Avoiding Suicide Again

As a response to the death of someone I knew, I have written about my attempt to kill myself more than 20 years ago and my subsequent hospitalization.  I ended up at my parents’ home.  I never tried to kill myself again, but I did set out to do so a couple of times in the next few years.  Both times, something small stopped me and the impulse passed.

It was hard for me to find medical treatment when I returned to my parents’ home.  I did not have insurance.  They wouldn’t take me at the local mental health clinic, because they were overwhelmed with demand and a single hospitalization was not enough to put me on the list of patients who most needed care.

I did have an evaluation with a psychiatrist there.  He was kind and well-meaning, but he misdiagnosed me as bipolar.  That created two major problems for me.  First, it kept me from getting the kind of help I needed.  Second, it made the problems seem permanent, with the only solution being medication.  People in the mental health field sometimes compared it to diabetes, a permanent problem requiring a lifetime of medication.  So, when medication didn’t help, I didn’t have any hope.  There was no other solution offered to me.

There are a few things, at least, that make it difficult to diagnose mental health disorders.  First, the symptoms are sometimes very similar.  It can be like trying to tell the difference between a bad cold and the flu.  Second, doctors have to rely on patient reports and their own observations.  There are no tests they can run.  Third, the lack of tests makes it impossible to be sure that the mental health diagnoses doctors use are describing separate, unique disorders or that they describe all mental health problems.  A diagnosis might actually describe multiple problems, for example.  The Diagnostic and Statistical Manual of Mental Disorders is now in its fifth version, referred to as DSM-5.  Further revisions are inevitable.

If patients don’t know what to report or have difficulty identifying their feelings, that creates one problem.  If they don’t present classic symptoms, that creates another problem.   I have read that a diagnosis description is considered accurate if 80% of psychiatrists reach the same diagnosis when following it.  That amazed me since it allows for an error rate as high as 20%, or one in five patients.  This may not always matter, but the differences in treating bipolar disorder and post traumatic stress disorder are fairly significant.  One is treated primarily with medication.  The other does improve very much with medication.

I did not present the classic symptoms of post-traumatic stress disorder at that time.  I was not connected well to all of my feelings and didn’t know how to describe them.  The different traumas I had experienced were either blocked from my memory or either I or therapists did not consider them to be serious enough to cause trauma.

Part of the problem is that people respond to trauma differently.  It may be genetic.  It may be from an accumulation of factors in the environment, or both.  In the end it makes no difference why some people are affected by trauma and others aren’t, any more than it matters why some smokers develop emphysema and some don’t.  You still have emphysema.  Why it was you that got it and not some other smoker is not particularly relevant to either you or your doctor.

The mental health clinic referred me to a therapist who charged on a sliding scale.  I found a doctor who would manage my prescriptions.  He was perhaps not the most reputable.  My mother had gone to him and was not convinced they knew what they were doing there, but there was no other option.

I couldn’t function.  I didn’t know why.  I met an old acquaintance who offered to help me apply and get an interview for a job.  It would have been a great job for me, but when I sat down to fill out the application, I couldn’t do it.  I was frozen.  I decided that if I couldn’t even fill out the application there was no way I was going to be able to do the job and I dropped it.  This did not go over well with my parents.

Feeling frozen was the same reason that I had been unable to work or study in my last semester before coming home.  I could not force myself to do things.  No amount of will or self-manipulation would work.  It was the same feeling I had when confronted with a high diving board.  There was nothing in the world that could get me to move my legs, go to the end of that board and jump off of it.  This feeling is so strong that I have sometimes wondered if I could jump out of a plane with a parachute if it meant saving my life.  I am pretty sure I would need someone to push me out.

I did not recognize this as anxiety.  No one else called it that, either, although I was eventually prescribed an anti-anxiety medication (which did not help).  I also did not understand that the fight or flight response to fear has a third variation: freezing.  That was (and is) my main response to fear and it does not seem to trigger the same response from doctors.

