The last week has been unusually difficult for me. Rest assured I would score quite low on scales used to measure suicide risk, and I don’t think there is any real chance of my harming myself in any way. Nevertheless thoughts of suicide have not only lurked but lingered, and that is an indication that things aren’t good. So, among other things, off to see my doctor this afternoon, and I’ll be seeing another on Friday.
Neither one of them is a psychiatrist, for which I am thankful. One does have extensive experience with mental health and more counselling training than most psychiatrists do. No doubt we will discuss possible medication changes, but I have no fear of loss of control over my own care, and it’s possible nothing will change on the pharmaceutical front. At a minimum I will know that I have done something fundamental to my own self care in reaching out (as I am also doing in writing this), and pride in those actions will itself be a bulwark in facing all the
real challenges [regarding my strikeout of 'real' -- it's funny how even those of us who struggle mightily with them still see mental health problems as not real] that are the cause for my despair.
Much more than medication, someone in my state of mind needs increased companionship and physical affection, problem-solving support, fun and amusing distraction, things to do that are intrinsically rewarding and positive like exercise, helping others, completing simple tasks, making something. The mainstream psychiatric establishment is rarely a welcoming or desirable place for someone dealing with what I am dealing with — real and daunting, but solvable, problems in the context of a serious mental health condition. Accessing the most visible mainstream mental health services brings with it valid fears of unwelcome over-medication, confinement (though that alone is not frightening to me, were it not for all the things that may come with it), skeptical and suspicious observation, and artificial empathy.
That is one of the things I don’t understand about suicide: how as a society we (fail to) provide effective options for support. It does not surprise me that few people speak up and seek help until it is too late. Even without the direct experience of the mental health system that I have, the fears of how others will perceive us and what will happen to us if we access mainstream mental health services are strong and valid. Thankfully there are places, such as the Gerstein Centre, which offer a more accessible preventative approach, but their public profile is not as great as it could be, and the philosophy which the Gerstein works from is nowhere near as accepted or well known as it should be.
Another thing that I don’t understand about suicide is the journey to isolation that enables others to embrace it as an option. No matter how despairing I might feel, I have never been able to bring myself to make a choice that I know would leave so many people feeling deeply hurt, desolate, guilty, and remorseful. Sadly many who commit suicide do so in no small part because their social ties are limited or non-existent. But I cannot (thankfully) grasp the degree of despair, pain, and emotional isolation that those with loving families and friends must face when they choose to end their own lives.
Certainly some, particularly those facing chronic illness, make a careful and deliberate choice that engages their loved ones and seeks to minimize the distress to those who are left behind. But stories of those who end their own lives and who leave bewildered and distraught families and friends behind are deeply saddening to me because they speak of how little we know and understand about how to effectively connect with and support people facing that kind of pain and despair.
I did once write a poem describing the closest I have come to being in that place. I’ve shared it before and will again, because it speaks explicitly of a kind of love for others that is invisible, and not heartwarming in the way that love often is. And yet it is powerful for me to bear in mind in the face of the kind of emotional anguish and despair that can lead to suicidal thinking:
love that binds me here,
in its care
my selfish thoughts
be silent threats
of broken trust
no testament can silence give
they cannot know,
and yet my love
that does not satisfy
can still usurp a wish to die.
© David Mordecai 2002
Thank you to the many people in my life who leave me with no doubt that I am greatly loved, and valued, and would be deeply missed.