Friday, June 16, 2017

Before the Act

I have been pondering for a little while about what to post next here that others might find helpful and what might help others understand what goes through my head and why I do what I do.

One thing that so few people seem to be able to understand is why I attempt suicide. What goes through my head before I do it. What happens in the days, hours, minutes, seconds before I actually try. What thoughts do I have? What actions do I take? Why do I even get to that point in the first place?

Well I will first review some foundational information that I have covered in my previous blog posts. The first thing is that I am chronically suicidal. I feel hopeless on a daily basis. I am what is known as a high-risk patient to any psychiatric worker because of that. However, I cannot control that. I cannot control whether or not I have the thoughts.
The second thing is that I have BPD (Borderline Personality Disorder). While that is not an excuse, it is an explanation. It means I feel emotions much more intensely than the average person. Marsha Linehan, the creator of DBT, compared people with BPD to third degree burn victims. What would feel like a breeze of air passing by a normal person would be excruciating for a third degree burn victim. It's the same with emotions for people with BPD. A general letdown for someone can feel like the end of the world to someone with BPD. One rejection can feel like the ultimate rejection. It also means that happy things feel like top of the mountains and above.

Taking these two foundational principles into account, what leads me to attempt to end my life?

There are 2 types of attempts that occur: the planned and the impulsive.

For the planned one, the first step that leads me in that direction is a series of stressful events. Sometimes it can be a series of smaller stressful events or it can be one huge stressful event. Having BPD, I don't handle stress well. I feel stress a lot more intensely than most people do and that makes it even more difficult to handle even the smallest stressors. Once one stressor comes, everything after it seems even more stressful because by that point I am already in a vulnerable situation. For example, one morning my car doesn't start. This is the initial stressor. After that, I get a correction from my boss, I forget my lunch and then get into a small disagreement with my friend. This leads me to think (irrationally) that now I may lose my job and lose the friendship I have. All of these fears are intensified by the BPD and lead me to feel hopeless about the future. Then I feel hopeless about life in general. Other thoughts that can be included in this would be that I am a burden to other people and they would be better off without me, that I have no worth, and that this pain will never end. These are all distorted negative thoughts that I have when getting to the point that I am wanting to take my life. These thoughts, combined with the chronically suicidal thoughts, can lead to me deciding that I am going to try to take my life. Once I have made that decision, then the preparation for that comes. I usually try to figure out all the logistics. This includes when, where and what with. This is also the place where goodbye letters are written and last wishes are finalized. This is when the dangerous part comes in. If I get to this stage, this is where hospitalization would take place.

For the impulsive one, it is exactly that, impulsive. It means that there isn't much time between the thought of ending my life and the actual action. This is also something that is quite common as well. According to one study, anywhere from "one-third to 80% of all suicide attempts are impulsive acts" according to the New England Journal of Medicine. This type of suicide attempt is the most deadly and the hardest to help because it comes without warning. For me personally, it usually means an event has happened that upset me majorly and I don't feel like I can handle the pain that I am currently experiencing. It also usually indicates I have access to the means to attempt. This kind of attempt occurs quickly and without warning. I don't spend time thinking it over and I don't spend time preparing for it. I just act on the thoughts that I am having.

Usually when I attempt I tell someone or hint at it somewhere that I am going to do it. What this means is that I really don't want to die, but I just want people to understand how much suffering I am going through. It really is a cry for help and for someone to just notice what is going on with me and try to help me get help. This is also true for many other people. Many people who attempt suicide just want the pain to stop and just need help to get there. Many realize after the attempt that they didn't want to die, they just wanted help. That is what should be focused on.

What I am hoping to do with this post is help everyone realize that those who attempt suicide are not trying to be selfish in attempting. In their minds at that moment, they think they are helping the world and helping their family because they feel like such a burden to them that they would be better off without them. Their thinking is distorted by the pain they feel. People who attempt suicide need those around them to support them, to show them compassion, and to love them. Those things are what will make the difference in recovery.

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