Being suicidal embarrasses me. To anyone who hasn’t felt suicidal, this probably seems like a ridiculous remark. If I was a stranger to suicidal ideation, I would probably think the same—but I’m not. My earliest memory of feeling like I wanted to die occurred at age 14. At the time, I didn’t dare tell anyone. My life was, and still is, incredible. I had a family that provided not only food and shelter, but perhaps more importantly, unconditional love and support. For the most part, within reason, I got almost anything I asked for. I had activities that I loved doing and an abundance of friends who cared about me. I went to one of the best schools and took all accelerated classes, receiving straight A’s. From the outside, everything appeared great—I had it all. That’s why when I started experiencing the thoughts telling me that I’d be better off dead, there was no chance of me sharing that with anyone. To my friends and family, I was a happy and capable girl full of potential. I couldn’t ruin their perception of me. I couldn’t let them think of me as weak or broken. I kept quiet. Despite the increasing frequency of these dark thoughts, I refused to acknowledge that they were a problem. I didn’t fit the bill of what I believed a depressed person looked or acted like, so I didn’t call what I was experiencing depression. Instead, I told myself I was just going through a rough patch and that it would pass. There was no way I could be depressed. Meanwhile in my journals and iPhone notes, I wrote:
“Every ounce of me is repulsive. I don’t know how there is anything left to love. I’m unlovable. Intolerable. A complete waste of space, drowning in misery and self-loathing.
You know what hurts? Realizing how completely and utterly alone you are.
I don’t know why I’m feeling like this. It’s like this kind of sadness that I can’t escape. I feel like I’m struggling just to have motivation to do simple things like hold conversations and go to class and finish homework. Why is it so hard? Why am I so sad? There isn’t anything to be sad about.”
The American Psychiatric Association defines depression, or major depressive disorder (MDD), as a common and serious medical illness that negatively affects how you feel, the way you think, and how you act.
The symptoms of depression can include the following:
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite - weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
- Feeling worthless or guilty
- Difficulty thinking, concentrating, or making decisions
- Thoughts of death or suicide
Check, check, check... I was checking all the boxes. I fit the textbook definition of depression. To receive a diagnosis of MDD you have to experience these symptoms for at least two weeks. I was experiencing nearly all of those for months, so why couldn’t I believe I was depressed when everything I was thinking, feeling, and doing qualified as clinical depression?I guess the short answer is that I didn’t know those were the qualifications for depression. I realized I was struggling but believed it was just part of who I was. Plus there was the added aspect of the lack of dialogue about depression and mental health in general, thus I kept my mouth shut. I went on suffering in silence, because I didn’t know there was any other option.
The first time I went to therapy I was 16. I began having panic attacks regularly that were so intense I genuinely believed I was dying and would beg my parents to take me to the hospital in the middle of the night. Anxiety was not something I could hide. My anxiety terrified me in ways that depression did not. To this day, I still feel the same. At just four years old, I told my parents that I “got the jitters” and received reports in preschool about having trouble with speaking up for what I wanted and that I was shy. My parents understood that I was anxious, so when the frequency and severity of my panic attacks became alarming, I began going to therapy, which I think was my mom’s suggestion. My first few sessions I could hardly even speak because I was too busy crying the entire time. Even still, I mostly hid my dark thoughts from my therapist because without ever being explicitly told, I knew they were something of which to be ashamed.
I wouldn’t go to therapy again until I started college. I continued to have thoughts of wanting to be dead, but instead, I was more concerned with my anxiety. I only went to a few sessions before avoiding therapy for nearly two years, because I felt embarrassed about going. By the time I went back to therapy my junior year of college, I was desperate. Dark thoughts in the back of my mind turned into hysteric crying spells while my brain screamed at me that I was worthless and should be dead. Buildings and the big bridge in the city became things off of which I could jump. Cars and trucks became things I could walk in front of. Water became something I could drown myself in. I still felt a sense of shame surrounding going to therapy, but I went anyway because for the first time in years, my depression was the one scaring me. Actually, it got so bad that I made an appointment with a psychiatrist to try taking medication as a last resort—I felt I was all out of options and could not manage this on my own. I was finally diagnosed with major depressive disorder (on top of generalized anxiety disorder and panic disorder) and written a prescription for Prozac. My anxiety and shame told me not to take the medication, but the one rational sliver I had left in my brain told me I needed help and that it was my only choice. So I took the Prozac.
