Suicidal ideation is not the problem. Its the escalation of intensity and inability to clearly sift through the numb pain and reach out to those you care for and trust.
I took this picture of myself at the end of a day I spent in bed, scared and crying, feeling alone and hopeless and completely desperate.
This is the face of my mental illness. This is the face of my sadness when it is at its most inexplicable and its most pronounced.
I am not ashamed of it.
The news of Robin Williams (as of this writing) asphyxiating himself at age 63 has many people in a state of shock. Similar to the recent loss of Philip Seymour Hoffman who suffered a similar fate not to long ago. Our Social Media newsfeeds will be off the hook for a couple days and then short-attention spans will retreat back to cat meme’s and Buzzfeed quizzes and “#fml for missing my bus.” Then in a month someone else will commit suicide and we will re-enact that same cycle of “omg” to “who cares” to “omg” to “who cares” and on and on.
This response of shock is normal anytime someone dies- but the shock that Williams killed himself dumbfounds me. Robin Williams struggled with addiction, depression, and his work was a textbook manifestation of hypo-mania (if not full blown mania). To say there were not a plethora of signs is to not be tuned in/paying attention/or a form of denial. Sure you couldn’t have done anything to help Robin Williams but you have an immense power to help people you do know.
If I know anything first hand - it’s death & suicide. Lots of death & lot’s of suicide.
I am bipolar. My mom’s side of the family was riddled with this mental illness and subsequently most of them committed suicide. My mother’s father killed himself (as did both his parents) when she was 13. The gene skipped her and latched onto me. Since I know my risk of suicide is high- especially with the type of bipolar I have - it is increasingly important for me to stay on top of my mental health. With that I feel a personal responsibility to share my stories/experiences/and knowledge for those struggling. However this post is focused on how to help other people.
I’ve seen the devastation that suicide leaves behind and I have vowed never to do that to anyone I love. When the feeling strikes and I know the desire to harm myself hits a peak I’ve trained myself to follow a strict set of steps - the final straw being a surrender to the ER. Surrender doesn’t mean giving up. It takes a strong mother fucker to admit they need help so it’s something to be damn proud of. That is not a very easy step for many and when we are feeling depressed certain parts of our brain responsible for decision making are not functioning properly. That is where having a great support system can be life-saving.
Never choose death over ER bills. Most hospitals will work with you via their financial department. Regardless- that should honestly be the least of your concerns if the alternative is shooting yourself in head, ODing, jumping off a bridge, etc. I say this as an incredibly poor unemployed person- I totally get it. If this is not an option for you then come up with a saftey plan for yourself. That will be another post. I almost feel like turning this into a series because there are so many things to say / talk about with this massive subject. I will return to the topic of saftey plans later.
I am very open to talking about these things despite stigma because being out about mental illness is a political act. When we hide our suffering we are already on the road to self-destruction. The personal is political, remember? Because of my personal connection to the subject of Suicide I took a job years ago for 800-SUICIDE and worked the hotline. It was truly one of my most favorite jobs and I learned a great deal about the need people have to connect with others if only to be heard for five minutes. A fucking five minute conversation could potentially keep someone from hanging from the ceiling that night. It may seem extreme and of course is not always the case but we can not deny the power we have in just listening to someone.
IMPORTANT: No matter what you do- you can’t control someone else. If they are going to end it all you essentially you have no power to stop them. But that bit of power that you *do* possess if you educate yourself and take action implementing may subsequently save someones life.
Being able to distinguish what you do and do not have control over is a very crucial piece in this situation (and your sanity).
So what is the solution?
You. Me. Everyone not only have power to help someone before they take that step but it is not an easy power to give yourself over to when we are all running around in our self-absorbed world and afraid to confront something that feels scary and uncomfortable. In fact many will feel anger that the person “just wants attention” rather than viewing it as “this person NEEDS attention is crying for help for a reason.”
Whenever someone dies many will commonly say to the family “if there is anything I can do please let me know.” How about we take that mentality to pre-death and catch this shit before it even comes to funeral arrangements and the deep psychological trauma to those left behind.
If we do all we can to prevent suicide we are doing the work of superheros and you don’t even need to change into a spandex suit and cape. And, most of the time- you can help someone from your couch.
Before I list ways to help/steps to take I want to address the fears/reasons that this doesn’t happen anywhere near enough. I am leaving many things out but hopefully my few examples help paint a decent picture.
1. We don’t like to talk about or confront that we will die. We die. Everyone dies. I will die. You will die. Everyone you love will die. Maybe today, maybe in a week or maybe in 50 years. But fact of nature is we all have to go at some point. It’s part of nature like sex, childbirth, and even joyful marijuana. We are terrified by this fact and do all we can to not think about it. This is one reason we don’t want to catch/confront a person exhibiting signs of suicidal ideation. After all if we did then we have to confront something uncomfortable and admit mortality. We are great and writing “R.I.P” but terrible at saying “can I help you?” Even R.I.P is an abbreviation - we want out of this situation fast as possible.
