Long Hard Road Out of Hell: Suicidal Thoughts and Suicide Prevention

I want to fly into your sun
Need faith to make me numb
Live like a teenage Christ
I’m a saint, got a date with suicide

I am chronically suicidal. There are times when I am in crisis and I am not safe, and there are times when it is just a fleeting thought in the back of my mind. Most of the time I can push the thoughts back and focus on the now. My life is about getting through moments and living in the moment. Because when I look at the big picture, my past, my present, and my possible future, I don’t understand how I am still alive, why I am still alive and why I should keep on fighting. It is in those moments, the ones that I call moments of clarity, that it becomes dangerous. I look at my life from the outside and realize that everything is so messed up, so hopeless and trying is so useless. It logically makes sense to end my own life. That is when I start planning, writing goodbye letters and am determined.

There are other times when I get triggered into a flashback and get reminded of the abuse and trauma of my past in a very direct way. That is when I need it to stop. I don’t want to live with that past, I don’t want to ever be reminded of that past again and I need to put an end to it. Those are the moments when I don’t have much control about what is happening and when impulsive suicide attempts happen. A flashback raping your soul, raping your mind. And you want to get rid off that abuser, but you can’t because it comes from inside of you. So the only thing that makes sense is to get rid off yourself.

But most of the time, I manage to focus on the now, and on distracting myself. Then, the suicidal thoughts are passive, are not an active risk. I don’t care if I live or die. I don’t want to be alive but I also don’t want to put any effort into actually doing something about it. That is a state of normalcy for me: suicidal ideation.

My suicidality also gets very much affected by my bipolar disorder. When I am in depression and mixed episodes, it becomes more acute. In hypomania and during stability, it is only a buzz in the background.

Oh Mary, Mary
To be this young is oh so scary
Mary, Mary
To be this young I’m oh so scared
I wanna live, I wanna love
But it’s a long hard road, out of Hell
I wanna live, I wanna love
But it’s a long hard road, out of Hell

I am aware of that many people can’t relate to this level of suicidality. But as a survivor of extreme trauma and abuse during my childhood years, someone with serious mental illness, many physical illnesses, with no friends in real life, no contact to her family, no job, no money and a bleak future of things getting worse physically and mentally ahead of her, with having tried way too many medications and therapies that have made things worse, and with an inability to be consistent in routines and planning? Suicide is always an option. When is the line crossed? When is it too much? I don’t know. I have tried to kill myself over 20 times, I have been close to trying an attempt hundreds of times. I have spent months upon months in psychiatric hospitals.

Chances are, I am going to die of suicide. The statistics speak against me. Putting all my mental illnesses together, and even keeping my physical illnesses into consideration and my lack of a strong support system and zero professional support, my chances of dying of suicide are 72%. I did the maths, yes. 72%.

But see, there are moments when I think I could beat those odds. When I hope that the times when the suicidal thoughts are just a buzz in the back of my head, can become more frequent. Because I believe that no one has to die of suicide. There are always ways for things to improve. Suicide is a final solution to often temporary despair. The stronger the support system, the higher likelihood of people not taking that last step.

I shared my own experiences so people can become aware of that suicide attempts have a face. That it is real, not about weakness and definitely not about selfishness. And we can all help someone who is struggling with suicidal thoughts, you, yes, you, can save someone’s life by asking the right questions and by being non-judgmental.

Suicide Prevention

Suicide is the 18th leading cause of death globally, in the group of people between the ages of 15 to 29 it is even the second leading cause of death. That basically means that there are almost a million people a year that commit suicide. Every 40 seconds someone decides to take their own life! And there are 20 suicide attempts on every successful suicide. Attempts can lead to terrible chronic pain, brain damage, not to mention the huge negative effect it has on the person who is struggling and those who love them.

