Let's Talk About Suicide

The last week or so, a post has been trending on facebook. It goes something like:

"Hey, I'm trying to prove a friend wrong, if
I can get 3 people to repost this to show that
people really do care." #suicideawareness

Or something like that. I appreciate the effort. I'm not sure exactly what reposting a post is supposed to prove because when you're in a life or death situation, a memory of who posted what a few months ago, will not be there. I have 200 something friends and I can count on one hand the number of people I would contact if I were suicidal. Not that the other friends don't matter or I don't trust them, but I know these handful of people will know what to do. They will know what to say and how to get me help. They will contact who needs to be contacted and they will follow up.
I know this because this has happened many times. I have been to that point where the quick sand is swallowing me and I reach out one last time, and these people have pulled me from the abyss by finding me help, contacting my family, keeping in contact with me and asking me the hard questions. You have to know what it feels like to be suicidal in order to know what to say.
Being suicidal appears to be threats and only that. A person is suicidal because they are saying they want to kill themselves and sometimes, they actually do. People on the outside view it as an external behavior. What people don't understand is the significance and impact of the internal thoughts, what you can't see.
When I'm suicidal, my mind is racing with reasons why it would be a good idea. My mind twists things around and makes excuses. It convinces me that I should kill myself. A slideshow of my dead body plays in my mind and I can't stop it or ignore it. Over and over I see myself hanging from a tree or in a bath tub with blood. The images loop around and if I close my eyes it's all that I see. At this point I'm decided on killing myself. My mind has already been made up. On the outside, I say nothing. No one knows what is going on in my head. No one knows the images that I'm seeing. On the outside, I seem content.
After this, at some point, I realize that I need help. So once, for just a second, just one attempt, I will reach out and see if anyone grabs me. If no one reaches back it feeds into my self-fulfilling prophecy that no one cares. But every time, someone has reached back.
I confide in them where I'm at. I'm at the decided stage. I've made up my mind that I have to die and I'm beginning to mentally plan a good date and time, a clean mess free method and something that will get the job done. If I don't contact anyone, if I'm alone and I could do it, I start to rapidly think of ways that I could do it now. Anything. A train, a gun, rope hanging somewhere, a plastic bag.
One time I reached that point quickly due to trauma and I began to frantically run through the house attempting to grab any knives or pills I could get my hands on. I just couldn't live for another second. I couldn't take the pain anymore. My family would be better off without me. I'm a burden. They deserve better. I'm a failure. I don't deserve to be alive. I just take up space. I'm pathetic. The world is better off without me. I'm a parasite. I am doing everyone a favor.
My mind races while images of my dead body fly through my head as well as ideas on what I could do to accomplish to the task. I appear silent. Preoccupied. Quiet. But my head is nothing but quiet. It is deafening and screaming at me. It is so loud that I can barely carry on a conversation. I wish I could turn down the volume but I can't.
I'm slowly slipping towards the white light and no one around me is even aware of what's going on. If you asked how I was doing I would say "ok", but I was not "ok". I was anything but. Having never had a successful suicide attempt (obviously) I don't know what it's like to be in the final moments before your own death. But I do know what it's like to be sucked in to the obsession of your own death, and to have your mind convince you it's a good idea.
When a person reaches out, TAKE THEM SERIOUSLY. I cannot stress that enough. People (typically) do not threaten suicide for attention. Wanting to live is a basic human instinct. Having the obsession to die is seriously dangerous. Try to convince them to go to the ER or a Crisis Center. Try to convince them to contact a suicide hotline. Contact their family if possible. Them reaching out to you could be the only thing keeping them from attempting suicide. This can be their one chance and you can save them.



National Suicide Prevention Lifeline
1-800-273-8255
Online Chat:
http://chat.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx

Social anxiety and the holidays

There is a time of year that I look forward to all year long. These three months are my element. October, November, and December. Sweatshirts, cocoa, pumpkins, Christmas lights, Christmas music, Christmas anything. These three months are what I look forward to when it's 110 degrees outside for the fifth day in a row. My heart twinges with excitement as the weather begins to cool down because I know what's next; October, November and December. My months. Gift giving and pumpkin pies and rainy days and the smell of the heater kicking on. I love it all. All except one thing.
This tiny little thing is a big thing to me, and as usual, my reaction to it is way above and beyond what is normal. This tiny thing is social events. As the weather cools and the wreaths get hung on doors, in pour the invitations for social events. Office parties, family potlucks, friendsgiving and heaven forbid I host ANYTHING. The mere mention of these events and my fight or flight kicks in. My immediate thought is "no no no, I'd rather curl up into a ball under a mound of blankets". We can't possibly go to these events, I want nothing to do with them. My social anxiety's nemesis is a potluck at Grandma's house.
See, when I go to these events, I kind of freak out. It's not the delicious food that intimidates me, or the holly above the door, but it's the people. The interactions that come along with being at a group gathering as well as paranoid thoughts that everyone is judging me for everything I do. "What have you been up to?" is a question I'm dreading this season because "nothing" isn't really an appropriate response, or should I tell them I've made a breakthrough in therapy? I do well at events in which I'm expected to have little to no social interactions such as a very big office party. I can sit at a table and munch on chips all day. But when people start talking to me and asking me questions, my panic button goes off.
Going to Grandma's potluck is a doozy as well. My family all gathers for a holiday and I immediately want to find an excuse to not go. The questions and feeling like everyone is judging me. Not to mention the teeter tottering into a panic attack feeling that goes along with it all. My family is nice and cordial, always sweet and kind. But inside I'm screaming and I feel like running away.
Getting together with a large group of people is difficult for many people that have a mental illness. And sometimes we tell you that we can't go because we just can't go. We just can't. I try to force myself to go to what I can. But sometimes I back out at the last minute or decline invitations because I just can't. I don't have the strength.