2. We fear that if we ask someone “do you want to kill yourself?” we may trigger them to do it. It is quite the opposite I assure you. In fact you are doing a great service by bluntly asking this question. Many who are suffering will find relief that you are being so attentive and that alone could make a difference in their feeling of isolation. However, the response they give will key you into the next steps and I am going to tell you what those are shortly. Never fear you “put the idea in their head.” Trust me- they are already there. And if they are not - you asking the question won’t send them to the grave but it may keep them from it.
In the time it takes to play five rounds of Candy Crush you could have helped your friend get passed a moment that could have ended in tragedy.
3. We fear that if we call 911 on someone they will stop being our friend / partner and view us as a traitor. Consider this: Would you rather lose your friend over trying to save their life or lose your friend because they OD’d on pills and you didn’t take steps to help out of fear? Odds our after the ordeal the person will be grateful. But even if they are not- you know you did the right thing because the alternative was permanent.
You may be wondering “okay well I get that I should do something but I have no idea what signs to look for and what do actually do to help?”
Because the concept of how to help is so vast I am going to focus on crisis management for right now. If you are actively worried someone is going to harm themselves these are the steps to take, the steps that you do have control over.
To gauge the risk in the moment the following questions are standard.
The following is copied from www.HelpGuide.org. It is identical to what I would do when I worked the hotline and legit information. There are four components you want to ask about: Plan, Means, Time, Intention.
The following questions can help you assess the immediate risk for suicide:
Do you have a suicide plan? (PLAN)
Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)
Do you know when you would do it? (TIME SET)
Do you intend to commit suicide? (INTENTION)
*courtesy of helpguide.org
The answers to the questions above will guide you as to the next step.
Level of Suicide Risk
Low — Some suicidal thoughts. No suicide plan. Says he or she won’t commit suicide.
Moderate — Suicidal thoughts. Vague plan that isn’t very lethal. Says he or she won’t commit suicide.
High — Suicidal thoughts. Specific plan that is highly lethal. Says he or she won’t commit suicide.
Severe — Suicidal thoughts. Specific plan that is highly lethal. Says he or she will commit suicide.
The short version: the more specific the person is and action oriented the more you need to be concerned with there immediate saftey. If someone is in the Severe category it is imperative you call 911 (or if you are there take them if they are willing to go). As I wrote about above never let fear stop you from making a call to 911. Even if you are across the country - your job is to take this assessment seriously and act on it no matter what. Better to have a friend angry at you then a friend dead. And in the end most people want you to help - generally that is why they are open to speaking with you in the first place.
There are miles of paragraphs I could write on this subject and I will probably do another post on the subject soon. However in the meantime I hope this can help in some small way.
For more information:
In the U.S., call 1-800-273-8255—
National Suicide Prevention Lifeline
I just had a triplet of appointments: Nutritionist, Chiropractor, and (thanks to a gift certificate from my awesome momz) a Massage. I feel very grateful even though I am sore as fuck right now. As one of many people with multiple health issues I can attest to the brutal struggle of finding good care In the US. No matter what you think of Obama there is no denying that his healthcare policies have changed my life for the better. When you are little its hard to understand that what we vote on directly impacts us but this has truly changed my life and kept me from probably dying a lot younger then I need to. A few months ago I wrote about how I was sent to every specialist in the world to figure out why I was having ongoing (& debilitating) Vertigo attacks (so bad that I had to go on temp disability). None of the specialists could figure out the problem - but the worst part was the lack of communication amongst the doctors. How could it be that my physical therapist had no notes from Audiology and how did the ENT department not know I had seen either of the two? And why was I even seeing a Physical Therapist in the first place? It is just a complete system breakdown; an environment of dis-ease can’t help find cures for shit. Then the anxiety and stress from all of that chaos breeds more health issues- its a horrid cycle.
When I lost my job last year due to discrimination and whistle-blowing I also had to say goodbye to my insurance and I honestly can say that had Obamacare not kicked in I would not be here right now typing this. I honestly need to write more about how Obamacare changed my life both in terms of health and as an artist. Being an artist is something you don’t have the same freedom to do in this country when you need health insurance from a 9-5 40hr a week job. Working part time jobs allows you to make art in a way working in an office everyday doesn’t. So, thanks to having healthcare I was able to look into other places to get seen and have found one of the most amazing places ever.
Everyone works so seamlessly together and I truly feel each person who I interact with is on the same page working with me as a person and not a medical chart/computer generated number like cattle.
I’ve never felt more trusting of healthcare professionals in my life and for that I am truly fucking grateful.