Saturday, 16 February 2019

The Search for a Deeper Understanding of Suicidality

quote [ “Suicide,” goes the popular expression, “is a permanent solution to a temporary problem.” [...] This tends to be the prevailing narrative around suicide and suicidality— [...] The problem with this, though, is the obvious reality that some problems really are permanent [...] We may, with the right therapy or psychopharmacological help, change our perspective of such problems so that they don’t cause us so much ongoing distress. But not all problems fade with time; some actually do get worse. It should not be irrational to acknowledge this existential fact, and yet it remains stubbornly difficult to talk about. ]

Related to this recent post I found interesting.

I believe that if people have a right to live, they have a right to die as well. I believe the reasons may seem objectively rational, but they don't have to. A subjective reality is still objectively experienced by the individual, and if it's bad enough, I can't blame them for taking the only route of escape they can see available.

Should we work to prevent suicide? Yes. That means getting people to choose to live because they actually want to, not by guilting or shaming them, but by actually changing their experience whether those changes are internal, external, or both.

It isn't right to force people to live just because we're uncomfortable. To say our grief or burden is greater or more important than that of the suicidal is at least as selfish as we often claim the suicidal are. Who are we to condemn, to demand someone to suffer for our own convenience? In those terms, it's obviously unethical.

These are things people have a hard time talking about or reasoning through, but I think we have an obligation to try. I also think SE has enough brain cells to rub together and enough people who deal with this issue in some aspect that its users might have insightful and meaningful things to say on the topic.
[SFW] [health] [+8 Insightful]
[by snowfox@8:24amGMT]

Comments

hellboy said @ 1:56pm GMT on 16th Feb [Score:1 Insightful]
Thanks for posting, this is a great article.

Our culture has a very difficult time talking about or dealing with death in pretty much any form, much less the self-inflicted variety. The article makes a good point about the permanence of problems (therapists and self-help coaches regularly make the argument that you're not going to solve your problem, you're just going to learn how to manage it - maybe). And you make a good point about the right to die - a good friend of mine's parents committed joint suicide when my friend was a young adult because of unsolvable medical issues. Was it hard on my friend? Very - but they did their best to minimize the impact, and my friend understands and respects their decision.

The article mentions that one of the problems with depression (and the cognitive distortions that come with it) is that it warps perspective and leads to bad judgment. I just heard Sigrid Nunez on NPR talking about her novel about the aftermath of a suicide and she said that one thing she discovered in her research was that many people who survived a suicide attempt reported immediately regretting the decision once they'd jumped or otherwise crossed the point of (usual) no return. It could just be a survival reflex, but that sounds to me like a pretty awful way to spend my last few moments. There's apparently a website on the internet somewhere that gives detailed and accurate instructions on how to kill yourself - but is also punctuated by suggestions that you wait an hour or a day before the next step (what have you got to lose?), with the strategy of delaying the final decision until it doesn't seem so compelling.

I think you're right that changing the experience is the best way to deal with depression and suicidal ideation - but of course that's often very difficult (certainly more difficult than guilting or shaming), as my friend's story shows.

I liked this bit a lot:
Indeed, for so many of us—especially us rationalists—it is this shared appreciation of the fundamental meaninglessness of life, of the funny tangibles of chaos, of being momentarily alive as the fleeting, flawed creatures we are that, ironically, offers us the greatest hope against suicide. What other choice do we have? Sometimes, we have to embrace the absurdity of living to survive our own sanity.
steele said @ 8:04pm GMT on 23rd Feb [Score:1 Insightful]
5th Earth said @ 1:49am GMT on 17th Feb
For a significant period of my life, before I was formally diagnosed with chronic depression, I held the perspective that the primary reason not to kill myself was that I didn't have a reason to. Not, I wanted to live, just, I didn't think my life sucked enough that I could justify dying.

From a chemical standpoint, the idea that "it's not going to get better" rings very true. I've been mostly on medication in the roughly 20 years I've been taking Prozac. Stopping it for any significant length of time always leads back into depression. I've come to the conclusion that I can successfully treat the condition but I'll never be "cured".
Onix said @ 5:47pm GMT on 18th Feb
I am suicidal myself. My life sucks and there are no things worth mentioning in it save for great kids and a great girlfriend. Those are the things that keep me afloat until I get better.
snowfox said @ 9:27am GMT on 22nd Feb [Score:2]
You're not alone in that. I have frequent suicidal thoughts. In a strange way, sometimes they can be empowering. If I continue to live, that's my choice and one I've made consciously. I'm not just living by default or out of fear of death.

