Choose life.

Trigger warning: suicide, rape. I describe feelings of suicidality in detail to communicate the seriousness of this issue and that there is hope. If you feel triggered or overwhelmed by my story, please stop reading, call a friend or the National Suicide Prevention Lifeline at 1-800-273-8255.

Suicide kills over 800,000 people worldwide every year and is the second leading cause of death among 15-29 year olds. Why are we killing ourselves and why is it so hard to prevent what may be the most preventable cause of death? I can only speak from my personal experience.

My first encounter with the mental healthcare world came just a few weeks after I was raped in my last year of high school. When I slept, I had nightmares about being raped, and when I was awake, I constantly replayed the events of that night in my mind. I started drinking, and my anxiety progressively worsened each day—especially about having to go to school. I slept through most of my classes and slept in my car during lunch. I was ostracized, broken, and completely alone. If anyone at school or work brought up the rape, I just brushed it off like it was an awkward first-sex experience toward which I was completely indifferent. I desperately tried to convince myself that what happened wasn’t that big of deal—that I’d get over it soon enough—but all that mindset did was leave me with an unbearable amount of anxiety to which I could not attribute a cause. Really, it never crossed my conscious 17-year-old mind that the reason I was anxious, afraid, not sleeping, not eating, and suicidal had anything to do with rape.

My mom noticed my anxiety and thought medication might help, so we made a doctor’s appointment. First, we saw a nurse practitioner who asked if anything significant had happened that might have caused my anxiety. I quickly replied that no, nothing had happened. As far as I was concerned, it didn’t matter why I was having anxiety issues if I was just going to get the same prescription regardless. She asked if I slept okay and if I felt sad or lonely or unmotivated, and I explained that I was just really stressed out about school and that I couldn’t ever relax. When I answered have you ever thought about hurting or killing yourself? with, “Well yeah, I’ve thought about it, but I’m not going to,” I immediately put my hand over my mouth. I didn’t mean to say that, and by the look of shock on my mother’s face, she didn’t expect it either.

I explained to the nurse and my mom that sometimes I felt like it would be easier if I could do something to make the anxiety go away. I wondered what would have happened if I said that I’d rather be dead than have to re-live being raped every day in my nightmares and thoughts—that I’d rather be dead than have a constant reminder of my transgression by being ostracized at school. But I couldn’t even understand, let alone vocalize, my pain. And with everyone at school knowing what happened to me, the fewer people in the world who knew what a dead, broken girl I was, the better. I didn’t think there was anything anyone could do to help me anyway—nobody was going to be able to undo what had already happened, so I just had to live with it.

The nurse sent us to see a psychiatrist, Dr. Bird, who actually looked like a bird—like a weird, old emu. He spoke with my mother and me for about five minutes before he diagnosed me with bipolar disorder. My mom and I both knew he had no basis for this diagnosis, but he prescribed an antidepressant, Paxil, that I was willing to try. A few weeks after starting Paxil, I began to notice that I wasn’t so anxious anymore. I was much more relaxed and sleeping better. But I now know that prescribing an antidepressant, like Paxil, alone is not an appropriate treatment for bipolar disorder, which isn’t even a correct diagnosis for me anyway.

Nine months after starting Paxil, and un-coincidentally a few days after a second encounter with my rapist, in which he banged on my apartment door in the middle of the night, pleading to come inside, I attempted suicide. I knew I couldn’t survive another rape, and it just felt so inevitable that it would happen again now that he knew where I lived. I was a prisoner in my own body, but nobody could see how trapped I was. This was in 2004, right around the time the FDA issued their black-box warning that Paxil can lead to suicide in children and teenagers. My mom told me that the Paxil caused my suicidal ideation, so we made another doctor’s appointment for the following week. The doctor took me off Paxil, and instead of switching to a different drug, I decided to see how I would do without any medication. Aside from a week of some strange withdrawal symptoms from the Paxil, I felt much better. Now that I was un-medicated, I started drinking again, and I felt confident that I didn’t need any medication to feel normal. I had no idea how much I needed alcohol to feel “normal” though.

