Real Talk About Suicidal Ideation

I am often frustrated by the discourse around depression and suicide. If only people felt that they could admit that they are suicidal, if only they would go to the doctor and get a prescription for an SSRI, then it would all be fixed. The “it’s such a tragedy” comments about suicide completion are frustrating to me because it’s not so easy to find a solution on my side, someone who has dealt with suicidal ideation and deep depression off and on for nearly two decades. It’s just not simple at all for me and for many of the people I know.

Just keep trying medications until you find the right one, they insist. You have to keep trying. No one talks about the horrible side effects of these medications. One I tried made me so dizzy I couldn’t stand up. Another made me so sick I couldn’t eat more than 500 calories a day for two weeks. And then the doctor insisted I had to stay on it for three months to determine whether or not it was doing anything useful. But it wasn’t. It had an effect, sure. But only a negative effect. It made all food taste like dirt and it stole my libido entirely away from me. And these are considered “normal” side effects that patients are expected to accept as the price of feeling a little less depressed.

How many years does it take to find the right medication? It can take more than a decade, even if you are constantly trying a medication. For me, I haven’t found anything that helps in two decades. But because I refuse to keep trying, doctors call me “non-compliant” and don’t want to deal with me.

And expressing my suicidal thoughts to a therapist (the other supposed solution to depression)? The last time I was open about my actual spiraling thoughts around suicide, my therapist called my primary care physician and insisted that he make an immediate appointment for me. Not so bad, right? Except that I knew that behind this was the threat that she might call the police on me. That I could be forcibly committed to a mental institution. I’ve seen it happen. More than once. Put in handcuffs and carted away.

But this is really for the best, right? Put them in a behavioral health unit and then they will survive this short bout of suicidal ideation. They’ll get the care they need, get on proper medication and therapy and all will be well. Crisis averted.

Except that how many people have the financial resources to actually pay for an extended hospital stay or the therapy visits that come afterward? Not to mention the constant appointments to change medication. And the battles with insurance to insist that the medication has to be this one, not that generic one. When you’re depressed, it’s a full-time job to get care. And let me tell you, it’s not a full-time job I have time or energy to embark on—even if I believed that it would lead to a good outcome, which I no longer do.

What about suicide helplines? Surely that’s a good thing. Now if you have a suicidal friend, you can talk them into calling a stranger on the phone. Who will call the police if they express suicidal thoughts? Go back to the previous two paragraphs. Rinse and repeat.

I’m not saying there is nothing to be done. I just don’t think that people in general are realistic about how easy it is to fix depression. Or how much it is a societal problem, not an individual one. People who are released from hospital stays for suicidal ideation aren’t often miraculously cured. Many just learn to keep their mouths shut and to definitely NOT go to see a therapist and to NOT tell their doctor about how bad it really is in their heads. They learn after a suicide attempt that they have to be better next time at making sure that they don’t survive. Yes, many people are helped. I don’t mean to imply no one is. I’m just so frustrated with the assumption that the solution is so simple. It isn’t simple. It isn’t inexpensive. It isn’t without time and energy cost. And if there is a solution for someone like me, who is extremely sensitive to medication, I haven’t found it.

I do all the things. I get 8 hours of sleep a night, not too much, not too little. I exercise. God, do I exercise. I will beat any of you in a competition of exercise. I eat healthy food. Are you getting 10 fresh fruits and vegetables a day? I am. I have not just one therapist, but two. I meditate at least twice a day. I read books about depression. I seek out other possible diagnoses for my problems. And it’s still a daily battle. Every damned day, it’s a tax that I didn’t ask for and just carry with me as a hundred pound weight on my back. I used to be happy. I haven’t always been like this. Something happened to me that triggered it and I haven’t been the same since.

Please don’t offer me solutions. If you imagine I haven’t heard it before, you’re wrong. I’m not saying I won’t try anything else, but I have no idea how I can manage that as a divorced woman scrambling to get by in a world where housing is outrageous and even my good health insurance doesn’t cover any of the actual therapists that know anything about my unique condition. I keep working 40 hours a week to have health care so—why again? So I can keep working forty hours a week?