when I first had the experience of wanting to die, but I was young. It wasn’t so much an urge to kill myself, more the desire to have never existed. By the time I was 11, I was trying to figure out how to justify my existence day to day. At that point I was fighting to work out how to live, but that’s changed over the years. 

If I could simply stop breathing by choice, then I would. That’s part of my everyday experience. It has to do with living with pain and always being tired and feeling so worn down most of the time that I have no idea how to keep going. There’s also too often nothing much I’m excited about and moving towards that makes me actively feel like I want to live. This is not the same as wanting to commit suicide.

I’ve never actually experienced it as wanting to kill myself. Sometimes what I have is an intense and overwhelming desire to not be in pain anymore – physical or emotional. Sometimes it is a thing that rises up within me and seems intent on killing me – and thus far I’ve managed to fight that, although what it brings up for me is violent, terrifying and close to overwhelming. I don’t know how to describe it except to say that it feels separate from me.

I’ve reached out for help many, many times. As it happens I’ve had years of asking people for things that would give me a better chance of not being in so much distress. What this has taught me is that help mostly isn’t available. On days when I’m struggling with self-harming impulses and the thing in my head that wants to kill me is menacing me, it’s hard to imagine who I could take that to who could actually help me. I’m not an easy person to comfort – this seems to be a brain chemistry issue. I’ve reached out for medical help, and it wasn’t there and I don’t have it in me to keep fighting – be that people or systems. I’ve been fighting myself for a long time. At this point I think I’ve worked out who would be both willing and able to step up in an emergency, but its taken a while.

Sometimes, the only thing I can do is to keep doing something. To put some kind of action between me and my death. To go one breath at a time in trying to figure out what there is to live for and how to keep going. I mostly don’t know how to keep going. But if I’m typing, I’m not doing anything else and there have been times when writing blog posts has got me through.

I did not write this blog today, it is not an urgent issue so no one needs to feel like they have to come and rescue me right now. Part of the point of writing is to try and explain so that other people are better equipped for their own experiences and the suffering of people in their own lives. Part of the point is to flag up that people won’t always tell you when the help they ask for is a matter of life and death for them. It’s not always easy to tell what might get someone through an otherwise impossible day and how much good you can do without knowing it.

And sometimes the answer is to write, because writing isn’t dying. Today (the day when I wrote this), not existing is an attractive idea – more so than it usually is. I can see no way forward, no way of doing anything good enough, no way of making my existence bearable. I’ve been here many times and I know things won’t get better but that I may learn how to make do with less and how to keep moving despite how much it all hurts.

Helping your suicidal friend survive

The most important thing to know is that if one of your friends is suicidal, you probably won’t know. You might even have no idea that they were depressed. People hide their issues and often suicide comes as a massive shock to everyone who knew the person. Encouraging people to reach out when they need help isn’t that useful.

If you know that someone has suicidal feelings, the single best thing you can do in the short term is keep them talking. Any topic will do. A person who is talking isn’t dead. Don’t judge, undermine or belittle anything they tell you. Don’t make light of things. Don’t argue with them by telling them they have so much to live for. Don’t make it about other people – being told to endure unbearable pain for someone else’s comfort doesn’t actually make people feel better. Don’t make it about you. 

Most of the time you won’t know if someone else is struggling. What this means is that helping your suicidal friend survive actually depends on what you do all the time. How would you speak and act if you thought anything you said or did might be a life or death issue for someone else? With this in mind, perhaps we’d see fewer people on social media telling others to delete themselves or get in the sea. Perhaps we’d see less violence in language. Perhaps we’d cut back on the mockery, ridicule, shaming, put downs and other casual forms of cruelty.

When we make nasty comments about celebrities for being fat, or depressed, or not looking pretty enough – they will probably never know, but your suicidal friend might think this is what you think of them. 

It may sound like a lot of work to have to pay attention to everything you say and to act like someone’s life could depend on it. One of the contributing factors to people being suicidal can often be that maintaining the comfort of comfortable people is treated as more important than taking care of the person in crisis. I’ve seen this kind of shut-down many times. When people tell you they are tired of your gloom, bored of you talking about your issues… depressed people often hear that someone else’s comfort is more important than keeping them alive. It’s done so casually, carelessly and off the cuff, often, that I’m not even sure most of the people doing it have any idea that they might be pushing someone towards the edge. And some of them do know, and fat shame and disability shame people they know under the banner of ‘only trying to help’.

