The Ultimate Selfish Act

The Ultimate Selfish Act

This is how I have heard various people; individuals and mental health professionals alike describe the act of suicide.  I do not hold myself to be an expert, but I have had some experiences in my life that would give me cause to doubt the veracity of this widely held belief. 

Treating people on the psychiatric unit is very different from knowing what they are going through, but when a patient talks, I listen.  Some things become evident very early on in the conversation, some other things take some time to draw out.  I have seen more than a few teens come on the unit after a “suicide” attempt because their boyfriend/girlfriend broke up with them. I placed suicide in quotations because that is what we term it as, but the method used (usually an overdose of Tylenol) does not meet the level of a genuine attempt.  A few Tylenol will make you sick, but will not kill anyone.  A lot of Tylenol will make you very sick, and may kill you eventually of liver failure, but will not kill anyone right now.  But I digress, it is evident pretty quickly that this is more a cry for attention, an attempt to manipulate the boyfriend/girlfriend to come back to the relationship.  It almost never works, and if they do come back it is only temporary.  But since the stakes are high, every attempt must be met with equal seriousness.

Then there is the impulsive suicide attempt, again, usually seen in teens.  This attempt is usually met with gravity; the teen really did mean to end their life.  This is a sign of immaturity rather than a desire to end life.  The teenager often is unable to grasp the real consequences of their actions, and often has other issues at play, such as impulse control.  In both cases, there may be the thought “They’ll be sorry when I’m dead.”    In both cases, I would give credit to the statement “Suicide is the ultimate act of selfishness.”  And that is where that ends.  Children are inherently selfish, it takes a lifetime of learning to know what it is NOT to be selfish.  It is something we are born with, a survival skill.  At 48, I am still learning not to be selfish. 

The vast majority of suicide attempts, and the ones who are successful, however, are not selfish.  It is an act of desperation, an act of a life so unbearable that killing themselves seems to be the only answer.  From the outside, a person’s life may not appear unbearable.  This is the mask we show the world.  All of us do it; we have a miserable night at home, but wake up the next day, go to work with a bright happy smile on our face.  It is not acceptable, nor professional to allow our personal pain to be known, so we might pay a counselor.  That is, if we even allow ourselves to admit to ourselves there is something wrong.  Many more people suffer in silence, hidden away far from even those closest to us.  When they attempt suicide, or succeed in killing themselves, it is a shock felt through everyone who knew them even in passing.  The pain was hidden so well that no one knew the extent of the suffering.

We need to allow that people do suffer; there is pain in this world.  We need to allow people to be human, to acknowledge when there is pain.  Until we do, we cannot begin to treat the darkness that consumes someone who feels suicidal.  Most of all, we need to acknowledge that suicide is not a moral weakness, a flaw in character, that it is the result of a disease process that was not treated in a manner compatible with life.  That’s right, suicide is the end result of a disease process.

Not so very long ago, a cancer diagnosis was enough to strike terror into the heart of everyone who heard the term.  It was, for the most part, a death sentence, which was carried out only after a great deal of immeasurable pain and suffering.  Often, the treatment, the hope of a cure even, was worse than the illness or prospect of death. The pain so great, that in some cases, the person chose suicide over prolonged exposure to pain.  No one judged the person who chose to end his or her life early; the suffering was evident and horrific.  Cancer was a terminal illness.  Now, we have better treatments, we have acceptable pain management when end of life is near, and we do have hope of a recovery for some people.

People who suffer from long-term mental illness, from depression or other conditions are very much like those early cancer diagnoses.  The difference is that in general, the suffering often is minimized or goes unrecognized.  When suffering is acknowledged, a number of various judgments are placed on it.  There are many people who believe that “just pull up your boot straps and move on” is an effective mantra for “the blues.”  The treatments can at times be worse than the illness itself in extreme cases.  The medications have side effects, and there is a stigma associated with taking them.  Men are at greater risk than women, because men view emotions as weakness, and are less likely to seek help.  Some people are tortured for years, and the emotional pain is unrelenting.  They try to mask it with work, drugs or alcohol, but sometimes the pain is too much.  Some people are so good at masking the pain that they just keep on functioning until the day comes that they can’t any longer. 

