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the girl with violets in her lap [userpic]

This post is NOT aimed at anyone who RTed this. I love everyone who cared enough to do that.

May 3rd, 2009 (02:08 pm)

I didn't realize how much of a grudge I held against the 1-800-SUICIDE hotline until this "1,000 RTs for $1,000!" thing started on Twitter. I mean, it makes sense, right? Suicide prevention's an important issue, I'll be the first to tell you that. But 1-800-SUICIDE... well, I first got a little squidgy about them several years back (2005ish? I 'unno) when they went from being privately funded to being funded and essentially run by the Bush administration -- as I understand it, a government agency was now staffing and training the hotline counselors. I didn't, and don't, really know how to process that -- I have no idea if the dangers were exaggerated or what. I know they were logging/keeping records of the people who called, which is of course a concern as far as confidentiality goes (there had also been concern that frequent callers would find it more difficult to get life insurance, but I don't know how likely that is, and as far as I know all it ever was was speculation.)

What I do know firsthand is that one night I myself called them in crisis. I should note that ever since one very bad night in college when I poured a bottle of pills into my hand and then knew I couldn't take them, I've known suicide isn't an option for me. It just isn't. There's something in me that wants to fight and wants to live -- probably because all my demons are in my head, and there are so many people in my life who love me and will help me fight. I have had tremendous luck in being born into the family I was. Anyway, the point is, I can't commit suicide. I know this. I flirted with the idea for years until I hit that point where it was "you either take these pills or you flush them, and decision time is right now." And I flushed them. And whenever I start to feel that suicide would be a good idea, I think back to that moment, and I know it isn't for me.

But the fact that suicide isn't for me doesn't always make things feel *better*. Actually, a lot of times, it makes it feel worse in that particular moment. Because that way, I have no out. A friend of mine recently referred to suicide as an "emergency exit"; it's a scary idea and I wish it didn't feel that way to anyone and I don't want anyone in this world to ever take it. But I know that feeling. And I know that while I used to feel like I had an emergency exit, I know now that it isn't true. And if I'm trapped in a room and the walls are closing in and they get tighter and tighter until they're pressing in on me on all sides and my chest can barely expand and I'm gasping and I can't see how I could push them away -- I can't even trick myself into believing there's a way out. All I know is I have to get through to tomorrow, and there are times when I have absolutely no idea -- I mean, no idea at all how I'm going to do that. My brain stops working right. I start wanting to fling myself into walls, grab a pair of scissors and whack off all my hair so fast and careless it'll leave welts in my skull, make a bunch of little cuts on my arms so tiny that they almost don't bleed and then throw salt and alcohol on them to make them sting. I start thinking I don't even know what. None of it makes any sense. I'm alone in my head and it's this alien landscape and I can't get out of it and it's just damn scary.

So one night I called 1-800-SUICIDE because I didn't know where else to call. My thoughts, such as they were, were that, okay, I wasn't actively suicidal, but everything was *so* wrong in my head and I knew I was a danger to myself even if I wasn't going to actually kill myself. A self-injuring mindset is a bad place to be in. A mindset that's almost, but not quite, mildly psychotic is a bad place to be in. I knew just enough to know that, knew just enough to know that a bunch of tiny cuts or a bloody bald head weren't the answers. So I called the suicide hotline. I may not have conveyed it properly in this entry, but the state I was in was my bipolar version of severe depression -- for me it bottoms out in, well, this kind of shit. And I desperately wanted someone I could talk to, someone who would make me feel less alone, someone who would reassure me that it would be okay, that this was all in my head, who would talk me through what sorts of things might make me feel better. I thought if they had tactics to talk someone down from suicide those same tactics might work to get me off the brink of whatever this was. And I thought that even if that wasn't an option, there would at least be a voice on the other end of the line, someone to care about what was happening to me.

And so I called. And this is the conversation that we had.

KYLIE: [troubled, withdrawn, and not articulating very well] Hi, I... was hoping you could help me... I -- I'm feeling depressed, and I thought... is this, like, somewhere I can call to talk to somebody?
HOTLINE LADY: [with a trace of impatience] Are you feeling suicidal?
KYLIE: I... no, I don't think -- I mean, not exactly. I'm bipolar and it's... a bad night and I... no, I'm not suicidal, because I know I couldn't do that, but I feel like... I mean, it's a bad night.
HOTLINE LADY: This is a suicide hotline.
KYLIE: So... I can't talk to someone there? This isn't somewhere I can call?
HOTLINE LADY: [more impatiently than before] It's a suicide hotline. You're not suicidal?
KYLIE: ...no. I guess.
HOTLINE LADY: Then I can't help you.
KYLIE: Is there... I mean, like, somewhere else where I could call? Where they could help me?
HOTLINE LADY: Not that I know of.
KYLIE: ...okay. So I guess I should go?
HOTLINE LADY: All right.
KYLIE: Um... thanks...
HOTLINE LADY: You're welcome. ::click::

And I do know it's a suicide hotline. And I know the techniques they are trained in are probably meant to bring people off the brink of suicide.