Saving lives means being as actively kind as you can manage. All the time. It means thinking about how your words and actions might impact on other people. Paying lip service to mental health does nothing. Caring for people actually takes effort and attention. Finding out how to support people takes effort. Finding out what allegedly normal speech can do to vulnerable people is uncomfortable. Damage isn’t all about big drama, it can be the cumulative effect of countless small woundings.

You probably won’t get a cinematic moment when you grab your friend and bodily prevent them from jumping off a bridge and thus heal their pain and make them want to live again. You probably won’t ever know if what you said or did made a difference, either to save someone, or to push them closer to death. What you do, matters.

Self Harm

People who self harm do so for all kinds of reasons. From the outside, there is often no way of knowing what’s going on. It may be tempting to think that stopping the self harm is a good thing to do that will improve the situation, but this isn’t always the size of it.

Sometimes people self harm as a way to not kill themselves. It may be a survival skill that enables them not to do something far worse. For some people, it is a way to vent otherwise unbearable emotions – and in the short term that can also be a suicide-avoidance strategy. For people who are numb, it can be a way of feeling something, and feeling can be a lot better than not feeling – extreme numbness makes some people feel suicidal. It can be an act of reclaiming control over body and self.

While it may not be optimal, it may be necessary in the short term and just trying to get someone to stop won’t deal with the underlying issues and may put them at risk in other ways. It probably isn’t a cry for help, although it can be. It probably isn’t attention seeking – although just occasionally, that’s part of it. Most usually the self harming person is someone in great distress, although there was a boyfriend in my distant past who used it for emotional control of others, which was grim. These are unusual things, and it is better, safer and kinder to start from the assumption that a self-harming person is in a lot of distress.

Not all self harm is obvious. It can be about not eating. In fact, if you starve yourself and lose weight the odds are that people will emotionally reward you. It can take the form of alcohol abuse or drug abuse. Self harm can be about intentional acts of self-sabotage. For the person who has internalised worthlessness and who is full of self hatred, self harm can be about delivering the punishment you’ve been taught to expect. It isn’t always obvious to the people doing it what it is for and how it is supposed to work.

There are no easy answers to helping someone who is self harming. Don’t disempower them – whatever is going on, making them feel powerless is going to make everything worse. Don’t assume you know better than them what is going on. Don’t let your discomfort over what they are doing be the most important thing – the distress prompting the self harming needs to be the most important thing. If you’ve no experience of this kind of thing, don’t imagine you already have the tools to help someone who is doing it – educate yourself and get support. Be kind and be patient and don’t get cross with them – that isn’t going to fix anything. Don’t make your feelings about the self harm their responsibility – the odds are that guilt and shame are already part of what’s making them hurt themselves.

Suicide, utility and recovery

I’ve been dealing with suicidal feelings since my teens. After a particularly awful round last week, I was able to sit down and make a list of the persistent thoughts occurring to me around why I should kill myself. This was not an easy process, and when I’m not very close to these things I can’t readily access them and mostly don’t want to go there.

The list had themes, and I only saw them because I’d written them down. A few of them were about pain – physical and emotional and not being able to take any more. I’m fine with that. On its own, I can deal with pain and I also feel that wanting to die in face of a pain overload is a perfectly reasonable response. The thing to work on, if I can, is the pain. Most of the reasons were about utility – that I am not good or useful enough to be entitled to live. Some of them were stacked on that as issues of how I fail as a human being.

I note that every time I’ve kept going in the past I have done so on the basis of not hurting or letting down anyone else. It works in the short term but feeds the narrative that the worth in my life is my utility for other people. I need to stop doing that.

Philosophically, this outlook is bullshit. It’s not what I believe, it’s not my value system and I wouldn’t apply it to anyone else. It isn’t me – and I’d never really seen that before. It represents a way of thinking about people, worth, and life that I do not believe. It is not something of my making. It is, I realise, a consequence of what’s been done to me. After more than twenty years of living with these thoughts, this is a significant breakthrough. It changes who I think I am, and it changes what I think is happening when I fall into these patterns of thinking.

To be worthless as a person depends on having a way of measuring a person’s worth that isn’t simply that they exist. It raises questions about who is supposed to benefit from my life and what I am supposed to be for. Narratives that make a person all about their utility are intensely de-personning.  We live in a culture that does a lot of this, especially to the poor and disabled and to anyone disadvantaged.

I’ve also realised that these thoughts come up as panic responses, not as depression issues. Depression is just a miserable grind, but it’s not the thing trying to kill me. The dangerous stuff is what gets set off by high levels of panic.

