Firstly I want to note that this may be distressing for some people to read so please bear this in mind. Secondly I want to make very clear that these are MY experiences and opinions. Finally I also understand that I have never experienced the impact suicide has on those left behind and that this post may cause offence or raise some difficult issues. If this is the case please feel free to message me personally or leave comments on this post.
Some facts: suicide attempts are very high amongst those with Bipolar, 15 – 20 x higher than the average population and around 20 – 50% of those with Bipolar will attempt suicide at some point in their lives (http://www.nhs.uk/Condit…/Bipolar-disorder/…/Prevention.aspx)
The difficulty with mental health is that the thing that needs fixing when youre unwell is your brain, all your thoughts and emotions, your senses, the things you see and hear, they are all part of the illness and it is impossible to step outside of that. I remember being very unwell and running for hours, thinking I might be able to escape my thoughts just for a couple of seconds, if was quick enough I could outrun them, I remember seeing my shadow on the floor next to me and hating where it joined my feet, I just couldn’t escape myself.
When I was first diagnosed in day hospital I remember asking my psychiatrist ‘but who am I then, if all of the things I associate with myself are an illness which bits are really me?’. Most of my young adult life I have been chatty and outgoing and it felt like someone had slapped a massive label over it and called it mania. I suddenly felt like the things that made me me were infact an illness. It felt as though someone had told me who I was as a person was wrong, when that happens you lose an enormous sense of identity and purpose.
When I am ill, in full blown mania or depression, I would say my life is like living a nightmare. If you think about the worst emotional pain you have ever felt, that first moment you experienced it, where it physically hurt you – Bipolar is like that but without a cause and without a time frame. I remember when I first got ill that I would read every evening until my eyes were sore because it was the only time where there was any hope that I might wake up in the morning feeling ok. When I would wake up feeling just as bad it felt like a kick to the stomach knowing that I would have a whole day, hours upon hours of this indescribable pain. Most people associate this kind of grief with an event, a death, a break up, something significant; with Bipolar this grief comes from nowhere, knocks you for six and has no end point. When you can rationalise your grief it is much easier to cope with, even a death, which is so horrible, can be understood, you know why you feel the way you do and your reaction is completely justified.
Being unwell makes you feel utterly helpless and out of control, even your thoughts are not your own. I think people sometimes imagine depression as an exaggerated break up, you feel very down, loss of appetite, cant sleep or sleep too much…. And that’s because on paper that’s exactly what it is- a list of symptoms that everyone has experienced at some point. The difference is the internal agony that goes alongside those symptoms. Every single moment of every single day is hell and with Bipolar you know that you’re going to experience that hell several more times in your life.
Once you understand this I personally think it is very easy to see why so many people with bipolar attempt suicide. What you are asking someone is a very simple mathematical question- does the good outweigh the bad? When you are in that sea of hell you need a lifejacket to save you, that might be family, friends, your job, anything that creates meaning in your life. For some people that lifejacket is always there, close by, they can grab hold and just about stay afloat. For others the lifejacket is there but when you grab hold its too small, its not enough to keep you afloat and you cant keep your head above water. For others, and this is the worst, there simply isn’t a lifejacket, these are the people that become lost and ill very quickly.
For me my lifejacket was too small; I can clearly recall being told that suicide was selfish and would devastate my younger siblings. I adore my siblings so it is testament to that pain that I thought ‘ no, im sorry but that’s not enough’ .This was pre diagnosis and I think that’s possibly a whole other kettle of fish, its much harder when you don’t know youre meant to be searching for a lifejacket in the first place. I tried to commit suicide by overdose, I carefully researched online the amounts in grams that I required for death as opposed to organ failure. We had a business park near campus and I went into several different shops over the course of a few days in order to get enough medication. I never wanted to die, no one does, but everyone who attempts suicide wants out. Im not sure what I expected to happen I just knew I didn’t want to exist anymore, I didn’t want my own thoughts running wild in my head, I felt like Bipolar had turned me against myself. I was taken to Hospital and monitored and then discharged a couple of days later.
I would say that during every depressive episode I have had there has been a point where I have contemplated suicide. During the early stages of every depression I buy enough medication to overdose, even now. I never want to have to stay here, I never want to have no choice in an illness which has already taken so much free will. As a result of this and the fact im highly impulsive I generally need to see my mental health team almost every day when im ill and I am usually only given three days worth of my prescribed medication at a time. Sometimes my team know I hold onto medication I have bought for an overdose, they usually ask to have it and depending on how well im feeling I might hand it over.
People usually say that suicide is very selfish, my personal opinion is that no one commits suicide feeling anything other than indescribable pain. As far as I am concerned the ethics of euthanasia apply to mental health and suicide. If someone is in excruciating pain then we should allow them to make a decision as to whether they want to continue to experience that, the inhumane thing is to force someone to continue that life. The difference is whether the mental health problem can be cured or managed so that the person can have a happy and fulfilling life. I am not against intervention and I think its important, but I also think if there is nothing you can do to improve that persons quality of life then as long as they can comprehend it they have the right to make that decision. My personal opinion is that it is selfish of other people to expect someone who is that unwell to continue their life for the sake of others.
Recently a 24 year old woman was granted the right to die by lethal injection in Belgium due to the unbearable pain she was suffering as a result of long term depression, this has caused a lot of controversy but is based on the same principles I have described in this post, you can read more about this at: http://europe.newsweek.com/healthy-24-year-old-granted-right-die-belgium-329504 (11.2.16)