Must I constantly feel suicidal as a private penance, a perpetual atonement for all the bad that I think, all the bad that I am, and all of the bad that I do? What kind of person could bear to be me and not even want to kill himself to spare the world of such evil?
'I am terrible! But don't hate me. I know I deserve to die. I would kill myself today, if I only had a two guns and two bullets, to shoot myself through the left temple and the right at once.
Each of my successive suicide plans, even unimplemented, is like a bead prayed on the Rosary, atoning through the grace of death beseeched for my perpetual sin.'
Many times I have forgiven myself in the night, commuting my own suicide sentence, only to awaken in the morning, once again on death row. I'm tired. Can anyone blame me if I sleep and don't wake up?
Each day I will swim toward the horizon on the waves of eternity, offering my life to God - that FUCKER - and and feeling both grateful and resentful when I make it back to shore.
Take me if you want, but stop torturing me, you FUCKER! You dirty Holy FUCKER!
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7 comments:
I'd guess that suicidal ideation is typically a reaction to a mental disorder or extreme stress.
Do you double-count the extreme stress of having a mental disorder?
I'm no psychiatrist, but most people I've met with frequent adult suicidal ideation have had at least one of the following:
Clinical Depression
Bipolar Disorder
Post-Traumatic Stress Disorder
Extreme stress, like non-Clinical Depression, tends to fade relatively quickly; unlike Bipolar Disorder in particular (and to a lesser degree, these other two), you don't get extreme highs and lows which are particularly likely to result in not just suicidal ideation, but suicide attempts.
Don't get me wrong - many mental disorders cause stress. However, suicidal ideation has a high linkage with lows, and suicide attempts have a high linkage with coming out of those lows; because of this, uncontrolled Bipolar Disorder in particular is one of the highest risk factors for suicide attempts.
I rapidly cycle from feeling very good and usefully competent to feeling very bad and worthless. Then, I have myself and I want to die, urgently.
Several psychiatrists have diagnosed me as manic depressive, but lithium and valproic acid have no effect on how I feel one way or the other.
My present cognitive behavioral therapist says she doesn't believe I'm bipolar because I don't have psychotic highs with voices.
Although I sometimes attempt to accomplish great and even seemingly highly improbable things, I often do accomplish those things, in coalition with others, and so many of my improbable schemes are not truly "unrealistic," by that test. I've got a law degree to go along with my grandiosity, for instance.
But I've had two close relatives, a brother and an uncle who are, without a doubt, manic depressive.
My therapist thinks I'm "dysthymic" with, perhaps, Borderline Personality Disorder, as well.
But, my present psychiatrist says he doesn't think I have BPD, because I am not as dependent as his BPD clients are.
Antidepressants work for me to some degree, but not well enough. They don't cause mania in me, which is another indication that I am not "typically" manic depressive.
So, what am I, you ask. I believe I'm chronically depressed, with symptoms of all of the above, a lot of whose origins are surely in post traumatic stress, leading to post traumatic stress disorder.
Again, I'm pretty far away from being a psychiatrist, but my understanding is that most mental health professionals prefer to use Diagnostic and Statistical Manual of Mental Disorders, which (while it has numerous benefits compared to older coding schemes) still has a number of problems. Basically, it's a lot harder in mental health to identify a single ultimate cause of a mental disorder than it is in, say, physical health. This means that likely in a number of areas, there is poor and under-classification of mental disorders (much as physical disorders were, particularly prior to germ theory). I'd guess that within the next century, that will only be true for fairly small sections of disorders, but at the moment it looks like a bit of a mess (compared to physical disorder coding).
In any case, at least at the moment, while successful coding would be nice, it still doesn't always perfectly coo-relate to a treatment.
Have you had successful therapy for post-traumatic stress disorder?
Are you willing to talk about what started the post-traumatic stress disorder?
I've talked a lot about what started the Post-Traumatic Stress Disorder, with psychiatrists, psychotherapists and in anonymous groups, as well as with family and friends. But what I've learned is that it's really a matter of Post-Chronic Traumatic Stress. There is no one thing or even one thing chronically repeated, but rather a course of related and only tangentially related chronic stresses.
There's family alcoholism, family sexual abuse, societal, family, and community color-aroused ideation, emotion and behavior, the riots, general sexual repression and homophobia manifested in specific traumatic personal experiences . . .
And then there are the more routine sorts of psychic trauma that arise in family and individual therapy.
These things explain why I periodically have dreams that cause me to wake up screaming in the night, and angers that make it hard for me to live with others, as well as anxieties about situations in which I know the anxiety is disproportionate to the circumstances at hand.
I've read the DSM-IV on psychiatric disorders through and through, both in the context of helping legal clients and in trying to understand myself. What becomes clear, even in speaking about this with psychiatrists and other therapists, is that individual symptoms and circumstances often don't fall neatly into any one of the categories. Often response to medication for particular disorders is the final indicator of what disorder group a person falls into, for example. The inability of doctors to predict what medicines will work for which people reflects, to a large degree, the fact that they really don't understand with specificity what causes these illnesses and what specific pathways would have to be reached in order to remedy the symptoms. It's still a educated guessing game. And, statistically speaking, there are some people who are never helped sufficiently in spite of the their own best efforts and the best efforts of doctors, with the best efforts of family and other loved ones.
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