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Thursday, July 5, 2012

The 5th of July and the Executioner Within

From time to time in this blog, I take on some heavy topics and this is one of the heaviest.

Suicide.

I've mentioned before that we each carry a private calendar in our heads where we have recorded the anniversaries of losses and that most of mine have to do with major mental health crises. July 5th is one of them.

A little background: I went home for a couple of months after my second psychiatric hospitalization in January of 2004, but returned to Chicago in the spring, determined to get my life back on track, resume grad school in the fall, and in the meantime, look for work. Looking for work was always very hard for me because it forced me to do the kinds of things that my social anxiety made the hardest to do, like make phone calls and approach people and ask them for favors (like giving me a job). I tried to force myself to do at least one job search activity each day, but it was very hard and my inability to make myself do these things made me feel really bad about myself. I spent most of my time at my boyfriend's apartment because I couldn't face being alone with my depression in my nice little studio apartment with no internet, no TV, no movies, or other distractions. He often worked swing shift, not arriving home until 10:30 at night, so rather than leave his place and not being able to come back until he got home after dark, I simply didn't leave at all. Finally, I managed to get a full-time job through a temp agency. I was so quick to pick up the skills required that within two weeks of starting, my supervisor was having ME train the next round of incoming temps. It was also a swing shift job, at a busy office in one of downtown Chicago's skyscrapers, so from 2:00 to 10:00, I worked on projects like putting weekly drugstore ad circulars on the web. I befriended one of my coworkers who also lived on the Blue Line so I didn't have to walk alone through the dark and eerie streets of downtown to get to the el station and I was doing well enough (and was tired enough!) that I could once again stay in my studio apartment. I still wasn't doing great--my medication doctor was concerned about my overall lack of progress--but I was doing so much better than I had been in previous months that it looked like my life was getting back on track.

The 4th of July was on a Sunday that year and my boyfriend and I spent it with a longtime friend of mine who was also a former coworker of his; she'd been the one who introduced us. I'd lived with her before I found my own apartment, but hadn't seen her since September because she was down in Hyde Park going to school at the University of Chicago and Hyde Park might as well have been on the moon because there's no good way to get there by public transit that is both safe and convenient. But on the 4th of July, my boyfriend and I drove down there and spent the day with her and her fun roommates and a few other friends. The evening culminated with eating pizza while watching "The Omen" and being very silly. It had been a good day and I was feeling happy as we drove up Lake Shore Drive on our way back to Logan Square. I remember that the windows on the Blue Cross Blue Shield Tower, overlooking the north end of Grant Park, were lit to spell out the word "Taste," as in "Taste of Chicago." My boyfriend and I had gone the day before and eaten all manner of fried things as well as an excellent matar paneer from an Indian restaurant we planned to visit soon. Life seemed to be looking up.

And then the next morning, on Monday, July 5th, 2004, I woke suicidal.

It was a complete and utter shock. It was also wholly unlike how I'd imagined being suicidal would feel. I'd always thought suicidal feelings would be something that would creep and grow over time, that there would be a downward spiral over days or weeks, that it would center around a belief that life wasn't worth living. That was not my experience at all. I didn't WANT to kill myself. I felt like I HAD to.

It was a terrifying experience. It caught me completely off-guard. In some ways it paralleled my experience with urges to harm myself, which had always manifested in a frightening need versus a deliberate desire. But to have your own mind want to murder your body without any "I want this" feelings attached? It was horrifying and appalling. I was too shocked to even tell my boyfriend what I was going through, even though he'd already seen me through two psychiatric hospitalizations. I did the only thing I could think of to keep myself alive: I lay in bed and didn't move. Well, I think I got up to use the bathroom once. But I didn't eat, didn't speak, just lay as flat as I possibly could and tried to outlast this treacherous urge. I had a nasty headache, but I didn't dare get up to take any Advil because I knew I'd be unable to stop myself from taking the whole bottle.

