My brain has gotten me to the hospital emergency room more than the rest of my body. I’ve been twice, both in 2011. I read an article about people who had bad experiences in the ER with their mental health so I thought it might be good to share what’s happened to me. I wrote about my first experience in the ER in the last blog entry. You can find that here.
The content below is an excerpt from my memoir, Fiercely Lonely, which will be released at some future date.
The second time I was in the emergency room it was as though I was another person. This time was for an actual suicide attempt, as opposed to the first experience, which was for suicidal thoughts. After my attempt to take my life I became dead inside, but somehow still functioning. It was as though my mind kicked into a role it knew how to perform, but one which I was unaware of until that moment.
I went to a different ER than the first occasion, one closer to my apartment. In fact, I walked through Harvard’s Arboretum on a sunny, warm June morning. I listened to the birds chirp and saw the squirrels play and then proceeded to stroll into the hospital. I carried with me my gym bag packed with clothing and items I knew I would need for a week at a psychiatric facility.
At the hospital nurses and doctors asked me questions and with no shame I answered them in a blunt manner. I told them exactly what I did and spared no detail. The staff acted cool and calm and casual. Sometimes they were friendly. At other moments alienating, their conversations mechanical and detached. A suicide experience heightened their senses, though. I understood they took it seriously by the questions they asked and the way they approached me. The questions were the same as the first time I’d been in the hospital: “What did you try to do?” “Why did you try to do it?” And down the line it went.
I didn’t have to spend the night at the hospital the second time. Once again, through this new survival role that my brain possessed, I advocated for myself. I made sure to speak up for what I believed to be the best option for me.
The first time I was in the psych ward, people who could talk and were coherent shared everything related to their mental health experiences. They rated meds and doctors and other hospitals. They told me the best hospitals to go to, and while in the hospital the second time around I still remembered their words. “Can you see if there is room at Lochstead for me?” I asked the ER doctor. “I want to go to Lochstead.” Time stopped and I exited. Lochstead it was.
My brain has gotten me to the hospital emergency room more than the rest of my body. I’ve been twice, both in 2011. I read an article about people who had bad experiences in the ER with their mental health so I thought it might be good to share what’s happened to me. There is a range of experiences in emergency rooms for those with mental health issues. You never know what might happen, so it’s always good to go if you’re feeling as though you may harm yourself.
At the end of 2010 my psychiatrist and I changed up my medication and things weren’t going so well. I had intense suicidal ideation and didn’t feel safe so in February 2011 I went to the ER at a local hospital in Boston that also had a mental health ward. My insurance provider’s website directed me there. I had no context to know whether it would be a good fit so it was pretty much like throwing a dart at a list.
The content below is an excerpt from my memoir, Fiercely Lonely, which will be released at some future date.
The entry to the emergency room was smooth and the wait time non-existent. I felt calm and casual with my conversation with the nurse and intake worker. As I went through the check-in process and found my way into a bed in the emergency room, I actually felt pretty good, all things considered. I received my own room with my own bed within the ER. There was a nurse’s station outside that watched over all the rooms. Once ensconced I changed into a gown and received a blanket and lay down while Valerie (my girlfriend) sat in a chair next to me. A nurse came in and asked what I had planned to do to kill myself. At first I thought that was none of her business, but I realized that she was asking so that she could keep an eye on me.
There was a window where a woman sat and looked at me every few seconds but otherwise kept her head down in a book or crossword puzzle. I didn’t understand why she kept looking at me, as I thought she was a nurse. But I soon realized she was the person making sure I didn’t kill myself. That was her only job: making sure I stayed alive.
Throughout the evening a psych doctor came to ask me questions. She was very calm and gentle in her presentation and with the manner in which she queried about my condition. The typical questions were: Do you want to kill yourself? Do you have a history of mental illness? Have you tried to kill yourself before? She spoke without belying a sense of happiness or sadness. Her manner was direct. I felt uncomfortable with her because she appeared embarrassed to be around me. Was it because she wasn’t used to handling mentally ill patients? Or was I being too sensitive?
