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Everywhere and Nowhere: A Journey Through Suicide (newyorker.com)
48 points by gringoDan 35 days ago | hide | past | web | favorite | 64 comments

To be human is the ability to defy our instincts. From the simplistic "I choose not to eat", to the extraordinary "I choose to end my life."

I strongly believe that suicide is only a cultural taboo, and thus it is 'safe' to label it as a mental illness.

I have struggled with wanting to end my life for 35+ years. "Talking about it" does not work. Medication/Meditation/Mediation has not helped. To put it simply; I do not wish to exist.

I tried to kill myself once. [Dammit i suck at everything! /joke] Not a single day goes by where I don't think about doing it again. I regret failing.

And yet I get up and go to work every day. There is a momentum to living. It is just a habit. I take no pleasure from my hobbies. I no longer have solace within peace and quiet. I am unable to escape in the written word.

If I could end my life and know my family would be cared for financially I would in a heartbeat. My obligations keep me alive, and it is a torture.

I am surrounded by people who love me, and would be devastated by my death.

As near as I can tell, this is the meaning of life; and I want it to end.

I've gotten to the point where I look at suicide as a reasonable option like any other choice I would make. However that doesn't mean I'm suicidal - simply that I've taken the philosophical gravity from the concept.

That, given what I've been through, I know that it's something that I can do at anytime I want. Strangely enough that makes me feel less trapped in my life, and way more intentional about what I do.

Not that I don't waste a lot of time (mostly here), but that I try and be fully engaged with whatever I'm working on and am completely honest about all those habits and responsibilities. It also means I'm constantly evaluating if what I'm doing is supporting my long term goals.

What I realized is that nobody wants to feel like they are a burden. If you tell your family that they feel like a burden, I would guess they will get out of your way and you'll be able to create an intentional relationship - but then, I don't know your family.

As Camus said: There is but one truly serious philosophical problem and that is suicide.

As someone with moderate to severe ADHD, I can empathize with the sense of feeling utterly trapped by mundane responsibilities.

As you say, the human condition is shaped by our ability to make choices that defy instinct, and making the choice to keep going-- when you'd rather not exist-- is a display of immense mental fortitude.

I admire the hell out of you for persevering.

Thanks for saying that.

I believe there is still hope for you to enjoy life and experience joy again. I'll stop short of recommending things to try since I'm assuming you've tried it all already, but you never know what the future will hold.

I am sure that most people who expound the joys of life when talking someone down from suicide, mean well, but I feel they're mostly trying to convince their own selves that life is always worth living.

That could well be the case sometimes, I personally disagree though. I genuinely am full of joy most days. For me, I attribute this to every step I take against my habit of walking away from God, and especially the manifestation/experience of God's love in my relationship with my wife. So if I attest to that, it's an appeal to truth for the sake of someone else, not because I'm struggling to believe. Though even if that were the motivator, it seems like a healthy enough mechanism of society.

I have a slightly different take on this. I also experience joy most days these days but God has nothing to do with it. Rather, I manufacture this joy from within myself through sheer force of will, simply because I find living this way more pleasant than the alternative. I wasn't always able to do this, I believe it is a skill that grows stronger with practice. It is a matter of both shifting perspective and (re)structuring one's life/environment to support joyous moments.

After I felt suicidal, I was abused by people in Liverpool hospital in NSW. Three years later and I still feel suicidal at times, and I have not for a single day felt or experienced joy. Literally every day since then I have felt anger, shame and depression at what happened to me. I don't sleep well (I get nightmares), and nothing (and I mean nothing) is helping - not exercise, medicine, family, therapy, friendship - nothing.

Fuck, that is shitty. I really wish that hadn't happened to you.

Maybe of interest: "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel A. van der Kolk https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/01... "Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring—specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy—and a way to reclaim lives."

A lot of it is historical, so you might want to skip to the sections on treatments like EMDR. The author shows how nightmares are the brains attempts to process what happened and has suggestions for moving past them. While Bessel van der Kolk practices in the USA, perhaps you could contact him (or the group he works through) and see if he or they can suggest an informed and compassionate practitioner in your country?

Bessel van der Kolk and his associates can be reached here: http://www.traumacenter.org/

An interview with him: https://onbeing.org/programs/bessel-van-der-kolk-how-trauma-...