So throughout that long day I wrestled with the part of my mind that wanted to exterminate me. I reminded it of all the people who loved me and who I loved in return, my talents and potential, my recent progress, things I loved about living. In return, that terrible part of my mind responded by making a plan. I'd been warned that if I was ever experiencing suicidal ideation and came up with a plan for carrying out those thoughts, it was time to get help IMMEDIATELY. I tried my utmost to shut that plan out of my mind. The terrible part of my mind responded by telling me that if the Talking Heads song "Heaven," containing the lyrics "Heaven is a place/Where nothing ever happens," came on (my boyfriend was listening to the Talking Heads while he worked at his computer within sight of the open bedroom door), I was to carry out the plan immediately. I was starting to doubt my ability to resist that order.

A good friend of my boyfriend's was in town and that evening, my boyfriend, who'd been unable to get me to tell him what was wrong and who had been watching me with worried eyes all day, stood in the bedroom door and asked if I would mind if he and his friend went over to the neighborhood bar for a little while. I thought it over. By this point, I knew, without a doubt, that it I were left alone, I would try to kill myself. My plan was well-rehearsed: all it required was for me to be left alone for a while. I'd spent all day giving myself reasons for living and had every single one crumble against the cruel iron will of the suicidal part of my brain. But as I gazed at my boyfriend standing in the bedroom door, looking helpless and worried, I realized that I could live for him. I could easily imagine how devastating it would be for him to return to the apartment to find that I'd attempted to kill myself in his absence. He'd stuck by me and tried so hard to do everything he could for me while I'd been so sick despite struggling with some fairly substantial depression himself. It was so tempting to succumb to the urge to kill myself. But, for him, I made myself say, "I think you'd better stay here."

And so I lived.

Of course, the battle was not over yet. The next day, terrified by what I'd gone through, I called up the useless therapist I'd recently fired and explained what had happened and he gave me a brilliantly useless answer. ("Eat some ice cream!") The day after that, because, unlike the suicidal urges, that nasty headache still hadn't gone away, I called up my medication doctor and explained my situation to him. "Go to the ER. NOW!" he said. So my boyfriend took me to the ER and they gave me Demerol in an IV for the migraine because it WAS a migraine, even though I'd never had one that felt like that before and I hadn't had any since I'd started taking Wellbutrin in January. (It would go on to be my first "transformed" migraine, lasting two weeks, eventually broken when I was given anti-inflammatory injections every six hours for two days.) When I woke up from the blissful, narcotics-induced sleep, they admitted me to the psych unit once again because, as the intake doctor said, my case had red flags all over it. I would spend twenty-six days in the hospital that time and was only discharged because my parents insisted on it and swore they'd look after me. My doctors had been planning to send me to the county psychiatric hospital (I learned later); I'd had two more episodes of suicidal urges while I was in the hospital, including one just two days before I was discharged into my father's care, who'd flown out to Chicago to bring me home.

(It was very strange to feel suicidal in the hospital where there was nothing that could be done about it. It was a very strict psych unit, much stricter than the one in the hospital near my home I went to once, and I appreciated that. No one was allowed to wear a belt or even shoelaces, the utensils were plastic, the windows were unbreakable, there were no razors or scissors, and the staff was extremely alert and watchful. Patients who were considered immediate risks for self harm were placed under 24 hour observation, but they kept an eye on everyone. If they hadn't seen you for a few minutes because you were in the shower, say, they'd knock on the door to check. I believed that I couldn't harm myself there, so it was a strange feeling to have those urges, sort of like floating.)

When I came home from the hospital in August of 2004, I was capable of sitting, sleeping, and crying, but not much else. My parents were true to their promise to the hospital doctors and kept me safe. I was never left alone, all the sharp items and medications in the house were kept under lock and key, they ferried me to numerous appointments, and spent thousands of dollars on the medications and therapy not covered by my insurance. I have absolutely no doubt that if I hadn't had this intensive and extensive care, I would be dead by now. Sooner or later, the side of my brain that was bent on my destruction would have triumphed.