But I also know this. Not everyone who is suicidal is able to articulate those words. Just calling a hotline called 1-800-SUICIDE ought to be a tip-off that the caller is not doing well and is probably latently, if not overtly, suicidal. (Years after I made my "to swallow or to flush" decision, a psych evaluation showed that I had "significant latent suicidal ideation" and that I needed to be carefully monitored to make sure that didn't become overt.) Hotline staffers should be trained to deal with the fact that some of their callers *will* be in a "I mean, I could never actually do it, but..." state, and they should be trained to ask what's after the but, what's underneath the ellipsis. And even if they can't help the person who's calling -- they may not be trained to deal with psychotic states, for example, although I believe that they should be -- they need to show some kindness. Not impatience. Not "I can't help you" with an undernote of "why did you call 1-800-SUICIDE if you're not suicidal?" and an even stronger undernote of "get off the phone." I heard *no* kindness in that woman's voice at all, and I needed to hear a kind voice so badly that I would have taken anything I could get. There was nothing *to* get. Just impatience, and a distinct impression that if I didn't know that 1-800-SUICIDE was strictly for suicidal people, I was kind of dumb.

Maybe 1-800-SUICIDE is a good hotline for bringing overtly suicidal people -- the people who can say "I am seriously considering slitting my wrists/swallowing these pills/using this gun/whatever" -- off the brink. And that's a good thing. That's a great thing. But what is so scary is feeling like if you don't have those pills held up to your mouth, there's no net to catch you if you fall. There's no one you can call at 3 in the morning who will speak to you kindly and help you through this.* And it's especially awful when you call the only hotline you know of and they tell you you're not worth their talking to. That what you're going through doesn't matter because it doesn't involve an immediate threat to your life.

Whenever you hear statistics about depression and such, what you hear most is "Depression kills x number of people each year." Through suicide. And most of the efforts to work with depression are aimed at suicide prevention. Which is huge. Crucial. Immediate. Of paramount importance. I could give more adjectives, but you get the point.

But what those stats ignore are the people living in misery every single day. We fall off the radar. Hospitalization programs are designed for people who are suicidal; suicidality is the magic key that unlocks the door of the ward.** A good therapist or prescriber will worry about severe depression even if there's no suicidal ideation, but a bad one -- and I can vouch for this personally -- will not devote a whole lot of energy to ameliorating that. I had a therapist once -- saw him for a year, actually, because I didn't know any better options were available to me -- who literally did not care if I was barely able to get out of bed, so long as I wasn't going to kill myself and I wasn't going to go manic.

I'm not severely depressed today. But what that woman on 1-800-SUICIDE taught me was that if I was ever going to get out of those super-depressed states, I was going to have to fight my own goddamn way out, hanging to the cliff face by my fingernails and listening to them rip one by one and praying I'd find some sort of a foothold before the last bloody nail pulled off. When I posted the other day about how when my brain starts to go quasi-psychotic, I take a quarter dose of antipsychotic and then watch the Golden Girls? No one ever taught me that. No one ever even taught me what dosage of meds would be appropriate in that situation. No one ever taught me strategies to get out of that scary place. I had to go through trial and error a million times before I learned the sort of music that will bring me out of a specific headspace, the difference between that and the headspace in which coloring is the most helpful thing for me, and the difference between both of those states and the state in which Seroquel and the Golden Girls are best. I did it all on my fucking own. And I'm proud of that, and I resent that, too. For about four or five years, starting a year or two after my diagnosis, I had a good therapist who helped me through the worst of things, and she's the reason I was able to carry on for myself after a point. But things with her collapsed, as things are wont to do. And now this fight seems to be mine and mine alone.

And that's fine. You know, it's fine. Whatever. I'll handle it. I do handle it. I'll keep handling it.

But in retrospect, I am so, so angry at that woman from 1-800-SUICIDE who told me that since I wasn't suicidal, my problems didn't matter, and she couldn't help me. I am so, so angry that she wouldn't show me some kindness. I am so, so angry that she didn't care.

Maybe she was just one bad hotline staffer. Maybe the rest are better. Maybe the issues surrounding the Bush administration's takeover of the hotline and the confidentiality issues and all that don't amount to much.

But goddammit, that was a bad night, and it got worse after I called that woman. And I didn't know how much that bitterness was still a part of me -- how little I'd forgiven, much less forgotten -- until I saw so many RTs on Twitter asking for funding for that hotline. If I'd never called them, I'd have RTed it myself. Actually, I did RT it myself when I first saw it, because promoting suicide awareness when I can is such a reflexive thing for me, before I stopped to think for a second. I deleted the RT after thinking about it. And now I can't stop thinking about it.

I just wish that things could be different. I wish the most well-known mental health hotline in the country weren't one that only helps actively suicidal people. I wish there were a 24-hour mental health hotline available to everyone who feels they can't survive the night. Because there isn't. I've looked. When last I checked, anyway, the only general-mental-health hotline available was open 9-5. Who in the hell needs that sort of hotline 9-5? Night is the bad time. Night is statistically the most likely time for decompensation. During the day we can call our therapists and expect a call back at ten of the hour. During the day there's a world out there that is still alive and waking and available to help us. During the night, we are alone.

And there's no one for us to call. Hence, The Golden Girls.

::sigh:: I don't even know where exactly this rant is coming from. I've been writing so much about mental illness lately, after a period of writing so little about it for so long. I don't know why I'm suddenly feeling compelled to share. To break my own self-imposed silence.

I don't have a good way to end this post.


*Calling family and/or friends is completely different and not what I, at least, wanted in that moment. They're too emotionally invested. They can't be objective and caring at the same time.
**Not that a psych ward is necessarily a great time, but around-the-clock care and constant monitoring of medication/adjustment of meds as appropriate is a very important resource.

Comments

Posted by: Mel (pollymel)
Posted at: May 4th, 2009 05:45 am (UTC)

Also, they should TOTALLY be offering resources. Man, the more I think about it, the angrier I get.

Posted by: Mel (pollymel)
Posted at: May 4th, 2009 05:50 am (UTC)

OMG, I can't shut up. Have you had a look at Beyond Blue?

23 Read Comments