The psych doctor didn’t have many answers at that time; they were looking to see if there would be an opening in the ward for me the next day. If not, I would spend the day in the ER once again. I couldn’t imagine sleeping on that bed for more than one night. It wasn’t made for any sense of comfort, cushioned but without much depth, the vinyl feeling unnatural against my skin. I didn’t want to get up too much and worry the nurse and the woman watching me. I was, even at my worst, more concerned with others instead of my own sense of well-being.
With my future placement in question, I did the best I could to make myself comfortable. My clothes and other items went into a locker. My sense of suicide and depression was still hovering in the background. It was waiting for an opportunity to make itself known once the newness of my situation had worn off.
I tried to sleep as my guardian peered into my living space to make sure I still existed. I received water, and nurses checked my blood pressure and vitals throughout the night. I felt as comfortable as one could in that situation. It was the best they could do, all things considered. I wondered if everyone I had so far encountered deemed my rather cheery albeit somewhat tempered disposition confusing.
I woke up in the middle of the night a couple of times to go to the bathroom (located down the hall). Both times I exited my room I noticed that the woman set to watch me had fallen asleep. One time, as I left the room, she woke up, startled, and stared at me, mouth agape with a surprised look on her face. It was as though she was looking at an angelic apparition and yet at that moment I was far from any sense of perfection.
Outside my room, the nurse at the ER station looked up from reading her magazine and asked me, “Everything okay?”
“Yeah, I just need to go to the bathroom,” I replied with an upbeat tone in my voice.
“Okay honey,” she said and went back to her magazine.
When I got up the next morning, I turned on the TV encased behind Plexiglas. I kept track of what was occurring with the latest round of riots in the Middle East. My sense of self-destruction failed to silence my curiosity with what was going on in the world.
The same doctor from the previous evening was still on duty the following morning. After the routine blood pressure check by the nurse, staff told me there was a room for me in the psych ward. This hospital was a preferred provider by my insurance, a perk in my situation. I learned later that at other hospitals people often spent two or three days in the ER before receiving a transfer to a psych ward. People were falling apart all over the Commonwealth of Massachusetts.
There are some days I struggle with my hypocrisy. I try not to think about it too much, if at all, because it gets under my skin. I tell others to hang on when they’re feeling down in their lives. I want people to keep on living when they’re feeling suicidal and depressed.
Yet, the fact of the matter is that I don’t always want to keep on living. There are often times—usually once a month or so—when I want to throw in the towel and end it all. It’s a thought and sometimes it’s fleeting—gone in a minute. But I feel overwhelmed, tired, and trapped by responsibilities I don’t want such as work I don’t enjoy. Sometimes what I need to accomplish in a day—chores, errands, projects—seems too much. I’m unable to live in the moment and take pleasure in what I have.
I then think about the hypocrisy involved with that. There is a light that shines in us and I know that. To extinguish that light is tragic, as things can often turn around and get better. I’ve felt that in my own life.
Depression is a slog, though. It’s asking whether the glass is half-empty or half-full. Sometimes I look at it as a life-long struggle that never ends and that discourages me. I think about how depression will always be there and how much it tires me.
There’s another part of me, though, that recognizes the depression goes away. That my default state isn’t sadness, but kindness and helpfulness. Those times of feeling down are bumps along the way.
I think about people whom I know who seem mentally strong but at the same time hide their suicidal feelings. Sometimes they give in to them.. I never want to be that person. Past experiences have shown me I want to live when given the chance. Yet suicidal thoughts hang there, on the periphery and stare me down as I tell others, “Keep going.”
I know that for many people, their depression is fleeting. A message of encouragement is what they need in their darker hours. So, every little bit of help I can give to others is great. But it doesn’t mean I don’t struggle. And it feels hypocritical to tell others to keep going when I want to give in.
Regardless of what happens to me, I figure if I can get one person through a mentally rough patch, it’s worth spreading the word of staying with us. We need you, even if I may not always feel that way about myself. It doesn’t change that fact that you’re good and wanted and loved by so many others. And I know I am, too. If only that could always be enough.
Trigger warning: I get in the weeds in speaking about suicide in this entry. It may not be for everyone.
Suicidal ideation is a scary topic to talk about, both for the speaker and the listener. It's safe to say suicidal ideation is generally considered a bad thing. But there are parts of it that I’ve come to realize are worse than others. It’s one thing to think about throwing yourself in front of a train but knowing you’ll never act upon it. Yet suicidal ideation has many layers, some of which affect the individual more than others.