My scary experience with suicidal urges that came more-or-less out of nowhere helped me understand, at last, that with my bipolar II disorder, I wasn't facing a minor medical inconvenience that was a small pothole in the road of life. I am, in fact, living with a medical condition that is potentially fatal if not properly treated. I have to say, it was years, long after I'd stopped having any thoughts or urges, before I was able to trust myself enough to allow my parents to permanently remove the kitchen knives, the household item that worried me most, from their locked box. I now have faith that my treatment will hold and I won't be blindsided by a sudden need to kill myself, but the experience I had a couple months ago, when a different brand of lithium proved ineffective, showed how quickly things can disintegrate. Within three days, the destructive part of my mind had returned and was already starting to think about self-harm. It took all of my coping skills just to tread water until I could get my regular brand again. In other words, time and therapy have not eradicated the lethal aspect of my disease; it is merely kept at bay by a cocktail of chemicals that I must ingest daily.

The good news: if I do take my medication, I'm fine. More than fine, in fact: I thrive. I'm able to cope cheerfully enough with having a disability because that chemical cocktail is so effective. I'm able to fully enjoy all those good reasons for living that weren't enough to save me on July 5th, 2004. If you met me, you'd never guess that I have a mental illness, much less a killer slumbering in my brain.

I still don't know if my experience with suicidal ideation is anything like what others go through. I've read that most suicide attempts are impulsive acts, so maybe the notion of the downward spiral of gloom leading to suicidal despair is mostly fiction. What I DO know is that without treatment, I would be dead. The part of the brain that urges self-destruction is incredibly persuasive, seductive, and very, very powerful. Altering the brain's chemistry is the only way to effectively silence it. It's one reason why access to affordable and effective treatment is so important for individuals with a mental illness. (I also find it essential to have a dog because I know that if for some reason I were to feel suicidal again, needing to care for the dog would be my reason for living and enable me to ask for help.)

It's been eight years now since I was betrayed by my own brain and had to plead for my life with an executioner that dwelt within. I'm so thankful that I survived the 5th of July and the subsequent rocky weeks and months and have been well long enough and have enough confidence in my treatment that I can trust that I will not be ambushed by terrifying urges to end my life. And please, if you are ever find yourself thinking about suicide or planning a suicide or are beset, like I was, by a sudden urge to end your life, tell someone. Tell a friend, a family member, a doctor, a therapist. Call the National Suicide Prevention Lifeline at 1-800-273-8255. Call 911. Go to the ER. And if someone you know mentions suicide, take it seriously. You can find information on what to do and what to watch for here. No one should have to die because they feel like they are out of options or because, like me, they suffer from warped thinking caused by a biological illness. If you or someone you love ever is overwhelmed by the desire to die, I fervently hope that you, like I did, survive your own 5th of July.

You can read about my first hospitalization here and my second hospitalization here.

9 comments:

  1. Thank you for sharing this Colleen.... It has given me a little insight into my Brother's suicide July 16,2004. I am so glad you have found the cocktail that works for you my dear.

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  2. I knew some of this story already but the details of your suicidal episode have really struck a heartbreaking chord with me, and given me a better understanding of how persuasive one's own treacherous brain can be. I'm so thankful that you got help and are doing better and you're right, you'd never guess at any of this from meeting you because you're such fine, clear spark of life.

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  3. Thanks for sharing this, it's so courageous. I can relate to what you went through, even though I've never been able to articulate it to another soul.

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    1. Much love to you, Shelley. I'm sorry that this is something that you can relate to, but am glad you're hear to read about my experience. with it! I have found, by being "out," that there's a whole legion of seemingly ordinary people out there who are acquainted with this kind of suffering.