Many years ago, I was misdiagnosed as Bipolar.  Being the highly motivated person I am, I did everything in my power to embrace being well.  I took the medications, I attended counseling, but the problem was I kept getting worse.  I was getting worse because I was being treated for the wrong condition, but the medical professionals determined that I needed more medication.  So I was prescribed more medications.  This induced a state in me that was so indescribably painful; I have nothing to compare it to.  The emotional pain was wrenching.  It was as if I had just been told my child had died, and that initial wave of grief and despair that hits just stayed.  Grief occurs in waves, the pain washes over you, and then you have a moment where there is relief.  As time goes on, those moments of relief are longer, and the waves of pain are less intense.  The emotional pain inflicted upon me by the medications was so intense that nothing gave me a moment of relief, and it endured for an eternity. 

I could no longer remember what it was like to be happy; there was only the pain and darkness.  Most people abandoned me, for reasons I don’t judge, but a couple of friends remained with me.  They listened.  I remember telling my friend that I didn’t really want to die, but I didn’t know how much longer I could live with this pain.  I wanted to be better, but I had no hope.  I not only considered suicide, I attempted it.  Thankfully, I lived.  One of my friends was my advocate, she knew something was wrong with the course of treatment the doctors had decided upon, but didn’t know how to get me help.  We tried different doctors until one of them had the good sense to take me off the medications and see what happened, because it couldn’t get much worse than it already was.  By the 3rd day of hospitalization without any meds, I awoke feeling better than I had in a very long time.  I was far from well, but I could think again, I didn’t feel as much emotional pain, and I started on the very long journey to get my life back again.  The wrong diagnosis had destroyed pretty much all of it.  The best part is, there has not been one thought of killing myself in all of the years that have followed. 

When I attempted suicide, it was not the act of a selfish person.  It was an act of such desperation that I could no longer live in the condition I was in.  I believe that people are suffering to a degree that we cannot imagine from looking at them across a desk at work.  For me, the solution was simple, remove the medications inducing the state, and there was no more pain.  For others, solutions may not be simple, but they are available.  There is foulness in the air right now.  I feel it.  I hope that the wind will change, and we will return to a more optimistic state.  But right now, people are suffering and in danger.  Today, I was informed of another suicide, that of a 15 year old boy.  Yesterday was the suicide of a young woman.  It is becoming epidemic.  I personally know of 2 suicides this week alone, and it is in my personal life, not from work.  We must be more aware of the people around us.

The Internet fosters a false sense of intimacy.  I have over 500 “friends” myself.  There is a superficial intimacy that occurs in the feed, people you talk to and seem to get the feeling that you know them.  It is replacing real human interactions.  It is easy to be friends with someone on the Internet; they will never call you on being stupid.  They often support you, and offer helpful suggestions.  It is a safe place to foster these friendships because if you are feeling unsociable, you simply close your browser.  You don’t have to interact with someone who even has an opposing view from your own.  It is a world you create, and play a persona you want to be. 

It is the real people in your life that support the intimacy and connections we need for the human condition.  The chat with your neighbor, having coffee with your coworkers, or lunch with a friend is what we need to have.  These relationships are falling away in such little bits, we are hardly aware of it.  When was the last time you talked to your friend, mother or sister?  Do you really know what is going on with them?  Would you be able to recognize a tiny shift in the way they look or talk?  Would you be surprised if they took their own life?  We used to know people so well, that if our best friend was having a bad day 3,000 miles away, we would know it by the tone in their voice.  How many times has it been too long since you talked to the people in your life you care about?  Sure, we are all “busy” but now “busy” can be a veil for depression and loneliness.  Reach out to the people in your lives, for that may be all it takes to recognize someone is in trouble and needs help.

Suicide is a permanent solution to a temporary problem.  It is also the result of a disease process that can be averted with proper treatment.  Most treatments are successful with enough perseverance.  We have a long way to go toward decreasing the number of suicides resulting from untreated, or poorly managed illness, but we can get there. The consequences of not receiving treatment are suicide for the person suffering, but once they have committed suicide, their suffering is over.  The suffering of everyone around them is just beginning, and will continue for years to come.  Children of a parent who has committed suicide are much more likely to commit suicide themselves.  This is a terrible legacy, and some think it is because the children see suicide as acceptable.  I think it might be because the children may be suffering from the same untreated illness as the parent.  We need to rethink how we view people who are in trouble.  We need to regain the connections we have let slide by so we can recognize when someone we love is suffering.  We need to learn to live our lives with people in it, and not let the Internet substitute for human connection.  It is a false sense of connection that could prove to be deadly for someone suffering.