Suicidal Ideation, 2020
By: John Ege
Tags: Abuse, Mental Health, Suicidal Ideation, Reframing, Suicide

Thinking about ending your life could be evidence for a mental health condition, but it doesn’t necessarily mean you’re broken. It could mean you’re human. As someone who works in mental health, I have experienced a continuum of where people fall on a map. There is a range of severity, duration, and several qualitative measures to determine where people are. There is a passive ideation, like, “God, this world is hard, just take me in my sleep,” to “Fuck, I think today I will walk out into traffic.” These are two different places. There are places in between and on the other side. It can be a daily struggle. It’s a thing some people use to cope, a thing some people use to manipulate others, and it’s thing that blocks people from thriving. It’s a thing.

Contrary to popular belief, it is not just a psychological experience. It’s a quirk of society. Specifically, Durkheim, a famous sociologist, wrote a treatise on how the rates of suicide vary from culture to culture, and from time to time. If suicides were just a quirk of faulty brain chemistry, then this fact would not be true. It’s statistically verifiable, but it’s not the thing that is sorted in a community mental health clinic. That’s not a fault- when it comes to the individual experiencing this, it is necessary to get out of a macroscopic frame and work with the person. We still need to address social-cultural dynamics that influence suicide.

In addition to experiencing suicidal ideation as a professional, I have also experienced it in my personal life. Very few know this. Maybe more people should. My mother suffers, has suffered, from chronic depression. I suspect a personality disorder. I can tell you that generational sex abuse has been a thing in our family. Drug use, physical abuse, sexual abuse, and suicides have shaped my family. I can recall sitting in a hospital hallway waiting for my father, while medical people worked on my mother. She in her 70s and she has attempted in the last year. She is a ‘frequent flyer.’ She checks herself in, doesn’t get the care or medication she thinks she needs, she checks herself out. I remember one incident, in childhood, where she asked if I wanted to ‘go out’ with her. She intended to take me and my brother out and then herself. What I don’t remember about that particular moment is how we came out the other side of that. If she had given me the cool aid, I would at drank it. There are several major blank spots in my childhood and adolescents- not something muddy, or that lacks clarity- its gaping holes in the continuity of my timeline. And I am known for having a pretty good memory.

I have experienced suicidal ideation personally. I have had persistent, passive suicidal ideation since about the of age 6. Yes; children can hold suicidal thoughts, and they have been known to act on them. I have been all over the map. I probably just missed getting tagged with a personality disorder. AN oddity to me, there were times when people expressed genuine interest in me, wanted to extend friendship towards me, and I would experience an increase in suicidal thoughts. I remember being emotional and using that threat to manipulate the arena of my life. I can say it never really worked in any significant way. It didn’t increase connections with family. It didn’t change their behaviors to me or each other. It didn’t win me any friends. It significantly impacted every relationship I was in as a young adult, in a negative way. It still flavors my cup of tea.

In 2006, I attempted. I was experiencing migraines upwards of four times a week. I had access to all sorts of pain remedies, none of them working. I went to the ER a minimum of 1 time a week to be sedated. My first marriage was already being closed out by lawyers. I was unhappy at work. I had lost property, 14 acres, and about to lose a home. I was just unhappy. So, I set out all my medication. I took down a fifth of rum that was meant for cooking. I don’t drink. Hearing that helps you to know, I had no tolerance for drinking. I drank that fifth in about five minutes thinking I would then take the pills. I remember being tired, laying on the floor, and then the next coherent thought was being asked questions in ICU.

Even that didn’t go the way I imagined. I was released from ICU to go home. Not a psych hospital. Which is odd, because I clearly remember being defiant and probably pissed off the doctor. I wrote him a disparaging letter. Yeah, that screams personality disorder. I remember the nurse being angry at me, “you have your whole life ahead of you, why would you do something so stupid?” I just heard, ‘you’re stupid.’ I was told I was uncooperative in the ER, law enforcement talked to me, I had charcoal in my stomach, and I eventually vomited that onto the ER nurse. I can’t imagine the hell I gave her or that department that day.

I asked work for time off. It was denied. I told them why I was hospitalized. I was still expected to show up at work. I was like, ‘seriously, I just tried to kill myself and you want me working on the ramp, where I can walk into a jet engine and…” It does feel like, sometimes no one listens. It feels like sometimes there is no help. In hindsight, going through the motions of work was likely a good thing- like therapy- don’t stop living.

Part of my experience, and a running theme of my life, was feeling like I wasn’t being heard. I had no intentions of telling my family. I had been minimizing contact with them for years, and the only reason I was speaking to my parents and maternal grandmother was because wife at the time wanted to know them. She informed my grandmother, the matriarch of our family. Her response was, and this was in person, ‘So, you fucked that up, too?” And then proceeded to rant about how she never got help raising all of us under her house… She made it about her. That was 2006. We have never spoken again.

So, nice little picture there. I have shared that with you in hopes to letting you know, if you struggles with ideation, I can relate. I can relate to the subject, not necessarily your experience. I have no clue what you may be going through, and that is true for everybody. Communication can close the distance between people, but it’s never perfect. Also, what I share next might help you flip your experience into something that might improve the existential meaning you hold for life. It might make it bearable. I find it useful to know I am not the victim of my thoughts, but a survivor. I experience thoughts, I am not my thoughts. I experience the sun rise and moonlight, I am not these things. And yet, we are all these things.