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  4. i like you so much and am so glad you are still here.

    my own bouts with thoughts like that were a little bit on the descending gloom side, but also fairly histrionic. i'd say that that probably means they were safer, except with the way my dad died and the brain chemistry we share, i don't know. fortunately all i, personally, seemed to have really needed was for a therapist to help me "switch the tapes" in my head when i'm going through self-destructive/self-loathing times... which sometimes makes me doubt the difficulties of others. thank you for writing this-- it reminds me to stop being so smug in my own recovery. everyone's path is different. and you are clearly awesome.

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    1. That switching of tapes is an incredibly important aspect of keeping oneself safe and being able to get in touch with wellness--I'm so glad it worked for you! There are many people who would benefit enormously from knowing what you know and it's something I had to learn to do as well, but yes, there are some of us who need the chemical adjustment, too! You're right, everyone's path IS different, and it just so happens that you are awesome, too.

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  5. Thank you thank you for writing this. I greatly appreciate your candidness. I truly believe that if people could speak about the unspeakable the world would be a better place. I have battled with depression, suicidal thoughts and self harming. In my day to day life I am an open book. I freely will talk to anyone about what I have been through because I just think it's important. If I'm judged that's ok. You never know who is going through something and just that simple piece that they aren't alone, or a freak can be enough to keep someone on this earth. Or perhaps it can give them a window into the mind of someone they care for. For most of my life telling myself how devastating it would be for others if I killed myself kept me from harm. Sadly I think that was mostly untrue as I wouldn't have been through most of the pain I had in life if someone really cared. No matter how bad I hurt I could never bring myself to hurt another. Then the day finally came when there simply wasn't anyone that cared. I was alone, alone with hurt so bad I felt as if my heart would burst in my chest. And that was the day the inevitable occurred. It was only due to an overwhelming voice in my head that screamed out I must call 911 immediately that I am still here today. I took an entire economy size bottle of Excedrin. This was no attempt it was the real thing. I didn't have anything else and I didn't know if it would kill me but I sure hoped so. I was one of the lucky ones. Despite my call to 911 I experienced a miracle that day as according to all the doctors I either shouldn't have made it or suffered severe internal damage to my kidneys and liver even with the many gallons of water they pumped in and out of me. My organs are unharmed. I vowed I would never go through that again but unfortunately suicidal thoughts don't work that way and frequently they crop up again. The thing with suicide is the feeling is so overwhelming and the worthlessness is so loud that the last thing on earth you want to do is try to get help. You just want to end it. There have been many times I sat with shaking hands with a knife or a razor in my hand wanting to cut so badly because of pain that has occurred. I am happy to say I haven't. Not once, not in 20 years. Never giving into those feelings even a little is the most important. Otherwise it's like a downward spiral. I'm rambling. Just...thank you.

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    1. You're so right, never giving into those feelings even a little bit is so important. I'm thankful I bear no scars that would be daily reminders of the sinister aspect of my illness. I'm so glad that you've never succumbed since that one episode to the overwhelming and persuasive desire to harm yourself. And while I'm so sorry that you've felt like there haven't been enough people who cared in your life, I can tell you that it is equally horrible, in a way, when you have plenty of people who care, and yet all their love means nothing. Stay strong, my friend!

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    2. Colleen, I appreciate your bravery so much. Having experienced extended periods where I felt my brain had betrayed me -- not to the point of planning suicide, but certainly to the point that I felt living inside my own head had become intolerable -- I can relate to a point. I went to a workshop on anxiety and depression, and the number one thing I took away from it was this statement: "Your thoughts can lie to you." I had never understood that before, believing myself to be, as you are, an intelligent and rational person. But this kind of mental illness has no connection whatsoever to intelligence, or goodness, or self worth. It's just that our brains can be treacherous and traitorous. I used to believe that the darkest times were the times that I could see the "truth", like I was getting a glimpse into the true nature of things. Now I have learned enough at least to recognize the falseness, the lie of those dark periods, and I can hold on and ride them out until they pass and I get back into the light.
      Love you for your courage. Love you for you.

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