My second suicide attempt came after my second rape, two-and-a-half years later at a college party. Rape and substance abuse were destroying me from the inside out. Lying on my back on the floor of my unlit apartment, my frenzied mind knew that I couldn’t live like this anymore. Darkness caved in on me and I knew that night would never end—I fell backward into a bottomless pit, and saw the outside world quickly disappear in the hole’s shrinking entrance. I literally crawled into my kitchen and sawed on my wrist with the same dull knife I’d used three years earlier. I survived that night thanks to a friend who came to my apartment, but it took another five years of alcoholism, drug addiction, and PTSD before I found healthcare professionals who could help me.

When I first acknowledged the profound effect these rapes had had on me and started seeing a therapist, at 25 years of age, my world dramatically improved even within the first month of treatment. Granted, things were really bad so it didn’t take much for life to get better. But even with some relief during the first year of my therapy, I still made a daily conscious decision whether or not I could put up the fight to live. I’d left behind my unhealthy and self-destructive coping mechanisms, but that just left me vulnerable and unable to cope with anything at all. Even a magnet falling off my refrigerator would reduce me to a pile of tears. And then knowing that I couldn’t (or at least shouldn’t) drink to numb the pain of said broken magnet would summon a welling of fear and anger and sometimes rage. I know, I know—it wasn’t really about the magnet; it’s never about the magnet. But I’d tell myself all the time, “You don’t have to do this if you don’t want to.” Knowing that I could end the struggle at any time gave me the strength to at least attempt to make it through the day. I didn’t necessarily want to die, but I didn’t know how to live.

The desire to live is sometimes outweighed by unimaginable pain. One unseasonably warm October Sunday morning in the first year of my therapy, I awoke and immediately started writing. It was like I went from being asleep in my bedroom to waking up in my living room typing furiously. I didn’t know what I was writing until I stopped and read my computer screen:

 

“Please don’t tell people that I was always such a happy girl, that I was always so carefree. I suffered an unbearable amount of pain for much of my life. I know my death will cause many people grief, but I’m not being selfish or weak. I have always been unable to communicate my suffering to those that love me. I didn’t think my mother could live with herself if she knew of my anguish. Nobody could see my pain, and thus, nobody could see me. Suicide is the only way to express such indescribable pain—the only possible way to express my true self, without whom I am merely a shell of a falsely-constructed being, and that is not a life. In death, I will find my life. I loved you all very much.”

 

I’d written a suicide letter, admittedly one with a flair of dramatic undertones. I felt an enormous amount of pain for reasons I couldn’t explain, but then I realized that the nine-year anniversary of my first rape was coming in three days. This would be the first year I faced this time sober, and I was completely unprepared for what I was about to experience. Over the course of the next week, my dreams, emotions, and physical sensations chronologically paralleled what I went through in high school in a very real, terrifying re-experiencing of the past. Anniversaries of traumatic events often trigger intense “anniversary reactions” in people with PTSD, which can range from mild distress to more extreme re-experiencing, panic attacks, or suicidality.

I desperately tried to get help from psychiatrists for my severely increasing anxiety and suicidality but experienced the same frustrating lack of support that I received in high school. The doctors I made appointments with looked at me and saw an attractive, clean, young woman who was probably just under too much pressure like all the other PhD students out there (even though this time I was completely open about my history of rape, substance abuse, suicide attempts, etc.). I refused to take benzodiazepines because, according to AA, this would be considered an “alcoholic relapse” and I did not want that kind of failure on my conscience. But I knew the antidepressants they prescribed me wouldn’t help in my acute state of crisis. I saved my suicide letter and told myself I would get my affairs in order at work so I wouldn’t leave my coworkers in a bind, and then I would end my life.

But before I could get my “affairs in order,” one of my coworkers killed himself. This heartbreaking news hit me hard, not just because he was a friend, but because the first thing I felt when I heard about his suicide was envy—envy that he was able to end his suffering while I still lived with an unbearable amount of pain every day. I felt like I was floating around in space, and I’d drifted so far that I was surrounded by nothingness—no light, no planets, no sound, just a complete void. I had no frame of reference to time or space. There was no way anybody could find me, and there was no way I could move myself in any direction—I was completely helpless, just slowly starving to death and running out of oxygen. I knew I’d die a painful death in the near future, so of course I wanted to end my life quickly and painlessly.

