Tuesday, January 7, 2014

Suicide and Self-Harm: A survivor's guide to coping, seeking help, and understanding

Before I start this, I would just like to include a warning, as I don't pull punches with some of the content. Please be mindful in your reading.

Who am I?
I suffer from severe depression.

I have self-harmed since I was 14.

I have lost multiple close friends to suicide, and have nearly lost even more to attempts.

I myself am a survivor of multiple suicide attempts.

This is my burden.

I feel like unless you have stood on the brink of self-conclusion, or hurled yourself blindly into the numbing sea of over-stimulation and suffering, you can't understand it fully. I think this gives rise to the stigma.

Depression is a disease. It eats away at everything. No part of your life is free from the cancerous grasp of depression. You aren't sad. You're not upset. You're empty. It's a cold feeling seeping into the very fiber of your being, bleeding out every notion of an emotional response. And you don't know how to respond. You want it to stop. You want it to go away, so you can be better.

So you struggle, and you fail, and everything compounds and builds up until you're being crushed. You fall behind. School, family, friends, work, relationships... they all suffer, and you feel at fault because you think you should try harder, do better.

The truth is, you can't. It's all it takes just to get out of bed most days, and even that little bit you hate so much for that feeling of defeat. And you hear it all.

"Get over it."

"Man up."

"Just stop being sad."

"You're just being too sensitive/dramatic"

You get so used to these dismissals from people who don't understand, that you build up a wall. You withdraw into yourself, and the isolation compounds it. Or you do what I did and you cultivate this respectable mask of easy sociability where you have nothing wrong and the world is perfect, and you're not allowed to be sad or worn out. That exhausts you more. The constant deception. The constant effort you have to put in to just keeping up the pretense because that's easier than answering questions. You end every day even more tired than it started.

And then you spend hours staring at the ceiling, thoughts racing, your mind whirling with everything you could have done better, or different. You start to avoid social situations because you just don't have the energy to maintain your facade. You want so hard to be that person everyone thinks you are, but you can't.

So you do your best to regain the focus, the composure, the feelings. You want to capture your humanity, because every day you feel like a robot whose batteries are winding down, and nobody knows how to change them.

You find healthy outlets. Music, poetry, writing, dance, painting, drawing, nature, fishing. You try to recharge. This only goes so far, because no matter the release, you're always trapped. For me, this was music. I can still get lost for hours in playing, and the world fades away. In that time, everything is perfect. I don't want to hurt myself. I don't feel worthless. I feel like a human being.

You drink until you're sick or blacking out. You put so much alcohol into your system that the self-loathing and failure is as dulled and sluggish as your senses. You push the limit, to the point where you remember very little, and it's better that way. At least when you're drunk you're not able to feel much of anything. The buzz isn't even that good, but it's better than being able to think, because thought is the death of you.

You do drugs, mainly for the same reason, though this was nothing I ever got into. You want to escape thoughts and feelings. You want some superficial euphoria because you can't find it on your own.

You latch onto people who remotely make your feel good, and this seems like some desperate clinging... and it is, but you're not clinging to them. You're clinging to the semblance of life they give back to you. You're clawing desperately at the slim notions of humanity they restore. But you're too much to handle. You push and pull and demand, and they can't take it. And they leave, and you're further in the depths than you were before.

You fuck and fight. I lump these together because they're fulfilling that same need for interaction and physical stimulus. Whether you just want to fuck and orgasm and blank out or just hit someone and get hit and hurt and fade out, the idea is that same. You're drowning the pain and emptiness under superficial biology.

You spread yourself thin, with obligations and activities, hoping that no time to think means no time to be depressed. Wrong. You just push yourself into situations where you're constantly rushed, and stressed and dying for time to yourself, even though you know you'll spend it locked in a dark room trying to keep from falling apart. For me, this meant being hyper-involved in everything at school, both secondary and college. I took a maximum courseload, joined a ton of clubs. My junior and senior year of college I was taking 18-20 credits per semester, plus working, plus 4 officer positions in clubs, plus active in 5 OTHER clubs, plus I tutored in multiple subjects and volunteered at a local high school as well as 3 offices at the university I attended. I was spending 6-8 hours a day in classes, another 8-10 at meetings, functions, and events, and then homework and (not) sleeping. You burn out fast, and it doesn't help.

