segunda-feira, 8 de agosto de 2016

About Suicide

I wrote a previous post About Depression. There I mentioned that, sometimes, when I am depressed the idea of committing suicide starts to make logical sense. Of course that when I am not affected by depression that idea has no merit. Still, I would like to talk a little bit more about suicide.

I mentioned in the Portuguese version of this post that Brazil is currently 8th country in the world with most suicides. Also something that saddens me that in the last 25 years there was a 30% increase of suicide rates among teenagers. Which means there is a lot of people, also young people, who end up making that decision every single day. To a point that an estimate made in 2010 pointed out that 24 people committed suicide per day, mostly in regions/states more economically developed.

Which led me to wonder if we have today any way to prevent that in a consistent manner. Some way to help people that opt to take this route, to end their lives. If there are things we are not doing to prevent them from taking their own lives, of helping and supporting them through this dark patch of their lives.

By wondering that I realized how difficult it is to talk about suicide with people in general. For instance, when I told my parents I was mentally unwell, and unstable, and that I was thinking about committing suicide they supported me. Even if they weren't able to do that in the best of ways. They constantly took "rounds" to visit my room and wouldn't leave me alone even for a moment. Even though it is a bit extreme I can see the reasoning, and well intentions, behind their actions. They are parents and want to help their child.

At the same time I couldn't help but notice how they refused to even talk about the subject with me. They didn't try to ask me why I was feeling this way and how they could help me deal with that. They merely asked if my therapist was aware and they left it at that.

Social, psychological, cultural and other factors can interact to lead a person to suicidal behaviour, but the stigma attached to mental disorders and suicide means that many people feel unable to seek help. Despite the evidence that many deaths are preventable, suicide is too often a low priority for governments and policy-makers.
In the long-term, importantly, reducing risk will go only part of the way towards reducing suicide. Furtherance of protective factors will help build for the future – a future in which community organizations provide support and appropriate referrals to those in need of assistance, families and social circles enhance resilience and intervene effectively to help loved ones, and there is a social climate where help-seeking is no longer taboo and public dialogue is encouraged. Source: WHO,

I can't help but agree with the WHO report on suicide. If the taboo and stigma surrounding suicide is deal with then more people would be able to ask for help and receive the appropriate help. My parents would have felt more comfortable about talking about it and helping me in a better way (I don't doubt of their good intentions in any way, but I could sense they were at a loss on what to do to help me).

The same is also true for all the other people who suffer from this, specially teenagers. That time of our lives is already comlicated and confusing, talking with adults about such a delicate topic is even more so. I can certainly see how it is possible for teens to avoid having this discussion in fear of the repercussion it could generate. Also that given the whole stigma and taboo nature of the topic drives conversation about this, with anyone, even further inside the realm of impossibility.

So let's talk about suicide.

Why do we attempt/commit suicide?

As I mentioned in my post About Depression I tried to commit suicide when I was 15-years-old. At that time I finally came to realize what my sexuality entitled and how society had a very negative view about it. This led me to think negatively about myself and, a few months after my realization, I tried to kill myself.

Eventually I came to the point where I couldn't deal with all of that, I had to kill myself.
I managed to acquire, from a high school friend, some pills and made the calculations of how many of them it would take to kill myself. But instead of doing the math based on the percentage of one of the components, which was lethal in high dosages, I calculated using the pill whole dosage. So I took a significantly smaller lethal dosage of the pill's component that was supposed to kill me. I was sick and vomited for hours and felt stomach pains for days afterwards.

Over the years I never really thought about that part of my past. I never tried to understand exactly why I tried to commit suicide. What led me down that route instead of asking for help. Instead of trying to talk to someone about how I felt before making such a drastic choice.

I found out later that a large part of why I attempted suicide was because I felt ashamed of myself. Just as I felt hatred towards myself. Disgusted about how I was and the whole notion that my sexuality was something horrible. An opinion I based on the hundreds of people online cursing and expressing loathing for what I was. All of that drove me into a deep state of depression.

At that point in time I felt an amazingly large pain, a deep despair and an overwhelming lack of hope regarding my future. I believed, deeply, all those things there was said about people like me. I let those things define how I viewed myself and that view was very dark and very negative. Eventually I came to the point where I couldn't deal with all of that, I had to kill myself.
Many people don't really want to kill themselves. They don't take a fully conscious decision about it. They simply feel so devastated by the pain, the hopelessness and depression they are experience that it overwhelms they ability to manage those feelings.

We are all human and we all have our limits. No one is bad or weak or sick or crazy for wanting to kill themselves. You are just someone who is overloaded emotionally at this moment and which, unfortunately, end up having a very pessimistic view of the world. This notion ends up making suicide a valid option, even if logically this doesn't make sense.

That is the cognitive distortion I experience from time to time. When I'm in a major depression phase, and I don't think I have a future ahead of me, my perception of myself, my situation and the world shifts. At those moments it seems as if dying is the best solution for me.

At those times I need to calm down and take a long breath. I have to tell myself that in a couple more days all will come to pass. That if I can survive a few more days things won't look this bad and that there is a valid way out. However that is not always easy.