One of the most important things we can do is to fight the stigma around suicidal thoughts, to talk about mental health and mental illness, to educate ourselves and others about it, and to make sure that we do not judge. The reason why people do not talk about when they are struggling, might it be with mental health issues, might it be with life, with financial worries, with worries around their physical health, is because they are afraid to be judged and are convinced that there is no help out there.

Having Suicidal Thoughts is not Selfish

You never said forever, could ever hurt like this

“What is wrong with you? How can you give you up, don’t you even think about how it would affect your loved ones?”

You never know how much someone is struggling, you do not know the mental or physical pain they are going through. You don’t know how long they have been plagued with that pain, with guilt, with shame. How long their thoughts have been preoccupied with thoughts of solutions, with self-blame for not being strong enough.

Suicide is not selfish, and even if it would affect the people around the person who is struggling, everyone has the right to their own life, and their own happiness. Would you really want someone to suffer for the sake of you not having to go through grief? So you wouldn’t be in pain for a while?

Here is the thing. Guilt-tripping someone for having suicidal thoughts will only make them more desperate. It will make the pain greater. While it might at least stop someone in an acute crisis, someone struggling with suicidal thoughts has definitely considered and thought about the people they love, over and over.

Whatever the reason for someone’s suicidal thoughts, most times these people feel like they are a burden. They feel like they are stuck in a forever and always situation, they feel like they would only be a bother, they would only be told that they are selfish! They feel alone, they see no way out, no way to fix anything.

So telling them to think about how their struggles affect others, can very much be the least helpful thing you could say.

“You are so selfish, think about how your choice would affect the people who love you!” – “I know, I am a terrible person. I can’t get myself together, I don’t deserve to be loved. I really only deserve to be dead. I am just a burden and I can’t fix things. I know. I am sorry for being selfish, but maybe if I disappeared, you’d only go through a short period of pain, and then don’t have to deal with me, the selfish burden, anymore”.

Instead, yes, there is an instead and better ways to respond to someone’s suicidal thoughts! You focus on them, their struggles, and not yourself or the people in their life. You can validate their feelings, you can ask them what makes them feel so overwhelmed that they consider something so final. You can let them know that they are not alone and that you want to help them get through this moment of utter pain and suffering. And ask them what would make them feel better.

Suicidal thoughts are not selfish. They are an expression of that someone has tried for too long. They are a sign of that someone is going through a pain that is incomprehensible to someone who has never experienced it. It is someone’s final door to open. It is about the person, not you, not the people around them, it is about their pain. They deserve attention, care, love, and support. They do not deserve anyone making them feel even worse.

Suicidal Ideation, Passively Suicidal and Actively Suicidal

Suicidal ideation is a preoccupation with thoughts about taking one’s own life. Most people have once in their life had the fleeting thought of “I wish I was dead”. It is very common to have thoughts like that when feeling like there is no solution to a life-impacting problem, when the mental or physical pain is too much. Suicidal ideation is more like always having the possibility of death on one’s mind.

For some, that means no danger. It can be relieving to imagine the ways, the tools, the moment when it happens. Just knowing that that option exists, can be a relief, even a motivation to carry on. Thoughts are not actions after all.

But that does not mean that suicidal ideation is not serious. There must be some underlying issue for someone to have such thoughts, they are struggling enough that the suicide door is visible for them. And the longer you have such thoughts, even if there are no urges, no actions, the deeper they sink into your subconscious. And if there suddenly is a crisis situation, those thoughts are already ready to push you into dangerous directions. Always take suicidal thoughts seriously.

Spin my way out of Hell
There’s nothing left this soul to sell
Live fast and die fast too
How many times to do this for you?
How many times to do this for you?

Right. Suicide ideation can be both be connected to passive and active suicidality. Someone who is passively suicidal might say things like: “I can’t take this anymore”, “I wish this all would end”, “I see no way out anymore”. Those thoughts do not mean that someone is at risk right at that time, but it could go into dangerous territority. In a moment like that, it is important to ask questions and make sure that you do not judge! Ask for clarification. What do they mean? What makes them feel that way? Are they safe right now?

