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At Risk To Yourself Or Others: Life On the Fringes of Depression & Suicide

From Unsplash, by Matt Artz

I never met Karl, but I heard enough about him from others to know that he was loved from every corner of Straight Blast Gym International.

I heard enough about him to know that he was respected and admired as one of the first black belts and founding coaches of the organization.

I heard enough about him to know that he put all his energy into making the people around him better and brought laughter into every room.

I heard enough about him to know that a year before he killed himself my sister and her husband stayed up with him one night, because he was suicidal and they didn’t think he would make it to morning.

Karl fought mental illness his entire life. He fought it with Brazilian Jiu Jitsu and coaching and laughter and making the people around him better.

Karl suffered from bipolar disorder, mania, and depression. He had a history of being suicidal, and his death was not unexpected.

All the same, his death was an excruciating loss to everyone who knew him, some of them the people closest to me.

Leah Taylor, an SBG black belt and overall badass, is my roommate and one of those people. After I heard the news, I asked her how she was doing.

With an expression that morphed with pain and anger, she said, “Oh you know it’s only the third suicide we’ve had in a year.”

While Karl’s suicide was not unexpected, the two others before him were. One of them had been on the phone with a teammate the night before he killed himself. They were making plans for an upcoming tournament that was a month away. He gave no sign of emotional distress.

A few weeks after Karl’s death, Leah and I were talking about the protocol for mental health intervention that SBG was developing. We talked about why fighters suppress their mental illness and emotional distress, because they feel like they have to appear tough and they don’t want to be seen as weak.

Something that Leah said stuck with me. It explains our culture’s biggest misunderstanding about mental health, and why people like Karl — and like me — struggle to live with it.

“The intervention should happen weeks before the suicide, before the thought even enters their head. After that it’s too late.”

***

The horror movie, 30 Days of Night, takes place in a small Alaskan town located so far north that every winter it experiences 30 days of complete darkness. A horde of vampires descends on the town during the 30 days and commit all acts of horror, leaving a handful of survivors in their wake.

That’s the best analogy I can give you for how my head felt during my most recent bout of depression.

A “good day” was gathering the energy to put together a clean outfit. Or to prepare breakfast. Or to leave the house on time for work.

After that, there wasn’t energy for anything else, not writing my fiction or looking for work, much less thinking about the next day, the next week, or the next month.

It got as bad as it did, because it took two years for me to get treatment. Not all days were that dark, but I had enough of those days to know beyond a doubt that I needed help.

Throughout the years, I’ve had great health coverage, and it was the easiest thing to get services. All I had to do was pick up the phone and call. I’ve also had some real shitty coverage.

When I first noticed problems with my mood, I was living in Portland, had just started my business, and was on Medicaid.

The only provider who offered the services I needed was far out in East County, an hour bus ride away. When all was said and done that was 3 hours out of my day once a week. I was desperate for help, but the 2 hour commute was making me feel desperate.

Here were my options: I could choose to make that agonizing commute, or I could choose to wait until I could afford better coverage. I chose to wait.

This wasn’t my first time playing the waiting game.

In 2008 I was covered by Kaiser through an employer. When I called for counseling services, they put me on a wait 3 month wait list. When my name came up, I couldn’t make the appointment, due to a work obligation. Back on the wait list and another three months of living with depression.

Six months after my initial phone call, I got another shot at an appointment, and what do you know, another work obligation. I begged them to get me in sooner, but they couldn’t. So I decided, “Well fuck Kaiser.”

Six months later, my employer offered open enrollment, and I switched to Providence.

Sophomore year at Lewis & Clark College in Portland,OR, spring semester 2004, I snapped at my roommate Chelsea in a hurtful way. When I apologized to her, she told me something that I heard for the first time in my life: she thought I was depressed and suggested I visit the counseling office.

I was scared that I may have had this thing called “depression”, but because of it, I hurt someone I care about. I went to the counseling office.

There’s a waiting list.

When you ask someone with depression to wait, it’s one more day of pain and darkness. It’s one more day for the gangrenous rot to spread. It’s one more day of hopeless thoughts and wondering, “Am I always going to feel this way?”

Those providers who put me on waiting lists? When I begged them to get me in sooner, they always asked, “Are you at risk to yourself or others?” Meaning, are you about to slit your wrists, are you about to shoot yourself in the head, are you about to shoot someone else in the head? No? Well, then, you have to wait.

You have to wait, unless you want to slit your wrists. You have to wait, unless you want to shoot yourself or other people. In that case they hustle you in.

For those of you at home, the pain does not ebb just because you are on a waiting list. It does not sit idly by until your first appointment. It just gets worse.

When I chose to delay my treatment because of an agonizing commute, it just got worse.

When I was put on waiting lists, it just got worse.

When people are physically ill, it’s socially acceptable to go to the doctor. Their need for care is not in doubt.

Yet when it’s a question of mental health, their well-being does not hold the same worth, despite it’s life threatening affects.

Like the vampires in the Alaskan town, depression is a monster that tears apart everything you hold dear while you hide and watch.

Karl lived in the UK. I don’t know whether he had access to quality care, but with a condition such as his, there is no question that he needed it.

“The intervention should happen weeks before the suicide, before the thought even enters their head. After that it’s too late.”

***

Despite the episodes of profound depression that I have experienced throughout my life, I’ve never had the desire to commit suicide. The reason? I’m too squeamish. I hate the sight of blood, and I’m too sensitive to commit any kind of harm or violence on myself.