In watching how people reacted to my coworker’s death, I learned that suicide is often seen as an impulsive, rash decision, but I knew there were many years of pain leading up to his decision to end his life. People said that he had no reason to kill himself—he had plenty of opportunities; he was smart and nice and cute—but I understood why a person who seemed to have a lot going for him could still want to die. Even when you have a lot of things to live for, there can still be a lot of things you don’t think you can live with.

When I attended his funeral, I couldn’t help but think this could have been my funeral. I saw the grief everyone experienced, and I couldn’t believe that just two weeks earlier, I’d written a suicide letter. I couldn’t believe that I’d felt like I needed to end my life any second, and I couldn’t believe that I’d been envious of this young man for ending his pain. Now, I just wished that he could have held on a little longer so he could have found some hope.

People said that this suicide was a selfish act, but I saw it as an act of pain, not an act of selfishness—someone who wanted to remove themselves from existence was not being selfish. When people said that a suicide victim was selfish and didn’t think about their loved ones, or that there was no reason that person should have killed themselves, they refused to acknowledge the amount of pain that person must have been in. When people said that a suicidal person was weak, I wondered if they’d walk up to a person who was on fire—their entire body consumed in flames—and tell them that they just need to be stronger to get through the pain.

But I understood that many of these reactions were expressions of grief, and being at this funeral made me realize how people could see suicide as selfish when it seemed that he wasn’t thinking about the pain his death would cause others. I always knew a lot of people would be devastated if I died, but I thought that once I killed myself, they would know the excruciating pain I felt, and they would be relieved that I ended my suffering. During the funeral, I recognized that my suicide wouldn’t have helped anybody to understand my pain or made anyone feel relieved. This realization shattered my impression of what suicide actually was—I’d revered suicide as this powerful thing that held my life in balance, but now I finally believed that suicide was the ultimate end to any hope of things getting better.

I felt immense sadness for my friend and haunted by the fact that it took another person’s suicide to give me the perspective and motivation to figure out how to live a healthy life. I felt a responsibility to give other people hope so his death wouldn’t be in vain. I wished he could have had some assurance that things could get better—it’s the hopelessness that is really unbearable—but I was in no position to give him that while he was alive. I didn’t know that things could get better. I, too, thought death was the only way out. I now know that the pain can end; things can get better. There is hope to heal a broken life, and there is more to life than just surviving each day.

I really thought that I could just go through my life not feeling anything whatsoever. I was willing to sacrifice experiencing any happiness or pleasure in order to not feel the pain, and it worked for a while. But after so many years of complete numbness, I wasn’t even sure that I was alive anymore, and I didn’t know why I kept putting up the fight to live every day if I was already dead. When I finally allowed myself to feel my anger and my pain, I thought the power of those emotions would surely kill me—I couldn’t live with those intense forces weighing down on me, and I didn’t know how I could ever make them go away without returning to the numbness. But as I let myself experience the pain (screaming in my car helped) and anger (punching bags helped), the frequency and intensity of those seemingly intolerable emotions subsided—they came and went in waves, and in between the suffering was great joy. The more I worked to acknowledge and accept my past and to express my true emotions, instead of ignoring them and numbing them, the more I experienced all of the beautiful things the make life worth living.

As a teenager, I thought everyone thought about how they would kill themselves and revered suicide as a way out. Everybody does not think this way; this is a sign of something seriously wrong. But it’s something that can be fixed. It wasn’t until much later that I was grateful for the person who “happened to be in the right place at the right time” to prevent my death (it probably wasn’t as much a coincidence as I thought it was), but for a long time, I was angry that I’d failed at both living and dying. Suicide is not a “cry for help,” and even if that’s what it ultimately comes down to, then please, by all means, help. Even though sleeping or sobering up might make someone feel better, anyone who attempts suicide or is harming themselves in any way should be taken to the hospital.  Visit these sites for information about suicide and how to get help. Or just contact me and I’ll try to help…or at least help you get help.

Depression and Bipolar Support Alliance

American Foundation for Suicide Prevention

National Suicide Prevention Lifeline

 

Photo credit: Bud Kibby

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