As a person with bipolar, I can tell you, I did and I didn’t ask for help before my suicide attempt. I had been asking for mental health help, begging for help with bipolar disorder before my suicide attempt; however, I did not seek out suicide-specific help before my suicide attempt. And while we have data saying that many people see a doctor before attempting suicide, what we also know is that many people with bipolar disorder are not asking for help before a suicide attempt — even if they do see a doctor.

Seeing a Doctor But Not Asking for Suicide Attempt Help?

Several studies have reported that between 20% and 76% of patients who commit suicide have seen their primary care physician (many having seen mental health professionals specifically) in the prior month. In other words, people are seeing doctors and on some level really, really want help, but they just aren’t getting it.

In the case of those with bipolar disorder, there are so many reasons why they might not get help before a suicide attempt, even if they do see a doctor. Just off the top of my head:

  • Those with bipolar are not taken seriously, possibly due to chronic suicidal ideation.
  • The person with bipolar disorder is assumed to be exaggerating or even lying for attention.
  • If the person has had previous suicide attempts that were not considered “serious,” it’s assumed any other suicide attempt also won’t be “serious.”
  • The doctor doesn’t see what he or she considers the signs of serious suicidality.
  • The doctor doesn’t even consider that the patient may be considering suicide.
  • The doctor doesn’t have time to engage in a real discussion with the patient about suicide.
  • The doctor doesn’t ask the right questions about suicide and the seriousness of the suicidal ideation.
  • The person with bipolar doesn’t readily admit to having serious suicidal feelings.

There are so many reasons that any of the above might occur, and I think it’s important to realize that I’m not trying to place blame on the doctor or the person with bipolar. This situation has wound-together factors and is complicated. While doctors are the final gatekeeper in this scenario, they can’t, solely, be pointed to as the single-point-of-failure because, let’s face it, sometimes we’re to blame, too. If we lie about being suicidal, if we aren’t forthcoming, it’s almost impossible for someone else to help us. I wish someone could reach into the brains of those who are suicidal and help, but that’s just not the way it works. No one truly knows what you’re thinking about but you.

Bipolars Not Asking for Help Before a Suicide Attempt — Why?

As the above notes, many, many of us seek medical help before a suicide attempt and yet we don’t get it and I believe a lot of this is because we’re not being forthright about our suicidal ideation. We’re not saying we’re suicidal or we’re not saying how suicidal we truly are.

And I get this. I’ve been in this position. When I ended up hospitalizing myself for suicidal ideation, even though I had been seeing a psychiatrist, I didn’t make it clear to him how truly suicidal I was. That’s why I ended up in the Emergency Room one night sobbing for hours and being admitted that way.

Often, people with bipolar don't ask for help before a suicide attempt -- but why? I've been there and I know why people don't ask for suicide attempt help.

While that may sound nutty, I can tell you that sitting in a room in front of a doctor and trying to relay how suicidal you are is extremely difficult. It seems impossible at times. I have seen people over and over talk about their suicidality on Facebook, for example, but not be able to talk to a healthcare professional about it. Telling, literally, the world on social media is easier than telling that one person staring at you in that tiny room. 

Maybe it’s because telling that one person in that tiny room makes it real and means that action has to be taken. This plays into all our fears. It plays into our fears of scary mental hospitals, treatment without consent, forced electroconvulsive therapy (ECT) and not being allowed to leave, among others. These can be scary, scary things to play in your head. They can be brick walls between you and a doctor. 

But I can honestly tell you that “action” being taken isn’t necessarily a bad thing. In fact, it’s likely exactly what you need. And the action being taken is rarely what you fear. For example, if you’re coming to a psychiatrist and saying that you’re acutely suicidal and need hospitalization, you’ll likely be checking yourself into the facility. You won’t be there against your will. You won’t be given treatment against your will. Certainly, no one is going to strap you to a bed and force ECT on you. This is just fear talking. That fear is real and should be listened to but it also should be talked back to.

There are other reasons you might be scared of admitting serious suicidality to a doctor too:

  • You might not want to “let the doctor down” by admitting that you’re so sick.
  • You might be worried about being judged by the doctor.
  • You might be worried about any additional ramifications this may have — your family finding out, your work finding out, missing work, etc.
  • You might be scared the healthcare professional won’t listen to you or believe you.
  • You might be scared the doctor won’t help you no matter what.

Of course, this is all assuming you still have enough of your faculties to think clearly and rationally and posess insight. Unfortunately, this isn’t always true. But I might argue that if you don’t have your faculties enough to think through the situation and you’re on the brink of killing yourself, you likely need hospitalization no matter what — to save your life. 

If You Have Bipolar and Are Considering Suicide

You know what I’m going to say now, don’t you? I’m going to say this:

If you’re feeling suicidal, you need to talk to a professional as soon as possible, no matter what. Walk into an Emergency Room or call 9-1-1 if you have to.

You need to talk back to your fear. You need to stand up to your fear. You need to know that doctors are there to help. I know that sounds trite, but it’s true. And you need to know that if you run into a bad doctor who doesn’t believe you or who doesn’t help you, you need to keep talking to professionals until you get the help you need and deserve. Remember, your life is important and fragile and you need to treat it as such.

I understand why a person with bipolar disorder may not ask for help before a suicide attempt. I get it because I’ve been there. But I don’t want anyone else to be there. I want you to know that things can get better and you can get the help you need without taking that final, drastic step. Believe me, doctors really do want to help you. I know you can run into bad ones and I’m sorry for that, but overall, these people are in a helping profession and that is what they want to do. Get suicide attempt help with their aid or without it, just get it because you matter. Your life matters. I want you to be here to see your best tomorrow.

See here for a list of helpful suicide attempt phone numbers and websites.