I think it probably isn’t just me. I wonder how many people who end up wanting to die do so because their sense of self has been cripplingly injured.  How many people feel there is no point in living because they’ve been taught to measure their own worth in terms of utility to others? It’s also really hard to ask for help when you feel that you are suffering because you are worthless and useless. It’s hard to believe you deserve help, or that you are entitled not to feel awful, when the thoughts driving the experience are all about what a waste of space you are.

No one gets here on their own.

Talking about mental health

In a recent blog post, Cat Treadwell flagged up some of the things that reliably happen if you try to talk about mental health problems.  It is unfortunately quite normal to hear that you are attention seeking, making a fuss, being a drama queen, over-reacting and things of that ilk. It is also equally normal, when people turn out to have self harmed, attempted suicide, or managed it, to find a lot of people wondering why they never said anything and never asked for help. As though these two things are totally unrelated.

Talking saves lives. Emotional support, witnessing, expressions of care and help with the problems that are causing the depression in the first place all increase a person’s chances of survival. Our culture tends to frame mental health problems as personal, but usually it isn’t – poverty, lack of opportunity, poor physical health, insecurity and a lack of dignity all pushes people towards the edges. These are social, systemic things and we could fix them. Western culture makes people lonely.  The solutions to this lie in community and relationship, but if you can’t speak of it, you can’t access that support.

How something is experienced depends a lot on resources. The less resourced you are, the harder a setback can be to bear. So, if you are doing ok, and your friend appears to be in a similar situation and struggling, is this because they make more of a fuss than you do? What’s the bigger picture? Throw in a large debt, a health problem,  an abuse history and the thing you think shouldn’t be a big deal becomes much harder to manage.  When people ask for help we can’t always see the scale of their issues, so it is as well not to dismiss or diminish whatever is mentioned.

Some people are more sensitive than others, but society tends to view sensitivity as weakness. To care, to feel empathy, to be afraid for the world, to grieve over the loss of species, or the homeless on the streets, or the hungry children depending on food banks – there is so much to break your heart over. Increasingly to be viable is to be heartless. To care about anything is to live with a broken heart. If we prized that sensitivity we’d be a lot closer to fixing the entirely fixable woes we create. If we treat sensitivity as a failing, we can only push on to make life worse for each other.

You may think that if someone was suicidal, you’d be able to do and say the right things to keep them alive. What many non-depressed people don’t realise, is that your suicidal friend isn’t likely to pick up the phone and tell you they are going to kill themselves. It’s not what we do. It’s not when the windows of opportunity occur most reliably to save lives. Your very depressed friend might however speak up about some aspect of how they are suffering before it fully overwhelms them.  It may not make any sense to you. It may not seem like a big deal. Often, the life and death stuff is much smaller looking than is really the case.  Respond well to those smaller expressions and the person you are supporting may never end up trying to kill themselves.

Tell someone they are making a fuss, and when they no longer know how to keep breathing, they may remember that, and not reach out for help.

Struggling with mental health

I wrote this in the middle of the night recently, crying, unable to sleep, overwhelmed with panic and despair. The first version went up on Facebook. I’m mostly trying to out a brave face onto my online presence – easy to hide behind a screen. But, I doubt I’m the only one feeling this way and I think it needs talking about.

TW – Suicide issues.

Like a lot of people, I was suffering from anxiety and depression before the virus. There has never been much help available for us, and now there will be less.

Many of us have lost key things that were keeping us going. We may express hurt over that online – the loss of the gym, the dance class, the pub time, the live music – we may not be being super selfish when we express distress. We may be talking about the things that helped us stay alive. Depression also kills people. Knocking people back for expressing distress or difficult, really doesn’t help.

It’s really hard for me, reading people saying ‘stay in’ and ‘don’t see anyone’ with a clear message that anything other than total isolation makes you a terrible person. I’m really struggling with feeling like a terrible person, I expect I’m not alone. I don’t do much going out at the moment, and I’m being careful and have been for weeks. But I’m also not sleeping, and crying a lot, and terrified of being trapped in this flat and what that would do to my already poor mental health.

Tom has some serious anxiety issues and for him, being trapped in a building is deeply problematic.

So maybe don’t share the memes about how all you have to do is sit on the couch, it isn’t that hard. For some of us, isolation could well be a death sentence.

And yes, lots of anxiety about how selfish I am in not wanting to end up suicidal. I’ve been through periods of wanting to kill myself before now, I’m fighting not to go back there. I’m seeing people online hoping the virus will take them quickly because they’ve already lost the will to live. I see the same thoughts creeping in with me. ‘Selfish’ can be something of a trigger term for me and again I suspect I’m not alone. I think people who kill themselves often do so because they think its the best thing they can do for the people around them. What else is there, if the things you do to try and stay alive are deemed selfish?

