Suicide is the 10th leading cause of death in America. It’s #2 for 10-14 year olds and #3 for 15-34 year olds.

90% of people who attempt suicide have depression and/or have substance abuse issues.

(www.addictioncenter.com)

Trigger Warning: Suicide and Suicide Attempts discussed in light of bringing an end to the shame and stigma surrounding Mental Health Needs and Substance Abuse. 

If you need help NOW, call 9-1-1.

I was 14 years old when I intentionally overdosed on Tylenol. This was my first and only serious planned attempt at showing the world – my family at least – that I was sad enough to try and end my life.

In the days leading up to it, I pictured how it would happen, and it came to fruition exactly that way. Out of compassion and sensitivity to my family and those that may be grieving losses of their own, I’m going to leave out details.

Despite the amount of pills I took, I was fairly sure I would not actually die. I knew my mom would take me to the hospital and she did. The first nurse in the ER that I encountered (or ER tech? I’m not sure) said “Seems like a pretty stupid choice. You knew what you were doing right kid? Looking for some attention.” He was right – I needed attention and felt there was no other way to show what it felt like inside of myself. A physician assessed me and said “This is really the worst way to try to die. You wouldn’t die right away – but you’ll hurt your liver so bad you’ll die slowly anyway.” He didn’t offer any quicker solutions however.

The next 4 days were very confusing. I was able to rest, which felt like a small break from the unrelenting anguish I’d experienced. The doctor prescribed a tylenol antidote which they mixed in Diet Coke. After drinking it, I’d throw up,  which infuriated a particular elderly night nurse. It was so disgusting that I couldn’t drink, or even smell Diet Coke, for the next 10 years.  (Many nurses I know have a story about themselves or a loved one being cared for by amazing nurses. This hospitalization was my first, and nothing about my caregivers made me want to follow in their footsteps. That career choice came later.)

A psychiatrist or psychologist came in and asked weary, uninterested questions. He sat very far away from my bed. His final statement was “I don’t really see what we are going to do for you.” That was the only conversation anyonehad with me regarding my emotional and mental state. As soon as my liver enzymes came back to normal I was sent home.

I began seeing a counselor (not a psychiatrist or psychologist) and was prescribed an anti-depressive by my family doctor that caused terrible panic attacks, so I quickly went off of it. My diagnosis changed frequently – Bipolar, then not. Bipolar 2. Then not. (It was 1995 and seemed everyone was suddenly Bipolar). “Take a pill, see a counselor once a week, and don’t do anything dangerous.” The one time I told a counselor I was considering going to a party with my friends, she said “That’s against your treatment plan. I’m either telling your mom or I can’t see you anymore.” The choice was obvious to me. It also reinforced that I couldn’t be honest with ANYONE.

My treatment was sporadic for a few reasons. I was resistant. There was chaos and divorce in my family home. Then I had a daughter myself at 16 and for years my emotional turmoil sank far under the surface – deeply ingrained but with no outward warning signs for others.

When depression and anxiety resurfaced as an adult, I didn’t fully recognize it. I’d been a mom and nurse for many years. I believed that extreme stress was normal, and that I “should” be more capable. With a perfectionist, overachieving attitude, I added more stress to my life believing that if I accomplished more, I would feel better. Maybe I felt so nervous and dissatisfied because I wasn’t doing enough to feel happy. I went back to school, I got married again, and I took on a supervisor role at work.

And then I began to crash.

I had suffered migraines for years, and when I was prescribed Vicodin, it took away a lot more than headaches. It removed the constant fear of the future; the regrets and dismay of my past. Add alcohol to it and I had found the magic elixir – for awhile. I didn’t know it, but by numbing out everything “bad” in my life I was also numbing out everything good. Alcohol and opiates are strong depressants, and were adding to the problem at the same time they were helping me stay oblivious. I played around with how much I could take while maintaining daily functions. Slowly, passively, I was still trying to end my life.

Sitting across from my counselor about 6 years ago, I admitted “My thoughts are so dark. I constantly picture putting a knife through my chest. I’ll be walking through a grocery store and picture holding a gun to myself. I don’t really want to do this – and I don’t have a gun. But I also don’t want to go on.”

It didn’t occur to me that even as a strong, capable nurse, it would be OK to walk myself into an ER or call a crisis hotline. I couldn’t imagine that I needed – or deserved – that kind of help. I couldn’t “afford the time off” or “show my weakness”. The years went on and the substance abuse – my own personal treatment plan for the emotional and mental pain I was feeling – increased.

