Suicidal: Conversations on the Edge

This is a collection of observations based on times when I or a friend was suicidal. Do not freak out. I am not suicidal now. My thinking is, I admit, a bit disordered because of my toothache, but I’m quite safe.

Many of us, in the course of a lifetime will either talk TO a suicidal person, or talk AS a suicidal person. And I think we all wonder what to say or do…as usual with these posts, there is no one answer that is always right. And sometimes, an answer I list here as a wrong answer might be the right answer in a particular situation. You see, humans are capable of infinite diversity.

Scarred forearms of a schizophrenic.. Suicidal people might engage in self harm
Photograph by: James G. Owen

As always, I advise you to take suicidal persons seriously. If you have no idea what to do call this number. If the suicidal person is unable or unwilling to talk on the phone, they will talk to you and tell you what to do. Don’t get alarmed or frustrated if the suicidal person will not talk on the phone. It’s not just me, many suicidal people get weird about the phone.

Remember, when you are talking to a suicidal person, you are talking more to an illness than a person. Their illness has already shot down any positive thoughts they might try to cling to. It rarely helps a suicidal person if you approach them with the ‘Think of all you have to live for’ line. That illness, that depression, that bi-polar, that schizophrenia has already undermined all the good bright things in life. The ‘Think of all you have to live for’ attitude may only increase their sense of guilt, shame, and depression.

Another thing well-intentioned people do is try to play John Wayne playing a good-hearted Army sergeant. They grab you and say ‘Talk to me!’ This approach can scare or intimidate the suicidal person badly. A better tactic is saying “May I listen?” Remember that a suicidal person is living in a realm of rapidly diminishing choices. Their tunnel vision is tapering down to a single point. Inviting them to talk adds a new option, and it sometimes can change how they view the world.

Sometimes suicidal people engage in self-harm. Most cutters, burners, and scratchers only engage in these behaviors privately. But when people are very suicidal, they can become disinhibited, so you might see these behaviors. And they are not pretty things to see. Everyone who sees self-harm wants to say “Stop that!” and that is a reasonable impulse. But curb that impulse. Ask them, instead, “Are you doing that so you don’t do something worse?” Now, that might seem like I’m giving you poor advice, and it is poor advice, but it is also sound advice. Weigh the consequences. You would prefer to have your friend as a live cutter than as a dead friend who will never cut again.

Suicidal people often quit sleeping or eating. And that isn’t good. Try tempting them to eat with hyper-palatable foods…try ice cream, milkshakes, twinkies, doritos, whatever you think they might eat. Don’t worry that you are offering them unhealthy choices, just try to get some food in them (and if it’s me, offer pork rinds!) If they aren’t sleeping, try to get them to take a nap. They will be resistant. Build them a blanket fort to nap in, let them put their head in your lap to sleep, promise to stay while they sleep…again, do whatever you can to get them to sleep.

When you are dealing with a suicidal person, realize that they are still ‘in there’ they are just very small, very scared, and nearly voiceless. Their illness has grown large. It occupies all the space where the person normally lives. The person you know has been crowded into a very tiny corner. So speak slowly and clearly. Be prepared to repeat yourself. Your voice is a tiny whisper, the illness is roaring.

Remember, too, that the illness is the enemy. This sick, suffering person is not the enemy. You are not trying to outwit the person to get them to a safe place, you are trying to outwit the illness. The struggle is real, but you will make a mess of things if you do not know what you are struggling with. Also remember that getting the person to agree to go to the hospital can be very difficult. It is even more difficult if the person has been checked in before.

Suicidal People might be afraid to go to the hospital
Health does not always feel as comfortable as illness.
Image by ♥KatB Photography♥

The hospital will take the person’s complaint very seriously. The hospital will go to heroic lengths to keep the person safe. But the hospital is, first and foremost, a hospital. The scared, sick, suicidal person will be subjected to indignities, they will wait a long time in an ER bay (waits of 2 days to be admitted to psych are not uncommon) The hospital is good at what it is good at, warmth and comfort are not areas where the hospital excels.