You may also find this book of interest too: "Out of the Nightmare: Recovery from Depression and Suicidal Pain" by David Conroy https://www.amazon.com/Out-Nightmare-Recovery-Depression-Sui...

A key point David Conroy makes is that all too often when people reach out for help with pain exceeding their coping resources (and so leading to suicidal thoughts) that the people they turn may just heap more pain on top of everything, which sounds like what happened to you. But it does not always have to been like that and David Conroy explores alternatives in his book.

And you might also want to look into "The Lifestyle Cure" which has a fairly high cure rate for depression using a combination of omega-3s, sunlight & vitamin D, exercise, social interactions, mental habits to avoid negative ruminations, and improved sleep: https://tlc.ku.edu/

But if it is past trauma that is causing the worst issues, addressing that first might help get you on an upward spiral and then you could try those other ideas to continue towards greater wellness. Hope this helps.

> "There is a momentum to living. It is just a habit."

The truth and simplicity is undeniable. Take away the routine - and its why there are so many routine routines - and my sense is nearly everyone would end up in a twisted game of chicken with the void, with the absurdity.

So get there and finally decide to opt out. Sad in a way, but none the less quite brave.

There is a lot of suffering in life, there's no denying that.

You ever play "Getting Over It with Bennett Foddy?", it's an interesting game and one of my favorites to talk about. See, you play as a man with his bottom half in a cauldron who's only means of locomotion is swinging a sledgehammer. Your goal is to climb a mountain of random garbage. It's an intentionally difficult game.

You're constantly faced with frustration. You'll spend long periods of time trying to work your way just a few more feet up the mountain, then fall and find yourself back near the beginning of the game. Again. You repeat this over and over, with Bennett's narration helpfully reminding you that he'll save all of your progress for you, including your mistakes. Speaking of Bennett, he'll provide you with some interesting thoughts about culture and our relationship with frustration along the way, but also he spends time subtly ribbing you whenever you fall. It took me 11 hours to climb that damn mountain. The average for people who don't quit is 5.

I think it is very illuminating on the nature of suffering and life. The mountaintop is your goal. No one is making you do it, you chose it by playing the game, and no one worth speaking of will judge you for quitting. It will probably seem impossible, and in fact it may even be impossible for any given player. Every setback, every failure, every time you drop and end up back in The Pit of Despair will hurt. You'll rage, you'll sigh, you'll swear the death of Bennett Foddy, and you might even cry a little. You'll certainly think about quitting. A lot. But if you keep playing you'll notice the strangest thing: every time you fall, you get a little better at getting back up.

When you're young, you kinda hate your parents, and you probably think they hate you too. They're the ones who make you go to bed early, do your homework and chores, eat your vegetables, etc. And they're the ones who punish you when they feel your behavior needs correction. Later on in life, you'll probably come to realize that all those things were good for you and made you a better person. Well ideally anyway, nobody is perfect, not even parents. The point is that even though you thought they made you suffer because they hated you, it turns out that the opposite is true.

Bennett made the game to hurt you, but not because he hates you.

And it is kinda the same with life. Suffering is an inescapable part of the process of growing. That life is full of suffering doesn't mean that it hates you.

A funny thing happened when I finally reached the top of Bennett's mountain. First there was the immense relief, then the surprising reward for my efforts, and of course a celebratory beer. Then I started the game up again to see if I could do it faster. Over months I eventually got my time down to about 7 minutes and climbed that mountain 200 times. Why did I do that? I think of all the players who quit, and how they must think they'd be happy just to reach the top. It turns out happiness doesn't work that way. There are always new challenges, new goals that we drive ourselves towards, more frustration, more suffering, more growth. Would we really want it any other way?

I am not speaking as a man of great successes, who's perspective may be skewed by that. I'm speaking as a man who has never found love and no longer expects to, who never shipped a product he was proud of, who doesn't make six figures, isn't the boss of anyone, hasn't traveled the world, and isn't recognized as an expert in any field. I don't need my whole hand to count my friends. I am a failure by many common metrics, but maybe success isn't really what we're about anyway?