Of course, I don't have kids or a significant other, so I have different motivations.

I can't tell anyone close to me that I have these thoughts and feelings without them flipping out and over-reacting (and subsequently making it worse as a result). So I either have to hide this big part of myself from everyone close to me or just not let anyone get that close. Medical professionals especially can't ever know; the number of ways the world can and will punish someone for admitting to suicidal thoughts is staggering. Can't get medical treatment, can get locked up and have freedom taken away, can be put on watchlists, can lose the ability to own weapons, get a security clearance... it's less like anyone cares, and more like they just really hate to be inconvenienced by the existence of someone like that. Pretend to be happy or at least don't burden anyone with your existence or face the consequences.

Is your experience similar? Can you tell people close to you? I suspect it would be different for men than women. Involuntary commitment has long been a weapon of choice against women who dare to be unhappy for some reason... for men the weapon of choice seems to be prison. Women are hysterical, men are criminal.
Onix said @ 6:42pm GMT on 23rd Feb [Score:1 Interesting]
Hi Snowfox. It's been a while. I can relate to that situation of not being able to share my feelings. Most people flip out like you say or tell me things like "be happy, do something nice" or my favourite "ride a bike". I actually called a suicide line back then and I also gave my girlfriend a call fearing the worse. I am moving back to Mexico City in a couple of months and will get some professional help.

The problem I have is pretty complex since it doesn't just involve depression and suicidal thoughts. It comes with a brain injure I had since I was born. I am taking tegretol per medical prescription, but that doesn't help a lot now, since it seems I am getting worse. Believe me, it's no better for me being a man, particularly here since they expect you to be strong and all that. I have lived with an incresingly bad problem all my life and my family and previous partners just seemed to make it worse and worse with their lack of understanding and preparation to deal with it. And I can't tell my kids, because I don't want to screw them up more than they probably are (they are turning pretty good by the way).

In the end, yep. I choose to be alive too, but not because of me, but others that I think need me. For example, who's gonna take care of my dogs? How can I leave my kids now that they are teens and they need me, even if they are in Mexico City now.

I guess the most complicated thing for me has been the lack of self appreciation and lack of success complicated with a lot of failures piling up. And borderline poverty also.

But you know, if I may say it, you are pretty young and have a chance to get better. Myself, I feel that every time I reach rock bottom I dig even deeper and deeper.

Sometimes you are just too old to still have hope for a better day. Those days are over for me I guess.
snowfox said @ 12:16am GMT on 24th Feb [Score:2]
Thanks for sharing. I'm sorry to hear about the brain injury. I hope your kids lead good lives. Your dogs too :)
Onix said @ 9:30pm GMT on 25th Feb [Score:1 Informative]
Thanks Snowfox. I wish all the best for you. You know what I think my deepest problem or source of frustration is? It's perhaps the fact that I was born with this thing and I will never know what a normal brain is like. I'll never find out that.

But, again, really, all the best for you.
snowfox said @ 3:42am GMT on 27th Feb
That is a shitty feeling to have. I respect the resilience it took you to make a life for yourself. You may not have a normal brain, but you're doing things that people who don't have brain damage can't manage, and I'm counting myself among their ranks.

Thanks for the well wishes.
arrowhen said @ 5:58am GMT on 24th Feb [Score:1 Insightful]
So, you've been fighting your whole life and managed not only to survive yourself but also carved out a situation in which the children and animals in your care could thrive. That's been the basic standard of success since pretty much the dawn of time and it's only been in the last tiny sliver of human history that a few soft assholes who never had to stuggle a day in their lives decided to add some bullshit money score on top of that and call *that* success.

And even today, if you were fighting off packs of wolves or whatever to keep yourself and your family alive, everyone would be all, "damn, that guy is a total badass!" But wolves are easy. You've been fighting against *your own brain* trying to kill you! That's the stuff of legends, or would be if we'd had the slightest clue about mental health back when we were making up legends.

Also, your teenaged kids won't need you as much 10 years in the future as they do now, but they'll need you even more when they're 35 or 45, so you might want to think about getting more dogs to keep you busy until then.
Onix said @ 9:26pm GMT on 25th Feb
Yep. I am concious of the fact that I can be called "bad ass" or maybe "resilient". And I know that's pretty cool and all that, but something in my head won't allow me to feel it and feel that it is right, even when I am aware of all that. That's the problem most people with mental issues face in modern society I guess. The stigmatization of it all.
arrowhen said @ 12:04pm GMT on 22nd Feb
Not the person you replied to but it's been years since I've had *frequent* suicidal thoughts. But I still have them more often than I'd like.