But getting the suicidal person to get help, getting them to go to the hospital should be a major goal. BUT do not lie to them to get them to go. Find another way to get them to agree. Understand that they might very well know exactly what the hospital will be like. Understand that they are scared to go to the hospital. Understand that they do not want to put up with the indignities of the hospital. Just keep truthfully bringing it up as the best option. (and, sadly, it is the best option, in fact, it is the only option.) Try to offer to take them to a ‘better’ hospital. Because we all know that some hospitals are better than others. We all know that the better hospital might transfer them to a hospital that is not so good, but going to the better hospital greatly increases the odds that they will be admitted there.

Finally. A suicidal person is generally not seeking attention. If they reached out to you, it was the last desperate act. Reaching out to you took tremendous effort, probably it took all their energy to do it. They are being suffocated under the weight and volume of their illness. Do your level best to get them help. There is something about you that the suicidal person believed and trusted in with the last of their will. If a suicidal person asks for your help they are telling you how highly they think of you.

In very rare cases, some types of illness use suicidal threats and behaviors as a way to manipulate others. These illnesses are more rare. And being used like that makes YOU feel terrible. You can feel angry or betrayed. Try to put that confusion and those negative feelings aside. Remember that this person has gotten so sick that they are threatening themselves to be heard. Get them to a hospital, get them help. They are really sick, and they are a very real danger to themselves.

Basically, helping a suicidal person is the same as being a good friend at any other time. Have empathy. Listen intelligently. Use your head and your heart. Put yourself in their shoes. And act decisively to get them the help they need. The world is a hard and scary place sometimes. We need all of our friends healthy and alive as long as normal mortality permits.

Suicide and Suicidal Thoughts: An Inside Perspective

Remember:

Oppression thrives off isolation. Connection is the only thing that can save you.

Remember:

Oppression thrives off superficiality. Honesty about your struggles is the key to your liberation.

Remember:

Your story can help save someone’s life. Your silence contributes to someone else’s struggles. Speak so we can all be free. Love so we can all be liberated. The moment is now. We need you.

~Yolo Akili

A dear friend of mine shared these words with me a while back, and I took them personally. They reminded me of why I chose to come out of my shell a little bit and write this blog. They reminded me that I have a responsibility to save my own life first and foremost. They reminded me that if I save my own life, I might then be able to help someone else save theirs.

I’m in sorry shape right now, holding in there with this toothache that has been horrible for over three weeks now.  I told the housemate the other night that I was having a hard time with the toothache. No one wants to live with a bad toothache. I don’t want to live with a bad toothache. But I have to be clear with myself that there is a huge difference between the words ‘I don’t want to live with this toothache’ and ‘I don’t want to live.’ I got caught up in the toothache and lost sight of the difference between the sentences for a short time. But I climbed back on the horse. And I really don’t want to live with this toothache.

Voodoo doll with large clamp on her head. An image of suffering.
Voodoo Doll Tatto Flash by S. Grice, colored by me.

 

But even as recently as this past October I could not differentiate between ‘I don’t want to live if I have to feel this sick’ and ‘I don’t want to live.’ And I got lucky on that one. If I hadn’t gone to the hospital crying ‘I don’t want to live’ I may have died from a near-fatal lithium level. You see, the lines get blurry and there isn’t always a right or wrong answer when someone is feeling suicidal.

I believe that every person to some degree or other has a suicidal impulse. I think part of free will and self-determinism is exploring the idea of NOT living anymore. Some people will only ever think of suicide in the most abstract fashion, “I was so embarrassed I wanted to die.” Some people react to many conundrums with some kind of suicidal impulse. I must admit that I fall into the latter camp. If I am brutally honest, even on my best days, suicide crosses my mind at least once. On bad days, it is the only thought I can hold in my head.