Given this I can understand those people that committed, or attempt, suicide. Just as I understand the people who have never been through such a moment can so easily criticize suicide. The truth, however, is that most people aren't equipped to help, and support, someone who is feeling suicidal. Because to those people that thought, of harming oneself, doesn't make sense. We, as human beings, have a hard time feeling empathy for something we can't understand.

With that in mind it is important to realize we can fight against suicide. Just as that scale picture shows it is necessary, at least in my opinion, two things: 1) We need to try and make our pain smaller (or basically deal with what is generating that pain). 2) We need to increase our capacity to manage our emotions (increase our emotional maturity, get help and lean on others -- such as friends, family or professional help).

Think about this

Considering all of that I would like for you to think about a few things. It's things that over time I came to realize about this whole topic and that I would like to share.

You can survive this!

A lot of other people go through this same difficulty, of having suicidal thoughts and feelings. Every single day. They manage, in their own ways, to get through those periods. Sometimes in a better shape, sometimes in a worst shape. Still they manage to keep themselves alive. You are not alone in this and you too can survive it. Maybe this knowledge helps you go through that though moment. Remember that suicide is a permanent solution for a temporary problem.

Give yourself some time!

One of the things I learned, while I was searching online about suicide, is the concept of waiting a period of time before doing anything. Be it one or a few days or a whole week. For me the time that seems to work the best is waiting 3 days. I tell myself "Ok, wait 3 days before doing something.". This commitment I make to myself gives me time to stop and breathe. Knowing that I don't have to 'obey' my suicidal thoughts during that time frame is great.

Somehow this separation between suicidal thought and suicidal action is beneficial. When these thoughts and feelings show up it is very easy to fall into a despair state and an increase in anxiety that could lead me to try something immediately. By consciously separating the thought from the action my head has some cooling off time to reflect about everything that is going on.   

I almost always reach the end of that deadline not wanting to kill myself. I may still be feeling pain, and be in depression, but they are smaller and more manageable. They are not running as high as they were before. In my mind I am not seeing the world in such a distorted fashion anymore. This helps me keep my mental health.

It is only possible to feel relief if you are alive! 

To me, when I am in a very dark place, killing myself is the only way to end the pain. Of feeling a sense of relief from everything that I am going through. Relief is a feeling however and the only way to feel something is by being alive. It isn't possible to feel relief, or anything for that matter, if you are dead. So this relief you are searching for can only be obtained if you stay alive and work your issues out.

Some people will never get you

I know how complicated it is to talk about your suicidal thoughts to other people. I have even heard that I was "simply exaggerating the whole thing" or that "I was being silly" or that "those are not reasons enough to kill yourself". It's very hard for a person to be able to react in a supportive way and they might just end up saying something that will make how you feel even worse.

However it is important to remember that those opinions are rooted in ignorance and fear. As I said before most people have never been in the same place you are when you are feeling suicidal. They can't fathom how someone can achieve a state of mind where they might want to end their own lives. This ends up creating an empathy issue on their behalf and a non intentional aggravation of your situation.

Still, there are people who can help you. People that will hear you out and try to understand your problems, that will give you a shoulder to cry on and advice in order to help you not kill yourself. I have used such services before and I am happy to say that it helps. I know how scary it is to call a stranger and talk about your feelings but, in a way, it can even make that easier as it is almost like talking to yourself.

You can check online for a list of suicidal hotlines available in your country. At least here in Brazil when I type "suicide" they already offer me the phone number for the national suicide prevention hotline (which is neat!). I found this list of suicidal hotlines in the US and this one for international ones. I urge you to give it a call whenever you are feeling down and you need someone to talk to. They won't judge and will only try to help.

Living after surviving!

Surviving those suicidal periods is tough and traumatic. I always feel exhausted after those periods because I know that I spend a whole lot of energy on trying to stay alive. Every time I go through such periods I talk to my therapist about it. Just as I talk to her while I am going through one.

Talking about those periods, about how I felt and what led me to it help me a lot. Having a better knowledge on the "triggers" that lead me to one such phase help me become more aware of future occurrences of them. It also helps me to be able to talk, face to face, with someone who listens, without judging me, about how it is like going through that. These ventings help me manage the post-trauma effects and also help me prepare for the future.

If you can find professional help to assist you with this I highly recommend it. I think therapy has a lot to offer for people's lives, specially during these dark periods where you need some support.

At the end of it all

Know that you are not alone. That there are people out there that despite never meeting you want you to stay alive. That by finding pages/posts such as this one these people want to share what they feel hoping that it helps you deal with your emotions better.

Know that it is possible to deal with how you are feeling. It isn't easy but it is possible. Maybe some of the things I wrote here help. I find it important to say that there isn't a rule on how to deal with this, each person ends up developing their own coping mechanisms. This is how I do it and I adapted it from several other sources online I found.

More important than that I hope that by the end of reading this you feel more confident about asking for help. Be that help from someone in your personal live or the suicidal hotlines or a therapist. If this posts accomplishes that it will have been a major victory in it of itself.

We are all here in this world together. Please, try and stick around a while longer ok?

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