Motherhood, mental illness and beyond

Posts tagged ‘suicide’

Suicide isn’t selfish

Trigger warning: suicide

Last week this image caused a bit of upset on Twitter:

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It’s from the American Foundation for Suicide Prevention, a non-profit organisation that seeks to understand and prevent suicide through research, education and advocacy. They also aim to help those affected by suicide. It seems to be a good organisation with good intentions, but out of context their image (originally posted in 2012) raised some hackles in the British mental health community. Why? Because it removes the focus from the suicidal person and it seems to feed into the “suicide is selfish” idea. This belief is unfortunately common. Killing yourself is often seen as selfish, cowardly and weak. It’s yet another part of the stigma that surrounds mental illness.

I recently shared this image (from Boggle the Owl)  on my blog:

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The response was overwhelming. So many people contacted me to say that it had made them consider suicide and/or mental illness in a different light. I’m so glad, because it did the same for me when I first saw it. Despite having been mentally ill since my early teens I too had bought into the “suicide is selfish” rhetoric, and realising that my suicidal urges didn’t make me selfish was a huge step. It lightened the load. Because in my experience, that’s what suicidal urges are, an enormously heavy burden that weighs you down. And it’s one that is incredibly difficult to he honest about; during my most recent crisis, in February/March this year, I hid my increasingly suicidal thoughts and feelings from almost everyone. The previous times I had felt suicidal, and the one time I seriously attempted to kill myself, absolutely no-one knew.

There’s a lot of ignorance about suicide. Firstly there’s the idea that people who talk about killing themselves will never do it, when in fact most people who kill themselves have told at least one person that they want to do so. Then there’s the suggestion that telling someone you’re suicidal is just attention-seeking. Can you imagine that? Your world has shrunk to the confines of your own mental torment, your existence is so unbearable that you’re considering ending it, you pluck up the courage to tell someone how you’re feeling because you know you need help, you’re drowning in pain and BAM! You’re dismissed as attention-seeking.

Equally as bad is “You owe it to your family/friends/hamster to stay alive” and “It’s a permanent solution to a temporary problem”. I’ve had mental illnesses since my early teens – what’s temporary about that? While for some people depression and suicidal thoughts may be relatively fleeting, for many they are a recurring or constant problem. Imagine 2, 5, 10, 20 or more years battling your own mind, your mental pain, every single day. Or maybe it’s physical pain and illness that you’re fighting against. While holding down a job, bringing up children, maintaining a facade of normality for the outside world. It’s exhausting. And being told that you “owe it” to other people to keep yourself alive? No. Just no. That’s implying that they are more important than you, that their feelings trump yours and that your anguish doesn’t matter. All that matters is how your death will make others feel.

Lastly there’s the nasty sentiment that people who jump in front of trains or off motorway bridges are just a selfish inconvenience to others. Let’s think about that. Another human being, someone who loves and is loved just like you, has found their life to be so unbearable that they saw no alternative to ending it. Their pain was so immense that it blocked out all other thoughts. And you’re complaining because your journey has been delayed?! That’s the true act of selfishness, to me. Seeing someone else’s pain, suffering and death only in the context of how it affects you.

So no. Suicide isn’t a selfish act. It may be a desperate one but it is not selfish.

For further understanding please read these incredible posts from BipolarBlogger: Count no blessings: How a suicidal mind works and Ten things not to say to a suicidal person.

If you are suicidal or know someone who is and you need support, please check out the “Want to talk to someone?” bar at the top of the page.

Changing minds

This post is one I’ve been meaning to write for a while, but I’ve finally got round to it today after seeing the #ChangingMinds tag on Twitter. The question posed was what do you wish more people understood about mental illness – so here’s what I wish more of my friends and family understood.

We all have mental health, just as we all have physical health. Some of us just aren’t as healthy as others.

1 in 4 people will have a mental illness during their lifetime. It’s that common.

If you ask how I am and I say I’m fine, I’m probably lying. But don’t push it because if I really want you to know I will tell you.

Just because you know someone else with the same diagnosis as me doesn’t mean that I’m capable of the same things. Your friend with anxiety and depression can go to social gatherings; I struggle to.

No, cyclothymia isn’t “pretend bipolar”.

Most people with a mental illness look and act just like everyone else.

Anti-depressants aren’t a bad thing. They can be life-savers, literally. They’re not a magic cure though and it can take time to find the right ones.

The same is true for any kind of psychiatric drug.

