About three years ago I attempted suicide. It’s a long story but it involves a doctor denying me access to healthcare. I’m still alive; so I guess I got lucky.
But the question is, now, three years and many treatments later, am I still suicidal?
I’m sorry to say, the answer is, “yes.”
Depression and Suicidal Ideation
I’ve found that when seriously depressed, I want to die. It’s pretty simple and I’m hardly alone there. Suicidal ideation is, after all, a symptom of depression.
And myself, I’ve been depressed for a very long time. And being depressed for a long time certainly doesn’t decrease one’s desire to die.
What’s the Difference between Suicidal Ideation and a Suicide Attempt?
The difference now is that I’m not about to take my life today. Or tomorrow. Because while I feel suicidal, it’s not the same kind of active suicidality I felt when I actually attempted suicide.
Active Suicidality vs. Passive Suicidality
In my view, there are active and passive suicidal thoughts. If you’re suffering from active suicidal thoughts, you’re a danger to yourself as you feel likely to act on those thoughts. On the other hand, with passive suicidal thoughts, the thoughts are there, and you may ruminate on them, but you have enough of your mind left to ensure you don’t actually act on those suicidal urges.
In my experience, one can remain passively suicidal for a shockingly long amount of time without an actual suicide attempt. And when queried as to why I haven’t attempted suicide, my answer is quite typically, “I don’t know.” There doesn’t seem to be any serious, tangible reason not to suicide but I just don’t. I suspect it’s biological in nature. People don’t want to die. Even when suicidal.
Passive Suicidal Feelings are Better
So while I’d love to say that treatment has been a raging success and that all my suicidal feelings are gone, that just isn’t true. The truth is, the suicidal feelings have just changed, but they’ve changed in a way that makes them less deadly. So there’s that. I’m not actively feeling like I’m going to die at any moment. So there’s that. Passive feelings of death are infinitely better than the active ones. So there’s that.
Treatment has hardly been a tea party, but it has saved my life. So there’s that.
(Quick note: I’m not suggesting that you’re safe if you’re feeling passively suicidal. That can change in an instant and all suicidal feelings should be dealt with immediately.)
(Note #2: there have been times in the intervening years that have been much better. They just didn’t last.)
No I died, but thank you for asking. Feel much better without a body to bother me.
Seriously, that day will come and I will learn how true I was to myself.
Moderate this: The urge for killing oneself can be overcome by redirecting that
urge to another person, or people. This replacement fantasy works in your head, but is a
useless delusion that offsets the desire for self destruction. The idea began as a dark joke
but when applied has worked. Since then I think less of anyone’s death including my own.
Promoting fantasies to reality makes great things happen, and stupid thoughts less inviting.
(personal opinion only)
Well said, I think you’ve got the point. Passive suicide thoughts have been in my life almost since my childhood times and have never really withdrawn completely although 3 years ago I stopped considering suicide as an option. Still they accumulate in the times of crisis so you’re right, even passive ones are not safe. Thank you and have a great day :)
It is terrifying knowing it can change so fast. I hate being so scared of my own mind. Feel like i have no control, and dont know what will happen a second from now.
This was informative thank you. Today is a good day. I am on meds that work as good as it gets for me. I still have a low grade depression that is influenced by life & newly Dx PTSD & memories,symptoms etc coming up. Anxiety & Depress ebb & Flow. I am quite often in mental & emotional pain and using coping skills I have learned to ‘deal’. Throughout the 10 or so years I have struggled – no attempts..I immediately verbalized my thoughts – TELL that SECRET – will keep me safe. It has so far..the urges subside. I do tho, have this secret belief that I won’t live out a natural life. I don’t know when or how….but I am pretty sure that in the future I will absolutely run out of energy in this fight..and may not find what I’m fighting ‘for’. Not today, not now…But if I stop healing..or get too tired again..That is what my secret plan is…silly – probably never happen..But how long can one be ‘strong’
I call it the “death gene”. It’s just there. Dying would put me out of my misery, it seems. When you don’t have insurance, when you can’t afford medication, when you’re sick and tired of fighting this miserable beast…thoughts of dying are so comforting. I hobble on, though. There is always sleep. Sweet, oblivious sleep.