Now, you're probably wondering why I'm talking about a computer game, and the truth is it's because I'm not the guy who's going to tell you that you shouldn't kill yourself, or that life is really great, or any of that stuff we both know is crap. I've taken the drugs, talked to the psychologists, cried in the shower, begged to just die in my sleep, spent long periods of time doing and feeling nothing, and mentally tallied all the ways I could end myself with just what was around me. I'm not going to tell you that I can help you, or even that I know what you're going though.

But I can tell you a story about a game, and the meaning I found in it, and maybe somebody reading this can find some meaning too.

Your story reminds me of this guy's: https://www.youtube.com/watch?v=viP4psS3MUQ (Dark Souls Helped Me Cope With Suicidal Depression).

I rather enjoyed his other videos, despite the verbosity/pomposity, but this one stood out to me because I had a similar experience playing Celeste. Unlike Dark Souls, Celeste is difficult in a more straightforward manner, but the story (about perseverance and facing anxieties and climbing literal and figurative mountains) is also much more integrated into the gameplay.

Thank you for telling this story, I really needed to read it. I mean this sincerely.

elwell 35 days ago [flagged]

Sorry to hear that. Since you didn't list it and out of curiosity, have you given religion a try?

I am tired of 'being nice' in life. So you, dear anonymous internet stranger will bear the brunt of my retort.

>have you given religion a try?

I don't believe in imaginary people. Organized religion is one of the worst things our species has come up with and is nothing more then a method to exert control over a population. So please go away.

Organized religion sure, you could make that argument.

Anthropologists and historians often argue that religion and spirituality - in their purest forms - are actually a coping mechanism that humans evolved into. Think of the hunter gatherer cultures - or even before language was invented. Every moment not spent hunting and gathering and reproducing, they would spend worshiping the sun, or trees, or turtles, anything. An expression of wonder and albeit servitude to the mystery of life. It wasn't until Pharoahs that we started to worship humans (which could be where we screwed up =/ ). Nonetheless, this is how people have made sense of their existence. Still in present days, even absurdists (myself) or atheists/agnostics are just doing their best to apply logic to an existence that doesn't make a lick of sense. We're still searching for a concrete reason for being. I think it's hilariously unlikely, and so amazing that a billion years of wandering stardust turned into an organism that strives to question where it came from. Just wow.

If I could convince you read one book, I would choose "Be Here Now" by Ram Das. It is by no means ordinary english literature - but it's a fantastic journey inside and outside of yourself.

I've read all your comments in this thread, and it sounds like you've spent quite a lot of time in despair - and I want to share my sympathies with you. Love will always be able to bring us out from those dark places. Hey...Obi-Wan Kenobi said so.

elwell 35 days ago [flagged]

> I am tired of 'being nice' in life. So you, dear anonymous internet stranger will bear the brunt of my retort.

If we expect to make any progress, we have to be brutally honest. So thank you.

> I don't believe in imaginary people.

OK, of course I don't either. (I feel like you gave "strawman" argument)

> Organized religion is one of the worst things our species has come up with

I agree as much as I can with a blanket statement like that. However, the message of Jesus seems pretty different: “Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light.”

> is nothing more then a method to exert control over a population

Again, that may be true of some religions or sects, but the message of Jesus would probably be the opposite of that. I mean, the Roman empire tried to destroy the followers of Jesus because their "Way" threatened the organization and control of their empire. After "Christianity" became institutionalized and part of the government it seems to have strayed from much of Jesus' actual teachings.

> So please go away.

If you're sure that's what you want, then I can unwillingly (doubt it or not: I care) oblige. But I would still feel obligated to respond to any further comments, since this is a public forum.

You didn't have to try to be nice and then just push Jesus like that. I mean there's at least a handful of other religions that would go in its place just as fine, but the person you anwser to already gave you clear directions regarding religions, so why push harder?

elwell 35 days ago [flagged]

Because I care about them.

Sounds like you care about your own sect more than him.

Not sure what you mean. If we're taking the perspective that I actually believe Jesus' way can help OP, then wouldn't it be more selfish to keep quiet?

Nope because you are a follower of an organised prescriptive proselytizing religion. You can not help another human being if the answer for that human beings spiritual search is Islam, Buddhism or a pantheistic nature religion.

You are not unselfish, you are acting in the way that your religion tells you,to try to "save" people and up the numbers in the group with the "right way".

