Farewell, cruel world. Saturday, November 20, 2010.

“Screw you all. You don’t care about me anyway. No one cares about me. This is it. I’m done. I’m throwing myself onto the subway tracks. I hope you all are happy!!!!” – Fictional compilation of dozens of suicidal farewells I’ve seen on Facebook

I don’t have many rules for the Suicide Attempt Survivors board, but this is one of them: If I see a suicidal farewell note, I will delete it.

One such note appeared recently. I removed it and sent out a reminder about my rule. I received the following PM from a fellow who then blocked me:

“wow I see if i got in crises I'm wasting my time in your group. sorry but whats the point to have a group about suicide and help if don't want see goodbye notes, hello excuse me you'll see them duh. specially from people who don't have any places to look for help. i haven't see any more selfish and sucker than that. and giving her a simple # won't help.”

Wow. Maybe I need to clarify.

SAS IS a place to come for help. I want it to be an online support group. Those of us who have survived a suicide attempt are the only ones who can really understand each other. If you’re feeling depressed and anxious, if suicidal thoughts keep invading your mind and you don’t want them there, if you’re feeling misunderstood or triggered, by all means post about your feelings. You must realize that the board is not moderated 24/7, that we can’t help in an emergency, and that we’re not professionals. But we can lend an ear and a virtual hug.

However, if you’re just pissed at the world, or you’ve already decided you’re going to do yourself in and you’re hoping for an audience, then I suggest another board like “Suicidal Venting.” There is a big difference between seeking help and seeking attention.

What happens when you post a suicidal farewell on Facebook? Well, you upset a lot of people, many of whom are depressed, anxious, and vulnerable. But it’s not like announcing your intent IRL. Here on Facebook, we don’t know who you really are, where you really live, or how to really help you. So all we can do is feel scared and helpless. And for every Facebook farewell that culminates in a real suicide (and there have been some), there are probably 500 that do not. Which means in a few days or weeks, chances are you’ll be posting your farewell again.

So please. We are all here because we are healing, and because we’ve hit bottom and don’t want to be there again. We all know how it feels. If you are feeling depressed and hopeless, go ahead and tell us about it. If you are scared because you might hurt yourself, there are numbers to call (like 1-800-suicide).

But if you just want to shock people or make us feel guilty, there are other places to post.

Peace/Love,

Alizah.

Putting on boots. Wednesday, November 17, 2010.

“It's not our fault that we got sick, but it is our responsibility to get well.” –Dr. Abraham Low

One day when my son was about 4, I had to make a run to the Laundromat to rescue a basket of clothes I’d left behind. His dad had just left for work, and I had forty-eleven things I needed to get done that day. “Get your coat and boots on, Eli,” I said. “We have to do a quick errand.”

Eli had always been an exceedingly obedient kid, so I was surprised when he refused. “No,” he said. “I want to stay here by myself.”

“It will take five minutes, and I don’t feel comfortable leaving you at home alone yet,” I said. “Come on. Jacket and boots.”

Eli put his jacket on, but he drew the line at his boots. “I don’t want to go,” he said. “I’ll just stay here and watch TV.”

“Honestly, Eli, it’s not an option,” I said, mentally checking off the various tasks I was attempting to complete as I headed out the door. “This is not an Eli-decision. This is a mom-decision. You need to follow me, right now.”

I walked out to the porch, which was covered with several inches newly-fallen snow. With a loud sigh, Eli followed me, stepping out into the snow – in bare feet.

Eli screamed like I’d driven a metal stake through his skull: “IT’S COLD!”

“Jeez Louise, Eli! Of course it’s cold. It’s snow! Where are your boots?”

“You let me come out here like this!” Eli cried. “It’s YOUR RESPONSIBILITY to make sure I have boots on!”

I still laugh at Eli’s little rebellion that day. I made it clear that it was his own feet, and therefore his own responsibility; he had the option of going to the car with or without boots. He chose boots.

People recovering from emotional disorders are much the same. I’m not saying that we’re like 4-year-old children (although some of us can be). I’m saying that recovery is hard work, and often, we would prefer that someone else do the heavy lifting.

