Suicide: a How-To Guide

I came across a website today.  It’s all about suicide.  It provides a range of information – statistics about suicide; what causes it, who commits it, how they commit it. I read further and discovered several pages discussing the various suicide methods. There is even a table compiled, listing the fatality rate of each method, along with expected time required for death to take place and the amount of pain thought to be experienced from start to finish.  To my horror and disbelief, I also found a detailed guide on how to successfully off yourself using each method.

This website was one of the first to come up in a Google search for depression and suicide.  I imagined a person at their lowest stumbling upon this; a website to help them select whichever method seemed to best suit their death wish, and all the information required to implement their heart-breaking plan.  The worst possible form of “help” I could imagine for these poor souls.

It made me angry.  Livid. Why on earth would someone provide the world with information on how to end their own life?  How does this person sleep at night, knowing their words might have been (arguably) responsible for someone else’s death?  What in the world possessed them to create such an awful tool?

I continued reading, and I changed my mind.

On top of the how-to-suicide-guides, I found unbiased, factual information regarding the likelihood of failure (and potential lasting health implications) for each method.  For the particularly gruesome suicide styles (such as firearms, jumping in front of a train, or hanging), there was a section outlining what someone would be exposed to upon discovering the body – how it would look, the trauma the person may experience, and the clean-up they may have to do.  There were statistics, references and resources listed at the bottom of each page.

The website is written by a person with a history of mental health struggles and suicide attempts.  He shares a brief summary of his story on the website, carefully separating fact from opinion.  He describes his own suicide attempt, and his honest and raw thoughts upon realising he failed, “I woke up I don’t know how many hours later – it was still light on the same day … feeling like shit, and being bitterly disappointed I was still alive.” These words took me back to some of my own dark moments.

It’s not at all uncommon for a suicide attempt to fail.  “For every successful suicide attempt, there are 33 unsuccessful ones. For drug overdoses, the ratio is around 40 to 1. In fact, if attempting suicide, there is a much greater chance you’ll end up in hospital alive, with either short or long term heath implications, than dead.”

The author goes on to summarize these facts into one eye-opening statement:  “The first thing you should be aware of if you are trying to kill yourself is the odds are against you.”

On top of the suicide statistics, I also found information on the reality of mental illness.  The writer makes a comment many of us have likely heard before, comparing cancer to depression – both are real, diagnosable illnesses that have the potential to be deadly. He shares some referenced facts to show just how true that statement is, “According to the American Association of Suicidology, major depression is the psychiatric diagnosis most commonly associated with suicide. The risk of suicide in people with major depression is about 20 times that of the general population.”

To compare, the chances of developing and dying from cancer (of any form) in the United States is an average of 22.83% for men, and 19.26% for women. 

This information seems daunting at first glance – as though major depression were a death sentence, much like cancer can be.  Fortunately, the next paragraph presents us with statistics that prove otherwise, “The risk of someone suffering from an untreated major depressive disorder trying to commit suicide is around 1 in 5 (20%). However, the suicide risk among treated patients is around 1 in 1,000 (0.1%).”

So, this confirms that a depressed person has a 20% chance of falling victim to suicide, much like the average person has an approximately 20% chance of dying from cancer. The fortunate difference for those who fall into the former category is when depression is properly treated, the suicide risk factor is greatly diminished. 

The author writes in a way that is completely open: not encouraging, but also not directly discouraging, a person from committing suicide.  He writes in such a way that his readers are forced to take a step back and view suicide objectively; everything is to the point, and nothing is personal. 

While this website does provide information which could be used to end one’s own life, it also offers a refreshingly realistic and matter-of-fact discussion about suicide.  It allows suicide to be seen as the epidemic it is in today’s world, instead of hiding away from the reality we should not dare deny.  Instead of simply saying “don’t do it”, this website informs about everything that goes along with suicide – before, during, and after – to allow a person to really think strongly about what it is they are considering, opening their eyes to what suicide really entails, without attempting to persuade them one way or the other.

Suicide is a taboo subject, and the majority of articles online don’t go into too much detail – especially avoiding descriptions of how a person can successfully commit suicide.  One can assume this is because people are afraid of planting dangerous ideas into already unstable minds.  So, instead, they stick with the “just don’t do it” approach, which seems safe.

