Many times they commit suicide.
The truly tempting thing about suicide is that it’s a solution to pretty much everything. Not a constructive solution or a solution other people want you to use, but still a solution. We can opt out. Once you realize you’re strong enough to end your own life, that knowledge will never go away. When you’re happy and engaged in life, that knowledge makes your life better because of the profound meaning there is to be found in the awareness of death and the empowerment of choosing to live. But when you’re feeling awful and you get to feeling awful enough that you think you’d do anything to change the way you feel, the knowledge that you could kill yourself becomes lethally dangerous.
Suicidal ideation is a very dangerous symptom. It can be caused situationally or purely chemically; by life events or medicine and chemical imbalance. If you’re experiencing suicidal ideation, it can be tremendously difficult to ask for help. If you’re past ideation and you’re fully suicidal, seize any moment of doubt in your plan that you find and TELL SOMEONE. There are way worse things than going to a hospital. If you’re strong enough to kill yourself, you’re definitely strong enough for a 3 day hold. Sometimes those three days is all it takes to restart your life. You see a psychiatrist and a therapist, and they prescribe medicine and evaluate you during your stay to make sure the medicine is working and you are safe from self-harm. You go to the hospital to get better.
I’ve had two failed suicide attempts and three psychiatric hospital stays. The first attempt was during a manic episode when I was already at the hospital. It was the most intensely miserable I’d ever been at that point in my life. I tried to hang/strangle myself in a very makeshift way involving a phone charger and a door hinge, but I got caught and a nurse cut me down. The only damage I achieved was leaving impressively large and colorful bruises around my neck. I had only been diagnosed for a month at that time, and had no tools whatsoever to deal with a manic episode. I had been having suicidal ideation and other symptoms for a month or so and had planned my suicide, but I came home from college to go to the hospital instead. I was able to seize a moment of doubt and tell my mom I needed help. Trying to hang myself was an impulse. What I felt was so unbearable that I needed out THAT MINUTE. My second suicide attempt was not at all an impulse.
I had been on lithium for about a month when the color started to drain out of my world. Any given medication can help or harm different people in different ways. Lithium is a fantastic drug for many people, but it was hell for me. I knew I was done when I couldn’t feel love anymore. No one loved anyone. Love didn’t exist. I did my research and made a careful plan. It took me two weeks to get everything in order. It was not a cry for help. It was not an impulse. It should have worked, but it didn’t.
At the hospital I was given new meds and taken off of lithium. I improved very quickly, and my stay was really nice. All the patients were also some form of bipolar, and we spent most of our time outside of therapy and activities sitting outside, chain-smoking cigarettes, and trading war stories. It was good to be with people who were so different from me in personality, but understood even my extreme experiences because they had had them too. I felt validated.
Before I left the hospital that time (in 2008), I made a contract for myself in my journal. I wrote down the things I could do to get better, and I signed it. I promised myself to take my medicine on time every time, to not let scripts run out, to not miss any doctor or therapy appointments, to eat regularly, to exercise, and to meditate. Each of those things (the things that keep me stable today) was monumental to fulfill. I had to work at it for a long time. I have learned how to do all of those things, and I have not attempted suicide since then. I have had many episodes, plenty of depression, and along with that, I’ve formed lots of plans to kill myself; very detailed plans. I have to seize those moments of doubt to tell someone I need help. I also have to recognize the warning signs that things are getting bad. If I ever get to the point again where I can’t feel love anymore, I know to go straight to the hospital, because I am NOT safe.
Suicide happens when the pain becomes greater than your ability to cope. If you deal with suicidal ideation, you’re going to need to work hard to build your coping skills and tools. Make a toolbox for yourself: write affirmations and coping strategies on index cards and keep them somewhere that you will remember when you’re in an episode or really hurting. Go through them at these times until you find one or two or five things that might help. You’re the person most likely to save your life.
Finally, there’s professional help. Psychiatrists are there to prescribe medicine to return balance to the chemical levels in your brain and body. Psychologists and therapists are there to listen to you and teach you how to cope and help yourself. If you are mentally ill, you need these people on your team if you’re going to survive. I do not say that lightly. There is no replacement for quality professional help. If a doctor or therapist is not meeting your needs, find a new one instead of giving up completely. You are your best advocate as the patient, and you know what you need.
The perpetual question mark of suicide rests in the back of my mind as an all-purpose solution that never goes away. Living is hard, and harder for some than for others. Sometimes all I can do is be stubborn enough to not let my brain take me out.
If you’re suicidal right now, call this helpline at 1-800-273-8255. It’s confidential and might save your life.