Also exercise. Although it can be helpful to some people, it can be detrimental or just unhelpful to others.

People with a mental illness are far more likely to be the victims of crime than the perpetrators.

It can be frightening, fighting for control of your own mind every day.

If I drop off the radar for a while, it’s almost certainly because I’m having a hard time and nothing to do with you.

The same is true if I cancel plans to meet at the last minute.

Some people recover from mental illness. For many it’s a lifelong condition.

Not recovering from a mental illness doesn’t mean you’re not fighting it hard enough, or that you’re wallowing in it. It doesn’t mean that you’re weak either.

Feeling suicidal isn’t weak or selfish. Killing yourself isn’t weak or selfish.

Self-harming, in whatever form it takes, isn’t weak or selfish. It’s a coping mechanism when nothing else can help.

Talking about mental illness and sharing experiences can be really interesting.

If you’re sympathetic to someone with a physical illness, you should be sympathetic to someone with a mental illness. It’s just as painful, often more so.

Some days just getting out of bed or leaving the house is a struggle. That’s not the same as being lazy.

Mental health services are having their funding cut across the board. It’s never been easy to access help, in some cases it’s now nearly impossible.

If you don’t understand something, it’s better to ask than to make assumptions.

I could write many more of these but I won’t – please feel free to add your own though, and please do look at #ChangingMinds. I’d like to leave you with this:

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(From/by Boggle the Owl).

My net

Trigger warning: suicide.

For ages now I’ve been pottering along, coping ok with the usual day-to-day stuff and seemingly well thanks to my anti-depressants. Until a few weeks ago, that is. For no discernible reason my mood took a nosedive and I began to have suicidal thoughts for the first time in almost 3 years. I’m not saying that I wanted to kill myself, I didn’t. But thoughts of suicide were continually popping into my head and I found myself dreamily considering ways of ending my life. Needless to say, this terrified me. Which, in a way, was a good sign – when I’ve been truly suicidal these kind of thoughts have been welcome, even comforting. But this time they were intrusive and frightening.

I’m lucky to have a great GP, who managed to squeeze me in at short notice. She listened sympathetically, checking that I felt able to keep myself safe and that I had people I could turn to if that changed. She increased the dosage of my anti-depressants and fired off an urgent referral to the community mental health team (CMHT). Much to my surprise they called me later the same day and offered me an appointment with a mental health nurse the following morning. The appointment went well and the nurse was reassuring. She agreed that I seemed able to keep myself safe despite the suicidal thoughts, and gave me the details of the CMHT helpline in case I started to have difficulties with that. She also referred me back to a psychiatrist for mid-April, just to be on the safe side.

Gradually my mood began to improve, and I went from barely being able to move off the sofa to throwing myself into the housework with an enthusiasm that’s most unlike me! I haven’t had any suicidal thoughts for days now. I’ve seen my GP again and she’s happy that I’m safe and managing far better. For now I’ll continue on the higher dosage of anti-depressants, but if I start to get too high or notice an increase in hypomanic episodes we’ll try lowering it again.

I consider myself to be very lucky. I have nothing but praise for the NHS, my GP and the CMHT, who saw me so swiftly. DH is my rock, and my wonderful sister and parents are supportive. My dear friend Sutton is a treasure beyond compare and I also have some amazing friends on Twitter who, although we’ve never met, are kind and caring and incredibly supportive (you know who you are!). I am so grateful to all these people; for listening and reassuring, and for being the safety net that stopped my headlong plunge into darkness. I really don’t have the words to express how thankful and humbled I am by their love and support, so I’ll just say this, from the bottom of my heart:

Thank you.

Hollow and hopeless

I admit it – I’m struggling. I’ve not written about my mental health for a while because I’ve seemed stable on the medication I take and it felt like I was coping ok. But I’m starting to realise that I’ve been fooling myself and using too many crutches to get through each day.

This last week has been an eye-opener. 2yo DS had surgery on Monday; it was only a minor operation but involved general anaesthetic and that pushed all my anxiety buttons. Then he developed a stomach bug the same night and the next 3 days were filled with more vomit than a high street on Saturday night. After a few days DH and DD got it too. Everyone’s pretty much recovered now but I’m still struggling. I feel like I’m constantly full of adrenaline, buzzing and unable to sit still, but at the same time lethargic and morose.

