Suicide Didn’t Kill Me, But Capitalism Might

May is Mental Health Awareness Month

I spent February through August of this year as a mental patient, living on a behavioral health unit in the National Institutes of Health. Driven by desperation, I came to participate in medical research exploring new treatments for depression. One of the studies I participated in was investigating the neurobiology of suicide. During the battery of interviews this entailed, I noticed how ashamed and guarded I felt talking about my suicide attempts and suicidal ideation. The interviews were 2-on-1 or 1-on-1, were carried out by compassionate, thoughtful people, and occurred in the hopes of helping other people like me. But despite the relatively benign context — and the fact that the researchers had carefully considered the ethics of the study — I struggled to get my words out. It took me months to unpack my shame, and to fully comprehend the truth of my situation.

The author performing madness while hospitalized.

For most of my life I thought everyone had thoughts like mine, that suicidal impulses were a public secret. As I got older I learned more and more to hide those thoughts, and then to hide my hospitalizations, and ultimately to hide the extent to which my mental health had deteriorated. I accumulated a medley of diagnoses but couldn’t seem to get good healthcare for them. I isolated myself from most of the people who would notice how badly I was doing. Mental illness has traumatized a number of my friends, and I didn’t want to retraumatize anyone. As a high-functioning depressed person, it was often easy to hide how much I was struggling. As a high-functioning depressed person, the severity of my illness wasn’t taken seriously by most doctors/therapists I sought help from. The only times it was taken seriously were when I disclosed my history of suicide attempts or suicidal ideation. That pretty much went one of two ways: 1) immediate involuntary hospitalization or 2) being denied services due to liability.

A dominant narrative about suicide is that people don’t seek the help they need. For some that’s true. For others it’s not. People seek, and seek, and seek, but love and friendship can’t keep them alive. People seek and are denied. People seek and are made even sicker by the low quality, punitive care that is available. People seek but aren’t seen or heard. People seek but are ostracized. The situation sucks. If you attempt suicide, live, and are lucky (read: privileged, white, or in a privileged white zip code) you might get sent to the hospital. It’s usually an unhelpful and traumatizing experience. If you attempt, live, and aren’t, you might get taken to jail (our country’s true first line response to mental illness). If you have a mental illness or other disability and encounter the police, you could be killed — particularly if you are black.¹ ² ³ We’ve just passed the anniversary of the Attica prison uprising, and the historic prison strike continues. So it’s necessary to mention that if you attempt suicide — or live with any mental illness — and are an imprisoned person, you’ll likely be punished with tactics widely acknowledged to be unconstitutional torture methods. I’m updating this essay on October 10, Columbus Day, so it’s necessary to mention the ongoing indigenous suicide crisis (a direct result of centuries of genocide, displacement, economic disenfranchisement, and erasure). ¹ ² ³

The situation sucks. Most of the medications currently available for depression take an agonizing 6–8 weeks before you even know if they work. Side-effects can be intolerable. And for many people, medication fails to manage symptoms adequately or at all. Then there are the barriers to even getting medication. Insurance is a bureaucratic quagmire. Medication can be too expensive. Doctors are hard to find, afford, keep, and otherwise access. Therapists might be unequipped to help you navigate the biological dimensions of your illness. Doctors might be unable to help you navigate the environmental or economic dimensions of your illness.

The bottom line is that in this ongoing crisis, “awareness” and “ending stigma” are toothless if depoliticized. All the awareness in the world won’t dismantle for-profit healthcare. Applying free-market principles to human needs wreaks havoc on our bodies. Awareness won’t end capitalism’s tyranny over our survival. I just gave my body over to taxpayer-funded research, but a drug company could use that research, get a patent, and create a medication I can’t afford (just one recent example: EpiPen). All the awareness in the world won’t change the problematic definition of disability as contingent on one’s level of participation in the economy/desirability in the labor market. Ending stigma won’t end the reality that, in a carceral society founded on inequality, to be marked different/deviant is to be marked disposable.

Because personal autonomy is a bedrock value for me, I used to think of suicide as being a tragic, horrifying choice — but still a choice. Now that I’m older I understand a lot more about the world, like that independence and choice are neoliberal lies.

I believe that every suicide is a murder. And among the complicit parties are pharmaceutical companies, the for-profit healthcare system, and doctors who may be ignorant at best and abusive at worst. Of course, an ableist culture that stigmatizes all forms of disability and deviance is also to blame. The sane extract value from us — they get to construct themselves as sane in relation to us. They get to scapegoat us for acts of violence (which are actually usually a product of inequality and which also exist as behaviors discrete from mental illness). They get to feel independent, because being dependent, under capitalism, is the same as being inferior. They get to benefit from our labor as independent thinkers/artists/brilliant freaks but they’re nowhere to be found when we need support. They get to benefit from our invisible labor as patients, all the while demeaning us as lazy.

They get to benefit from my labor as a human test subject without having to contend with the fact that I needed to sell my body to the government in exchange for access to adequate health care.

In February, for the first time in 17 years, I got to experience life without persistent suicidal thoughts (shoutout to Ketamine!). I am going to turn 30 in a month but in some ways I feel like a newborn baby, because I’m finally living life without one foot in the grave. But others aren’t — and weren’t — so lucky. I haven’t (momentarily) forced my illness into remission because I’m special. I definitely am very special, but if you think this is a triumph of the human spirit over adversity story, you are missing the point. I’m alive because I stopped everything and went to go live in a research facility–a resource many don’t even know exists, a resource that should be made accessible to more people. I made it that far because I’m lucky enough to have been loved and supported, even though I’ve been difficult. Not everyone can have the privilege of the cutting-edge care I’ve received. That’s not because some people are lost souls, that’s not because I’ve been blessed. It’s because of concrete inequalities that are a product of our economic system.

What will you learn from National Suicide Prevention Week? Go ahead, spread awareness and end stigma. Do those common sense kindnesses that usually come along with this territory. Be kind to the people around you. For fucks sake, don’t tell anyone to just cheer up. And of course, don’t kill yourself, I love you. But more importantly: I challenge you to see the root causes of this crisis. See how it intersects with your politics. See us struggling to live, laboring our devalued labor for you. And to my fellow psychocrips: mad respect to those of you for whom it isn’t safe or viable to be openly ill. I no longer harbor reservations about sharing my story–this personal dimension of my life is so politically important to me that it cannot remain private. I don’t care if people judge me for parts of myself and my history that I cannot change. I don’t care about the consequences of being open, and that in itself is a privilege. If you can, I invite you to join me in being unapologetically afflicted. I invite you to feel entitled to visibility and to care. I invite you to claim your power.

Discharge day: showing off my certificate in my hospital room

Additional Reading (non-exhaustive list):
Ugly Feelings by Sianne Ngai
Depression: A Public Feeling by Ann Cvetkovich
Psychiatric Power, Madness and Civilization, Abnormal, and The Birth of the Clinic by Michel Foucault
Anti-Oedipus: Capitalism and Schizophrenia by Deleuze and Guattari
The Promise of Happiness and The Cultural Politics of Emotion by Sara Ahmed
Cruel Optimism by Lauren Berlant
Disability and Difference in Global Contexts by Nirmala Erevelles

This post is not an invitation to use me as a suicide crisis hotline.