Natasha… where is YOUR suicidal assessment range thingie? Every so often, you might want to re-post it.
At this moment, I am suicidal but not in the sense that I am giving in to the impulse that is pounding my mind, to actually do so. I am, as one message board person noted to me on another website… using my MENTAL BOOTSTRAPS to hold myself up and together, such as they are – frayed and unraveled.
Still.. I tell folks I’d rather be dead, I tell folks that I’m thinking of.. hell, I even wrote a note or 2… but folks tell me that I’m not serious (oh yes) or that I need to just lay down and rest a bit and it will be better when I wake up…. they aren’t getting that I don’t want to wake up.
So, instead I just sleep… sleep and sleep and sleep.
Suicidal thought is a symptom that my bipolar depression, because I do consider myself with the illness though many MH pros would differ but then they don’t know me beyond the 3-5 appointments… a symptom of my bipolar depression when it’s turned so far south, is suicidal thoughts.
To actively start wording out notes, telling folks, and asking for help to help decrease whatever there may be that’s pushing and pressing it…. and not be taken seriously because I’m “high functional” or not seen as…. just leaves me to really wonder, what is the point?
I’m struggling with whether to go IP or not and not wanting to go, at all. I’d be there for 3-5 days and sent home with a bag of chemicals. My life won’t have gotten better, as a whole, just heavily medicated. What damn difference does it really make?
Hi Tabby,
I think you’re referring to this post where I outline a (completely unscientific) scale for how suicidal a person is: https://natashatracy.com/mental-illness-issues/suicide/scale-suicide-suicidal-you/
I’m sorry to hear things are so tough right now. I understand what it’s like to be ignored because you’re high-functioning. Many people have been in that situation. It helps to have a mental health professional that really knows you and that you can be really open with. If you can say, “look, I know I took a shower this morning but that doesn’t negate the fact that I wanted to drown myself in it,” that can help them to really understand where you’re coming from. I find I have to be really explicit in order to be taken seriously. I know that’s really hard, but it’s what we have to do sometimes – we have to yell to get people to listen.
I can’t tell you what the point of IP is (I assume it’s some sort of emergency help) to you but what I can tell you is that emergency help can keep you safe when you, yourself, are not capable of doing it, and that can be worth a lot.
– Natasha Tracy
The living dead don’t commit suicide, they lay their bodies to rest. Very few of us desire to leave life simply because there is no rational need to. Courage to fight the good fight requires strength. When we wear down, we become dead because hope and love have become inaccessible. When we cease to exist our burden is lifted. The consequence of this act is unknown. Belief in these words sounds disapointingly fitting.
Oh sweet Jesus… the “living dead don’t commit suicide..” so, utterly, profound and true… at least to me anyway.
I’ve been told that I’m not allowed to suicide and I’m not allowed to go psych IP (the psych IP is to burden others of something they’ve been burdened with before and so do not want to again.)
yet, there does come a point… when your mind gets so far south…. that you just become the living dead
“courage to fight the good fight requires strength. when we wear down, we become dead because hope and love have become inaccessible.”
no truer words have been noted, in a long while
Suicidal thinking is a SYMPTOM., a very dangerous symptom of depression I find it interesting that some people who suffer from severe, debilitating depression. never really contemplate suicide while others are rarely completely free of these thought even when their depression is fairly well controlled. So far Lithium has proven to be the best drug to eliminate this symptom but it’s not a drug that everyone can tolerate, we need to find others.