What this approach fails to acknowledge, however, is that suicidal people are often so desperate that they are willing to try anything, and simple discouragement is therefore not enough to stop them.  Many suicides (attempted or successful) are done impulsively. If a suicidal person can’t find the information they are looking for at their moment of desperation, they will try whatever they think might work.  While their uneducated attempts will rarely result in death, there is a good chance they will experience other negative side effects – anything from superficial scarring to permanent brain damage.

The website I found today takes an entirely different approach – one I had not seen before, and one that is nothing short of controversial.  It takes the suicidal back to a child-like state in a way; offering explanations for everything from how to get things done, to what to expect in the (statistically likely) event of failure.  Instead of shunning away the notion of suicide, this website embraces it and creates an educating and empowering environment, allowing people to make sound decisions, rather than impulsive ones.

This website challenged my perspective on suicidal discussions and how we should approach the subject as a society.  Simply saying “no” without laying out the reasons why – in an unbiased, educational way – is a sure-fire way to lose the attention of a potential suicide victim.  This website shocked me into wanting to read more, and opened my eyes to the fact that there are many ways to help someone.  Sometimes, we need to shock people into realising what they are considering before we can expect to open their minds enough to truly help them.

For those of you who are interested, the website I have been referring to can be visited at:
http://www.lostallhope.com

Cancer statistics found at:
Lifetime Risk (Percent) of Dying from Cancer by Site and Race/Ethnicity: Males, Total US, 2009-2011 (Table 1.19) and Females, Total US, 2009-2011 (Table 1.20). 2014. Accessed at http://seer.cancer.gov/csr/1975_2011/results_merged/topic_lifetime_risk_death.pdf on December 27, 2015.

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A week in the psych ward

When my doctor told me I had to stay at the psychiatric hospital, I had to decide what to do about work.  I was working full time at a kindergarten.  Although the German health care system ensures you are paid for any work missed due to documented medical reasons, I wasn’t sure what to tell my employer.  Should I be honest, and risk ridicule or a change in people’s perception of me, or should I lie and say I was home with the flu, and have no one be the wiser?

At this stage, I was worried about that sort of thing.  I didn’t want anyone to see me as weak – I mean, after all, I was missing work for being ‘sad,’ wasn’t I?  Of course there is much more to it than that – but depressives don’t always give themselves enough credit.  And, let’s face it: unfortunately there is still a strong stigma, and not everyone is empathetic or understanding.

After much consideration, I ultimately decided to tell only one person at work the truth, and I told the rest I had bronchitis – that was believable because it happened to be going around the school at the time.  Apart from one colleague, everyone at work was left in the dark.  I preferred it that way.  They didn’t need to know.  My opinion on this matter – believe it or not – has not really changed.

So, along came that dreaded, long-awaited Monday morning.  Nick and I woke up, I threw some clothes and basic essentials in a bag, and we set off.  The hospital was only two subway stations away – I was about to be locked up a mere five minutes away from my comfort zone.  Somehow, that made everything worse – so close to home, yet so far from normalcy.  As we were sitting in the waiting room, organizing paperwork, I contemplated getting up and leaving – going back home to bed, pretending like nothing had happened.

We were sent upstairs, greeted by a nurse upon arrival.  I immediately didn’t like the place.  It was so cold and sterile.  There was no life in that building.  All doors were locked; a nurse and a key required for everything.  I was shown to my bed and Nick and I said our goodbyes. I knew I was going to see him later that night – he had promised to visit me – but despite that knowledge, I felt lonely and abandoned when he left. Everything was so foreign to me (in every possible way) and the thought of facing it all alone was not a happy one.

I was introduced to Evie – one of my three roommates, who happened to be ten times crazier than I was.  She was a very nice woman. I feel bad saying she’s a big part of why I felt so uncomfortable.

Just a reminder: I am Canadian, but I live in Germany.  I do speak German, however it is not my native language and therefore not my language of comfort. Handling such a sensitive situation would have been difficult already, and I had given myself the added stress of facing it in a foreign language.

Soon after my arrival, one of the nurses came to sit down with me.  She had a stack of papers, a whack of questionnaires to fill out together.  We sat and spoke for about twenty minutes.

Why are you here? – My doctor insisted.
You’re not German, I see.  Where are you from? – All the way from Canada to a German psych ward.
What sort of symptoms have you had?  – What symptoms haven’t I had?
Are you suicidal?  – Isn’t everyone?
(I was very cynical.)