I hadn’t realised until recently just how much I rely on DH to take the strain when I’m having a hard time. We’ve always done equal shares when it comes to parenting and running a home (especially while he’s unemployed), but there are times when I just cannot cope and he takes over for a bit so that I can be alone or whatever it is that I need at the time. However, just before Christmas he was diagnosed as having bipolar disorder and is now on new regimens of drugs and therapy while the doctors explore what works. I think this has prompted him to be far more open with me about his mental health than before and it seems that he’s been hiding a lot from me. Now that I know how he feels, how he’s been fighting his own battles, I no longer feel that I can rely on him as much as before. Not because he’s suddenly unreliable but because it seems unfair to give him sole responsibility for the children when he’s having as hard a time of it as I am. I feel guilty and selfish that I didn’t realise before.

I’ve been trying my hardest to put on a bright and smiley face for everyone, particularly the children, but the mask is cracking. I am cracking. I have a very short temper atm and the slightest thing makes me rage (internally, thankfully). The children’s chatter is like fingernails on a blackboard. Their bickering makes me want to break things. Their simplest request, for a toy or a hug or help turning on the light, is infuriating because I just want to be left alone.

I try to hide how I’m feeling and be their kind, playful, loving mother but I think I’m failing. I think they’re starting to realise that I’m hollow – fake happiness on the outside, a yawning chasm of despair inside. They don’t deserve this. They don’t deserve a mother who has to bully herself into playing with them, who counts down the hours and minutes until bedtime. They deserve better, the best.

I’m not entirely sure if there’s anything in particular that’s prompted my plummeting back into darkness but it has been a stressful time lately. If I’m completely honest there’s a part of me, a very small part, that is angry with DH for being diagnosed with bipolar disorder. How ridiculous is that? It’s hardly his fault. But in the past I’ve always been comforted by the thought that when things became too much to cope with and I eventually killed myself (I’ve come dangerously close to this several times) the children would have a strong, stable parent to take care of them. But I can’t do that to DH when he’s having his own problems. I feel as though my safety net has vanished. I’m not saying that I’m suicidal at the moment, I’m not. But it was always reassuring to know that if things ever became that bad again, I had an escape route. Now I don’t and there’s no hope of oblivion for me any more. I’m stuck in this defective body, in this tormented mind, until age, infirmity or an accident carries me off.

I really don’t know what I want this post to say, I’ve rambled a long way from my first paragraph. I’ve been far too honest and I’m not sure whether I should even publish it. But this is who I am and how I am. Bright on the outside, black as pitch on the inside and utterly without hope of escape.

Depression, SSRIs and pregnancy

Today the BBC has reported that according to an adviser for NICE (the National Institute for Health and Care Excellence) women who are fertile should be discouraged from taking SSRIs, a class of anti-depressant. The rather aptly named Professor Stephen Pilling was quoted as saying:

“The available evidence suggests that there is a risk associated with the SSRIs. We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we’re perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar – if not greater – risks”.

Professor Pilling claims that there is evidence that taking SSRIs in early pregnancy increases the risk of a baby being born with a heart defect from 2 in 100 to 4 in 100. If this is true then of course new guidelines need to be considered. (Having said that, in my experience doctors are already extremely cautious when prescribing any kind of medication to a woman who is pregnant or breastfeeding.) However it is other quotes attributed to him that have infuriated me. According to the BBC article :

He says that women not suffering from the most severe depression who become pregnant whilst taking the drug are taking an unnecessary risk.

“You’ve got double the risk. And for women who are mild to moderately depressed, I don’t think that those risks, in most cases, are really worth taking” he said.

“It’s not just when a woman who’s pregnant is sitting in front of you. I think it needs to be thought about with a woman who could get pregnant. And, that’s the large majority of women aged between 15 and 45.”

First of all the diagnosis of depression is extremely subjective, often relying on the individual answering a multiple choice questionnaire that has points assigned to each answer. If you score above a certain number then bingo! You’re depressed. But what one person interprets as mild depression may be what another person feels is moderate depression. Someone who is severely depressed may not believe they are because they’re not considering suicide.

I’ve had episodes of depression since my early teens, including 2 bouts of post-natal depression (PND) and 1 bout of ante-natal depression (AND). The first time I had PND I refused to take any medication because DD was breastfed and I was scared that the anti-depressants would affect her through my milk. As a result I was severely depressed for a very long time despite various other therapies and I planned my suicide on multiple occasions. I am concerned that if Professor Pilling’s reported opinions become guidelines the same may happen to women who are pregnant.