I know many of you are new to massive anxiety, and you just want everyone else to be more sensible so you and your loved ones are safe. Of course you want that. But some of us were only ever holding on by our fingertips, and now things are worse. Please, when you go online to vent your fear, consider how it might sound to someone who is having a mental breakdown. Someone – for example – for whom going outside for a run, or a walk is the one tool they have left to manage their failing mental health.

Your suicidal friend probably won’t tell you how they feel because that’s part of how this illness plays out. They won’t ask for help, especially not if what they need is time with another human being. You won’t know who is in trouble, most likely. Yes, isolation saves lives. Kindness also saves lives, and your depressed friends need to know that their lives matter too and that they are not failing as human beings for wanting or needing things that are difficult at the moment.

Suicide and selfishness

Trigger warnings, in case the title of the post wasn’t entirely clear on that subject.

This week has seen World Suicide Prevention Day, and a lot of conversations around why suicide happens and how to stop it. The idea that suicide is an immensely selfish thing to do has been challenged a fair bit, but, I wanted to pick over the mechanics. I feel this one keenly.

I’ve had a lot of rounds of wanting to die – not necessarily wanting to take my own life, but just wanting it to be taken from me so that I might stop hurting. I have also had rounds of wanting to take my own life and moving towards acting on that. Those rounds had one thing in common – the growing belief that it was the best thing I could do for everyone else.

When depression gets its teeth into me, I feel awful, useless and worthless. I feel like I’m a burden to everyone else, a nuisance, a problem. If my being depressed has a negative impact on other people, if my not coping causes someone else a problem, that suspicion creeps in that the best thing I could do would be to offer my absence. Usually I just step back, go silent, disappear, but death is the ultimate absence, and sometimes it starts to look like the single best thing I could do.

There are so many things around how people often respond to suicidal feelings that really, really don’t help with this. Here’s a non-exhaustive list. Calling it selfish. Focusing on how suicide would harm other people. Demanding that you get meds so as to not make the other person uncomfortable. Shutting you down when you try and talk about what you’re feeling because it makes them uncomfortable to hear it. What all of this does, is to make the suicidal person the least important person in what’s happening.

If you’re staying alive so as not to inconvenience someone else or to avoid upsetting someone, this is not a strong position to be in. Whether it’s ok to keep living or not becomes an equation in which you weigh their comfort against what you do. The worse you feel, the more depressed and stuck you are, the harder it gets to persuade yourself that the upset you’d cause by leaving is not in fact greater than the harm you cause by staying. When you’re feeling awful about yourself, it is hard to see your existence as anything other than innately toxic.

If you want to feel comfortable dealing with someone who wants to die, you are not the best person to be talking to them. That might feel uncomfortable, but I think we need to ask people who are largely ok to think carefully about how they prioritise themselves when dealing with people who are desperately ill and in massive distress.

If you want to keep someone alive, you may have to engage with what’s going on for them, and that may hurt. Consider whether it hurts more than the prospect of losing them. Consider what you can say or do to boost their sense of self-worth so they might want to live for their own sake. If you make it about you, then you may well be piling on the pressure and adding to their stories about how little their own life is worth.

Gender identity questions

On plenty of occasions, I’ve encountered people saying they have legitimate questions about trans issues. Most often, these come down to fears for female safety. There is certainly an issue around the scope for predatory men to temporarily adopt trans identities to invade female space. Toby Young – an infamous and vile creature who for reasons that make no sense to me has had some high profile UK jobs – admitted to dressing up as a woman to go after lesbians. However, there are a great many questions I don’t think we are asking, and should be.

Are we doing enough to support diversity in sexual expression? Are we looking after our effeminate boys and butch girls and allowing them to express that way, or are they under pressure to conform to hetranormative standards?

How much gender normalising do we do with children? Are girls who don’t like pink and passive toys being told they are boys? Are boys who like sparkly things being told they are girls? If some young people are being pushed towards trans identities it isn’t trans folk doing this, it is hetranormative pressures from the adults nearest to them and I think we should be talking about it. Historically, telling a child they were behaving like someone of the opposite gender was a scare tool designed to bring them back in line. How many people have been persuaded they don’t belong as one gender because others have told them they’re not acting like a ‘real boy or ‘real girl’?

Pushing people towards a gender change can be a way of pushing them towards heterosexual conformity. I’ve seen it suggested that in some countries, trans is considered preferable to queer because it holds up cultural beliefs about gender. We should be questioning this.

