Remember in September – Daily Post #26 for National Suicide Prevention Awareness Month

I was wondering if there was such a thing as chronic suicidality, chronic suicidal ideations or chronic suicidal thoughts. So, of course, I googled the words to see what kind of information I could find on this subject.

I almost feel like it should be mental illness of its own, a mental illness in its own category, but it is not. Having constant and chronic suicidal thoughts is far different then depression or having some suicidal ideations. It is at a much worse, severe and dangerous level and it just feels different.

Sometimes the suicidal thoughts are there for no reason, for what seems like will be the duration of my life. Sometimes I have suicidal thoughts when I do not even feel like I am depressed. It seems like these suicidal thoughts are living a life inside my brain and mind without my own ability to stop them. These horrific thoughts are constantly in mind for no apparent or obvious reasons, whatsoever. The thoughts just pop up like unwanted popcorn in my head. These very serious and scary suicidal thoughts just keep popping up and flooding and overflowing the popcorn popper inside my brain.

Chronic suicidal ideation most commonly occurs in people with long-term severe depression or personality disorders. This group of people is at higher risk of suicide in the long-term.

People living with chronic suicidal thoughts are always expressing suicidal ideations.

If you experience suicidal thoughts, the following posts could be potentially triggering.

You can contact the Crisis Text Line by texting “START” to 741-741.

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This is a great article on the subject of chronic suicidal thoughts…

Chronic suicidal thoughts . . . to be or not to be . . .

by Doctordan, July 19, 2008

The presence of chronic suicidal thoughts is one of the more difficult issues to deal with in psychiatry.  It is one of the issues that separates psychiatry from all other branches of medicine.  When patients see my colleagues, they want to get better.  Sometimes, when patients see me . . . they just want to die.  This freaks people out.  Me too, sometimes.  But it is part of the business so, I guess, I have learned to deal with it.

Part of the difficulty with it is the sense of being out of control of it.  Surgeons like to cut and sew.  If something is broken, the way to fix it surgically is pretty clear (tho’ obviously requires great skill).  Maybe it will work, maybe it won’t . . . but what to do is usually clear.  And the doctor runs under the assumption that the patient will do everything in their power to cooperate with the healing process.

Patients who present with chronic suicidal thoughts are not so simple.  This is especially true if the patient does not have clear stressors that are producing this sense of despair.Someone who has experienced significant loss, be it job or a relative, often has difficulty re-defining himself.  That sense of loss-of-self that comes with that situation gives us a clear direction to proceed.  Most of us have had such a loss, and most of us have entertained killing ourselves.  Thoughts like that are really quite normal . . . as long as you don’t follow through on them . . . And addressing the issues is relatively straight forward.  Redefine yourself while grieving the loss. (I didn’t say it was easy . . . just straight forward).

But what about the person who has relatively little life stress?  Or the stressors are not the sort that would seem to be at the root of such a strong desire to eliminate one’s self.This intangible state is what is most difficult for the patient, for their family, and for the health care providers that are involved.  For some patients, the presence of chronic suicidal thoughts can be the manifestation of past abuse.  It can be an indication of significant personality disorder.  But for many, it seems to be an independent entity that occurs with limited cause.

Very scary.

Very, very scary.

But, not without a possible solution.  More than with any other patient group, a patient with suicidal thoughts must be connected with a therapist that they trust and respect.

They must be actively working with that therapist on life skills management that includes social networking without fostering dependence, developing a pattern of activity for oneself that supports physical and emotional health, and strengthening spiritual connectedness with other people and whatever you conceive as “God”.

And, most importantly, an emotional distance between who you are and what you think. After all, we don’t have to follow through on EVERYTHING we think about doing.

Imagine the chaos if we did!!  Even though the thought to kill one’s self can seem as irresistible as the urge to take the next breath, it is necessary to purposefully distance yourself from that thought.  Acknowledge the thought . . . but distance yourself from it.  “OK, I have the thought to hurt myself . . . I think I’ll go for a walk instead . . . ”

I encourage those patients who I see with these thoughts to develop a very clear list of things that they will do before hurting themselves.  I don’t tell them they cannot hurt themselves.  I decided a long time ago that it was foolish for me to think that my admonishment to not hurt yourself would carry more weight than someone who is close to the person.  But I do expect that they will follow through on our plan (key here is OUR plan) to keep them safe.  And one of the items on that list of to-do’s is that they MUST talk to me or their therapist.  Not TRY to reach me . . . but actually talk to me or their therapist.