In rolls the tide, out rolls the tide.

Two days ago I had a wonderful day. I was motivated, I was ecstatic, I was energetic, I was talkative. I enjoyed the day and forgot what it felt like to not be so happy. It was a weird medicated version of hypomania. It lasted for the day. It was a good day.
But the aftermath isn't pretty. Slowly I can feel myself falling into a depression. My lack of motivation, happiness, contentment and pleasure in general tells me it's going to be a deep one. The world is grey. There is no end to this bad day because I wake up and feel the same, day after day. Thanks to medication it's not as bad as it should be. I should be suicidal. I should be laying in bed with the covers pulled up. I should be crying myself into oblivion.
But I'm not. The medication has taken the edge off but the pain is still there. So I grin and bear it. I push myself to be productive and complete tasks. I force myself to be social and smile even though it feels like I'm dying inside.
Two days ago I forgot what it was like to not be happy and today I can't remember what pleasure feels like. I can't remember what it's like to feel emotion. I hope it ends soon because I have shit to do.

The Med Controversy

Every day there is a controversy in medicine. Not the ones in hospitals or big pharma, but the one in my pill box. The one in my head. Every day the question comes up and it is avoided. It is put off and ignored until I have to sit myself down and say "Sarah, take your meds." This is usually about noon, when morning has literally passed and I still had not taken my morning meds.
The controversy in my head wages a war between the two sides, and it is a tough fight. Logic says "yes", take your medicine. It makes you better. It's only a pill. Just swallow and move on.
But my head says no. My head says to stop taking them all together. Flush the remaining pills down the toilet and move on with my life. Why? Because they are changing my life.
What if these pills are changing who I am as a person? What if they are changing what identifies me, as me. In some ways my symptoms are part of my character, and suddenly to blunt them is blunting me. My identity is changed.
Or what if this is all made up. Everything is just a sham. I've lied to everyone and there is nothing wrong with me.
Or what if I am just immature and everyone feels the way I feel but I'm less than. I'm weaker. I'm a failure.
The med controversy begins as soon as I wake up when I ignore them. It ends when I give in and take them. A fresh memory of not taking them is still in my mind and it was not pretty. So I take them.
And then at night I take them without a problem. Unless I'm on a med strike in which I lay in bed and glare at the box on my dresser.
The next day, the controversy begins again. What if this is changing who I am? What if it's all a lie? What if I'm being dramatic?
Every day, the med controversy occurs and usually every day, the meds win. But sometimes it builds up in my mind and I begin to cling to an idea and then I stop taking my meds. At which point I end up curled into a crying sobbing suicidal mess and I can feel nothing but darkness. I'm not sure if that's withdrawal or my reaction to not being medicated, but either way it is what happens when I stop taking my meds.
So I take them. Sometimes I don't.

No Motivation

As humans, we are wired to be productive. We may take breaks here and there, or even full days to relax. But for the most part, we are a productive species. We build buildings, we write papers, we mow the lawn, we go for a promotion and go to the gym. We do stuff. Something inside of us drives us to do stuff. The alarm goes off, we jump in the shower, we get dressed and we do stuff.

But what happens when that part of your brain doesn't work properly? What happens when the drive to do stuff isn't there? This happens to me. This is happening to me right now. Writing this and doing 1 load of laundry is all of my productivity today. I have opportunities to be very productive. Every day I have 2.5 hours when all of my children are in school. During that time I could do something productive. Every day, I try. I make tea. I do laundry. I research. I try. But it's a struggle to do anything. Without my children, there is zero motivation because no one is pushing me.

The part of my brain that is supposed to motivate me to get things done is broken. I get all set up, get all my ducks in a row, and when it comes time to execute the task, I just can't. I just can't. All of the motivation that I'm supposed to have isn't there. Instead of taking out the trash I have to drag myself to take out the trash. I ruminate over the laundry pile for hours before I finally start a load. I dread getting out of bed because that's all I want to do today.

But every day I drag myself out of bed and I force myself to complete daily chores. I help the kids get ready for school, I run errands, I take my son to preschool and I try to be productive in the afternoon. Usually I'm not. But that is an improvement from the time when I used to sleep the afternoon away every day. Now I don't sleep but I find things to do, and I force myself to do them.

Having no motivation makes life difficult. Everything is a chore. Every task, no matter how small, is a chore. It's an uphill battle with no end with each step being exhausting.