1. You never know what will set you over the edge
I can handle my thoughts most of the time but I live in fear of wondering what the thing will be that might set me over the edge. Will it be an unkind word from someone? A frustrating day at work? What helps is knowing coping skills that I can undertake when those difficulties occur in my life. I can try and adjust my thoughts and realize that things happen, but the important thing is my reaction to difficult situations. Things can change and that includes my feelings at that moment.
2. Other people don’t know what will set you over the edge
Once you share your thoughts of suicide with others, it’s possible they will fret about it. No one likes to hear someone they love is suffering, especially when it’s not treatable in an easy manner. I’ve come to learn that fine line between ideation and action. Thus I don’t always share when I’m feeling suicidal with others because I know there’s not a lot they can do about it. Yet, I must acknowledge friends and family can show emotional support which means I should share more often what’s going on in my brain. This support can go a long way to helping me recover from down times.
3. Wondering when it will go away
When suicidal ideation comes along, sometimes it hangs around for a few minutes, but other times it’s with me for days. It's not constant but it is consistent. Often times this is in passive ways that I don't register. This may include thinking about what it would be like to not exist when I have a difficult situation occur. Or it may mean thinking of how the impact of various vehicles would feel against my body if I jumped into traffic.
But I can’t help but wonder how long such feelings will stay with me. And that can be troublesome because in those moments I may believe I’ll never get better. I know I have to fight such feelings. They deny the reality that I do, deep down, want to be here on earth. But it can be hard if they’re going on for days at a time.
To combat this, I’ve learned that if these feelings go on for more than a day or two, I reach out to loved ones to let them know what I’m going through. Perhaps the ideation will pass away on its own, but when it comes to mental health, it’s always better to ask for support than not do so.
If you are feeling suicidal, or need someone to talk to, please call 1-800-273-8255.
Battling depression and clawing your way up from the deepest points doesn't always come with one breakthrough moment. One might think after my suicide attempt when I was 21 I would've had a clarifying thought. But I didn't. I was still stuck in the doldrums for over a decade after that.
While there wasn't one thing that happened after my second suicide attempt in 2011, the change came sometime after that. And it wasn't a skull-crushing one. Instead it was a number of things occurring over the course of years. The change in my life included a healthy dating relationship and financial stability. Also, a comfortable living situation, and direction on what I wanted to do with my life were helpful. And, in a basic way, general maturity and understanding of who I was. That said, I don't know everything but I do know enough to get me by.
If there's anything that has been a breakthrough, it's the thought that for the most part, I want to live. I can see the point in living and more days than not, life is pretty good and it's worth being here. This thought didn't occur overnight but instead took a few years. And then the thought came to mind: “Hey, this isn't so bad. I have some good things going on here. Perhaps it's worth sticking around.”
Speaking out about mental health has been influential in regards to finding clarity of thought and what my goals are. It took me a long time but recognizing what I enjoy, how I want to make a difference in this world, and what to do to keep me alive have been so helpful.
In the end, it doesn't matter when or how a breakthrough came, what's important is that it happened. If you're looking for a breakthrough with regards to your mental health, the best advice I can give is to find the tools that best help you to survive and then give life time until that breakthrough comes.
I have one last resort when things go wrong. When I am suicidal or incapable of doing anything, and want to give up, I turn to this document that I keep on a shelf by my bed.
Thankfully, I don’t have to turn to it very often, but it’s become my lifeline for when I feel horrible. I tend to work my way down the left side of the page and have found that, for the most part, by the time I get to the fifth or sixth question I’m feeling better. Your experience may vary and there’s nothing wrong with jumping around with the questions or doing some and not others.
This document isn’t a rulebook, but if you feel at the end of your rope, if you do enough of these, chances are you’ll feel better after a while. Your problems won't stop, but this document pulled me through a handful of dark times.
Last winter there was a snow day from work and I had a difficult time feeling motivated to do anything. I was disliking my job at the time quite a bit and was feeling hopeless and unmotivated with my life in general. Thoughts of suicide entered my mind. I had eaten and drank water. I had even showered. But I realized I hadn't been out of my apartment all day. So, once the snow eased up some I put on my boots and coat and trudged around my neighborhood. The lack of sound in the city made things quite eerie. Yet I found it very peaceful to see the snow lightly falling. I could tell the exercise and a change in environment were helpful. Things didn't change dramatically, but it was enough to pull me out of my severe doldrums.