You start to self harm. This actually took a lot of shapes for me. I used to work myself to the point of physical exhaustion. I would spend hours outside in sub-zero Farenheit weather in summer clothing. I've burnt myself, and yes, I cut myself. Now let's make this clear. Self-harm is NOT about attention. Most people who self harm take great lengths to conceal this from others.

Let me tell you about self-harm. It is fucking addicting. You do it because you realize that you control it. You control the pain you inflict. You control the damage. You own the moment. And the pain itself is like fucking magic. If you've never been there, I can't tell you. It felt so calming, so focusing, and that is terrifying. You sit there and you bleed and you hurt, and everything goes away except both those sensations. The pain keeps you honest. When you're sitting there, hurting and bleeding, pushing yourself into this unnatural state of pain, you know who you are. There's something introspective about pain that forces you to confront exactly who and what you are.

And on some level, you become master of life and death. The slightest inflection, the narrowest whim are all the separate you from becoming a statistic. In that moment, you control your entire future. When you're depressed, and that lost, the amount of control you get from self-harm is the most perfectly sincere, beautiful thing you can feel. For me, it is one of the only things that helps me focus... it pulls me out of the darkness, it reminds me about being a person and feeling things, even if all I feel is pain and a flood of endogenous opiates.

But what happens when you're pushed too far? You stand on the edge of oblivion, and you can't help but take one look back. Suicide is hardly ever impulsive. It may be, perhaps, the most ordered and controlled thing you do in your entire fucking life. You try to make everything perfect. The placement, the timing. I've heard critiques of suicide as "selfish" and "inconsiderate" and I can only assume those ignorant fuckwits have never lost anyone to suicide, let alone hovered on the edge themselves,

When you've hit this point, it isn't selfish. It's hopeless. You've exhausted everything. You've played the game. You've smiled your way through as much as you can, and that's starting to wear so thin. You hide your scars and pretend like you don't spend nights lone drinking and cutting and trying to sleep.. which you never do. You metaphorically and literally put yourself under the gun, and the weight of the world finally gets to be too much. You snap, and you are just looking for any way to not struggle. And if that means drowning rather than reaching shore, at least you're not fighting the storm and the waves anymore.

Suicide is a finality, an expression of the weight being too much to bear. They are not cowards. They are not weak. Until you've stood there, it's hard to explain the feelings. It's about the control. it's about being able to breathe then. You stop being afraid with a rope around your neck, or a blade on your wrist.

I still struggle in my day to day. I still put on that stupid fucking mask for interactions. I keep to myself and push people away, maintaining a very superficial level of interaction and charm because it is necessary to survive. As of writing this, it has been less than two weeks since the last time I self harmed. I struggle to get up in the morning, and to get motivated. I struggle to find sleep at night, even after long days. I can't focus on my schoolwork or study materials, and I try. I will sit for hours, and I will read the same passages over and over. I am currently seeking treatment. 

But even that's not my point.

Who are we?
We are sufferers of depression, bi-polar disorder, eating disorders, and other mental health issues

We are survivors of self-harm and suicide and abuse

We are those struggling to help those we care for fight these same battles

We are human beings, with unique thoughts and feelings and experiences

I survived because of people in my life who recognized how badly I was hurting and, even if just for brief moments, took that pain away from me and gave me a place to rest. These people weren't always good to me, or good for me. Most of them aren't in my life in any way now, and I have no negative feelings about that. The best thing anyone ever did for me when I was suffering was to just let me know they care. I didn't want advice. I don't think I could have even taken advice at those stages. It helped when they understood and could empathize... when we had shared trauma and experience to increase trust... but that wasn't necessary. They just had to sincerely want me to be better, or happy. 