I’ve seen people question the kinds of gender stereotyping trans women seem to go in for. I’m not seeing enough people asking why that might be the case, and what the link might be between performative femininity, and access to support. I am seeing a lot of trans women talking about the pressure to perform femininity in these narrow ways. I think we should be asking questions of what kinds of hoops trans folk have to jump through, who the gatekeepers are, and what kinds of ideas about gender are in the mix here.

If you believe the right wing media, a person, even a child, merely has to suggest that they might be trans to be rapidly operated on and plied with hormones. We don’t spend enough time asking trans people what their experiences are, or listening to the answers. How long does it take to get an appointment at a trans clinic? How many clinics are there and how far do you have to travel to be seen?  What do you have to demonstrate to be taken seriously? To transition, a person has to live as the gender they consider themselves to be, for several years. This includes using a name that is not their birth name, and all the technical problems you can imagine might go with this. What support is there? What help? What legal protections? We’re not asking enough of these questions.

One of the key issues with transitioning is that it reduces suicide rates. The one question I don’t see anyone asking is what else we could do that would help reduce suicide rates. Surgery is not attained quickly. It’s not available on demand. There’s years of process here. What could we be doing in other ways to reduce the suicide rate for trans people? What is it, specifically about the experience of being transgender that has people wanting to kill themselves? How much of it comes down to the behaviour and attitudes of the rest of us? What can we do, individually, to help the people around us be as comfortable as they can be with themselves?

How many people could have happier, more comfortable and viable lives if the people they dealt with simply accepted them as they are?

How to save a life

I’ve written here repeatedly about my ongoing issues with depression as I grapple with it, trying to survive, to overcome it, maybe even to heal. I don’t talk much about how bad it can get, because I’m afraid of sounding melodramatic, or worse yet, making someone else feel a bit uncomfortable. Wanting to die is a re-occurring issue for me. That’s different from wanting to kill myself – less violent, more like a yearning for a simple off switch. On my saner, calmer days, the issue of how not to get into such a dark place that I want to die, is something I pay attention to.

I know exhaustion is a trigger. The more worn down, burned out, threadbare I get, the more likely that I start to feel that only the end of my existence will put me out of my misery. Prolonged bouts of pain have the same effect, and both of which can be tackled without having to top myself, and mostly I do manage to remember this even though I can feel really, really awful.

Perhaps my biggest trigger – or at least the biggest one I’ve identified – is fakery. The more energy I pour into being a tidy, acceptable sort of person, the more likely I am to feel hollow, threadbare and suicidal. The harder it is for me to be myself, the less will to live I can muster.

The trouble is that I’m a bloody awful person to be around. I know a lot of people like my blogs, books, social media stuff, but I’m like this all the time. Always thinking this intensely, always as deeply emotionally engaged, always this intense. I feel everything keenly, I worry a lot, I think, and think more. In person, the emotional intensity may be more of an issue. Add to this that I’m obsessive (this is where blogs come from) and thin skinned. I care about everything I run into and have an awkward habit of loving passionately the people who are in my life. I try and tone it down, but it’s hard and requires a lot of attention.

That might sound ok as a paragraph in a blog, but in real life, it isn’t. There have only ever been 2 people who have encountered me in a sustained way as I really am, and not run away or asked me to tone down. It can be lonely sometimes, and every friendship is a waiting game. How long can I last? How long can I fake it for before I slip up and am too real? And all the while, the faking it is taking me apart and digging me a deep, dark hole.

For anyone who wants a quiet, gentle, peaceful, easy going sort of life, I am, quite simply, too much. Too intense. Too serious. Too passionate. Too giving. I’ve heard them all and more along the way, repeatedly. So I’ve bent and battered myself trying for more acceptable, harmless shapes. This morning I realised that this is, metaphorically speaking, killing me, and if I keep it up sooner or later it might quite literally kill me.

I’m choosing life.

This means I am not going to be a tidy fake for anyone again. I have a number of strategies for how I’m going to handle this. Absence and silence are at the top of the list. Not being in places where there are people. Moving away if I feel something. Holding distance. I’m an ok person to have as a casual acquaintance, but that may be the limit, and for everyone’s sake, I need to hold those lines better.

My bet is that most people won’t see much difference anyway. It’s possible there are one or two people who would choose to have me in the raw (ever the optimist, me) but I’m going to be looking for much clearer feedback in the future. People are going to have to opt in, really clearly, using the kind of small words I can’t possibly mistake for anything else. You would have to love me a lot to do that, and you would have to be ok with the idea of being loved in return.