Saturday, June 27, 2009

Choose to Reach Out For Help: That is Truly a Choice

Today's post is a philosophical look at suicide and life. I believe, in most instances, choosing the latter over the former even when in your bleakest, blackest moments is both the moral imperative and the choice people would make if they were feeling well. This is my opinion, but I believe there are good reasons to hold this belief. I hope the reader sees those too.

I am a great proponent of personal choice. I do not believe the State has any business interrupting a person's choice to do whatever it is they wish with their body and their life. As long as you are making your choice of your own freewill, and your choice is not harming another human being, or any sentient being, you should be able to do what you want in any given situation.

Your choosing to commit suicide may seem like it should be your choice. It is after all your body, and your life. In some instances, I believe it truly should be your choice. However, in many, probably most, instances suicide both is not a fully informed choice, nor is it one of those choices in life that harm no one else.

Even a Libertarian, those avid endorsers of freewill and choice, might agree. I suggest this because based on my initial criteria: "You have the right to choose any action as long as it is a choice based on freewill", and, "As long as it harms no other sentient being". Suicide as a valid, moral choice is limited by both.

Is suicide a choice based on freewill? I argue most times it is not. I say this in a moment of clarity, in a moment where suicidal thoughts are not floating through my mind enticing and often imploring me to end my life. Many times over the years (even a few days ago) I would have argued the opposite. When my brain is thinking clearly I can see living is important for so many reasons.

When I feel well, or even if I have brief remissions from my symptoms, I recognize my capacity to "choose" suicide is severely limited by my depression and its symptoms. It is not me who chooses to end my life. It is my illness.

I never plan or decide to commit suicide, or have suicidal ideation, or start pulling out all my hoarded meds, or plan to hang myself when I am thinking clearly. I do these things, think these thoughts, when my illness takes hold of my brain, when it renders me helpless and makes my life seem worthless and hopeless. When I believe suicide is a choice; when I believe I should be allowed to decide to die, I cannot truly choose because reason has left my mind and fear, sadness and desperation have taken over.

The scary thing is the thoughts and plans seem perfectly reasonable, and of my own freewill, at the time. It is only afterwards that I understand my capacity to choose has been impaired by my depression and my cycling mood. I cannot tell the difference between reason and false reason while in the midst of my suicidal sufferings. This is where I have learned to listen to my friends and my psychiatrist, Dr. X. I understand my brain is not "well". I need medication and therapy and extra support. I have learned that when my mind is moving, or stuck in this direction, I need external support and help. When depressed, mentally unwell, or thinking about and planning suicide I need to trust and accept an other's support and opinion.

What about the criteria of not harming another sentient being? The choice to commit suicide, actually the action of committing suicide, cannot fulfill this criteria either.

A very close friend's father committed suicide when my friend was 9 years old. He is 43 right now and he thinks of his father's suicide, is saddened by it, every single day of his life. His father's suicide led to a chain of events that may have been avoided had his father sought treatment and support rather than hang himself.

I won't go into details, but every single person in my friends family, and his family's life has been devastated by a choice his father made while his father was severely depressed. The sad thing is his Dad should have known he was not thinking clearly. His dad was a psychiatrist.

Even professionals who treat others with depression, or any mental illness, may lack the capacity to reason, to clearly choose, when it comes to their own suicidal thoughts, urges and actions. The thing is there are always people hurt and affected when a person commits suicide.

I know in my darkest moments I have sat down and written letters to my family, believing I could explain why I needed to go, and how they would eventually understand that my "choice" was best for us all. I have been so sick that I didn't care if I affected others; times where I kept thinking over and over again I just cannot take it anymore.

When I become less depressed I see how much my suicide would impact those I love. Even if I have no one, which in my depressive episodes has sometimes seemed the case, maybe my death would impact others I am not yet aware of, others who need me, or want me to live.

When depressed, or mentally ill the brain sometimes attempts to, and sadly too often succeeds at, telling us suicide is a choice; that it is the right choice, that it will not harm others. This is an illusion. The choice is not free, nor is it true others will be left unscathed.

Please, please, please...before you make a decision that is not really based on freewill and unbiased choice, a choice all too informed by depression, or an untreated/or undertreated mental illness; before you make a decision that will devastate the people you leave behind (and it will) please seek help.