I’m not exaggerating when I say if you deal with problems of suicidality, print this list out and put it by your bed. These items aren’t relegated to only the times you feel horrible—they’re good activities for general daily living. But they’re especially helpful if you find yourself at the end of your wits.
On occasion I fear a relapse into depression. Other times I find myself in the depths of despair. The best thing I can do to help me then is to remind myself that whatever I’m feeling, it’s happened before and I survived.
I’ve worked horrible jobs that I hated and where management was atrocious, so I know that should work get bad I can get through that. I often struggle with impatience. But I've found it’s helpful to remember that there were occasions where time took. I wanted out of my situation badly enough that I made the necessary plans to escape and did so. Thus, I am pretty sure I can do it again.
Even with new situations, such as going to a mental hospital, there’s a first time with that. I had never been through that. But I reminded myself there had been times before where I felt as despondent as I did then. I also knew to rely on those around me, such as my therapist and psychiatrist, for support. With their help I was able to survive that situation and now I know it’s possible to get through a hospitalization.
I also find some comfort in seeing how others have made it through difficult times and know that I, too, am capable of making it. I may not always feel I am able to do great things. Yet my success in other areas shows me that I have the knowledge and understanding to do something as well as those around me. I try and take hope in that.
Still, the more years I have behind me, the more experiences I have. I also see that with some planning and help from those around me, whatever is happening, I can get through it.
Once someone gets to a point of sharing about their mental health, others can assume, “Well, they’ve got it all together. They’re on top of things.” That couldn’t be further from the truth. In my case, I am stabilized enough to share my experiences with others, but I'm not to a place where I no longer suffer from mental illness.
I am diagnosed with bipolar II and the symptoms associated with that are fairly well under control. I’ve also made a great deal of progress on my anxiety and self-confidence. They’re miles above where they once stood and allow me to function well, without allowing doubts about my self-worth.
But here are the things with which I still struggle:
I get depressed. This is usually related to feeling stuck and bored with what is going on around me. I’m often impatient about the changes I want in my life. When they don’t happen it leaves me disappointed. A lot of my depression is about that disconnect between where I am and what I want my life to be like. This primarily means I want to be in a situation where I can speak and write about mental health. I’m working on changing that.
2. Existential depression
This article pretty well describes that situation. But to summarize, I have, for much of my life, felt like I don’t know what it is I’m here for. This can often lead to feelings of worthlessness and pointlessness with my existence. This is slowly changing as I find that speaking out about mental health has helped me find purpose. But I still have my doubts.
3. Suicidal ideation
I’ve written about suicidal ideation for an article at Medium. This can be a real tough one to handle. When I am stuck I revert back to feeling as though suicide is a proper way out. But I’ve seen time and again it’s not.
So, what about you? If you’ve made improvements in your life, what are you still working on?
Back in April of 2018 I shared an article about my suicidal ideation. I was impressed with how many people appreciated it and what a response it got. One of my friends asked me the question below and I thought it could be helpful to share a response with a wider audience.
I’d be curious to hear more about how you overcome your darkest thoughts and any suggestions you might have for the family and friends of those who feel depressed/suicidal.
I realize it can feel scary and leave one feeling helpless to watch a loved one go through suicidal experiences. The best thing I can do is remind myself that my mind is not telling me the truth. Additionally, whatever I'm feeling is something I've overcome and dealt with before. I find it helpful to deal with facts and truths that are unshakeable. I'm usually looking for stability and security when I'm unsure of myself and suicidal. So, if someone can give me something that is surefire, that's a safe feeling to me. Of course, all of this is built upon years of therapy and medication, so experiences you have with loved ones may vary.
If nothing else, you can encourage the person to take some self-care and see their therapist if they have one. And of course, just listening is helpful, too. It can be really difficult to get through dark times (both as someone suffering from suicidal ideation and as someone trying to help that individual) but I, as well as many others, are proof that it can be done.
This blog is an exploration of the subjects of belonging and loneliness. I also look at mental health issues. I seek to provide content to my readers that is informative and helpful. If you don't want to miss anything, sign up for my email list.