First thing you should know- you are not your thoughts. Do you have volitional control over your thoughts? Yes. You also have automatic thoughts. You also have automatic emotions. You also have volition over your emotions- and like lifting weights, if you never tried to alter your emotions, you may not have the ‘muscles’ to do it volitionally, especially if the current you’re resisting is a water fall. You are not your brain. You are the personality, or conscious awareness- and the brain is the organ that takes in intel, sorts information, and gives you a summary based on your established preferences. The eye sees more than the brain. You see what the brain illuminates. This does not invalidate what you ‘see.’ What I am saying is you can train your brain to sort more information and give you alternatives.

Your brain is an organ that does something, just like heart and lung and kidneys do something, but you can’t say you are just a brain. You’re a brain with a heart. And other things. The second thing you need to know is that your brain communicates in abstractions. It loves puns and metaphors. That’s why dreams are so interesting. After one vacation, I had a dream about falling; I stumbled and fell in slow motion and it was pleasant. Pun: that was a nice trip. Even the bad ones are interesting; they may not mean what you think it means. If you ask your brain a question, it will find an answer. It will always give you an answer. Even after you have asked the question, it will keep searching for an answer. In the absence of a valid answer, it will give you something. If you ask a question that comes with qualifiers, like, “OH MY GOD, I am so overwhelmed, how do I make this go away…” Brain responds well, death is an out. That’s fast and simple processing. You asked a question, you were given solution set to a problem. Your brain is always doing math. It will look for deficits before surfeits. If you qualify questions with ‘always,’ like ‘this always goes south for me’ well, always results in extreme ‘outs,’ too. Death is extreme. It’s always, by definition, the last option.

If you can focus on broad range of things, you move out of tunnel vision. “What are some things I can do to alleviate my thoughts and emotions now, or today, or this week…” Having options can help. The more options the better, even simple option. When you realize suicide is just an option the brain supplied you with, and you blow that off as, ‘oh, okay, yeah, but I would like some other options,” the brain will work with you. There is evidence for this. In places where medical assisted suicides were made available for terminal patients, the number of suicides in these place declined. Why? Well, if you’re in constant pain and you know you’re dying, but you have no options- suffering feels worse. But if you wakeup, you’re feeling like shit, your brain says, ‘well, the doctor gave you these pills…’ and then you sort it. “Yes, but we can make it a little further…”

I am certainly not saying it’s easy. For me, I suspect an OCD quality to my experience. Some people get the urge to wash their hands, or check the locks on the doors, I get this inner, verbal tic that asks are you ready to check out. I found a strategy for compartmentalizing it. For me, suicidal ideation has become a barometer for how well I am dealing with stress. If I am coping, if I am doing things to take care of myself, I might hear that chirp once a month? If I am not focused or dealing with something that needs to be attended to, well- it becomes weekly. If I get it daily, I am not dealing with something and it’s time to take a time out and evaluate. It’s time to ask the brain some open ended questions and broaden the visual scope.

2020 was hard for some people. I met many of them and because I was able to continue working, and I had food, and I am blessed in so many ways- I likely dismissed my own stress and concerns, and so those thoughts increased. I am not alone in this. I found more people at work snapping, in ways I don’t think reflect their true selves. We are definitely stressed. Interestingly, and maybe an attempt to spin humor into this, I have attached my own internal noise to the chirp of a smoke detector. I hate that damn chirp! During telehealth, I have discovered that many people live with that damn chirping in the background. They ignore it. They become immune to it. I will ask, ‘Do you hear that chirp occurring like every two to three minutes?” Some don’t acknowledge it all, even after pointing it out. One guy told me, “It’s birds.” “No, Sir, that is a smoke detector.” We argued. “Sir, have you seen any birds in your apartment?” No. “Have you seen any feathers? Any bird poop on the furniture?” No. “It’s not birds.” Some people were aware, but don’t have the money to replaces the batteries. This feels like a metaphor.

If you have suicidal ideation, don’t ignore it. Unlike the smoke detector metaphor up above, it doesn’t just magically go away when the battery finally fails. Don’t be afraid to talk about it. Couch it into hypotheticals if that’s what it takes. Call a hotline. 1–800–273-TALK. There are people who are trained to talk you through this. Diluting thoughts by increasing options is not the same thing as ignoring. But hypothetically, let’s say you ignore it, the battery goes out, and one day there’s a fire- you might miss something important because you didn’t have a working smoke detector. If your brain gives you something, there is a reason. Explore it. There is always a reason for the chirp.

If suicide is not your thing, but you know people in your life that you wonder about or have shared such secrets with you in the past- don’t be afraid to ask. You will not put it in their heads. You will not make someone suicidal by discussing the subject. In holding conversations on the subject, you may find more people actually think about this subject, academically, personally, clinically, than you realize. 2020 has been hard for people. Abuse has gone up. Domestic violence has gone up. Addictions have gone up. Our normal checks and balances were not available to the degree they were in the past, and quite frankly, the check and balances were always insufficient. A healthy society requires a greater number of people being proactive and engaged in meaningful ways than what we have practiced.

2020 could be our year of balance, better living through hindsight. If you struggle, you’re not alone. Reach out to someone. Take a risk. Ask questions. Find ways to do that thing you want to do, like love, even if it’s not reciprocated the way you might prefer. Turn Persian poetry into Yoda-isms. Be kind to yourself. Find a song. Write a blog. Read a blog. Share it.