The idea here is to create a system of diversions that waste time.  The more time that goes by, the more likely it is that the patient will move from the “have to hurt myself” stage to the chronic nagging stage of self-injurious thoughts that are much easier to ignore.While this sounds a bit simplistic . . . it can work.  If the patient “works it”.  As with all of medicine, the active participation of the patient in the healing process makes a profound difference.

From a pharmacologic standpoint, what is done with chronic suicidal thoughts?Obviously, the underlying depression or anxiety is treated.  But, in addition to that, Lithium can be used.  Of all the medicines that we have, Lithium is the only one that has been shown to decrease frequency and severity of suicidal thoughts.  Sometimes, the effect is very dramatic.  I have had patients who have had suicidal thoughts for years find resolutions for these symptoms after just a few days on Lithium.  It is magic when it happens!  Both for me and for them.

As difficult as suicidal thoughts are for the patient and for those around them, I can say that it is exceedingly rare for someone to not get better if they hang in there and work hard at it.  But it is the sort of psychiatric problem that requires openness with your mental health care provider, trust that things will get better, and resolve to do what it takes to make things better.

Most importantly, I try to instill the understanding in the patient that they are not alone.

That their life, however much they do not value it, is valuable to other people.  That the effects of suicide are much more than they can understand when they are overwhelmed by their thoughts.

The move It’s a Wonderful Life is a bit cliché and sweet . . . but every patient who has survived a period of suicidal thoughts or actions reaches a point where they say . . . “I’m so glad I’m alive”.

–Dan Hartman, MD

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My Biggest Challenge as Someone With Chronic Suicidal Thoughts

by Jennifer Davis

I live with chronic suicidal thoughts. At some point during every day the thoughts present themselves.

The biggest challenge with chronic thoughts is knowing when it is time to get myself to a hospital, and when to just cope my way through to the next day. I walk a very fine line between life and death on a daily basis. At any given moment I could rattle off multiple ways I could kill myself. From everything I have learned, the big warning sign to get immediate help is when you have a plan. Unfortunately, I always have a plan. So where does that leave me? It leaves me with a persistent fear of having that impulsive moment that ends it all. This fear has landed me in the hospital multiple times. I feel like I have become the “boy who cried wolf.” The problem is every single time it feels like the “wolf” is real to me. It is scary and frustrating when I really don’t know if today’s thoughts will lead to another attempt.

I have seen this frustration in both my prior psychiatrist and therapists when they involuntarily admit me to the hospital. I’m resistant to voluntarily go because I have been to the hospital so many times and everything turned out OK. I don’t want to waste everyone’s time. As professionals, they are not able to take a chance that everything will be OK like every other instance. Undoubtedly, they seemed upset they had to send me against my will.

My biggest fear is that I, or my providers, become complacent to my thoughts and I do attempt again. This time I may be successful. My life depends on living in a state of awareness and honesty of even the slightest shift in my thoughts.

I live one day at a time. Sometimes, one moment at a time. I have all the resources at my disposal 24/7. I still hold on to that small glimmer of hope that the thoughts will eventually go away. I use that hope to fight another day.

© 2017 Mighty Proud Media, Inc. All Rights Reserved.

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When Suicidal Thoughts Become Your “Normal”

by Daphnee Levesque

When I was sick, I thought waking up every day wishing to be dead was something everyone else experienced. For months, I pictured my death and visualized ways to kill myself — and I thought it was a perfectly “normal” thing to do.

Things were bad. There’s no other way to put it. They were so bad, I can’t even tell you how bad they were. Words can’t describe how awful those months were.In the midst of my illness, I couldn’t see or understand the potential consequences of my illness. I didn’t understand why my parents worried constantly, or why my friends kept such close tabs on me. I didn’t understand the concerned expression on my therapist’s face, and I didn’t get why the doctors in the ER kept saying I needed to be hospitalized. I didn’t get why those around me made such a fuss.

In reality, I was so sick I couldn’t even see how bad it was.

In the weeks leading up to my hospitalizations, not a day went by without my friends or family checking up on me. At times, it felt like they were babysitting me. Meanwhile, I thought being depressed and suicidal was not a big deal at all. I thought I was fine, and got angry when those around me replied that no, I wasn’t.How could they say that, when they weren’t the ones living in my skin? Shouldn’t I have been the one to trust my own judgment? Didn’t I know myself better than anyone else? 

When one doctor in the ER asked me quantify my suicidal thoughts on a scale from 1 to 10, I told her my suicidal ideation wasn’t a big deal. I told her I had suicidal thoughts for what seemed like forever. Three to four out of 10 I said. This doctor replied with, “No Daphnée, the fact you have thoughts alone — that’s enough to be considered suicidal ideation. The fact you can visualize it… we’re talking eight or nine out of 10.”