Sometimes the difference between a bad day, and a worse day really is something so simple as a "hello" or (if you have that rapport and connection) an "I love you."

We are not seeking attention. We are not being dramatic. We are ill, and we are wounded, and we're looking for anything that can help us stop the pain and stop being sick. If we hold on to you, it's because we trust you. If we cling too tightly sometimes, it's because at that point we can't afford to let go. If you can't handle that, we'll do our best to understand when you have to walk away. You need to take care of your own mental health, and we know how fragile that is. Please, though, try to understand. We don't mean to push, or monopolize on your time. We're just so desperate to stop feeling like we don't need to exist, and you... you do that for us.

And we can't always share our thoughts and feelings. It isn't that we don't trust you: sometimes we just can't articulate ourselves. Or maybe we aren't ready yet. We survive by doing things our way. We're so used to fighting alone that we develop our own process. That's hard to change.

We want to change though. We're your friends, your sons and daughters and brothers and sisters, or a parent or cousin. We're your server at a restaurant, the cashier at the supermarket. We are teachers and soldiers and farmers and unemployed. We are every race and creed and gender and orientation.We are people. 

That's it. We are people, and we are suffering. We don't expect a lot anymore, which may seem tragic on some level. But that means that every little bit... everything you do for us... we notice it. We may not always be great at showing appreciation, but those little things can literally be the difference between life and death.

So what can you expect from us? 

There isn't a real answer. Every person who struggles with mental health will have mechanisms for coping as unique as they are. They may self harm. They may isolate. They may get almost manic. They may need someone to hold them while they cry, or someone to give them some tough love. We may need a friend, or a lover. Mostly, what you can do for us, is be patient, and to let us tell you. It's easy to want to give advice,to want to just HELP and change things, but that's something only we can do. 

So please, don't push. Be cognizant of your phrasing. Give us space if we ask for it, and give us affection if we need it, and more importantly, if you don't know what you can do for us, ask. We don't expect you to read our minds, because we don't necessarily have a firm grasp of what's going on in their either. Encourage us to get better, but don't make us feel like we're rushed. We know how bad it is, and how it impacts our day-to-day. We just may need help. 

You don't have to fight for us, but being there while we fight means the world.

We know what it's like to wake up, every single day, disappointed that we didn't die in our sleep. We understand emptiness, and self-loathing. We know pain, and mental anguish. We don't feel safe, we don't feel whole.

Fuck, most days we can't even remember what it is like to feel like a person. We keep the face on, for the sake of survival. We go through the motions, literally trying to fake it until we make it. We take our pills and avoid discussions. We trace scars along our skin at night, desperately trying to avoid the urge to spill our blood. We drink too much, and joke about it so that nobody knows we're doing it to kill some of the nasty, dark things inside of us. 

We get to sit and watch our lives fall apart because we don't know how to keep them together. We see our friends and family and loved ones pull away from us because our negativity bleeds over into their worlds, and they can't take it. We're not well, but we don't know how to be better.

We've spent so much time staring hopefully at the light house, waiting for the storm to end as we swim towards the shore, but the shore seems to get further away, and the waves are high, and we just can't make it. We just think that maybe letting the waves overtake us is easier than swimming to a shore we'll never reach.

But fuck you, we say that, every day "Today is the day I stop swimming."

And some of us do, and the holes those people leave never stop bleeding.

And some of us say it, and here we are still swimming.

What can we do next?
We fight. 

We cling desperately to life, as best as we can. 

We seek help.

We do not enjoy the desperate feelings we wake with. We do not enjoy that our minds constantly race. We don't enjoy the compulsion to hurt, the self-loathing, the emptiness. We want to be better, but we don't always know how.