I try to empathize with and if you can love Jesus and that keeps you a good person, great for you. But please stop trying to push your solution onto other people looking for answers. Listen to them instead. Learn about other ways to look at life beside your own Christian way. Please.

People are ready for things at different times and you have to respect that. Some people undergo deep philosophical changes in a spurt, others very gradually, and at some point you need to accept some of the people will never warm up to some things, like religion or Jesus in this case. Then again not believing in reincarnation makes it harder to accept that some people need more than a lifetime to come to certain conclusions themselves. In any case pushing things is seldom helpful and just makes the subject more disrespectful of, in this case, anyone who claims to follow Jesus, so you're doing harm to more than one person this way, possibly to a multitude of fellow believers over a lifetime, with just one unthoughtful act.

You might want to look into "The Lifestyle Cure" which has a fairly high cure rate for depression using a combination of omega-3s, sunlight & vitamin D, exercise, social interactions, mental habits to avoid negative ruminations, and improved sleep: https://tlc.ku.edu/

From the author: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life. (Stephen Ilardi, PhD)"

Dr. Ilardi has written a self-help book based on the elements of TLC, "The Depression Cure: The 6-Step Program to Beat Depression without Drugs".

The book has an example of a guy who suffered depression for about forty years and within a few weeks moved beyond depression following this approach (much to his own surprise).

In another comment to this topic I mention this book and various other resources: https://www.goodreads.com/book/show/134266.Out_of_the_Nightm... ""Out of the Nightmare" presents a no-fault theory about depression and suicide. It argues that we should not blame the victim, the family, the caregivers, or society in general. It provides a detailed analysis of each of the barriers that stand between suicidal pain and recovery, and provides those who suffer from depression with hundreds of resources to find their way out of the nightmare. Recovery from depression is decomposed into recovery from envy, shame, self-pity, grandiosity, fear, stigma, prejudice, and the vicious circles of suicidal pain. The book helps sufferers find lasting relief from internalized negative self-judgments."

The key point there is to see suicide as an involuntary action that happens when pain exceeds coping resources. It is often possible to reduce pain (whether physical, emotional, or social). It is also often possible to increase coping resources of various sorts -- and different ones work for different people.

You mention a sense of obligation to your loved ones which is a coping resources of a sort. So is momentum of routine habits, which in a way are another coping resource. So, perhaps you might be able to build out from those -- perhaps to help others more directly and to develop new lifestyle habits to improve mood (like in the TLC approach)?

The book also suggests taking the time (ideally within therapy or consultation with some caring person) to outline all the hundreds of painful things that contribute to your depression (even events from the distant past) and then working towards improving the most approachable pains that are easiest to fix (e.g. an uncomfortable chair, a toothache, a specific negative self-judgement, a strained relationship, etc.) to make some positive progress. All easier said than done of course to get started, but a little positive progress may then lead to an upward spiral of other positive progress and so on. While it may be impossible to improve every painful situation in your life, if you can at least reduce several pains in your life, that reduces the impulse towards suicide.

Another book is aptly named "The Upward Spiral: Using Neuroscience to Reverse the Course of Depression" covers some of the same ground: https://psychcentral.com/lib/the-upward-spiral-using-neurosc... "After he describes the downward spiral, Korb helps us start moving in the other direction. He encourages readers to take small steps, since any change, no matter how tiny it seems, can have big effects. Making small, even somewhat trivial decisions when we are indecisive can help us feel productive, he writes, and is one step in the process of reversing depression. In addition to setting goals and making decisions, Korb advocates getting adequate rest, exercising, and developing positive habits. Most of his advice seems straightforward, but what surprised me was his emphasis on gratitude. Research suggests that opening a so-called gratitude circuit can have great positive effects on our brain. It not only decreases symptoms of depression, but also improves physical health, improves sleep, and boosts serotonin. Gratitude also plays a role in the production of dopamine, Korb explains, the neurotransmitter that increases enjoyment. And so, by activating our gratitude circuit, it’s easier for us to feel positive emotions."