I also occasionally think I'm really fucking awesome.

In reality it's unlikely that either of those things are true: I probably don't *really* want to die and I'm probably only a *little bit* awesome.

I absolutely 100% couldn't tell anyone I'm close to any of this, and really I wouldn't even mention it on SE except I'm shit faced drunk and replying to an old-ass post.

Also, as an occasionally slightly awesome person I think I know a little something about awesome people, and in my expert opinion you're one of them. Obviously that's only based on the random shit you've typed at or near me on the internet, but that's enough.

If you're ever feeling suicidal you're factually incorrect, and the only correct response is, "fuck that noise, arrowhen says I'm rad!"
snowfox said @ 3:06am GMT on 23rd Feb
I love you too, man.

If I had to guess, I would say most of SE and at least half the internet has these thoughts. There has to be a motivation for wanting to connect with people you don't actually have to see or be around...

I'm still waiting for an official block feature on SE that will never come. Some people on here just upset me and my experience would be so much happier and more pleasant if I just didn't see them or have to think about them existing somewhere. This is why I like Facebook XD I can even keep people on my friends list and talk to them directly about their lives but not see their political posts.

At some point, there is nothing productive about or anything to be gained by seeing things from people whose views will not change, will not change my views, and are fundamentally abhorrent to me. Why look at things I know will upset me when I have enough to be upset about already? But I am still happy to share recipes and cat pics with them.
mechanical contrivance said @ 2:08pm GMT on 25th Feb
And cat recipes.
snowfox said @ 3:49am GMT on 27th Feb
Shhhh don't tell Marcus Aurelius. I've been aging him for almost 13 years now and I don't want him to die from shock before age 15 when he gets really prime.
daffyduck said @ 9:36pm GMT on 22nd Feb [Score:1 Insightful]
I have decided that as long as my parents and my pets are alive, I will be too. After they are gone, all bets are off.
Onix said @ 7:01pm GMT on 23rd Feb
My kids, my girlfriend and my dogs are what keeps me alive. I lost my mom last year.
mechanical contrivance said @ 3:46pm GMT on 19th Feb
Have you seen a doctor about it?
Onix said @ 6:45pm GMT on 23rd Feb
Hi Mech. Yep, under treatment for a while. Just doesn't seem to work anymore.
mechanical contrivance said @ 2:05pm GMT on 25th Feb [Score:1 Good]
Maybe you need a different treatment.
Onix said @ 9:32pm GMT on 25th Feb [Score:1 Good]
I am getting in touch with a psychiatrist as soon as I am back in Mexico City. That's for sure Mech.
biblebeltdrunk said @ 11:10pm GMT on 25th Feb
BTW, Does any one have any tips on sites that deal with what to say to suicidal friends after you have gotten them to talk to a professional? I have gotten a few of my friends to talk to the Trevor Project and the like but don't know how to have follow up conversations.
snowfox said @ 3:48am GMT on 27th Feb [Score:1 Underrated]
If you got them to talk to a professional, that's probably a lot already. Just listen to what they have to say.

I won't go see a professional out of a severe lack of trust and an unwillingness to pay someone less intelligent than I am to tell me stuff I already know or can look up.

I don't know if it's typical, by from what Onix said above, I think it might be. The biggest thing for people who have suicidal thoughts is to just be able to tell people that and not have it blow up in their face. The reaction I really want to get when I tell someone is for them to shrug, "Man, that sucks. Wanna go play a game?"

I don't think most of us are looking for deep sympathy or even to get rid of our suicidal thoughts, we're looking to not be treated like freaks, shamed, boxed in, and defined. We just want to be accepted for what we are and know that people won't abandon or hurt us because of it.
biblebeltdrunk said @ 1:17pm GMT on 27th Feb
I guess i'm more looking for the tact for handleing bad situations. I just hate feeling like I'm makeing it worse by overbearing on the consern. Even when all I am doing is makeing sure they have someone actually qualified to go to in emergencys and being there if they just want to vent or to just hang out with.

It also sucks seeing so many of my freinds struggle with dysphoria because I haven't been able to act on addressing it myself. I feel like a walking reminder of why thier life sucks, rather then it letting me emphasize.

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