I disagreed with her.

At that moment, I was so deep in denial, and my refusal to accept reality was my way of coping. Like my therapist once said, sometimes when we’re undergoing a traumatic experience, minimizing the pain and downplaying the amount of struggle can serve as a coping mechanism. Normalizing allows us to get through the trauma. It’s only when we do look back that we realize how bad the situation was, and how severe the circumstances were.

The truth is, when I was sick, my symptoms weren’t symptoms to me. They were what they were and I didn’t think much of them. I didn’t realize how powerful and damaging they were until the moment they started to lift. Only then did I realize how much they had kept me feeling trapped and suffocated.

When my symptoms went from being severe to moderate, then became mild and almost nonexistent, I felt free. I felt liberated for the first time in months, and I felt like the fog that had blurred my life vision had finally evaporated. 

The thing to remember about mood disorders and chronic illnesses like mine is that they change your normal, your baseline. I got so used to being sick that I started to wonder if I was ever sick at all.

Personally, it is only when I regained my health that I realized how much I had lost and how many good days had been stolen away from me. Even now, living without chronic suicidal intent is a strange experience, and feels foreign to me. I feel it should be the other way around.

Lastly, I want to point out that mood episodes are so much more than just a few bad days. In my experience, my mental illness affected so much more than just my state of mind. It affected my relationships, my values and beliefs, as well as my physical state of well-being.

These days, it’s true that I am feeling much better. But I also feel much more unsettled and anxious than before. Not feeling depressed all the time genuinely confuses the hell out of me. It almost concerns me.

I’m so used to feeling a certain way that when I don’t feel suicidal 24/7, I have to take a step back like, Wait, what? What’s going on? What is happening to me?

Some days, I feel like I’m dreaming. Everything is surreal and I’m scared I’ll wake up.

Some days, I feel like it’s too good to be true, and ask myself, “Where’s the catch?” Like I’m convinced I’ll wake up tomorrow and everything will have changed, because life couldn’t possibly be that good, right?

Most days, it feels like my world has been turned upside down. Maybe it’s not like this for everybody, but for me, it’s hard to just feel OK — or even happy.

© 2017 Mighty Proud Media, Inc. All Rights Reserved.

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What I Want My Workplace to Know About Living With Chronic Suicidal Thoughts

by Yujia Ding

I’m sitting at my desk at work and my mind is wandering. I’m thinking about the conversation I had with my boss about how I am not cut out for graduate school. I’m thinking about the $175 I spent that I don’t have on clothes I doubt I’ll wear because I’m too self-conscious to wear them. I’m thinking about the fact that I wore a short black dress and patent leather ankle boot heels to work today and how uncomfortable it makes me. I’m listening to the Adele radio station on IHeartRadio and wondering what’s the point anymore?

When you are chronically suicidal, it is incredibly hard to speak up about how you are really feeling. It’s taken three years of intensive treatment — residential, PHP, IOP, outpatient groups, numerous therapists, 10 plus medication changes — to find a therapist I am comfortable naming my suicidality to. I battle my thoughts constantly, and with these thoughts come feelings of unworthiness, insecurities, hopelessness, uselessness, the list goes on and on. While mental illness is not an excuse, it is something that is affecting me in every aspect of my life.

Here’s what I wish I could tell the world I work in, if it were with lack of fear, judgment and received unconditionally:

1. I am trying my best. I promise. Some days are better than others. Sometimes just getting out of bed to walk the dog is the best I can muster. I will fall asleep for hours on the couch, and not get up except to try to stick to my meal plan and walk the dog again. Other days I am able to make it to work, wear something respectable and accomplish a few experiments and have some intellectual conversations. However, know I am trying. I may be in a brain fog half the day, but showing up sometimes is half the battle. And for that, I hope you can understand and forgive me.

2. I make mistakes and I’m not perfect. You don’t need to remind me I am making mistakes. I’m already hard on myself and not being perfect tears me apart inside. I am my hardest critic and I don’t need to hear it from the outside, especially from someone I would expect to be supportive of my endeavors. I hurt and am my own worst critic constantly, so please just understand and try not to humiliate me more than I do already myself?

3. I’m dying of heat exhaustion in my sweatshirt and jeans. And it’s getting to me, making me tired, exhausted and emotionally drained. Why? Because it takes extra effort to make sure you don’t show your scars from self-harm at work and when you have to walk to work in the more than 90 degree heat in a sweatshirt and jeans, and you can’t take off the sweatshirt for some relief, your mind becomes distracted from what you should be doing.