And here is a more radical idea (YMMV, so just for leading-edge background, not necessarily recommending): https://michaelpollan.com/books/how-to-change-your-mind/ "So began what grew into a two-year journey into the world of psychedelics—LSD, psilocybin, Ayahuasca and 5-MeO-DMT. The book explores the renaissance of scientific research into these compounds and their potential to relieve several kinds of mental suffering, including depression, anxiety, and addiction. It also delves into the rich history of psychedelics in America, tracing the promise of the early research in the fifties and how a moral panic about LSD in the mid-sixties led to decades of suppression, just now ending. I spend time with neuroscientists who are using psychedelics in conjunction with modern brain imaging technologies to probe the mysteries of consciousness and the self. Several of the scientists I profile are convinced psychedelics could revolutionize mental healthcare and our understanding of the mind."

Also, for any typical HN poster (maybe not you), looking into whether Asperger's syndrome affects your life and relationships may also be enlightening as Asperger's is associated with lifelong anxiety and depression from social anxiety as well as about a 10X higher than typical rate of suicidal ideation... https://psychcentral.com/news/2014/10/13/suicidal-thoughts-1...

I list more coping resource here including about Asperger's on the job among many other job-related issues: https://github.com/pdfernhout/High-Performance-Organizations...

All the best in finding ways to reduce your pain and increase your coping resources that work for you in your specific situation.

I believe suicide should be seen as a beautiful release for some people.

It's twisted and bizarre that this is such a taboo in human society, almost globally (I appreciate exceptions like Dignitas [0] in Switzerland.)

Why do we endorse "My Body, My Choice" when it comes to decisions like abortion, but take that choice away when it comes to suicide?

Why is the termination of life support for terminal patients seen as a mercy, but vehemently denied when someone who is otherwise healthy rationally chooses to die?

What if someone is simply bored with life? Would you force someone to play a game they don't enjoy, or can't ever win at?

I'm afraid suicide may never be universally accepted as a human right, for primarily these two reasons:

1: It acknowledges the possibility that life is pointless, which threatens many of our entrenched belief systems.

2: Money. If people could cleanly (without pain, guilt, taboo etc.) end their life anytime they want, it could seriously disrupt the economy. When people are no longer forced to live, many industries would make less money than they do (finance, healthcare, therapy, anything that relies on cheap labor, and so on.)

[0] http://www.dignitas.ch

If we ever get past the roadblock of social acceptance, I’d propose assisted suicide clinics, where one might submit a formal application stating their frame of mind and what they tried to improve their situation before they arrived at their decision.

If it's approved, they could be placed on a waiting period of 1-2 years, where they have to reaffirm their decision at regular intervals (every 3 months?)

At the end of the waiting period, if they have no outstanding debts, let them leave whatever they want to whomever they want (messages, heirlooms), set their affairs in order, make peace with close family and friends, and help them pass on with dignity.

If they ever changed their minds during the waiting period, they would not be allowed to apply again for say 3-5 years.

Even simply knowing that they have the option of a clean, socially-accepted and assisted suicide, would tremendously help a lot of people who might otherwise take their lives in uglier ways.

I suppose there are so many moral barriers (we try to make societal decisions democratically after all) that this will never fly.

Most non-terminally ill people who attempt suicide aren't making a rational choice to die at the time they attempt it.

Anecdotally in my experience there are three categories of people who wish to suicide:

1. People with a terminal illness. Enough said.

2. People acting on impulse and/or not getting proper help. Sure they need some crisis intervention to offer a chance for them to receive proper help.

3. People who have been getting proper help for a long time. They simply lose hope. They view the long time they have been getting proper help as seeming proof they will never feel life is worth living. They dispassionately read coronial reports and suicide methods, carefully put their affairs into an orderly state (in particular financial arrangements for dependents), acquire the required resources to execute a painless while assured lethal plan that imposes no safety risks to others, then go off and do it.

I was in the latter group, but I messed up by saying goodbye to my wife after a little wine (combined with Effexor) and that resulted in the full force of the law whack the shit out of me (and the fact it's obvious you're in this latter group means they take it far more seriously than if it seemed a fleeting impulse).

Anyway by any objective measure the third group are making a rational choice to die. It should not be the community's right to dictate they should indefinitely live in pain.

It sounds like you still want to die. Is that the case?

I am currently hopeful given a new treatment that's care-focused.

I'd also add that discontinuing antidepressants (with the associated emotional blunting, at least in my case) means I am more empathetic to the impact on my wife and kids.