If, through the media sensationalising this or through poorly worded new guidelines, a pregnant woman is made to feel the way I did it’s entirely possible that she may consider taking her own life (and therefore that of her unborn child). If a woman suffers from depression that requires a particular treatment then she should be given that treatment. At the end of the day, uncomfortable though it is for me to say, the life and wellbeing of the woman is more important than that of her foetus.

Any suggestion otherwise removes a woman’s bodily autonomy, her right to decide what happens to her body. This is dangerously close to a number of anti-abortion laws that have been proposed in the United States, where the supposed rights of the foetus (usually a non-viable foetus) would outweigh the rights of the mother, who is reduced to the status of a mere incubator.

As for Professor Pilling’s apparent suggestion that “pre-pregnant” women (so any woman who is capable of conceiving, and therefore presumably including pubescent girls) might be refused access to SSRIs, it’s ludicrous. Would a doctor refuse a diabetic woman her medication? Or an epileptic woman? Both of these conditions often require medications that can be risky for a foetus yet I doubt that many doctors would recommend their patients stop taking them merely because they might conceive a child.

What are your thoughts?

A school facilitated a pupil’s self-harm; why part of me wishes mine had done the same.

It was reported by various media outlets today that a pupil at a school in Surrey was permitted to self-harm under the supervision of staff. The child’s gender varies depending which account you read and his/her age has not been made public. The school in question provides specialist education for young people up to the age of 19 who have Asperger’s, higher functioning autism or an associated diagnosis.

This story resonated with me. I began self-harming very young, at the age of 7. I started by scraping a My Little Pony or Barbie hairbrush across the skin of my forearms until it bled. By the age of 10 or so I was using one of my dad’s disposable razors; by the time I started university I was using kitchen knives. I went to great lengths to hide what I was doing – I felt ashamed of it and didn’t want anyone else to know. At the same time I was desperate for someone to notice so that I could come clean, own up and get help.

The first time I ever told anyone about my self-harming was when I was seeing a bereavement counsellor at the age of 19. After a few sessions I hesitatingly confessed the shameful secret that I had hidden for so long. His response wasn’t what I expected – almost jovially he said “Oh don’t worry, if it helps it’s a good thing”. I was stunned and horrified by his response, and never went back.

Looking at it now from a more mature perspective I can see what he was trying to tell me. Self-harm is a coping mechanism. It’s a pretty rubbish one admittedly, and definitely not healthy, but it helps the individual to cope with or process feelings and situations that would otherwise be utterly overwhelming. Many self-harmers find that when their families discover their secret they remove anything with a sharp edge in an attempt to stop the harm. However well-intentioned this is it often does more harm than good; the self-harmer has no outlet for their feelings and may turn to far worse coping mechanisms in order to regain control.

Because at its most basic level self-harm is usually about control. When you are feeling overwhelmed, panicky, as though you are suffocating, self-harm is a way to focus and regain self-control. Having this coping mechanism taken away can be devastating and can sometimes cause a downward spiral leading to suicidal thoughts.

I suspect that this is what was uppermost in the minds of the headteacher and principal of Unsted Park school when they implemented their support scheme for the pupil in question. Apparently staff were told to give the pupil (who may be a boarder) access to sterile razor blades and accompany them to the bathroom, checking they were ok every couple of minutes. The wounds would then be cleaned and dressed.

Obviously this isn’t an ideal solution and teaching staff should not have to bear that sort of responsibility. But as far as I can see once the school became aware of what the pupil was doing they only really had 2 options; to try to put a stop to it and risk the pupil spiralling downwards or to make sure it was done as safely as possible while finding a better way to support and help the pupil.

By the time this policy had been in place a few days several staff had complained. The school, its headteacher and principal are now under investigation. There has been no mention of whether the pupil is getting more appropriate support, or indeed any support at all. I hope they are.

When I was young the thought of someone finding out about my self-harming both terrified and tantalised me. The thought of being escorted to the bathroom by a teacher so that I could cut myself would have been horrifying and humiliating, I didn’t want anyone to find out what I did. And yet if someone had told me that they knew I would probably have clung to them, sobbing with relief and begging them to help me stop.

There are no villains here, no wicked teachers encouraging children to mutilate themselves. There are only staff who, I believe, were doing their best to cope with an extremely difficult situation and fulfil their duty of care towards a pupil. Whether the policy in question was the best course of action is debatable. But a young person was supported and cared for and that’s the most important thing.

I wonder. If my school had been this aware and responsive would I still be a self-harmer 25 years after I first began?

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