What happens in the mind
The family I grew up in was not loving, nurturing, and safe as a family is supposed to be. It was chaotic, violent, and filled with addiction. I first became aware I was depressed when I was twelve. I wanted to go to therapy, but this was not possible. By the time I was 18, I was an alcoholic.
On two occasions I attempted suicide: once at age 16 and once at age 21. Though I got sober, like alcoholism, I have never been “cured” of depression, but rather keep it in remission. I have not been suicidal in many years, but the idea of suicide is like a fixture in my brain. A back door that is always there, though usually closed. The creature, depression, sits crouched in the corner ready to open the door when an escape is needed.
The dual diseases of depression and alcoholism remind me of the movie “Gremlins”. When you feed a Mogwai after midnight they turn into Gremlins and if they get wet they multiply. The word mogwai is Cantonese for monster or evil spirit. Depression may cause people to consume large amounts of alcohol in an attempt to self-medicate and feel better. However, alcohol makes the depression worse. It becomes a cycle that feeds into itself gathering intensity and very difficult to break, increasing the likelihood, frequency, and severity of suicidal thoughts.
I have been on antidepressants for about 25 years and have been told I will probably be on them for the rest of my life. Believing I was broken, I fought the idea of being dependant on medication and made four attempts to come off of them. Each attempt was a worse failure than the last with a faster spiral down. As recommended by doctors, I weaned off slowly, replaced the medication with exercise, focused on healthy eating, and maintaining a support system. This always seemed like a great plan that would work, but it didn’t. Like a diabetic dependant on insulin, I have learned there is no way to fix this. I have to take the medication AND take good care of myself. This keeps the creature quiet and the door closed.
The third time I came off the antidepressants I took a week’s vacation to Florida. It was January and I thought a nice vacation combined with acupuncture might help sustain a positive outlook. When I returned home, the cold rain hit me in a way that felt both physical and emotional. My young daughters were playing in the living room as I sat in my bed writing them a goodbye note. It was difficult to write because I wasn’t sure what to say. I simply knew they would be better off without me. Depression is weighty and illogical. It is exhausting to the point of wanting life to be over. Having spent a lifetime dealing with the signs and symptoms of depression and working with therapists taught me to develop an “observer mind”. Buddhist meditation teaches this as well. I knew my thinking wasn’t right. I knew that even though I felt completely hopeless and in immense emotional pain, that there was another way to feel. I was lost in these thoughts and feelings and I knew I needed to stop and ask for directions. I could not find my way out. I called a friend who was also a social worker. She gave me two basic instructions: hang up and call my doctor immediately to ask for the antidepressant, then call my friend right back. She gave me 5 minutes to do this. She later said she would have called the police if she did not hear back from me within 5 minutes.
The thoughts and feelings of depression that build into suicidal ideation are overwhelming and often non-specific. “I am a failure” “I can’t do anything right” “I’m a terrible mother” “life is too hard” “everyone is sick of me” “I’ll always be stuck here”. The creature is surprisingly strong and can tackle and pin you to the floor before you reach the phone, whispering these obscenities all the while.
Arguing with a suicidal person that they are wrong is not helpful. They will correctly assume you just don’t get it and stop talking to you. The creature will always be louder and more convincing than you are. Compassion, support, and quick actions to secure the person’s safety are what is needed. Don’t leave the person alone. Tell another supportive person, a family member or close friend, what is happening. Don’t be afraid to call EMS if you believe someone might try to harm themselves and they won’t cooperate with a visit to a hospital or doctor or a call to the suicide hotline. You might save a life.