But I do know the feeling of being so tired of the pain that I just want to be nothingness. I know how it feels to fight an exhausting fight until I have no fight left in me.

That’s how I felt last year when I started getting treatment, started seeing my therapist Cindy, and got on Lexapro and Wellbutrin.

That’s how I felt when CIndy diagnosed me with depression (not a surprise) and anxiety (a huge surprise). That’s how I felt when I started learning how to apply Cognitive Behavioral Therapy (CBT) to my anxiety and taking the drugs as if my life depended on it, because my life did depend on it.

Let me get this out of the way first, because I know you’re wondering about it. Before Cindy, CBT, Lexapro, and Wellbutrin, I was doing everything a person could do to take care of themselves.

I trained a good, oh I don’t know, 8–10 hours a week doing yoga, cardio, and strength training.

I rain on the treadmill, and I hate the treadmill. I told people that as an endurance runner, I wanted to stay in shape through the winter. Truthfully, I was an insomniac and the only thing that helped me sleep through the night was exercise that left me wrecked.

I ate well, not like a super athlete, but 3–4 meals a day of good whole foods. Some coffee, lots of water, and no sugary drinks.

Speaking of drinks, what was an occasional drinking lifestyle became a no drinking lifestyle, because I knew beyond a doubt that I was depressed, and alcohol doesn’t help that sort of thing.

I was dipping my toe into the dating scene for the first time after ending a long term relationship. While nothing had come of it yet, I was making a go of it.

I was working so, so hard to make that long night go away, but it wouldn’t. I was depressed. I had tried everything to feel better, but I decided I couldn’t do it alone.

My writing suffered, my work suffered, and my outlook on life suffered. My friends and family all knew it. They could see it in my eyes.

Maybe I wasn’t suicidal, but depression was killing everything inside of me, like a gangrenous rot.

I learned during that god-awful winter that depression is a kind of death. It’s a death of the soul.

When you can’t do the things that get you out of bed in the morning, that is a kind of death.

When you can’t think about the future, that is a kind of death.

When you have no energy for smiling, caring about others, counting the jumping jacks in warm ups, or so much as making your body do the very next thing that it needs to do, that is a kind of death.

Maybe I wasn’t suicidal, but depression was killing me. My life depended on getting treatment.

“The intervention should happen weeks before the suicide before the thought even enters their head. After that it’s too late.”

***

“Karl didn’t kill himself. His mental illness killed him.”

My sister and I are talking about Karl and his death, about mental health, and about a battle I’m waging for health coverage for my condition. I’m in the middle of sorting out the insurance debacle that started when the pharmacy couldn’t charge my health insurance.

My 18 year old nephew has had a seizure disorder since he was 6 months old, and Kisa has fought more than her fair share of battles with insurance companies to keep him alive. She tells me the same thing that Cindy told me, not to take this battle with my health coverage personally.

I know they are right. I know that I’m not the first person to get screwed over by the American health care system, and sadly, I won’t be the last.

But it’s hard not to see this as yet another way in which our society misunderstands mental health.

People are quick to judge the depressed as not doing “enough.”

If they would get out of bed they wouldn’t feel that way.

If they exercised more then they wouldn’t feel that way.

If they didn’t dress like that then they would feel better about themselves.

If they got out more then they would feel better.

Those things are not the cause. They are the symptom.

Not being able to get out of bed, poor appearance, shut-in behavior, loss of appetite, and loss of interest in activities — those are all symptoms of a greater ailment. If you are focused on the symptoms, then you are focused on the wrong things.

This is not something I’m doing to myself. This is not a condition I brought on myself, because I “failed” to do something. These are the cards I was dealt. I didn’t choose this, nor am I going to lay on the empty platitudes and sliver linings and “gratitude” so that we can all feel better. Depression and anxiety suck.

I did not ask for this life. Karl did not ask for his life. Like me, Karl did the best he could with what he had. It is all anyone can do.

He did not kill himself. His mental illness killed him. His chronic health condition ended his life.

Mental health is health.

“The intervention should happen weeks before the suicide before the thought even enters their head. After that it’s too late.”

***

If you’re going to change the conversation about mental illness, start by telling this story.

Tell the story about a man named Karl who was a part of laying the foundation for creating incredible communities throughout the world.

Tell the story about a man who devoted every part of himself, every bit of life in him, to making the people around him better.

Tell the story about a man who brought joy, love, and laughter, while carrying his demons.

Tell the story about a man who, as Coach Chris Hauter put it, “kept his demons at bay so others could fight theirs”.

Tell the story about a man who was loved by every person around him, demons and all.

Tell the story about a man whose brilliant life was cut short, because his mental illness killed him. Tell the story of all the unmet potential that man possessed and how much more life he had in him before his mental illness killed him.

Tell the story about a man who wasn’t weak for losing to those demons but who was strong for fighting them, because you don’t become a black belt in Brazilian Jiu Jitsu, train MMA fighters, play an influential role in an international organization, and fight a severe mental illness by sitting in the grass and making daisy chains.

It’s people like Karl who fight mental illness. They are more than enough. You can’t live with something like this and be anything less.

If you feel like you’re tired of fighting, your life is still worth fighting for. Call these numbers, and you won’t be alone in the fight.

Suicide Prevention Lifeline | 1–800–273–8255

OR

TEXT “HOME” TO 741741

FOR VETERANS

Veterans Crisis Line | 1–800–273–8255

If you’re a friend or family member, learn more about what’s going on with your loved one.

National Alliance on Mental Illness | 1–800–950–6264