Just a few days in, my thoughts of wishing I was dead turned into thoughts of “I should kill myself.” I would later learn in an intensive therapy program that suicidal ideation comes in two forms: passive and active. My thoughts of wishing I was dead were passive. My thoughts of wanting to kill myself were active, and I was terrified of them. I ended up calling my dad, petrified of what I would say, but then through heavy sobs said that I couldn’t stop thinking about dying and that I was scared. The next day I was on a plane back home, where I would be evaluated by a behavioral health center and placed in a partial hospitalization program. Here, I would be in therapy all day long and see a psychiatrist regularly to manage my medication. At the time, I had no idea how debilitating this force in my head would be. I naïvely believed that I would go to a little bit of therapy, take my meds, and I would be on my way to the happy life everyone thought I was leading. That was so incredibly far from the truth. Each time I tried to go back to school, I would wind up having intense breakdowns and thoughts of killing myself, and have to come home for more therapy and try a different medication. Each of the therapy programs I attended helped in their own way, but I soon learned that there was nothing that was going to “fix” me—that this was something I would be living with for the rest of my life. A forever disease. There is no cure, only learning how to manage these disorders and their symptoms. I was completely devastated by this news, as it only exasperated my hopelessness that depression instilled in me. As I lived in flux, moving in and out of intensive therapy programs, I became more comfortable with talking about mental illness. I soon learned just how many people were struggling with the same thoughts and feelings that I was. The sense of camaraderie and knowing that I had spaces to open up in made me start to feel like I wasn’t alone, like the depressive thoughts in my head caused me to believe. Perhaps one of the biggest lessons I learned came from the last therapy program I was in, when my suicidal thoughts were particularly bad. I told my therapist at the time that my suicidal thoughts were unbearably intrusive and that I had spent the night googling the suicide hotline number and how to check myself into an inpatient psychiatric unit. The suicide hotline number was easy enough to find, but I found myself crippled with fear. A fear so big it stopped me from picking up the phone. A fear that told me my problems weren’t bad enough, that I would be wasting the time of a person who could be helping someone who deserved it more than me. So I continued to google frantically, unable to find any answers for how to get the help I finally wanted. I realized there was not enough information on how to get help when in crisis. After I told this to my therapist, she gave me maybe the most important information that I had learned in my therapy programs: you can walk into any emergency room anywhere and tell them that you are suicidal or have a desire to hurt yourself, and they will admit you. I was in complete shock. How had no one told this to me before?! Where was this information for all the other times I had felt desperate and suicidal? Since learning this information, my suicidal thoughts haven’t held the same power over me, because I know there is help wherever I am, whatever time of day.
Knowing that there is a place full of people who want to see you safe and alive, even when you can’t see it for yourself, sometimes is not enough. Sometimes the thoughts in your head are screaming so loud that you have no choice but to believe them when they say you do not deserve to be safe or alive. These thoughts tell you not to reach out. They tell you to stay silent. They have told me to stay silent. In these times, there is a small voice in my head that whispers, “if only someone would just reach out to me, ask me if I’m okay.” But the thing is, people don’t think to ask you if you’re okay when you appear okay. Society tells us to wear the Mask of Okay-ness, because it’s frowned upon when we are not okay. Stigma keeps us from reaching out. Fear keeps us from reaching out. And worst of all, the thought that we might not be worth saving keeps us from reaching out. So I’m asking, pleading, begging: please reach out to anyone who seems to be struggling. Most importantly, please check in on people who appear to be fine—happy even!—because I know exactly what it’s like to be the “happy” girl who is too ashamed to ask for help. If you’re experiencing suicidal thoughts, please use these resources:
Call the Suicide Prevention Lifeline.