I was having suicidal thoughts last night. It had been a day of much fear, and repeated bouts of crying. Days like that often lead me to thinking that I’ll never get better, that I can’t face 30 more years of Bipolar symptoms, etc.
That train of thought is worrisome. It shouldn’t be ignored. That will be my ultimate point. Nonetheless, not all suicidal thinking is the same. I decided, as a break from my DBT homework, to share some personal reflections on that.
My suicidal ideations come in sub-varieties. Degrees on scale – though I wouldn’t hazard a strict ordering. At the lowest level lies pondering seriously the question: Why bother being alive? To ask, that is: What are the (dis)advantages ? In my own case, I land up here very frequently.
More serious than this is feeling indifferent to remaining alive. This presupposes a fairly detached judgment on the “Why bother?” question, to the effect that, actually, there is no good reason, though there’s no compelling reason to die either. Let the chips fall, etc.
A third sub-variety that I experience is hoping that something fatal will happen to me: a car accident, a heart attack in my sleep, tipping off my boat and drowning. What usually accompanies this, luckily, is the saving recognition that I would hurt others too much if I killed myself. It would scar them permanently. So, I’m not willing to do anything to bring about my death, at this third level; but I’ve given a darker answer to my question, namely that the disadvantages of continuing to exist outweigh the advantages. My resolve, then, is to endure the pain – which, I’ve concluded, overshadows the benefits – for others’ sake.
I’m not sure whether this next one is less or more serious than that morbid mildly hoping. It is running through scenarios in my head, assessing the pros and cons of different methods. Leaping into traffic or in front of a subway would traumatize the driver. Jumping off a bridge might leave me seriously injured rather than dead, hence even less happy, and even more of a burden to my family. Drinking poison would be painful. I’d need to hoard my pills. And so on. (This is also when I notice “opportunities” for suicide: as I take a knife out of a drawer, “I could cut myself with that”; as I cross over a bridge, “I could jump off”; as I wait at a light, “I could step out”.)
It’s these last two sub-varieties which show up during my depressive cycles, as opposed to on an isolated bad day. Thank heavens.
The most serious kind of suicidal ideation, still short of an attempt, is forming an actual plan. Settling on a method, a day and time, a place. This I’ve only done three times in my life.
Again, based not on scientific studies but on both chats with fellow sufferers and on my first-person gut feelings, I’d offer this advice for friends and family about my scale. It’s the last stage which is an immediate threat. If you have reason to think that someone has reached that point, it’s the time to call the police. (Ordinarily, the advice would be to take them to Emerg, but my personal experience there, twice over, was too awful for me to recommend it.)
That said, I would say treat all of them as serious, not least because a triggering event can move a person from the mildest to the most severe very rapidly. This I know from first-hand experience. That whole idea, thankfully not so prevalent anymore, of “Ignore them, they are just seeking attention” is a terrible one. Even if a person were seeking attention in that specific way, they are somewhere on my scale already. That’s a serious thing, and at a minimum requires compassion and emotional support.