Saturday 17 June 2017

The S Word


It has become increasingly apparent to me that one of the biggest hurdles for people who want to help loved ones suffering from mental ill-health is empathy. The ability to walk a mile in their shoes. To put themselves in their loved one’s position. Only then can they understand their condition, and only then can they even begin to know how to help that person.

I have never broken a bone. You could describe the pain to me, and I can see the affect a broken bone has on a person. But I’ve never felt that pain myself so if I want to help someone who has a broken leg I have to ask them what they need, listen to what they tell me, and believe what they are saying. Only then can I start to figure out how I can help them.

I have, however, lived with mental health problems for the best part of 30 years, since childhood. I have fought severe pre and postnatal anxiety, major depressive disorder, generalised anxiety disorder, suicidal ideation and PTSD. I have been admitted as an inpatient, I have run my own postnatal support group. I am “high functioning” which basically means that throughout all this I have succeeded at school, socialised, worked, married, had two beautiful sons, and the majority of people I meet would never know I had these illnesses weighing me down the whole time. I am currently in therapy with an NHS mental health team.

Recently a dear friend asked my advice on coming to terms with losing someone to suicide. I realised that a) nobody wants to say the word out loud, and b) for those fortunate enough to have never encountered a suicidal thought there is a real misunderstanding of what it means to be suicidal, and what can be done to prevent it. Now this, I do know about, so I gave my friend the following advice, to help her empathise and therefore understand and come to terms with what had happened… not to excuse it, or romanticise it, but to describe it for someone who has never been to that dark place…

Imagine you are stranded alone in a desert.

No food, no water, no shelter. You’ve been here for as long as you can remember. The nights are bone-shakingly cold, the days are unbearably hot. Your skin is burnt on top of burnt but you can find no way to protect it as it blisters. You’re thirstier than you’ve ever been. You shade your eyes with your hand and slowly turn 360°. You see nothing but unending parched, cracked land stretching to the flat, low horizon in every direction. The sun pierces your eyes even through closed lids. There is nothing around you to help you make sense of where you are, or figure out which way to go. Every step you take seems to lead you away from safety no matter how much logic and energy you apply.

Often, at sunset, you will be devastated as you stumble upon the first footprints you made at sunrise, having battled to make progress all day only to end up where you began. It’s feeling increasingly likely that you are stuck here forever, in the perishingly cold nights and blisteringly hot days, never getting closer to safety despite constant effort and grit, a perpetual horizon, un-changing and un-ending, sunburn on top of sunburn, blinding light, fading hope… this is your eternity. You cannot remember life before this, and you cannot imagine a way out.

And then.

In the far distance.

A glint. A whisper. Movement.

You turn to face it. You start moving towards it.

As you get closer you squint harder as the sun hurts your eyes, and then you hear it again. Breeze through a tall tree. And you see it. There is shade. There is water. There, in the far distance, is an oasis.

Now imagine how you feel about that oasis. Every fibre of your being is pulled towards it. Your body craves it, the cool clean water, the blissful shade. You ache to go to it. To feel at peace. To sit and rest. In fact the only decision you have to make is whether to stay put, suffering, burning, wilting in the desert for eternity, or go towards the oasis. You wouldn’t hesitate to move towards it.

But this desert is depression.

And this oasis is death.

The yearning, the craving, the immense pull from the cool oasis is overwhelming, and so unbelievably hard to fight against. It seems impossible to think about anything else, as the breeze whispers and the water glints, beckoning you.

It’s the craving of nicotine for a cigarette quitter.

It’s the heroin addict’s withdrawal sickness.

It’s the call of the bottle to a recovering alcoholic.
It’s a new mother’s primal urge to rush to her newborn’s cries.

It’s the song that swirls around inside your head, refusing to leave, whether you like it or not.

It is the forbidden food right in front of a hungry dieter. Look. Smell. But don’t touch.

Suicide is not something a person decides to do in response to a situation. It is not a cause and effect scenario. It is a spectrum. For the person who finds themselves at the scariest, most desperate end of the spectrum, who has battled in the desert for so long, fighting the overwhelming urge to go towards the oasis - despite their own dire need for relief - because they know it would devastate the people who love them if they were ever to succumb to it.

But, in the mind of someone with a mental illness, sometimes there is no fight left. Sometimes the lure of the oasis and its cool shady relief is utterly overwhelming, and impossible to resist.

On the outside, it may look like a person has made a conscious choice to end their life and devastate those around them.

Cowardly.

Selfish.

Weak.

What we don’t see, and can never truly know, is what kind of hellish internal reality depression had created for that person, what they were fighting against each day, and for just how long they resisted - with every fibre of their being - the lure of the oasis before they could resist no longer.

Imagine what it must take to succumb to this craving. Only someone in immense and unbearable pain would consider the pain and finality of death as any course of action. And then they are utterly terrified, but do it anyway. Because they are ill. Broken.

Depression is a deadly disease of the brain; the most complex and mysterious organ in our body.

Depression is not ‘stress’.

‘Depressed’ is not a mood or feeling.

It is a disease, as indiscriminate and uncontrollable as cancer. It is a cancer of the mind that nobody would ever choose to suffer and is not cured by being grateful.

Not everyone with depression finds themselves on the suicidal spectrum, thankfully. Some people have been somewhere along it for a long time. Like an alcoholic working hard to manage their craving. Every day. Distracting. Medicating. Fighting. Surviving. Living.

Someone didn’t ‘kill themselves’; depression killed them.

Someone didn’t ‘take the cowardly way out’; they took what depression had them believe was the only course of action left available to them after all their fight was used up.

Someone didn’t ‘give up’; they exhausted every last ounce of fight in them, but depression won the war. Depression is a monster. It lies, it punishes, it sucks the hope out of the poor human soul it’s infecting. It seeps uninvited into every crevice of the mind, body and soul like a poison.

If you’ve been affected by suicide and are left feeling understandably both devastated and furious my advice is to direct that anger fully towards this cancer of an illness, not to the tragic victim of it. Accept your fury, feel it fully as it is real and valid, and then be compassionate towards yourself and to the victim. Forgive your loved one and forgive yourself. Know that if your loved one felt in any way able to physically and mentally resist that oasis of peace and relief any longer, they absolutely would have. And know that they loved you, and their actions are no reflection whatsoever of the love they felt for you.

If you are worried about someone or believe they are on the suicidal spectrum, go to them. Say the scary words out loud - this takes away some of their fear and power: Are you feeling safe? Are you having scary, unwelcome thoughts about life and death? Are you thinking about how you’d want to die? Are you feeling suicidal? Saying the S word out loud will not cause someone to go through with it. In fact, getting the S word out there in the open may well prevent suicidal behaviour, by giving that person a safe space to confront their demons and diminish their power. By giving them the strength and time to see what’s real and what’s depression. To make their mental landscape more lush, less punishing, more comfortable than that hellscape desert so that the lure of the oasis is not so dangerously strong, or even have it disappear entirely.

If there is an elephant in the room, don’t ignore it. Run towards it, not away from it. Say the word out loud: suicidal. It could well be the best thing you could do for someone in crisis when they’ve no reserves left to save themselves.


Reposted with permission from author.

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