I started writing this weeks ago, when I first started therapy, before my life started falling apart. I've revised and edited and erased. I've re-read and started over. That's kind of how I feel about my mental state. It constantly needs to be looked at, changed, reviewed, pushed in a better direction.

I always hated the idea of therapy. It challenged my ego. It took a bad stretch and one wonderful friend to convince me that I was being illogical and irrational, and that my health was more important than any intellectual vanity. So I went.

It was uncomfortable. It was awkward. It's been weeks now, and the idea still bothers me. It's still hard, and frustrating, and I sometimes need to be reminded that I need this to be healthy. I'm still going. I even have a scheduled appointment with a psychiatrist. And yes, it does still feel like a blow to my pride, but at the end of the day, I'd rather be humbled than a corpse. Most days, anyway.

We need to be healthy. We need to be safe.

Maybe there is a sad truth that on top of all of our struggling to keep our faces on every day, we also have to seek out help ourselves. It won't come to us. 

It's hard. it's hard to acknowledge that we have this problem. We're constantly facing criticism for our mental health... being treated as if we're simply being histrionic. We're told to get over it, to man up, to just choose to be happy.

If you are one of those people, let me tell you right now that you desperately need an understanding of mental health issues. If you persist, you're an ignorant cunt.

Seeking help for mental health is a challenge because of the perceptions of mental health. We're not "crazy" or "just sad." We're people, dealing with something we desperately wish to stop. We're often doing it with people who don't understand, or don't know how to help, and society keeps telling us we shouldn't feel this way. 

We need to be heard. Not told what to do, or told how we should be feeling. Don't condescend to us. Don't get aggressive if we say something that you find to be irrational or childish about our mental state. We're fucking suffering, the last thing we need is for someone we trust to make it seem as if they don't understand (or want to understand) the state we're in. Oftentimes, the next best thing to professional help is just having someone be there. Just listen to what we have to say, listen to our feelings. Try to understand us, and make no assumptions. We just need to bleed the emotion out, and words are better than blood.

We can be healthy. We can be safe. We can't always do it alone.

Where we really stand
You are not alone.

You are not broken, or damaged.

It is not a flaw in character, but a flaw in chemistry.

You are loved

It may not be easy, but it will be worth it

You, my friends, need to know, that you are loved. I maybe don't know you. Maybe I never will. Maybe this is the closest we get, sharing this right now, where you read my words and my thoughts and my story, and you catch an insight into me, and yourself, and we are together in that moment.

Is that a ridiculous sentiment? I don't think so.

You aren't alone. There is nothing wrong with you. You are a person, with feelings and experiences and pains and joys. Don't ever feel the need to apologize for that.

We share the same scars. We are brothers and sisters, if only in our shared hardships. You aren't alone, and more than that, you aren't standing alone. We've all fought the battles. We've all fallen behind, and screamed our desperate frustration into a careless sky. 

If you are considering harming yourself, or committing suicide, please call one of these numbers and speak with someone: http://www.suicide.org/international-suicide-hotlines.html

If you are considering harming yourself, or others, please reach out to someone. Call a friend, call a professional, wake someone up. Please. Don't be afraid to seek help.

I would like to end this with a point I made before in an earlier blog, that I can't find better words for:

"If you struggle with your mental health, please, I beg of you, remember that you are not alone. If you have thoughts of hurting yourself or others, please call someone. We care. We want to help. You are not alone, and we know what you're feeling. I've had the gun to my head and pulled the trigger (not a metaphor), and I know the hopelessness that leads you there.

You are not alone.
You are loved
It gets better
I promise

Don't ever feel ashamed of how you feel, or what you think. 

This is not a flaw in you. This is not you 'overreacting' or being 'too sensitive.' You don't need to 'get over it' or 'move on.'

You need to know that this is something you can get through. Depression is a flaw of chemistry, not character.

I love you, for having the strength to fight this battle, and the courage to try to do it alone."

If anyone is interested, there is an episode of The Rational Talk where I discussed some of these issues with dear friends, and you can find it Here