I was told all about the daily routine:  7:00am wake up.  Check the schedule upon waking up – if your name is on the list, go for blood work before breakfast.  8:00am breakfast.  Medication rounds.  Meetings with doctors/therapy sessions.  Lunch at 11:30am.  Medication rounds, where required. Visiting hours.  Dinner at 5:00pm.  Medication rounds, where required. More visiting hours.  Quiet time after 8:00pm.  9:00pm: final medication round.  Lights out at 10:00pm.  Try to sleep through the noise of disturbed people all around you.

The schedule didn’t sound so bad (apart from the 7am wakeup, of course). I was happy to hear that I had lots of time for visits, and even happier to find out that I was allowed to leave the building during those hours.  The nurse was sure to remind me that – at least until they got to know my patterns and behaviours – I would not be permitted to leave without supervision.

After the nurse told me all she set out to tell me, I found myself alone in my room, desperately wanting to go home.  I knew there was a common room where I could entertain myself with board games, cards and fellow crazy people, but I wasn’t particularly interested in any of it. 

As I was lying in my new bed crying, Evie came in and started talking my ear off.  She spoke incredibly fast, and it was sometimes difficult to understand her.  She’d ask me all kinds of questions, but she never gave me enough time to answer before she moved on to the next one.  She was very friendly, and wanted to introduce me to everyone else in the ward.  I didn’t want to make friends.

That hospital had been home to Evie for over six months by the time I met her, and she had no idea when she would be allowed to leave.  Unlike me, Evie wasn’t there voluntarily.  Even more unlike me, she was more than happy to stay.

My first meeting with the doctor was pretty uneventful.  He asked me the same questions the nurse already had, and set up some appointments for the upcoming days – blood work, electrocardiography and an MRI.  He also gave me a few questionnaires to fill out, to help with coming to a diagnosis.

In the afternoons and evenings, I was lucky enough to have friends come and visit me.  I don’t think I spent a single afternoon alone.  That helped keep me sane, but also reminded me of how much I knew I didn’t want to stay there anymore.

At the end of the day, I just felt like the hospital was not the place for me to get better.  Being surrounded by so many people whose mental afflictions were much more severe than mine just reminded me of where I might end up one day.  I didn’t like that constant reminder.  For me, it was easier to imagine myself living a normal, happy life if I was surrounded by normal, happy people.  I felt like the hospital brought me further into my illness instead of bringing me to a point where I believed I could combat it.

This is not the same for everyone, as I learned from Evie.   She improved there.  She actually got the help she needed there, because it was the best, most comfortable option for her, and she wanted it.  She needed the stability.  She needed to be woken up every day.  She needed to meet with doctors.  She needed to have her meals prepared and placed in front of her three times day.  She needed routine created for her, because if left to her own devices, she’d never have it.  I didn’t feel that was true for me.

I decided one week was enough.  I was checking myself out.  The doctors and nurses tried their best to convince me to stay.  They reiterated again and again that constant observation and supervision was the best way to diagnose me.  I agreed.  However, I protested and stood my ground.  I was leaving.  I didn’t want to risk coming to a graver diagnosis, and I felt that was the only possible outcome if I stayed at the hospital.  With reluctance, they wrote a synopsis of my stay and passed all necessary information onto my psychiatrist.

I left with a diagnosis of “suspected bipolar disorder, type 2”. Several months later, I finally made a follow-up appointment with my psychiatrist.  Several months after that, I was diagnosed again.  This time, with schizo-affective disorder.  And thus began my “recovery.”

Do you love someone with depression?

lovesomeonewithdepression

I’m working on writing an article from the “outsider’s” perspective.
IE: the significant other-, the close friend-, the relative- of a person with depression.

If anyone could volunteer their input on this, I’d be ever-so-grateful! Either comment here if you’re comfortable with open discussion, or send me a private message or email (23brokeandhappy@gmail.com).

QUESTIONS TO CONSIDER:
-when did their depression begin?
or, had it always been going on?
-how did you recognize their symptoms?
-did they reject support/treatment at any stage? if so, how did you react?
-did you approach them, or had they already sought help?
-what was the most difficult thing for you to understand?
-what hurt you the most to see or hear?
-is there anything you wish you had done differently?

AND MOST IMPORTANTLY:
-what’s the number one thing you hope they always remember?

THANKS GUYS!! xxx
(if you could SHARE THIS, i’d greatly appreciate it!
I’d like to get as many responses as possible to paint a relatable picture.)

love you aaaaall!!
Becca