It's when there's no hope you want to leave the world. Especially when you have means that are painless, assured and safe to everyone around you. Plus you can use logic like financially your kids are better off with you dead due to testamentary trusts and the lack of your resource consumption (I had a startup exit, so retired long ago).

While I still hate living, I'm not actively planning to die at present.

This is purely for my own curiosity but did you try electroshock? It seems to have no effect on some people but work wonders for others.

I submit that people are far too willing to judge the choices of others as irrational.

Oh yeah? How many people have you spoken to about what was going through their minds when they attempted suicide? Did it sound mostly rational to you?

Why would it? I lack the context to understand their problems. I may feel like I understand, since I've been suicidal myself, but that's from a perspective of not currently being suicidal.

Regarding this particular question, my opinion is that context, in the form of problems that suicidal people face, is often a separate issue from the suicidal impulse itself. Lots of people face problems that might make them consider killing themselves, and perhaps rightly so. But in the moment of attempting it, the thoughts that go through most people's minds-- the thoughts that either permit or motivate them to actually carry it out-- tend to be "irrational." Suicide as anger/punishment, for example, is "irrational," as is (usually) the belief that people who love you would be better off without you.

and also 3: The fear of death is extremely difficult to overcome for most people, even when it's objectively their best option.

on this topic, there's an excellent blog post called 'Who by very slow decay' which I think would change most people's minds if they read it. https://slatestarcodex.com/2013/07/17/who-by-very-slow-decay...

suicide, if done right, is one of the best ways to die.

Maybe some people have a deep-rooted fear dying might not be a final act of suffering?

A list of suicide hotlines are available here: https://www.reddit.com/r/SuicideWatch/wiki/hotlines

Here are the numbers for the United States:

National Suicide Prevention Lifeline: 1-800-273-8255 (TALK) Veterans press 1 to reach specialised support.

Online Chat: http://chat.suicidepreventionlifeline.org/GetHelp/LifelineCh....

Crisis Text Line: Text "START" to 741-741

Youth-Specific services (voice/text/chat/email) from the Boys' Town National Hotline: http://www.yourlifeyourvoice.org/Pages/ways-to-get-help.aspx

Spanish: 1-800-SUICIDA

Despite almost everyone who has made an attempt on their life saying it's counterproductive and patronizing, this is consistently the first response on any thread or discussion about suicide.

I think this is symptomatic of the broader total failure to understand what could lead someone to suicide, and the tendency to assume what someone in crisis knows or just ditching them off. Maybe just accept that suicide is a human right and engage individuals in crisis as individuals with unique problems.

I've been to the edge and back. It never occurred to me to call a hotline and it never would, but I have no doubt that other people might benefit from it. If the prospect of saving a life isn't enough to get past some abstract hand-wringing then I don't know what is. The point of the hotline isn't to fix you or permanently stave off a desire to kill yourself. The point is to buy enough time for you to get real help.

Maybe. But they don't do it passively. They will call the police.

It's an absolute shame that you were involuntarily committed only to not get any help while you were in hospital, but are you taking the position that the hotline people shouldn't call the police if they think you're hanging up in order to kill yourself?

If they say it is a confidential service and you literally do not give your name, and mask your phone number - then yes.

Having someone who will listen without the threat of loss of freedom or involuntary death is no small comfort.

It's worse than that. Lifeline in Australia claim they have a confidential service, but in fact if you call from your mobile phone, don't give your details and turn off caller ID they still have systems that can identify who you are.

I should know - I was trying to talk myself down from suicide by calling them, and the next thing I know (hours after I had stopped having those feelings) the police forcibly took me to hospital where I received no treatment whatsoever.

The NSW Mental Health Act is an appalling instrument. I've been highly suicidal and scheduled via so-called "crisis intervention teams" (invoked by my wife) and all it achieves is reinforcing to a suicidal person just how utterly powerless they are and how grossly dysfunctional and incompetent the mental health system is. Locking up law-abiding people only lasts so long, then they leave far, far, far worse than if you had never done that to them.

Support services like Lifeline are a waste of time if you've already been plugged into medication and talk therapy for a protracted period. You don't need some well-meaning volunteer to state the obvious that there is help. You've been getting professional help for years. It's losing hope that leads people to suicide.

