What Helps With SI

Sometimes it’s hard to try to explain to people what helps and what doesn’t help with suicidal ideation. I get frustrated when I see the message that it’s “easy” to help with deep depression. The “if only” silliness that seems to indicate that if you just tell someone that you love them and that if they just had medication, then no one would die by suicide. This is nonsense.

First of all, have you looked at the state of the mental health system in America today? Have you tried to get a bed for someone in a psych ward? They’re all full. And because of the way insurance works, they kick people out once insurance runs—not when they’re safe and healthy enough to leave. Yeah, I know. It’s not the fault of the caregivers. It’s the system. It’s capitalism, that wants to make a profit off people who want to be dead.

This is what we do in America. We charge people for medication, often ridiculous prices for something that isn’t generic, we charge them for therapy, and often the good therapists won’t take insurance because it won’t pay them what they can charge without insurance, and so only the bad or mediocre therapists take insurance.

And let’s talk for a moment about the reality that insurance is tied to your employment. Which means that if you’re not employed, you have no insurance. Even with Obamacare, you still have to pay for insurance. And sure, yes, you can get on Medicaid. Have you tried to do that? Do you know how many years it takes? And how do you get to the end of that three-year period, after being denied multiple times because that’s part of the process, being denied repeatedly, because otherwise too many people would be on it and it would overwhelm the system.

So if you have a job and you might be best served by spending a month or three months NOT working and instead focusing on your mental health and getting a lot of therapy and figuring out your meds, guess what? You are kicked off your insurance because you got fired from  your job and what do you think happens to the suicidal ideation and your own sense of worthlessness and belief that the world would be better off with you dead. Capitalism tells all of us who are depressed that capitalism would be better off with us dead, preferably cheaply thank you very much.

Friends say to me all the time that they want me to reach out to them if I’m “in trouble.” Here’s the problem: when I’m experiencing suicidal ideation, I don’t think of myself as “in trouble.” I don’t think that contacting a friend will be helpful. When I’m in the grip of it, the problem is ME. I don’t deserve to be alive. That is what I believe is the truth.

So, yes, I can contact other people and tell them I’m feeling this way. That’s not the hard part. The hard part is believing that I DESERVE to be helped. Because my brain is telling me THE TRUTH is that I am a terrible person who deserves to be dead because I keep hurting other people and doing things wrong. It’s not that I have this idea that no one cares about me. I KNOW that people care about me. I just think that they’re wrong to do so, that I don’t deserve it, that it would actually be kinder to them if I stopped existing.

Do you see?

And even if I do contact people, what most people do is try to convince me that my brain is giving me incorrect information, that actually I am a worthwhile human being and that the world and everyone in it would NOT be better off if I were gone. But my brain is super loudly telling me that they’re just being nice and lying to me. I don’t believe these kind words because I can’t. Because I’m so filled with self-disgust. So the conversations aren’t usually helpful.

What is helpful? Well, not a lot.

Mostly, the message I’ve gotten numerous times that has been most helpful has been the suggestion that maybe I could just wait a week or a month and decide to be dead then. Will anything change in a month or a week? My brain will say that no, it won’t I will be just as disgusting then as now. I will deserve to be dead then just as much as now. So maybe waiting doesn’t matter? And if the other person really thinks that I should wait, then OK, fine, no skin off my nose. I’ll wait.

Mean brain says that I will still want to die. But actually my experience has been that mean brain goes away in a week or a month. And then I don’t hate myself as much.

Maybe this will help someone out there who hasn’t found the mental health care system helpful or who can’t access it because of financial constraints or who doesn’t believe it will be for them or who thinks they don’t deserve it. There are lots of reasons that people don’t get help and a lot of them aren’t changing anytime soon. In the gap, there is me, writing about it.