What I am about to write is probably a bit controversial. It may be triggering to some, yet it will resonate with others.
My hope is that by explaining suicidal ideation from the perspective of someone who has been there, it will generate conversations around how to better help survivors and prevent re-traumatisation.
At the age of 18, I experienced suicidal thoughts. I sought help, and was treated for anxiety and depression.
It turns out the anxiety and depression I experienced in my teens were symptoms that had resulted from childhood trauma. As I was misdiagnosed in my adolescence, my trauma remained untreated into my adulthood.
It wasn't until I was in my thirties that I was diagnosed with Bipolar Disorder and complex PTSD after having a complete breakdown.
During that breakdown, I again experienced suicidal thoughts. My husband called the ACIS team for help (ACIS is a community mental health group in my area). This was a difficult call for him to make, because he is a Paramedic.
Being a health care professional, my husband knew that, by law, expressing thoughts of suicide meant that I could be detained against my will, injected with medication to sedate me if I fought back, and then made to stay in a facility that takes away my right to decide what happens to me.
He also knew that if the paramedics (who were also my friends and colleagues) even remotely appeared as though they were going to detain me, I would have fought them, and fought hard.
From a trauma perspective, this scenario is re-traumatising in and of itself.
As a young child, my power was taken from me. My ability to decide what happened to my body and by whom was brutally denied. I was forced to endure horrendous acts against my will, whilst fighting for my freedom and my life, but to no avail. I had no control over what was happening to me - I was helpless and powerless.
Being detained, sedated, and institutionalised are the real, physical re-living of those experiences. Is it any wonder trauma survivors fight back when medical professionals (who are trying to help them) make decisions on their behalf?
The whole process is re-traumatising.
So whilst I was having thoughts about suicide, I did not want to die. I was, however, scared that I might die.
As someone with a mental illness and a psychological injury, I know the statistics. As someone who studies trauma and mental wellness, I know what the research says regarding my potential risk for suicide. And as such, I live in fear whenever a depression hits me.
You see, I don't want to die. Not one little bit. Even when I felt I wanted to take my life, I didn't want to die then, either.
My illness once told me that suicide was the only way to end my pain and suffering. Even then, I was still petrified of dying. Since then, it has been a huge fear that the illness may take over again.
And society reminds me all the time that because I have mental health issues, I am likely to die by suicide. It is drummed into me how high my risk of death by suicide is.
Thanks, society, because as someone with a neural network that from the age of seven has been primed to recognise any threat to my safety, I now see MYSELF as a threat!
Trauma has left me with hyper-vigilance - constantly on guard, assessing for any signs of threat to my emotional and physical wellbeing.
So now, I am my own worst enemy - the biggest threat to my life is ME!
Can you imagine how damaging that is to one's already compromised mental health and lack of sense of safety? Not only is the world unsafe for me, but according to the statistics, I am unsafe for myself!
But here's the kicker...
When I speak with my doctors and specialists, and they ask me if I have had any thoughts of suicide, I have to lie. I tell them no.
But the truth is, I THINK ABOUT SUICIDE EVERY SINGLE TIME I FEEL LOW OR FALL INTO A DEPRESSION.
Yep! Every. bloody. time.
Why? Because I am shit scared! I worry that "this" might be the depression that tips me over. THIS time might be the one that makes my brain say "that's it, we're out!", because that's what mental illness can do.
But I don't want to die!
I am PETRIFIED that it will happen again - that fear that suicide may present itself as an option. And that fear becomes all-consuming - the more I try not to think about it, the more my brain seems to fixate on it!
I live in constant fear that my brain may make the mistake of deciding my fate for me because I have a mental illness. Again, something that reminds me of how little control I have had over my own body.
BECAUSE I ACTUALLY DON'T WANT TO DIE!
Somedays, the darkness is so deep and heavy, I feel that fear creeping back in - that fear of "Oh my God, is today the day my mental illness gets the better of me?" And I panic. I get so scared that I might die, because,
I DON'T WANT TO DIE!
I am reminded at all times that because I have a mental illness, I can die from it.
I liken it to receiving a cancer diagnosis - you have the belief that the illness is going to take your life prematurely; it is widely stated that mental illness makes you more likely to die by suicide. And yes, the studies have demonstrated this, but that fact keeps me in the constant state of fear, and as a result, I think about suicide often.
But who can I share this with? My GP? Fuck no; she'll have me in an ambulance and whisked off to the nearest emergency department for an immediate mental health assessment! Against my will!!
I have seen this happen, time and time again.
But I don't blame them.
The law makes it so difficult for people like me to say what it is I really feel, because the minute I do, I fear my rights will be taken away from me.
Health professional's are so shit scared they will be held accountable if their patient dies by suicide, that they have to make those decisions in order to protect themselves. I know this, because I was an emergency nurse (and am now a trauma coach) and I know what my mandated reporting requirements are; I have a duty and responsibility to report if someone expresses thoughts to harm themselves (or others).
What we now face is a health system that has to report and act upon a person disclosing their thoughts about suicide, and a society of sufferers who can't open up about what they are really thinking and feeling because their power will be taken away from them.
I can say, hand on my heart, that I think about suicide every time I am in a depression - and the thing I am thinking is "I am so scared I might accidentally choose to die".
But this does not make me suicidal, it simply means I am "thinking" about whether or not I am suicidal. There is a big difference.
Yes, I know questions are asked to determine the level of risk and intention; "do you have a plan? Have you been getting your affairs in order"...but it doesn't matter.
As a consumer of mental health services, I feel as though you are asking these questions from a litigious perspective. Sure, you may genuinely care about my wellbeing, but deep down I feel you are covering your own ass - you don't want to be held responsible if I make that decision. And I get that.
And it's those thoughts that leave me feeling that you are not safe for me to talk to.
That's just how trauma affects my perspective, because I am fearful that if I disclose too much, I will be detained and you will take my power away. Or, that hearing that I have been thinking about suicide will cause pain to the ones I love, because they may misinterpret what I mean.
Because I don't want to die.
The irony is that we all think about death and our mortality - it is programmed into us to avoid death at any cost to ensure the survival of the human race. Does that make a person suicidal?
Of course not.
So do I have thoughts of suicide? My secret answer is yes, I think about it often - but it isn't in the way you may think.
But am I suicidal? No. However, as a sufferer of trauma and mental health issues, I live in fear of letting you know that these thoughts cross my mind. Even though I don't have any suicidal intention, (none at all!!) to answer that question honestly is not often an option, because the result could create an outcome that could be re-traumatising.
There is a desperate need for change in the way we deal with mental illness and psychological injury in our society, and thankfully, neuroscience is helping with this.
This is a personal reflection of my own experiences and not intended to be generalised to the public. It is a depiction of a personal journey with mental health and not created as advice nor substitute for professional medical assistance and professional advice. There is no intent to represent any other parties or to imply that the content herein is true for all survivors of trauma or mental health issues. If this article has created any unease for you, please seek help from someone you trust.