**TW: SUICIDAL IDEATION**

 

Suicidal thoughts, or “suicidal ideation”, are not uncommon for the 44 million people in America who have a mental illness. What you may not know, though, is that these thoughts happen along a continuum.

That’s right, just because I say I “feel suicidal” doesn’t mean I’m about to make an attempt.

Of course, any talk about suicide needs to be taken seriously, because it can escalate to a more serious level. It is always a real concern.

Let me repeat that: Any talk about suicide needs to be taken seriously. The number for the National Suicide Hotline (in the U.S.) is 1-800-273-TALK (8255), which is available 24/7/365.

That being said, there are a few stops along the continuum. It’s important to know what they are and what they might mean.

These are based on my experiences and conversations with other mental health patients and professionals in the field.

THE CONTINUUM

1. Passive Thoughts: I occasionally mention that I feel “a little suicidal” to my therapist or pdoc (psychiatrist). As professionals and mandated reporters (someone who must report child abuse or if a person is a danger to themselves or others), they, of course, need to dive in a little further to find out what exactly it is I mean and make sure I am safe.For me, a statement like that means “I don’t want to be here anymore; I don’t want to be anywhere.”For another person, it may sound like “My loved ones would be better off if I weren’t here,” or “I can’t do this anymore.” In other words, I’m having passive thoughts about suicide. I’m not panicking, I’m not fearing for my life, and I don’t have a plan (which is what the pros always want to know).

   Honestly, you don’t know how often a “fleeting thought” of not wanting to be around anymore floats through my head. 90% of the time, it leaves just as quickly and mysteriously as it came.Don’t get me wrong, these are serious matters. No one wants their loved ones to feel this way. I’m just saying there’s a time to lend some time (and an ear) and a time to do some crisis management and call 9-1-1. Most of us are just being honest and sharing what our brains are telling us, even when it makes no sense to you and doesn’t seem warranted.

2. Ruminating/Perseverating: These two fancy-pants words mean the same thing: you can’t stop thinking about it. Ruminating is often triggered by something, anything – a place, a person, a commercial, a song, something someone says, etc. It turns on the “Monster” part of my brain and I start thinking about all the negatives in my life.It’s kind of like a snowball rolling down a hill, gaining speed and power.

   These thoughts won’t leave me alone, and before I know it, I am thinking more actively that suicide could maybe, possibly, be an option. Again, it doesn’t mean it’s inevitable, but I know that when I’m in this stage, I often start to panic.I panic that “Those thoughts are back again” and “Oh, shit, what do I do?” I start to fear that I may try to harm myself.

   It is especially important for me to tell someone how I’m feeling at that moment. It helps take the power out of the thoughts that are running amok in my brain and gives the other person the opportunity to help me through to the other side.It can be really, really, really hard to stop these thoughts yourself. In my experience, it is sometimes impossible and they escalate even more.

   When I am stuck in this spot, I tell my wife (though I usually tell her before it gets to this point). I often call my therapist and wait for her to call me back so we can explore solutions to what I feel is desperation.

   CeAnne (my wife) will ask me what I need. Sometimes I don’t know. But she knows me well enough and we’ve been through it enough times together that she knows the best thing to do is distract me, ideally getting me out of the house.

   That can actually be physically painful, because I’m usually feeling the hole in my heart by this time and it feels like all I can do is curl up in the fetal position and cry. But she knows better. (So do I, in my head.)

   She also gives me lots of touchy-feelies during these times, which I need and adore.

3. Planning: This part is kind of self-explanatory. But there are two parts to it: Vague plans and specific plans.Vague plans are just that. It’s when you’ve been ruminating for a while and your brain just gives up.“I could overdose…” it might say. It’s still a bit passive, but it’s dangerous, because the thoughts have gotten a hold of your rational side.

   This is a very delicate time in the progression of suicidal thought. If you haven’t already reached out for help, you need to now.Vague plans can lead to specific plans if you don’t stop them. And that’s a particularly scary place to be.Developing an actual plan for suicide can include many steps: Giving your possessions away, saying goodbye to people, telling your friends and family that you love them, writing goodbye notes to people, suddenly feeling a sense of peace and freedom, and of course, coming up with the specifics.

   If you think someone is actively suicidal (or about to be), talk to them – or better yet, help them get in contact with a professional – and get them to a safe place, please! I’ve included a short list of resources at the bottom of this post to get you started.

   Humans have that self-preservation thing going on, so most of us who suffer every day – whether it’s from a mental illness, a chronic physical problem, or anything else – don’t really want to die.

   We just want to feel better. We want the pain to go away.

   (Sorry for the formatting issues!)

A FEW (DEPRESSING) STATISTICS

Did you know that white, middle-aged men between the ages of 45-54 are at the highest risk for suicide? Second is the over-85 age group(!).

And each year, forty-five THOUSAND people in the U.S. die by suicide. 45,000! That’s shocking! Firearms are used 51% of the time. In fact, suicide is the tenth leading cause of death in the United States. Please check out this link for the facts, a clickable display of the statistics in your state, and statistics on race, age, “method”, unsuccessful attempts, and more.

We need to be able to talk about this. One of the reasons the numbers are so high is because of the stigma of mental illness. Ninety percent of people who die by suicide have a mental illness, but only 44% of them receive treatment.

That is a travesty.

Of course, receiving treatment doesn’t necessarily guarantee that a person won’t go through all the stages of suicidal ideation. I’ve been there myself.

It sure helps to have a regular support system in place. As I’ve stated before, I have a pdoc, a therapist, and a case manager. I also take meds and have gone through TMS four times.

But I’ve also found myself in a psych unit more than a dozen times (all but one has been in the last 15 years) because I didn’t trust myself to stay safe and didn’t know what else to do.

But you know what? I’ve never made a suicide attempt. I know, right? After living with depression for over thirty years and being as close as one can be, I have, somehow, never attempted suicide. 🙂

FINAL THOUGHTS

I know this is a scary, touchy, depressing topic, but if we don’t start really opening up about it, the stigma will never go away and people who are suffering will continue to do so in silence until it’s too late.

You don’t want that, do you?

Neither do I.

Mental illnesses are serious business, all of them. As we see with the 90% statistic, all people who struggle with a mental illness (or two or three) are at risk for suicide attempts.

If you have mental health issues, or you love someone who does, please, I ask you to build a support system. Trusted family and friends are fine, but my opinion is that professional help is even better.

Hey, without my new pdoc, I never would have done TMS – and the results are what has become the foundation of a much happier, more productive me.

I’m leaving you with some resources today. Please use them if you need them.

Peace, Warriors.

And Keep it Real.

 

NATIONAL SUICIDE PREVENTION LIFELINE: 1-800-273-TALK (8255)

NAMI (National Alliance on Mental Illness): 1-800-950-NAMI (or text NAMI to 741741)

DBSA: Depression & Bipolar Support Alliance

Additional support groups through NAMI (Minnesota-based, but you can find your local NAMI chapter on the site as well)