In my case finding a clinical psychologist who prioritises mind-body therapy (with a strong focus on trust and non-violence) made a large difference. Unfortunately it requires far more sessions and a "follow your nose" approach based on the individual client so it doesn't have the empirical robustness of mainstream therapies. But it changes your outlook completely when it's a care-focused therapy (ie the complete opposite of what the Mental Health Act smashes you beyond recognition with).

Indeed, and again, pretty much everyone in the depression community knows this and actively avoids these services because of this. I think people call it chaptering now.

Related, something that really hit me and this community hard on suicide: https://gizmodo.com/the-agonizing-last-words-of-programmer-b...

Bill Zeller talks about difficulty overcoming early childhood trauma in his last words. He perhaps could have benefited from the techniques described in this book: "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel A. van der Kolk https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/01... "Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children. Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring—specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy—and a way to reclaim lives."

Thanks for these. I had never heard on Antrim before, and will be looking up some of his works as a result.

Holy shit, that was intense. Only read this if you feel emotionally stable and resilient. But it was worth the read.

If this is a problem for you, as it is for me, you might find the depression and suicide groups on reddit to be some solace.

Beyond that, I think of suicide as more of something to put off than something to "cure". What can you do to put it off for a bit longer? Sometimes distraction, sometimes drinking, sometimes just getting out into nature somehow.

There's a lot to be said for detaching completely from poisonous people and environments. You might think that you can't leave your awful job, declare bankruptcy, or never talk to your mother again, but you can. And maybe you should.

One thing to consider is the subjective acceleration of time. We all experience that each year seems to pass quicker than the one before, for the most part. I realized at some point that this makes suicide a lot less urgent, at least at my age (50s). Putting it glibly, we'll all be dead soon enough--what's the hurry?

Patience to live and die is the finest of arts.

The problem with recovering from suicidal thoughts is not the fact you wanted to commit suicide. It is how the emergency and health services treat you.

For a long time now, they have been putting people in seclusion, traumatizing a lot of people. They take away any autonomy, and the ED staff literally don't care about you - they are too busy dealing with critical cases and they see you as a waste of resources and an annoyance to be dealing with. Ironically, if you want to leave you won't be allowed to.

It's perverse and disgusting. I strongly recommend speaking to family and friends and do NOT call the police, ambulance or any other official service. And whatever you do, you do not call suicide hotlines - they must call the police if they think you are about to commit suicide so they aren't confidential, despite what they claim.

Also pro-suicide legalisation, also recommend anything but telling authorities (hotlines, therapists) about a full suicide plan. Being stuck in a mental health hold for a week does nothing to help anyone, especially given the abysmal state of many of these facilities.

Even telling psychologists partial plans will cause them to freak out. Here in Australia they do have professional association guidelines (which boil down to there must a realistic, specific plan with timing to warrant breaching privacy), and the Privacy Act has provisions as to when privacy can be violated (also very narrowly permitted), but you're talking about psychologists here as opposed to engineers or lawyers. So they will break the law, you will end up scheduled, and your mental health will end up an order of magnitude worse than at any point in your life.

I'd suggest if you are suicidal and you have already been seeing a specific psychologist for a while, the best thing to do is stop seeing that psychologist as their approach is not offering you hope. Switch to someone with a completely different treatment modality. Psychologists are as varied in quality as any other profession, but if you are increasing losing hope and thinking about suicide, it's time to switch.

Sure, I should have been more clear. I meant that you can tell a therapist that you are having suicidal ideation (thoughts about suicide) without a problem, as long as it's clear you don't have any specific plans or timelines to act on them.

I agree that a partial plan could possibly trigger a "better safe than sorry" approach to putting you in emergency detainment.

My experience was I had a full plan, but deliberately avoided disclosing the legal triggers, expecting the law would apply on two levels: (a) the psychologist did not meet the threshold to breach privacy and (b) even if scheduled the legal requirement to only provide treatment in the least restrictive environment would ensure I am released given I have a demonstrable level of compliance in the community.

What actually happened was the psychologist violated the law by telling them I had unusually strong legal knowledge of the Mental Health Act and as such I would say whatever is required to not be scheduled. So I got scheduled on information they should not even have, and did not assess the minimally restrictive criteria competently because they had reason to believe I was unusually knowledgeable of the legislation.