As the facilitator of an online support group for survivors of suicide attempts, I get a lot of PMs from people who are depressed, anxious, and discouraged. I’ve been where they are; sometimes I am still where they are; and I’m sure I will be where they are again. I’m not a doctor, and I have a family and a full-time job, so there is not much I can do except lend moral support.

Often, in an effort to help, I’ve done research to find books people can read or support groups in their area. I’ve found websites and online articles that might be of help. I’ve suggested social services they might contact. What I’ve discovered, though, is that very often I’m the only one making an effort in the scenario. I hear, “I’m so lonely.” I provide a half-dozen suggestions for meeting people. But a few days later, I get another PM: “I’m lonely.” “Did you try X?” “No. I’m too depressed. Because I’m lonely.”

Know what? I’ve hit bottom. I’ve hit bottom so hard that a razor blade and four bottles of pills seemed like a good idea at the time. But I also know that no one can get well for me but me. It’s not my doctor’s responsibility, or my husband’s, or my mother’s or my son’s. It’s mine.

My boots are my boots. Your boots are yours.

Sticky-glue. Tuesday, November 16, 2010.

“Once you label me, you negate me.” –Soren Kierkegaard

I am female. I am blonde. I am Christian. I am educated. I am intelligent. I am pretty. I am bipolar.

Which sentence caused you to sit up and take note?

It’s a strange thing about many mental illnesses. Unlike most other kinds of illnesses, their names are labels that define us. I have a friend who HAS cancer. Another friend who HAS lupus. But another friend of mine IS schizophrenic. Huh. Interesting.

Like most rules, this one has exceptions. For example, my husband is diabetic and my son is asthmatic. But there’s a reason why many advocates for the mentally ill work so hard to reframe the language around these illnesses, conditions, disorders and syndromes. When it comes to differences of the mind, labels cling to us like sticky-glue.

Of course, the language wouldn’t matter if there weren’t a stigma attached. When I was young and single, I was very open about my “manic depression” (as they called it then). Now that I support a family and make my living in publishing, I keep my diagnosis to myself.

I shouldn’t have to do that, and some people would tell me I SHOULDN’T do that – that by my silence I’m only increasing the stigma. There’s probably people who want to “out” me. It’s precisely because I work in a demanding field, take care of my family, and “seem normal,” they would tell me, that I should tell everyone who will listen about my diagnosis.

They’re probably right, but I can’t take the chance. It’s not about me anymore – it’s about my family, their privacy, and my ability to support them. There are laws that protect me, but I’m not so foolish to put my trust in them.

Besides, my credibility matters to me. As I wrote in October, it’s interesting that once you’re diagnosed with a mental illness, you no longer have the freedom to have the emotions others do. I know once my bipolar cat is out of the bag, all of my behavior is blamed on that. I’m not irritated because a co-worker missed a deadline, I’m in an agitated depression. I’m not in a good mood because I did well on a project, I’m in a manic high. No thank you. I’ll keep that cat in the bag.

None of this SHOULD be the case. And in reaction, some people go so far as to say there are no disorders at all, only different kinds of people. But I believe a label can be incredibly important and helpful. A label helped me to understand that I wasn’t just a pathetic loser, just as a different label helped me to understand why my father is the way he is. Labels give us an important context for emotions and behavior.

But just like sex and Merlot, labels have their time and place.

‘Don’t call me daughter.’ Monday, November 15, 2010.

For D.J.

“Schizophrenia cannot be understood without understanding despair.” –R.D. Laing

Chyna was halfway through her second try at college when “the Choir” came to visit.

The daughter of Laurie – a dear friend of mine that I’ve known literally since I was born – Chyna had dropped out of college a few years earlier after a nearly-fatal battle with lupus. All of Chyna’s organs had shut down. Laurie had stayed by Chyna’s bedside for weeks, caring for her and praying with her. Chyna’s survival was a medical miracle that literally cost the family everything they had. But Laurie adored her daughter. The sacrifice was more than worth it.