I briefly mentioned the anxiety to my physician, but kept the conversation short and light. I knew from past experience that I “shouldn’t” be completely honest with anyone, so I left out any mention of my drug and alcohol use. She recommended a low dose anti-depressant, but I was doubtful. MY depression and anxiety was “situational” I convinced myself. Life was tough! I was going through a divorce. And my doctor agreed. If I could just get a handle on the stress in my life, I wouldn’t feel so bad.

Nobody suggested that it was the opposite – that if I could find a way to stop feeling so bad – learn to accept and cope with painful experiences with self-compassion, learn to love myself and tolerate discomfort – that I would not only be able to handle the stress in my life, I would stop adding to my suffering.

My happy ending is that I did eventually find that formula. In active recovery for substance abuse I’ve learned to change my relationship to my thoughts. Once I was free from the substances, I could begin accepting myself and my life circumstances with love. I began making small daily choices that set me free from internal and external stress: Mindfulness meditation. Self Affirmations. Noticing my inner “saboteur” and working to not believe that voice. Lots of self care. Reducing my hours at work.

I dove headfirst into trusted self-improvement such as Byron Katie’s “The Work”. I found Brene Brown’s research on shame and vulnerability and began to believe that by saying ‘I need help’, I’m actually being my most brave, strong, courageous self. I took Mindfulness Based Relapse Prevention and learned that my thoughts are NOT me, and that I have a choice to let them go and can work towards choosing joy.

And I never, ever feel too proud or afraid to ask for help anymore. 

When I took 3 months off work to go to outpatient substance treatment, I learned that a mom with a full time job and a mortgage can in fact still find ways and means to pause everything and take care of herself.

I learned that no matter how “shameful” it is to be a nurse in state probation program, I can still show up at my job feeling proud that I’m doing the hard work of healing the wounds in my life, and that I still deserve to be here.

When I read the news this morning about Anthony Bourdain I was sobbing before even leaving my bed. For him and his family. (My father loved him – we watched him together many nights). For Kate Spade. For the desperation and hopelessness they must have felt. I imagine they felt like they couldn’t reach out to anyone. Perhaps they couldn’t admit what felt like weakness; that they didn’t want to be a burden. And no doubt they felt like they couldn’t go one more minute with their anguish filled minds.

I cried for myself, at 14. And at 30, for all the days spent visualizing harming myself. For all of the patients whose bedsides I have sat next to in the dark, knowing that they suffered so deeply and could see no other way out.

There are degrees of mental health/illness, degrees of depression and anxiety, and we should all receive individual based treatment. Mine stemmed from childhood trauma, years of self loathing, and a lack of healthy coping mechanisms, along with a strong lineage of depression and suicide in my immediate family. I feel lucky to have found light through my darkness, and hope that if I enter into darkness again I can speak up early knowing that there is hope.

There’s nothing more important to me right now than ending the shame and stigma of mental health disparities and substance abuse. No one should be afraid to say “I need help.” “I want my life to end.” “I’m angry or sad and afraid all the time.” No one should feel shame for “seeking attention” with this desperate act.

Luckily, healthcare is changing, and so is our culture. But it can do better for all of us. Depression and anxiety need to be treated holistically  – not “just” with a pill. Or “just” talking to a counselor. I don’t know the answer, but I want to be a part of finding it.

If you are feeling scared, depressed, anxious or hopeless, know that you are LOVED right now. I am sending you all the compassion in my heart. I have been there – maybe not exactly where you are. But in a similar place. And I have found a new way to live. There is NOTHING wrong with asking for help. NOTHING wrong with saying you’re spiraling out of control and you need someone to help you take of care of yourself. You deserve help. You deserve to love yourself. You are needed and wanted, and if you’re not finding the answers you need, don’t give up. It might be scary to pick up the phone and call the suicide hotline, or you may feel shame about showing up in your local hospital and saying that you’re considering hurting yourself. I promise you, the scary part is temporary. Life on the other side of real help and healing can be worth every scary minute of that first phone call.

Life is very hard, and very beautiful. It’s always changing. Don’t choose a permanent solution for temporary pain. Give yourself every chance to find the beauty.

IF YOU NEED HELP NOW, CALL 9-1-1 OR Call 1-800-273-8255 (SUICIDE PREVENTION HOTLINE).

Make an appointment with your doctor and a licensed therapist. Talk to a trusted family member or friend. Tell someone. And don’t hold back – tell them everything. You’re worth it.

My favorite resources for learning Self Love: 

Mindfulness Based Stress Reduction (find your local classes online)

She Recovers (www.sherecovers.co)

The Work of Byron Katie