Wednesday, July 30, 2008

Not at all painless

So I've been thinking, today, and for a while, about suicide.

No, not my own (so put the commitment papers away, Peng). But, working inpatient psych, suicidal ideation is probably 60% what we deal with; probably 80% of those admitted to the Crisis service. And it always amazes me, the crazy amount of people that think about, or even attempt, suicide.

I don't understand. I don't understand the people that impulsively down a bottle of tylenol because their girlfriend broke up with them or cut their wrists because they had a fight with their boss. I can't comprehend this idea of, I'm having a bad day, I think I'll kill myself.

Death is so final. It's so....dead. We don't know what dead is. Nobody really knows what death is like. Maybe it's just nothingness. Maybe it's heaven. Maybe it's worse than anything we can possibly imagine in this existence.

And beyond that, it's an end. Which, is why I can understand the patients that are super depressed or really traumatized and think of suicide. I'll admit, I've been there. Not actively suicidal, but, in that place where you're just like, if I died, you know? That would probably be okay. At least this would be over. But it never seemed like a reasonable way out, and certainly never like a quick fix. And let me tell you, when I had - transient, brief, evanescent - thoughts like that, whew, I was in the lowest place I've ever been. It was so far down. I could not have been sitting in the dayroom laughing and watching TV the next day if anyone had locked me up. I understand the patients we have that have no hope, that see no possible light at the end of the tunnel; most of the time they barely see the tunnel. That's a black, black place, and I can understand the need for relief.

I had a friend once who told me that, when she was in high school and realized she was gay, she went to her pastor looking for guidance. And he told her that she was going to burn in hell because of who she was. And she left there, and what kept going through her mind was how she was going to continue to be persecuted while she was here on Earth - she lived in Hicksville, Nowhere and they didn't take too kindly to her sort. So she had a life of hell ahead of her, only to be followed by an eternity of hell afterwards.

So she contemplated suicide, because, why increase her suffering by staying alive? Why not bypass that and go straight to hell? That I get. I'm really mad so I'm going to take all of my klonopin? That's the grown up equivalent of, I'm going to hold my breath until I die and then you'll be sorry. Except, holding your breath until you turn blue? Low lethality attempt. By the time we grow up, we use much higher lethality options. Pills, guns, drugs, stay blue.

And that doesn't even address the people you leave behind. Even if you have no family, no friends, nobody at all who loves you and would be distraught if you took your life, I guarantee, it'll matter to someone. It'll matter to your doctor. Losing a patient to suicide is something we all face at some point in our careers, but let me tell you, it shakes every one of us to our core. The very idea of it keeps us up at night. And chances are, there's someone out there - a friend, a neighbor, a family member, a pizza delivery guy - who's going to miss you. Who's going to be upset that you did what you did. Who's going to blame themselves for failing you. Who's going to be saddled with that for the rest of their own life. And suppose you do have a spouse, a parent, a child, a sibling left behind? Who does love you, who worries about you? How the hell are they ever going to deal with that?

I'm just sayin'. Think about it.

And for the love of all things holy, enough with the tylenol, people. If you need to kill yourself, there are ways to assure that you die. I'm not going to tell you what those are, obviously, but I can tell you one that WON'T work - a tylenol over dose. All it's going to do is kill your liver. And then you get to die a slow, awful, excruciatingly painful and uncomfortable death. I'm guessing not the quick fix you're looking for.

Seek help. Everyone has emotions that are intolerable; suicide is never the answer. Think about what suicide would really mean. Get to a hospital ER, call a crisis line, or better yet, seek psychiatric treatment before it gets to that point. Tell someone, tell anyone that you're in trouble.

Every state has a HopeLine. Ours, in NC, is 919-231-4525. The Teen TalkLine is 919-231-3626. You can find your state's by Googling "hope line" and your state. They often have toll free numbers as well. Or you can dial (800) SUICIDE. They're anonymous, they're supportive, and they'll let you talk as long as you need to. So if anyone out there finds themselves in that place, where suicide seems like the best - or only - next step, get help, and get it now.

You'll be glad you did.


penguinshrink said...

Dude, you are totally doing your own commitment papers and H&P if it comes to that.

Danielle said...

Awesome post, Kate! I don't know if anyone's ever thought of this but me, but here goes- if you seek help, doesn't that show that deep down, you don't really want to do it?

Tiny Tyrant said...

I wish my brother had taken the time to call someone like you before he pulled that trigger. Maybe he'd still be here.

The Dispatcher and Her Officer said...

Excellent post!! In our city suicide appears to be on the rise.. It's heart wrenching to hear the family member on the line calling in that final call! I'm greatfull for the ones that call and give us time to get out to help them.

otter said...

I had a client who's only way of talking herself out of suicide was to remind herself that it would increase the likelyhood of another family member killing themselves by 300% (I don't know if the 300% is the correct stat, but it's the one she was told by her shrink). Whatever works eh?