I don’t like to talk about this. Probably no one does. Someone who constantly talks of suicide begins to look manipulative, and even if they aren’t manipulative, the topic is pretty much a downer. Whether I like to talk about it or not, today I’m going to talk about it.

Now do not, I repeat, do not get freaked out. I’m talking about my thoughts here. I am not talking about actions. I’m fine, I just have a toothache. I’m not letting a toothache push me off the Dravosburg Bridge. So remain calm, remain seated, keep your trays in the locked upright position.

I think there are a surprising number of people who go through their entire lives being quietly passively suicidal. For the most part, they just buckle down and get on with it. But life can be hard and a big enough stress, or a bad enough situation (say a toothache that is over 3 weeks old) can push that suicidal inclination from background noise right to the forefront of their awareness. That person’s interior landscape changes dramatically. Suddenly the background noise has become a looming presence right in front of them shining a flashlight right into their eyes, blinding them to anything else. I’m sure it is different for everyone, but that it how it is to me.

Suddenly the person finds themselves in direct conflict with their very self. The will is screaming ‘DIE!’ while the body is screaming, ‘LIVE!’ The body becomes the enemy that must be defeated. Some people attack the body directly-they become the self-harmers, the cutters, the scratchers, the burners. Some people begin to quietly plot elaborate revenge on the body-they become the smokers, the drinkers, the hard drug users. Some people strive to outwit the body-they begin to pay careful attention to the contents of their medicine cabinets, they take careful note of tall buildings they encounter, they observe every rope, every bridge abutment. And some people try to retreat from their body completely-they withdraw, they become unresponsive. I’m a mix of all four, and probably most people are.  And look, I’m not saying that every person who exhibits these signs is necessarily suicidal, most probably are not…but if your friend gets weird in a way that you find scary, never rule out that they might be suicidal.

There is good news and there is bad news about suicide. The good news is that most people fail at it. The bad news is that some people do not fail at it. Every person experiencing suicidal thoughts and urges should be viewed as a potentially successful suicide. They should be gotten to a safe place like a hospital or treatment center with all possible haste, and they should be helped to feel safe with themselves. If you don’t know what to do for them call this number.  And don’t feel bad about calling, sometimes the smartest thing you can do is call an expert. Please don’t mistake my next words. Suicidal people should be helped. Please don’t mistake my next words.

BUT.

BUT.

For some of us, we need to think these things all the way through. Sometimes alone, sometimes with help. But we have the right to our thoughts where we might not necessarily have the rights to our actions. I told someone here at the house that I was feeling suicidal. I explained why the normal actions were not appropriate in this case (if I am locked up in the looney bin, I might miss the dentists appointments that can fix the toothache, duh) and I retreated to my room to think it through. And my friend checked in on me regularly. I thought about things this way and that way. And I was able to realize that suicide is not an optimal toothache cure. And that sounds funny and obvious when I write it here, but it was not funny or obvious while I was arriving at that conclusion. It was big and dark and scary. But it was only big, dark, scary thoughts. There were no actions. “Just” thoughts.

I feel like I should tell you things to say or do for a suicidal person, and I promise I will in another post. What I want to say to you right now instead is this. I think there are a lot of people out there who are passively suicidal. I think if science were ever able to study that number, many people would be shocked at how many there are. And I think people have a right to be passively suicidal, they have a right to their thoughts, and they have the right to think them through. BUT. If someone tells you that they are feeling suicidal, then they are no longer passively suicidal, they are actively suicidal, get them to help and safety with all possible haste. BUT sometimes life gets weird. Sometimes a person IS actively suicidal, but being in the hospital could actually make the situation worse (say they have a toothache that has gone on forever…) then keep them safe yourself if there is no alternative. Be an intelligent friend. Give them some space, but be present, check on them, be prepared to interfere. Believe me, if I had taken one suicidal action, I would be writing this post from inside a hospital. I am blessed to have intelligent friends.