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With the launch of 988, the new mental health crisis hotline, I’m looking back on my days of chronic suicidality and my four suicide attempts. I regret the suffering I put my family through and I’m fortunate that none of the attempts proved to be fatal.
The introduction of 988 and the ease of dialing just three numbers to reach the National Suicide Prevention Lifeline represents a major step forward in providing crisis services to people in need. The old number consisted of eleven digits which were no doubt difficult to remember in times of a crisis and could even deter people from calling if they had to stop and look it up, stealing precious energy.
As the New York Times reported: "Anyone experiencing a mental health or substance use issue can call 988. Counselors on the other end of the hotline are trained in handling a wide range of mental health issues, including self-harm, addiction and suicidal ideation, said Hannah Wesolowski, chief advocacy officer at the National Alliance on Mental Illness.”
One of the hallmarks of borderline personality disorder (BPD), with which I was diagnosed in 1990, is chronic suicidality and self-harm. Fantasizing about suicide was a coping mechanism for me. I’d spend hours figuring out how I was going to kill myself, much in the same way I imagine other girls spend hours planning their wedding.
During a severe depressive episode I endured from 2006 through 2008, I’d just started with my then psychiatrist, Dr. Lev, in transference-focused psychotherapy (TFP). I sat across from her and spouted plans to kill myself that were so detailed in nature that she had no choice but to hospitalize me. I was admitted six times in 18 months during that period and received a course of electroconvulsive therapy (ECT), which worked initially, but was not able to sustain the reprieve from my depression. During what would be my last admission, I snuck into the hospital—past the security guard who checked my person and my possessions—several straight-edged razor blades, which I intended to use to kill myself while in the hospital. Instead, I ended up just cutting my belly and arms, which as you could imagine still caused quite a furor. I was immediately put on one-to-one observation, which was a royal pain in the ass.
My most recent attempt occurred in 2014, 11 months after my father passed away, borne out of the rage and resentment I never was able to express toward him. I’d convinced myself I was a terrible person and didn’t deserve to live. Around Thanksgiving, I wrote the essay, “Eight Months After a Suicide Attempt":
“Nine months ago, in February of 2014, I covered all of the mirrors in my apartment because I couldn’t stand the sight of myself. The white sheets had tiny blue sailboats on them and when I brushed my teeth in the morning I saw a fleet of ships setting sail for the ocean’s depths. The nautically-themed set of sheets were a spare I had stored in my linen closet in case a friend needed to stay overnight on the couch. Which hadn’t happened in years.
I hated myself so much I couldn’t stand to glance at my reflection. I hated the sight of my eyebrows and how they were imperfectly arched and asymmetrical. I hated my unruly dark hair that had turned dry and frizzy after menopause. Most of all I hated what was on the inside; the person that lurked within that ugly shell, the one who was never able to live up to her father’s expectations, who had never been able to fall in love and who at that moment believed she had totally screwed up her life."
I’m recovered from BPD now. I can’t say the suicidal thoughts have totally disappeared. I still get them in times of great stress. When I had my stroke in the spring of 2018, which left me with cognitive deficits, I wondered if I would be better off dead if I couldn’t get my brain working again. Today, there are times, when I have fleeting, intense thoughts — almost flashes of suicidal thinking, but I have confidence I won’t act on them. If I even get close, I know I would reach out to Dr. Lev, who still manages my medications and with whom I check in a couple of times a year, before I hurt myself.
It’s almost impossible to describe what makes one cross the line from fantasizing about suicide to acting on the thoughts. I know that for myself, it wasn’t so much that I wanted to die; it was more about wanting the emotional pain to end. I have multiple medical conditions and when my depression has been at its worst (and when my depression is severe, I become psychotic as well), I experience physical pain that is worse than any physical pain from any of my other conditions. I try to impart this to my physicians whenever possible, especially if there is an intern in the room.
Kay Redfield Jamison, author of the memoir An Unquiet Mind, wrote an eloquent op-ed piece for the New York Times titled “To Know Suicide” in 2014, shortly after the death of the comedian Robin Williams. In it, she communicated the horror of suicidal depression:
Suicidal depression involves a kind of pain and hopelessness that is impossible to describe — and I have tried … How can you say what it feels like to go from being someone who loves life to wishing only to die?
Suicidal depression is a state of cold, agitated horror and relentless despair. The things that you most love in life leach away. Everything is an effort, all day and throughout the night. There is no hope, no point, no nothing.
The burden you know yourself to be to others is intolerable. So, too, is the agitation from the mania that may simmer within a depression. There is no way out and an endless road ahead. When someone is in this state, suicide can seem a bad choice but the only one.
