The Unseen And Undervalued Work Of Battling Suicidal Ideation
We need to acknowledge the nobility and effort of making it through the day.
“We talk about how suicide is ‘selfish,’” a friend said to me a few weeks ago. “But that means that people who are suicidal but struggling to live are doing something incredibly selfless, every day. Why don’t we talk about that?”
On a societal level, we rarely, if ever, acknowledge all of the thankless work that people who wrestle with suicidal ideation pour into staying alive — labor that they engage in not for themselves, for the most part, but because they know how much their deaths would devastate family and friends. There’s not much in the way of resources or aid available to those doing their ultimate best to avoid suicide. Instead, we mostly treat those who are suicidal — as I am, sometimes — as morally deficient for even thinking about killing themselves in the first place.
In fact, the opposite is true. Staying alive as a suicidal person is one of the most altruistic things you can do.
The majority of people just live, without thinking about not dying. For them, staying alive is sort of like an involuntary muscle, one that expands and contracts at exactly the right times without them ever having to think about its functions. I don’t have the luxury of not thinking about that muscle; I have to flex it consciously, even when it’s exhausted. To extend the metaphor here, even during my best times I need a sort of emotional pacemaker, and my bad times are spent desperately trying to find some kind of life support that will take over that muscle’s functions until my body is well enough to manage it on its own.
We rarely, if ever, acknowledge all of the thankless work people who wrestle with suicidal ideation pour into staying alive.
Each of my days these days is filled with one little act of life after another, a chain that will hopefully guide me through evening and into sleep. First thing in the morning I tend to my plants, delicately checking them over and doing my best to assess their needs. Then I pick a room or an area of my home to clean, trying to carve out a calm space in the chaos that is a two bedroom apartment that houses two adults, a small child and three cats. I write. I draw. I go to a yoga class or sometimes a ballet class. I take care of my son. Each of these is in some ways about making something, shaping something, creating or sustaining life.
These tasks probably sound pleasant, and sometimes, when I am well enough, I do indeed find some pleasure in them. When I am not well, they are as grinding and draining as the worst kind of drudge work. During my worst days, staying alive is a full time job, one that is just as difficult and soul-sucking as sitting in a cubicle and spending eight hours answering passive aggressive emails. Except that it doesn’t end after eight hours, and I don’t get to go home, because I already am home and my home is my brain and all it wants to do is die.
Aside from my own custom-created Don’t Die daily routine, I also look for help from more professional arenas. I see a psychotherapist once a week, which involves an hour of dragging out, talking about, and ugly-crying over the parts of my life that I’d rather never have to think about again. I see a psychiatrist every other week, visits that turn my body into a laboratory as we test, combine, and refine dosages of drugs meant to fix my brain. At this point I have been on just about every antidepressant out there, the best of which have done nothing and the worst of which sent me into a two-week state of hypomania where even the strongest sedatives couldn’t get me to sleep.
All of this is also work.
Psychotherapy is work, not just the hour-long session itself but also the hours afterwards when, shaky and barefaced from having wept off all my makeup, I try to find my way back into the slipstream of everyday life. Seeing the psychiatrist is less emotionally intensive, but trying drug after drug is work — watching and waiting to see if there will be any side effects, enduring the sometimes debilitating side effects themselves, noting any small improvements or lack thereof. I have an Excel spreadsheet of all the medications I’ve tried and what they’ve done to me, just like how in a past life when I had a career in finance I had an Excel spreadsheet to keep track of all my clients.
When I was a young and newly-depressed teenager, I used to daydream about being hospitalized — the hush of tiny white rooms with white beds and white sheets, the kindly nurses who take your temperature and cluck kindly over the state of you, the absolute and perfect separateness from the dreaded real world. Several trips to the emergency room at the psychiatric hospital, and then actually being a patient on a ward there in my twenties, quickly put an end to those fantasies. Each experience was depersonalizing and humiliating; in almost every case I left feeling worse about myself than I had coming in. As Amy Fife wrote in an essay for Broadly that I have probably read about fifty times since its publication, the hospital is not a place where you figure out how to live. The hospital is the place where you go to not die.
And that’s sort of the crux of it, isn’t it? All of this work I’ve been putting in has been aimed not so much at figuring out how to live — a concept so foreign to me at this point that you might as well ask me to figure out how to colonize Mars — but at not dying, which seems like the lowest possible standard of being alive.
All of this work has been aimed not so much at figuring out how to live, but at not dying, which seems like the lowest possible standard of being alive.