Before I was hospitalized, I told my doctor about the intrusive thoughts of suicide I experienced.  Nothing I could do would keep them out.  They came into my mind over and over.  I was once able to stop them briefly by imagining a melody, a harmony and a third harmony at the same time, but that was difficult and I couldn’t keep it up.  My doctor was puzzled and took me across the hall to the psychiatrist who worked at the college health clinic.  He listened to me, was supportive, and prescribed me lithium.  This upset the therapist I was visiting, but it seemed to help.  Lithium is primarily used to treat bipolar disorder, but the psychiatrist who prescribed it did not diagnose me with that either at the time or in the hospital, where he also treated me.  It was probably a major factor in the diagnosis I received later

Just as my intrusive thoughts of suicide were not recognized as being obsessive or compulsive, my inability to act was not labeled as a symptom of anxiety or attributed to trauma.  I did not understand it.  My parents (as I always refer to my mother and step-father) really did not understand it and I lost their support, although they still allowed me to live with them.  With a little time, my mother’s support would return, but after I said I couldn’t work or go to school I never had the support of my step-father.  That was the end of that.

I was not much fun to be around.  My friends avoided me.  I was so frozen that I couldn’t do much.  For my part, I avoided people, since they were the primary cause of my anxiety.  I had lost the emotional support of my parents.  Since I wasn’t working or functioning my self-esteem plummeted.  And I had no hope things would get better.  So I got worse instead.

My first experience in the hospital had been positive.  I decided that if I got to the point where it seemed like I would kill myself if I wasn’t hospitalized, I would check myself into the hospital.  That day came.  They admitted me.  This second hospitalization qualified me for treatment at the mental health clinic.

My second hospitalization wasn’t as positive as my first one had been.  After the first week they transferred me to an unlocked ward.  I imagined walking out and killing myself.  It wasn’t an actual plan and I did not seriously consider it.  I did not understand it at the time, but the feeling of safety I had in the hospital was partly a feeling of safety from myself.  In the unlocked ward, I did not feel that safety.

They tried some new medications for me.  The doctor tried one of the anti-seizure drugs that is commonly used to treat bipolar disorder.  I was also prescribed an anti-anxiety drug at some point, but I didn’t keep taking it.  While anti-depressants never helped me much, anti-anxiety drugs made me loopy.  The side effects were worse than the symptoms they were meant to treat.

So, I did not get better and now I didn’t have the hope that hospitalization would help.  I started planning out how I would kill myself.  I took my time and prepared slowly, over time.

When I was finally ready, I took my preparations and got ready to leave.  I went to say goodbye to my pet parakeet, which my mother had encouraged me to get.  I named him Sam and then got him a mate that I named Trina.  He was my best friend until he died about five years later.  His cage was on the floor and he was sitting on top of it (I have never caged my birds).  I got down and told him I was leaving and wasn’t coming back.  He knew enough words in that sentence to understand what I meant.  He fluffed himself, as birds do after something unpleasant happens, walked over to me, placed his beak right next to my lips and sat there, motionless.

My heart broke.  I couldn’t go through with it.  I gave up my plan.  My pet bird, who I had because of my mother, saved my life.  Some years later, I wrote a poem about it.  Here it is:

The Trouble with Pets

I didn’t think anything

Would save my life that night,

Nor did I hold in my heart any desire for rescue.

I had prepared.

I was ready.

I would accomplish the deed.

I gathered my things

And went for the door,

Passing by the birdcage,

Which, at this hour, was on the floor.

Goodbye, I said, to the parakeets,

As they sat atop the cage.

And in words I knew the oldest knew, I said,

I’m not coming back.

Sam (as the oldest was called) fluffed himself,

As birds do after unpleasantness,

And he walked straight across the cage to my face.

Though at that time he shunned touch,

He placed his beak near my lips

And held it there,

In a prolonged kiss.

You can call him a dumb animal,

Who did not know, did not understand,

But to me, his act will never be but one of love.

This little creature would miss me.

As I loved him, I could not go out that door,

And I did not, because of love.

So I am alive today,

Truly, because of many things,

But, just as truly, because of one powder-blue sparrow-sized bird.

 

If you have thoughts of suicide please talk to someone you trust and/or call a suicide hotline.  Call 1-800-273-8255 or go to http://suicidepreventionlifeline.org/, where you can chat with someone online.  They have services for people who speak Spanish as well as people who are deaf or hard of hearing.

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