On the other hand, if someone says things like “I want to kill myself” or sends you ominous goodbye messages, things are in a different category. You need to take action! Do not leave them alone, if you are physically close to them. If you can’t be with them, give them the number to a suicide hotline, send someone there to check up on them (family, friends, and if there is no one, the police). They might not thank you right away but in that moment, the most important thing is their physical safety, the emotional care needs to come second.

Oftentimes it is not the loud screaming ones that are in acute danger. It is the silent ones. The ones that stop talking, that do not talk about how they feel, or they tell you that they are at peace. The ones that suddenly, after longer periods of struggling, seem calm. When something feels off to you, ask! Always ask: How are you doing, really? and be bold about it too, so they have no way to talk their way out of it: Are you suicidal? There is this misconception that asking someone that question will tip them over the edge, but the opposite is true. They need to say it, out loud, which makes it more real, and which opens up possibilities for support.

Who Gets Suicidal?

Anyone can get suicidal! It does not matter where you live, what gender you are, how old you are, how rich you are, if you have a huge family and a lot of friends. Suicidal thoughts can have a lot of reasons.

A lot of times it is connected to mental health issues, and the prevalence of suicide and suicide attempts is higher among those with mental illness. It can be a depression, it can be a personality disorder, a trauma related disorder, an anxiety disorder, chronic illnesses like bipolar disorder and schizophrenia. Struggling with a mental illness does not mean that you will end up with suicidal thoughts but the risk is bigger. Mental illnesses can happen to anyone, they do not discriminate.

Marginalized groups like members of the LGBTQ+ community, those with disabilities, the poor, those who are oppressed in their society, those who do not fit norms, are also at higher risk of suicide.

Physical illnesses can also lead to suicidal thoughts and suicide attempts. It can be a cancer diagnosis, chronic pain, chronic illness, physical disabilities, a long recovery following an accident. There are even illnesses that increase the risk of suicide due to changes in hormonal balances, like thyroid conditions, diabetes or menopause and PCOS.

There doesn’t have to be illness for there to be suicidal thoughts. A break up, being bullied, financial worries, grief after the loss of a loved one, loss in general, stress and burn out, life changes, loneliness, low self-confidence, rejection and so many more things, can lead to an increased risk of suicide. You might think that you would never end up thinking in such final terms, but even life and its hurdles can lead to a lot of pain and despair at times.

How to Help and How to Get Help

Sell my soul for anything, anything but you
Sell my soul for anything, anything but you

Helping someone who you either know is struggling or you suspect is struggling, is not very difficult but it still demands some effort from your side. You need to be willing to sit with the person who you care about, be non-judgmental, and not invalidate their struggles. Instead you can use active listening skills, give them attention and ask questions that will make them feel heard. Be kind, compassionate and understanding. And if you feel that someone is in crisis, always try to get them in touch with professionals who can help them through the moment, the temporary overwhelming moment, so they can regain the strength they need to deal with the issues that have led to the crisis situation.

If you yourself are struggling, there is help out there! If you feel like a burden and do not want to bother anyone close to you, there are professionals whose job it is to support those that are stuck in their pain. Depending on what has led to you having suicidal thoughts, there a lot of different channels you can reach out to! It could be psychiatry and a therapist, it could be specialists in different physical illnesses, support groups for people who struggle with similar issues, it could be one of those online apps for emotional support. And if you are actively suicidal and not safe, always, always reach out to suicide hotlines or reach out to someone you trust and that can be with you for a while! You deserve support, there are always options, this is just a moment, a terrible terrible moment, but you can get through that moment, I believe that you can! (list of suicide hotlines) .

Some further reading:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489848/

https://ourworldindata.org/suicide

http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

My post on a suicide attempt.

My Master’s post on how my suicidality affects him.

Lyrics from “Long Hard Road Out Of Hell” by Marilyn Manson