4. My mind is often, more often than not, thinking about how I can take my own life using the resources I have at hand. It’s not something I like to admit, yet it’s a part of me and I can’t keep denying it. I don’t have a plan, but I do have daydreams. I spend the better part of my day thinking about ways I could put myself out of the pain and suffering I feel in my life. Yet, I can’t admit this and I feel trapped, and the only way I can escape is by burying myself in some readings or taking a walk around the building and browsing social media to take my mind off of things. I can’t admit anything because I feel judged.

5. I live with profound mental illness, yet I am a functioning member of society who has responsibilities and a job. I’m also a student. I can do it, it just might take me a little longer. And if that’s not suitable for you, then I don’t know what I can say. I try hard, I am trying hard and if that’s not enough, then I am not enough for you and this isn’t worth my time.

Please know I am trying, as I’ve said many times here, and I am trying sincerely with all my heart. I battle my chronic suicidality. I battle my anorexia. I battle my post-traumatic stress disorder and triggers. I battle my urges and self-destructive thoughts daily, moment to moment, constantly. I don’t want to battle the rest of the world too.

So for now, please keep this in mind when you speak to me, and as I struggle to make my battle speakable and known.

© 2017 Mighty Proud Media, Inc. All Rights Reserved.

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Living With Chronic Suicidal Ideation

by Caroline Meadowlark 

I had my first passive suicidal thought at 6 years old. I remember sitting at the top of the stairs after being scolded by my parents, repeating over and over in my head, “I wish I was dead, I wish I was dead, I wish I was dead.”

The active suicidal thoughts came later. Somewhere in my late teens, it occurred to me I didn’t just have to wish I was dead; I could bring death upon myself. Since that realization, that I could be the catalyst, I have never been the same.

The thoughts come every day. On a good day, it goes something like this:

Brain: You should kill yourself.

Me: No, that’s silly. Everything is fine.

Brain: OK, cool. Just checking.

On a bad day, it goes much further, even into specific plans. The intensity ranges from mild to ambivalent to severe.

I was recently diagnosed with bipolar II disorder in addition to generalized anxiety disorder and post-traumatic stress disorder (PTSD). I get the thoughts on both sides of the coin. When I’m depressed, I ruminate and plan for days or weeks. When I’m hypomanic, I get impulsive suicidal urges, sometimes every few minutes. The anxiety also triggers thoughts that I can’t live through whatever challenge I’m facing, so I might as well kill myself.

I don’t know why my brain seems to want to kill me. I wish I could make it realize — no, make myself realize — it’s an awful idea. That my life is worth something, worth living.

I’ve been in therapy for almost three years. I’ve been through two psychiatric hospitalizations. The therapy has given me more techniques to try and handle the thoughts and reduce their intensity. I recently found a psychiatrist I trust, and I’m really hoping he can help me get stable. I’m a fighter and I’ll keep fighting these thoughts, but I am scared I’ll have a weak moment and do something I’ll regret.

© 2017 Mighty Proud Media, Inc. All Rights Reserved.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), the Trevor Project at 1-866-488-7386 or text “HOME” to 741-741. Head here for a list of crisis centers around the world.

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September is National Suicide Prevention Awareness Month

I am a numerous suicide attempt survivor. Praise God, I am still alive today.

I am a Mental illness advocate and it is my passion to educate about mental illness, increase awareness about mental illness, reduce the stigma of mental illness and the stigma associated with suicide and prevent suicides. I want to and must reduce the alarmingly increasing rate of suicides around the world today.

I continue to make a daily post about suicide everyday throughout the month of September for Suicide Prevention month. This is post #26 and if you have missed my previous posts, please check them out on my blog. Also, continue looking on my blog for more daily posts about suicide for the rest of September.

We must focus our attention on fighting mental illness stigma and the stigma associated with suicide and prevent suicide.

We cannot become complacent with this very important problem and issue. It is the new civil rights movement of our area. We must stop the bias, shame and discrimination people living with mental illness and suicide loss continue to face on a daily basis.

We must all make our voices heard very loud and strong about mental illness, mental illness stigma and suicide prevention. It is critical. It is crucial. Each life is fabulous, beautiful, precious and priceless.

We must prevent suicides and save lives.

Please know you are loved and you all matter… and you all make a big, beautiful and positive difference and impact in this world and in the lives of many people every day.

God bless you all always and forever…

Love and hugs, Sue

 

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