Bipolar depression sucks, let’s face it. I suffered with it for years, and had suicidal thoughts daily for years. I have taken so many meds for decades that I could not even remember them all, and none of them took those annoying thoughts and feelings away. Until I got transferred to a newbie Dr. whose suggestion to try Provigil literally changed my entire life and way of feeling and thinking. I was hesitant at first, because Provigil is a class 4 stimulant, and I studied about it online for weeks before I was willing. It is different from other stimulants in that it does not produce tolerance or withdrawal, the two culprits in addiction. Together with an antidepressant, this treatment not only helps, but it eliminates all that self-hatred, negative thinking, and slowed-down terrible I want to stay in bed and hide and just get off the planet thinking. This medication is expensive (to the tune of over 600.00 a month) and some insurances will not cover it. I have the Oregon Health Plan Plus, and have never had any trouble filling it. I would highly suggest to anyone suffering to at least consider this fairly new on the market ,and currently being studied for bipolar plagued people– medication. I can not imagine ever having to go back to the life I had without it! And thank you for this article. And thanks for your honesty. Suicide is a very real and dangerous option for many of us who have this disease. Not to mention that living with depression is horrible and ruins the quality of life people like us deserve. Apart from a cure, I hope there will be more miracle drugs like Provigil that take away our emotional pain and the damage it does to our lives and the lives of those who love us. I hope these comments can inspire others to have hope. Again, thank you. I always look forward to reading from you.
Hi Wendy,
Yes, armodafinil is an investigational medication for bipolar depression. I mention it here: https://natashatracy.com/treatment-issues/treatment-resistance/hope-treatment-resistant-bipolar-depression/
Keep in mind, it does only work in a subset of people. It’s not nearly a magic bullet.
– Natasha
I find the active/passive distinction interesting, I’ve not thingy of it that way before. I’ve had two instances where I’ve had a plan, and was very close to suicide. However, before and since those times, I think about suicide often. It’s alone the lines of ‘well, I can always kill myself’ and then I spend some time figuring out how I would do it. Fortunately these thoughts fade quickly…but I do have them often
I have been thinking long on this and for me the depression tends to be situational. I tend to be more manic rather than depressive and if anything that is a small saving grace. Very small indeed. I know that if I wait the depression and any suicidal thoughts I might be having will move on as well. It is bother some when they linger past that and I have to keep them in check. I feel like a warden only I am my own prisoner as well. I feel there is always as long as I keep trying. Sometimes trying is all I have.
Natasha, I think of suicidal thoughts and feelings the way you do. I haven’t actively suicidal or attempted suicide since I started taking antidepressants about a dozen years ago (there were three attempts before that, the first at age 14). But I still think about suicide, often, but generally not for very long and no, I don’t have a plan. I sometimes think about going off my meds so that I can get into a frame of being where suicide would once again appear to be a viable option, but then I remember that I’d have to go through all the shit that being off my meds would entail and I continue to take my pills (5 of them at the moment).
And Fred, you’re a lucky man.
I do feel like those thoughts come with the illness. Depends on where i am at in therapy, how well i can deal with the thoughts Now luckily im in a place where suicde is not an action i want to follow through with. But when depressed those thoughts linger. I used to get angy and wonder why! I know i did not activlly want to! Ive learned to live with this and take it as a sign my depression or hopelessness is at a different level. Time to call therapist and pysciatrist, get everyone on page and make an action plan.. there was a time i could not see this happening and take charge like i do now. Grateful for the most part im able to have more insight and self awareness into my disorder. It is scary.
Hi Natasha… To be sure, any suicidal thoughts are and especially if they linger for a very long time, as your have. It is interesting how you have classified suicide as either passive or active. Perhaps, your saying that it’s OK to have these thoughts…Just don’t ACT on them. I had thoughts constantly all of 1983 and into May of 1984. So there you have it ..When I ACTED on it . My Wife save my life and I spent 8 week in the hospital getting my head together. I decided to start kicking every negative thought out of my head, and decided to work on promoting “positivity” 100% to overcome all mood symptoms. The rest is now history with over 28 years of episode free emotional stability. And good by to suicidal thoughts. (So there’s that.)
http://www.amazon.com/Power-Positivity-Bipolar-Anyone-Else/dp/1478110147