Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Sunday, May 13, 2007

Suicidal Ideation: My challenge to you

One of the main reasons I was FINALLY diagnosed was that I became more and more aware in May 2002 that the depression that had allegedly gotten better was still there at a very deep level and that although I was able to smile again, I was spending a great deal of time planning how I could kill myself if and when I became severely depressed again. I knew I very likely would and I just could not stand the idea of living through that again. So I finally admitted how bad I felt, accepted better medication, and started therapy after years of refusing.

For that first year I struggled with suicide. After I lost my best friend because she thought my illness was due to things I was/wasn't doing, I just could not see what value I had and I wound up fighting very hard to stay out of the hospital. The only reason the doctors weren't more forceful, I think, was that my insurance didn't cover psychiatric admissions so instead they saw me more frequently outpatient.

During that time I realized/was taught about the consequences of suicide. I was reminded over and over that before doing anything that was a last option I needed to be sure that was what I really wanted. Ultimately that turned into something I use even now, a simple but very effective tool. Essentially I have a list of things I must do before I can harm myself. I have several people I must tell to see if they can help (a friend I know doesn't panic, my therapist, my psychiatrist). I have to find care for my cats; it is not right to leave them without care. Bills must be paid. I don't really remember the original list, and the list can be modified to meet current circumstances. It can also be extended by the therapist and myself to go on and on so that eventually I reach a safety zone. This works so well for me that I have never gone beyond call a friend, despite having wanted to die plenty of times.

Another reason that knowing I have a lot of safety valves is that I know how to do this effectively. I know meds well. I know anatomy. And because I'm on such high doses and go through so many meds per year, I have access to a lot of harmful stuff. I need to constantly make safe decisions.

A year ago my therapist forced me to give him a carpet knife I was trying to use in a home improvement project. Much, much later, after I was not angry and humiliated anymore, I admitted this was a good idea. Not because I wanted to hurt myself, but because I was dangerous to myself. Walking wasn't so safe so I guess sharp objects weren't so safe. I rambled on about was he going to want my kitchens knives next? My forks? Was I allowed to operate a hair dryer? But he was right.

It wasn't until much later that we talked about how amazed I was that I made it through last year without really wanting to hurt myself. Usually at least at some point the rage turns in and I no longer want to live through the mixed episode, although I can talk myself out of that rage. Last year it just didn't build.

Tonight though I was digging through my nightstand for something. That is where I store all my pills. I realized that over the years I have stockpiled plenty of pills that I really shouldn't have. I had a bunch of sample boxes of Geodon, which I took 3 years ago. I had a full bottle of Trileptal. I have sleeping pills. And I have my current meds.

I realized that even though I've gotten far beyond really wanting to hurt myself I have been afraid to totally let go of that for all these years.

So I flushed them. It was actually harder than I thought. I even considered handing them over to my therapist, but since that would open me up for the whole monitoring thing and I have no desire right now to hurt myself ever, I did it myself.

I realized I'm probably not the only one hanging on to bad things. So that's my challenge to the mentally ill world: rid yourself of dangers. Turn over that carpet knife. Flush the pills you don't take (and be prepared, capsules don't flush easily). Do whatever it is to make yourself safer the next time things are out of control.

I did. And I'm glad. Glad enough I'll even tell the psychologist, who is going to yell at me. But you only have to tell me. Or not.

Just do it. Please.

3 comments:

Emilija said...

I'm sure that what you did is right for you, but it isn't right for everyone. When I stopped cutting myself, I always carried razor blades with me. First, I always knew that I could cut if things got bad enough, and that helped, and second, I wanted stopping to be an act of will, and not of convenience. I knew that I could always, and always have, found sharp things to hurt myself with. I save all my old meds. In part because I might go back on them someday. In part because I alway want an out. And I want my life to be an act of will, and not simply not having the means at my disposal. That said, I have long said that I had to clean my apartment before I killed myself. And when I am depressed enough to be suicidal, I am too depressed to clean, and so I am very much alive.

Sarah said...

"I realized that even though I've gotten far beyond really wanting to hurt myself I have been afraid to totally let go of that for all these years."

Me too.

I went through my meds about a month ago and threw away all the "extras" that I had. I was done with 'em, like you are.

Congratulations friend. <3

Just Me said...

Emilja:

I've never been a cutter but I have worked with some. It seems to be the same thing, sort of. To my knowledge cutting is usually an extreme desire for control.

I on the other hand have the dangerous combination of mixed episodes, where severe depression combines with mania, which in me has an end result of irritability, impulsiveness, a constant need to do things, and so most of the time when depressed I have plenty of energy to hurt myself. That scares me because I've done some dumb things when mixed. And thus far no med has controlled that.

You're deciding you want to have control to have options to quit.

I'm deciding, during one of the rare periods I am well enough to make decisions, that this is not what I want and this is how I want to control that.

What I did, and continue to enourage others to do, is an ENORMOUS act of will. It is asking myself to trust that I can find alternative solutions because I just got rid of my easy way out.

Sure, I can still find lots of ways to do the same thing. I take so much depakote that I have a vast quantity available. I have PRNs I'm not about to toss. A bottle of Advil plus a handful of the lithium I take on a regular basis would be pretty bad since my level goes up so easily.

I still have outs. I just am choosing to make certain that if there is a time I want one I have to work EXTREMELY hard to get it.

I know that keeping pills I already know are harmful to me around in large quantities is not in line with what I want in my life. I guess I see having kept those pills as no different than having kept a gun in that drawer and lying to my therapist about it.

Again, this is me. This is a time in my life when I'm trying to settle into as little bipolar destruction as possible for the first time. This is what I need to do and what I suspect many people need to do.

I'm going to write a post about my conversation with my therapist and more along these lines; this is ridiculously long for a comment. More later, probably not until tomorrow.