Now, things were slowly returning to normal. Laurie was back to work. She’d found an apartment she could afford, even if it wasn’t in the best neighborhood. And Chyna was very excited to be back at school. But she found it hard to concentrate. It seemed that “holes” were opening up inside her brain and swallowing memories – entire years were disappearing by the week. And then the Choir arrived.

At first, Chyna thought it was a little strange that no one else could hear the Choir. But she could hear them quite clearly, and she felt compelled to do whatever they told her to do. When they instructed her to prepare for a marriage with her (already married) pastor, she ordered a wedding dress with money she didn’t have. When they told her to rip up a Bible, or shave off her long, beautiful hair, she did as they said.

When the Choir told her to take off her clothes and walk around the neighborhood naked at midnight, Chyna did that, too. In fact, she started doing it a lot. Laurie’s warnings about nearby drug houses and gang territory went unheeded – only the Choir was worth listening to. Having dealt with the fear of losing her daughter due to a physical illness, Laurie was now even more terrified for her daughter’s mind.

You’d think that a concerned mother could bring her daughter to the doctor, explain the situation, and get some treatment for her daughter. But Chyna was 29, legally an adult, and many of the professionals refused to provide information to her mom even though Chyna was clearly psychotic. Laurie needed to become Chyna’s legal guardian, and so began the long and complicated process.

What Laurie did learn from the doctors was sketchy. Chyna tested negative for street drugs. That left several possibilities: the lupus, or possibly the chemotherapy used to combat it, could have created lesions on her brain. She could be developing schizophrenia. She might have Huntington’s disease or early-onset Alzheimer’s. Perhaps she had suffered a number of mini-strokes.

The more questions Laurie asked, the more questions were uncovered. Medication was prescribed for her Chyna’s hallucinations and anxiety. The mediation would ease symptoms for a time, and Chyna would have glorious spells of normalcy. But her father, who lived out-of-state and hadn’t seen his daughter for years, was enraged that she was taking psychiatric medication and told her the pills were “poison.” Of course, the Choir agreed.

Chyna went off her meds, and Laurie had no legal means to force her to take them. Now the Choir began to order Chyna to hurt herself with whatever was handy – a fork here, a glass trinket there. The apartment had to be made “Chyna proof” and trips to the emergency room became weekly occurrences.

Chyna receives some state aid for medical care, and gets bare-bones treatment that might disappear if certain politicians have their way. The kind of group home her plan would pay for would be worse than living in hell, Laurie thought. So Laurie would stay awake all night long to prevent Chyna from running naked into the night, and her sister would watch Chyna while Laurie was at work. Sleep-starved, Laurie found it hard to function, and lost her job. “But at least I can keep an eye on Chyna all the time now,” she told me.

Still, Chyna managed to wriggle out the window or run through the door if Laurie or her sister took a 10-minute cat-nap. Finally, in an act I’m sure Laurie would never have dreamed of three months before, she installed bars on her apartment windows and key-locks on the doors – not to keep the gang-bangers out, but to keep her beloved daughter in.

A few days ago, things took a turn for the even-worse. Chyna’s father came to town to see her; she believed he was her pastor, finally come to marry her. Nothing he could say or do would dislodge her delusion. Laurie began making dinner in the kitchen. Chyna stared at her, her huge brown eyes registering nothing. Finally, she said, “Who are you? What are you doing in my house? … I know who you are. You’re Satan.”

Laura sobbed in my arms as she recounted the story. The Choir had grown louder and it was now telling Chyna to commit suicide. Laurie had already lost her brother to suicide; she was not about to lose her daughter as well. She’d checked into it before, and had found out that a 72-hour hold in the psych ward would cost $43,000 – more than twice her annual income. Didn’t matter. That time, when Laurie and her sister drove Chyna to the hospital, they came home alone.

When I saw her yesterday, Laurie looked like she had aged 10 years. A beautiful woman, Laurie’s eyes were puffy, her hair was graying, she’d lost weight and hot tears were streaming down her cheeks. “I love her so much,” she sobbed into my chest. “I know you do, hon,” I said.

Please don’t talk to me about how only unloving families opt for forced treatment, or how all psychotropic medicines are evil, or how there is no such thing as mental illness, only creative and unusual people who are unfairly labeled. I don’t want to hear it today.