There are family doctors, therapists, social workers, nurses and psychiatrist who really care about people struggling like we do. I know because I have a psychiatrist who makes my worst days survivable and sometimes even worthwhile because I am able to learn something about myself and others.

Please seek help. Every human being deserves to want to live, to have the option to live, and to build there sad or difficult life into a life that is worthy of their beautiful selves.


The Silent Voices in my Mind said...

Aqua - this is beautiful and powerful. I will have to give a lot of thought to the informed choice part - who's to say that the good moods aren't just as biased as the bad? But I certainly concur that suicide is devastating to the people left behind.

Every single day for years on end, I have had to make the conscious choice to live. I do it against my wishes. I don't want to be here and no matter how many lists I make on good days or bad ones, it always comes to the point where I don't want to be here anymore. I cannot recall a single day since Christmas morning of 2006 that I didn't wish to be dead and before that it had been a great long time since I wanted to choose life.

However, I have four young children and I have read the studies and the statistics on the effects of parental suicide on children. The subsequent suicide rate in those children is through the roof and even when they don't get to that point, they are set up for a lifetime of emotional struggles.

I love my children more than I hate life. So every day I choose to stay alive. I do it for them and only for them. I sometimes wonder if I will ever get to a point where I want to live rather than feeling I must not commit suicide in order to protect the children. Will I ever wake up and be glad that I am alive because I want to live?

I don't know the answer to that one either. But for now, what I have is enough to keep me alive and, according to people I have talked to, that's better than nothing at all.

Ironically, the only thing keeping me alive, which by most accounts isn't as much as it "should" be, is the very thing keeping me from getting help. Because admitting the depth of my pain and the fine balance of my struggle would end up hurting my family. They need me to be there and "happy" and functioning and when I end up in the hospital or being closely watched at home causes them pain, confusion, and logistical complications. And whether it is "right" or not, they judge me and some of them judge me quite harshly.

So it's a paradox: I live in a perpetually suicidal state yet the very thing keeping me from following through is the same thing keeping me from getting help...

Aqua said...

Hi SV,
I agree there are so many paradox's when it comes to suicide. I am one of those whose extremely good moods may be almost as ill informed and biased as my bad ones...I believe that can be true for many who become manic/hypomanic.

Your comment is heartbreaking, yet awe inspiring in so many ways. I love that you are powerful enough to choose life over all those awful urges and that you recognize your suicide would devaste your children.

I believe you can find treatment that would both help you and not harm your kids though. There are so many types of outpatient treatments; like a pdoc who would se you on a very regular basis, community based treatments that help you build the life you want (like my art clubhouse program)...there are all kinds of programs out there.

I am sad you continue to struggle (and I truly understand how that is, because I do too), but glad you have choosen to live and push forward.

The Silent Voices in my Mind said...

Thanks for the support, Aqua. I do see my therapist every week and my pdoc about once a month. The last time my pdoc found out the degree of my suicidal urges, I was hospitalized. I was there for 3 weeks until I finally started lying to them and saying I was feeling better. I did this because they were going to send me to a long-term care hospital 3 hours from home and I would be there a minimum of three months.

My family and friends get irritated (and worried) if they find out I have any suicidal thoughts. They blame me for them and make comments that boil down to their belief that I get suicidal by choice and I can simply "decide" to not be that way. I wish they were right - it would be so much easier...

But on the plus side, at least my reason for staying alive is strong enough make sure I do exactly that. Every day, I choose life. That's something at least.

BTW - I'm really glad to hear that you are back to a place where you don't feel suicidal. Good for you!

Harriet said...

I have already made up my mind to die if things don't change through therapy over the next year or so. But I have fantasies of the police showing up at my door and telling my husband and kids that they found my dead body and what kind of reaction and ramification that would bring to my family. As much as I think they'd be better off without me, it still pains me to have these fantasies.

Aqua said...

Hi Harriet,
I have those fantasies too. Right before I read your comment I was staring at my bookshelf thinking both how I could attach something to the top to hang myself from, and visualizing how I would look hanging there (whether it would work, how hopefully I could somehow minimize the impact on other's finding me etc.

I hope when the year ends, and next year and the year after etc., even if you are not well...I hope you are still here. You may not see how important you are to others, but you are. Your strength helps me keep trying.