The other day a friend and I were dreaming up a place where people might learn how to live. We called it the not-hospital, because it should be everything the hospital isn’t: warm, comfortable, loving, tolerant. A place with corners full of blankets and pillows where you can go cry if you need to. A place with huge heated tubs full of salt water where you can soak and read and sip fancy drinks. Common rooms where people can be together if they want to; individual rooms where people can go if they need to be alone. A proper convalescent home, where people can recuperate and rest and feel cared for — that’s maybe what the not-hospital would be.
But until we invent the not-hospital and start training people in how to live, the least we can do is acknowledge the massive amount of effort it takes not to die. Suicide has been on my mind a lot lately not just because I’ve been doing the work, but because recent pop culture phenomena have brought me face to face with how little we respect that effort. Late March saw the release of S-Town and 13 Reasons Why, a podcast and a Netflix series that both have suicide as their central themes. Earlier in the month a bookseller in Massachusetts announced that he was selling a collection of Sylvia Plath materials, including letters she’d written to her former psychiatrist, Ruth Barnhouse — letters so personal that Barnhouse had long claimed to have burned them — and records from Plath’s 1953–1954 stay in McLean Hospital. In that last instance, rather than being appalled at the breach of privacy represented by publishing letters that no one involved ever wanted published, let alone selling hospital records, many Plath scholars are excited about the discovery. Andrew Wilson, the author of a book about Plath’s life before she met Ted Hughes, called Mad Girl’s Love Song, was quoted in The Guardian as saying, “These letters look as though they could fill certain gaps in our knowledge, and seem as though they can shed new light on the turbulent, controversial marriage between Plath and Hughes.” Not once does he question whether we are entitled to have those gaps filled.
The popular Netflix series is, chillingly, the ultimate fantasy of teen suicidal ideation.theestablishment.co
The debate about how entitled we are to details about Plath’s death — and the larger debate regarding the ethics of how and why we discuss suicide — is an old one, but S-Town adds a new twist. The podcast is presented as a sort of true-crime series about the suicide of John B. McLemore, an eccentric middle-aged man in small-town Alabama — a man who sought out radio coverage, but who clearly could not have known that the story resulting from his interviews would be about his own death. The interviews with McLemore were intended to be part of a podcast about a local murder and its alleged wide-ranging cover-up, a murder that turned out not to have actually happened. After McLemore’s death, host and executive producer Brian Reed repurposed his existing material as the springboard for an investigation of McLemore’s suicide, his life, and whatever dusty skeletons Reed could unearth from McLemore’s closet.
The entitlement exhibited towards McLemore’s story — not just by Reed himself, but by the literally tens of millions of people who listened to the podcast — is staggering. McLemore never consented to having incredibly intimate details about his life and death broadcast on one of the most respected public radio networks, and yet Reed takes it as a given that he has some kind of journalistic right to share this story. Not only that, but Reed spent months chasing down and interviewing everyone and anyone he could find who had known McLemore, seemingly doing his best to unearth details about McLemore’s life that it was very clear he would have preferred to keep quiet. At one point, Reed even shares a piece of information that McLemore had specifically asked him not to record; he rationalizes this betrayal of McLemore’s trust by saying that by his own belief system McLemore is now “worm-dirt” and can’t be hurt by the story coming out now. This is the podcast that the New York Times praises for transcending its genre and which has garnered critical acclaim from many other news outlets.
When asked this week in an interview with The Advocate what he thinks McLemore would make of S-Town, Reed said, “He could be thrilled by [Shit Town] and excited.” But it’s hard to imagine a man being thrilled and excited about details about his life he had explicitly asked not to have shared being listened to by millions.
If the past few weeks have made one thing clear to me, it’s that our culture treats narratives about suicide as being everyone’s to consume.
If the past few weeks have made one thing clear to me, it’s that our culture treats narratives about suicide as not belonging to the people living (or dying) them, but rather being everyone’s to consume. As if by completing suicide you lose all right to privacy, to autonomy, to the secrets that you’ve struggled your whole life to keep from slipping from your fingers.
Who’s selfish, then? The people who spend every day fighting the urge to die? Or the people who get some kind of voyeuristic frisson from reading a dead woman’s hospital records?
In a perfect world, we could have the not-hospital and other safe spaces for suicidal people, and we would remove the shame and stigma from suicide that prevent people from talking openly about it. But failing that, it’s important that we at least acknowledge that people who are struggling with suicidal ideas are doing far more work to stay alive than most people are aware of. Doing that work should make you an object of more respect and admiration, not less.