These days I have a mental health lawyer ready to call the moment these people look at me the wrong way and I'll send him in. My level of cooperation with mental health will be zero in the future. At least in NSW the requirements to be scheduled are not strictly followed, so having a lawyer on retainer is the easiest way of dealing with these lawless do-gooders.

Nobody seems to have read this article although many people seem to identify with the topic because of their own suicidal feelings. I found the article very moving and I learned a lot about suicidal illness. The article is brutally honest. I understood how it could be that a person would not think about the pain their suicide would cause. I appreciated the amount of hopelessness and pain the author was in. One thing that is clear is that his pain is his mother's pain is his sister's pain is his family's pain... It's a large and complex family system, that has beget this suicidal person. It gave me a lot of compassion.

See also: Out of the Nightmare: Recovery from Depression and Suicidal Pain by David Conroy https://www.amazon.com/Out-Nightmare-Recovery-Depression-Sui...

"Out of the Nightmare. An all-out assault on the barriers that stand between you and recovery from depression and suicidal pain. decomposes recovery from depression into recovery from envy, shame, self-pity, grandiosity, fear, stigma, social abuse, and the double binds and vicious circles of the mythology of suicide. A drug-free approach to getting better and staying better. This book provides counselors with a bold new non-technical framework that is free from the prejudices that deter the suicidal from seeking help. It provides those who have lost a loved one to suicide with a broad array of new conceptual tools to understand the tragedy and to find help for stuck positions of bereavement. Most importantly, it provides all those who suffer from depression with hundreds of resources to find their way out of the nightmare."

A suicide by an employee or within the families of employees touches many lives and can significantly impact productivity. Along with advice for suicidal individuals, the book includes suggestion for first responders, counselors, friends, and those who sadly are survivors of someone else's suicide. A major focus of the book includes deconstructing harmful ideas surrounding how people often think about or respond to those who have suicidal ideation and suggesting a more effective way of thinking about suicide prevention called the aggregate pain model.

Some key ideas from the book are summarized here: https://www.metanoia.org/suicide/index.html

"Suicide is not chosen; it happens when pain exceeds resources for coping with pain. That's all it's about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn't even mean that you really want to die - it only means that you have more pain than you can cope with right now. If I start piling weights on your shoulders, you will eventually collapse if I add enough weights... no matter how much you want to remain standing. Willpower has nothing to do with it. Of course you would cheer yourself up, if you could. Don't accept it if someone tells you, "That's not enough to be suicidal about." There are many kinds of pain that may lead to suicide. Whether or not the pain is bearable may differ from person to person. What might be bearable to someone else, may not be bearable to you. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain. When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping resources. Both are possible."

One of the fundamental challenges in an organization or society is to destigmatize asking for help to avoid the classic dilemma those with suicidal thoughts face when they expect asking for help will only increase their pain from whatever reactions occur -- such as job loss or being ejected from a university community. By reconceptualizing suicide as an involuntary action that occurs when total pain exceeds resources for coping with pain, David Conroy provides a morally neutral way for organizations and society to think about suicide prevention in a productive way. Rather than focus mainly on intervening in a crisis, organizations can rethink their operations to reduce participant pain and to increase coping resources. This helps everyone in the organization, not just those who have reached a threshold where pain is very close to coping resources. Early intervention is much cheaper and more successful than waiting for a crisis. This model shows how organizations can approach suicide intervention in hundreds of way. One of those ways is also making people aware of success stories where individuals overcame depression and related suicidal thoughts.

Aggregate pain includes physical pain, emotional pain, and social pain. Reducing pain in any area by even a small amount may bring a person below a threshold for suicide. Similarly there are many types of coping resources from interacting with a friend, to going to a funny movie, to receiving adequate health care, to interacting with a pet. There are also some short-term coping strategies like denial or drinking which may have long-term negative consequences that become new sources of pain when done to excess.

More coping methods for transcending depression can be found in books listed here: https://github.com/pdfernhout/High-Performance-Organizations...

(Posted in memory of Robin Rochlin Cooperman -- a good friend from college who became a psychiatrist to help people who had mental illness and related challenges. I dearly wish she was still around for many reasons -- including to discuss such books with.)

Thank you for posting this.

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