Tomorrow I will drag myself out of bed. I will make coffee. I will smoke a cigarette and I will prepare for the day mentally. Tomorrow I will force myself just like I did today, and yesterday.

My Children Save Me

My children love me unconditionally. My children are saving me. It is because of them that I am still alive. Imagining their reaction to losing their mother is more than my heart could bear. But they also help me in other ways. They save me from myself.
Not getting out of bed, not showering, not eating, no motivation to do anything, feeling physically sick and on the verge of tears are some of the things I deal with sometimes. But my kids make me. I have to get out of bed, I need to help them get ready for school. I have to shower, my young son asks me to shower with him. I eat because they eat and I don't like to waste food. They pull me from the couch for parent teacher conferences and birthday parties as well as the whole pick up/drop off routine. I don't want to participate but I have to. I have to attend those things because what kind of parent would I be if I did not? Those are important things. I want to be there for the important things.
The day that I desperately searched our house for ways to kill myself and my husband held me down on the bed, he told me about our kids. Our daughter's wedding, our son's graduation, grandchildren. Those are all important things too. I have to be there for them. I sobbed as he named off what I would miss out on and how my children would feel as they had a milestone without their mother.
It is because of my children that I sought help. It is because of them that I fought when I have had to fight. It is because of them that I try to do better. Be better. It is because of them that I try my best. Of course some days are better than others but I try. It is because of them that I try.
Sometimes all I want is a studio apartment to myself. That way I have no one to disappoint, no one to drag down my path. But I know if I was alone, I would have offed myself already. I know their childhood is going to be different because they are growing up with me as a mom, but they are saving me everyday.

A secret

I have been seeing my therapist for over a year. She knows me better than most people. Actually, considering I share with her my deepest secrets and darkest fears, she probably knows me better than anyone. It is nice to have someone to share those secrets with.
It was at our last appointment that we approached the subject of a new diagnosis. I obviously have bipolar II (even though I doubt my diagnosis all the time). My chronic wave of moods has been blunted with medication but I still deal with them. As we talked about my symptoms the topic of my hallucinations and delusions came up. I again described what I was experiencing. Again, these have been blunted with medication but they were still present, and it didn't matter what mood I was in, I still saw little brown animals scurry across the floor and I still became paranoid that government officials were watching me when I came across a person with a walkie talkie or holding a notebook. I no longer believe my neighbors are peeking through my windows and I don't hang blankets over the windows anymore, but nevertheless, they were still present.
As I explained the small (to me, they are small) hallucinations and delusions I was experiencing, she folded her arms and observed quietly. She knew something I didn't know. She has seen me in every mood and she knows all of my symptoms.
Schizoaffective is what she suggested. I've heard that word before. My doctor had also suspected schizoaffective when I explained my symptoms. But he proclaimed it was "just a label", and prescribed me medication for schizoaffective but did not change my diagnosis. He mentioned it again at another appointment and he always asked about my hallucinations and delusions at each appointment. It was an ongoing discussion.
At my last appointment with my therapist we read books together that described schizoaffective and the criteria one needs to meet in order to be diagnosed.
I met the criteria.
There is one thing that I don't meet and that is the fact that I have Bipolar II, and schizoaffective only talks about Bipolar I. But surely there is a spectrum. And surely because I have Bipolar II doesn't mean that I can't have schizoaffective just because the book fails to mention Bipolar II when describing schizoaffective because I meet all the criteria.
Before my diagnosis did not include my hallucinations and delusions. Bipolar II specifically states that it does not have these symptoms, only in Bipolar I are they present. But I do not have Bipolar I. So my "extra" symptoms were being treated but were not acknowledged in my diagnosis.
It is now acknowledged. I have Schizoaffective-Bipolar Type. And all of my symptoms fit neatly in that box.
Schizoaffective is a progressive disorder, meaning it gradually gets worse over time. But treatment can slow or even stop that progression. The worse prognosis is going mute, not getting out of bed for weeks or months on end and the inability to care for yourself. Group homes is where patients sometimes end up. Inability to hold a job and homelessness are possible factors.
At this point I am able to function on a day to day basis. I bathe regularly. I cook and clean and care for my children. There are times when I just simply can't, and on those days I just simply don't. I do the bare minimum and nothing more. One of the symptoms of Schizoaffective is lack of motivation or drive to do anything and that is something I struggle with. Whether depression is present or not, I lack the motivation to live a life but my children force me to because I want to be a good mother for them. I want them to have good memories. I want to be supportive and loving. So most of the time, even when I don't feel like it, I still participate in this thing called life. And I do it for them. If it wasn't for them, I would have committed suicide by now.
Having this new diagnosis explains my extra symptoms and sheds light on some things, like my lack of motivation (even though I still push myself to live, for my children).
But having this new diagnosis carries a lot of weight. It is Bipolar and Schizophrenia mixed together. I am REALLY crazy now. But I have a name to put with it all and that is refreshing. Nothing has changed really. My medication will stay the same. My symptoms have not changed. But the name of my disorder has changed. And I am still coming to terms with that.