Content advisory: This post is going to deal with the subject of mental health, and will talk in general terms about depression, self-harm and suicide.
Today is #TimeToTalk Day, an initiative by Time To Change, a cooperation between the charities Mind and Rethink Mental Health. The goal is to encourage conversations about mental health, in order to try to overcome some of the social stigma still applied to mental health issues and illnesses, and still felt by a great many people living with them.
In that spirit, while those who know me will know I’m hardly secretive at the best of times (I’m basically the embodiment of Too Much Information), I thought today might be a good time to write a bit about my own situation, as a tiny little way in which I can perhaps try to contribute to that goal. I’m going to be open, and honest, and very wordy. If you don’t want to stick with me through this long post I will quite understand.
I’ve lived with depression and anxiety for as long as I can remember – certainly well back into my days at secondary school (for perspective I’m 44 years old now). The two elements work effectively as a team: anxiety stops me doing things I’d like to do (everything from hobbies and creative pastimes to job applications and career ambitions), while depression picks up on my not having done the things and assures me it’s because I’m actually genuinely, fully hopeless. Couple those with a particular specialism in health anxiety – otherwise known as hypochondria – and you have a recipe for some pretty annoying experiences.
That’s maybe something of an understatement.
Plus they can work in isolation as well, so depression can hit me all on its own without any particular source of anxiety.
There are countless websites and better writers than me out there explaining that clinical depression isn’t just a case of feeling low or gloomy. It’s a vicious, hateful thing that settles into your mind and literally warps your thinking, shifting your basic perception of yourself and the world around you. The smallest problem can magnify out of all proportion; things that might make perfect sense any other day distort and morph into incomprehensible, angry mountains it seems impossible to climb over. And there are giant trolls throwing rocks, like in the Hobbit movies (why were there three? There didn’t need to be three).
In the midst of this, interacting with people seems pointless or terrifying or both. Doing normal, everyday things – going to the shops, going to work, engaging in hobbies, even going online and interacting with Internet people – even engaging on social media or playing multiplayer games – just feels utterly unmanageable.
And, in some ways, the anxiety can be even worse. That brings with it the agitation, the racing thoughts, the promise of catastrophe. You can’t stay still, you start to shake; concentration just goes right out the airlock. If you don’t keep control of your breathing – which wants to grab all the oxygen it can in as short as possible a time to cope with the certain disaster to come – you can easily hyperventilate, driving yourself dizzy, even into a full-blown panic attack. And often you find yourself looking for ways to just. make. it. shut. UP. And the ways you eventually find might not necessarily be the greatest, health-wise, either.
The first time I recognisably self-harmed – I said I was going to be open and honest – I was in my early twenties. Something – I don’t recall what, exactly – had put me into that agitated, shaky, breathless state, and I took a sharp object and I ‘fixed’ it. (Spoiler: it doesn’t actually fix anything.) I wasn’t even conscious of doing it until it was done, but after that it quickly became a standard go-to response to anxiety. I found – as strange as it may sound – that it calmed me down. It shut the anxiety up – at least to an extent. (Again, I should be clear, it doesn’t actually solve problems and can in fact create more. I do not advocate it – but I can’t legitimately criticise it either, because I’d be a hypocrite). For a while I tried to hide it, even as it turned into a regular thing, but – perhaps inevitably – one of my colleagues at the time noticed, and I was referred to a doctor.
The doctor, sensibly, didn’t try to stop me, reasoning that taking away a working coping mechanism – however far from ideal it might be – may be counterproductive. He was concerned only that I was keeping myself safe – that I wasn’t doing unmanageable damage or risking infection, and that I was taking proper care of myself afterwards.
I was always very clear, though, that my self-harming behaviours, despite apparent superficial associations, were never based in suicidal thinking. They rarely are. Most people who engage in these behaviours have absolutely no intention of taking their own lives. The reasons for self-harm are many, and it’s probably not within the scope of this post to try to list them, but in the great majority of cases there’s no intention to cause lethal injury – though, of course, accidents can happen.
So this is how things have been most of my life. Things come and go, ebb and flow. Sometimes the depression and anxiety – the Evil Twins – leave me alone for a while, but they always come back. And sometimes they mount a protracted campaign: episodes can last hours, days, weeks or even months – and sometimes there can be only brief respite before they try again.
In my case, obvs, there’s a big elephant in the room glaring at everyone. I am transgender, and you might be forgiven for wondering whether that could possibly have anything to do with it. After all, I have had my hormones rebalanced. And even before that, before I came out and started transitioning, I was living with gender dysphoria/incongruence. Couldn’t that be a factor?
Possibly. But as sincerely as I can analyse things for myself, I don’t think it is. In fact, since I began my transition I’ve actually felt a lot better. I’ve had fewer episodes over that time, and until recently my self-harm had been in abeyance for a good few years. I’m satisfied it’s not strongly related, and that’s really all I can say.
I said ‘until recently’ just there, you may have noticed. This is because in the last year or so, things have got a bit odd. Some rather troublesome thoughts have shown up – thoughts of a distinctly different nature to the ones I’m used to living with – and they’ve become kind of persistent and annoying. I don’t know where they come from, why they’ve suddenly arrived now, or what’s causing them, but they’ve moved all their stuff in and settled themselves on my psychological sofa and made it quite clear they ain’t going anywhere, thanks very much.
See, my initial instinct was to make only oblique allusions to the nature of these thoughts – but… isn’t that defeating the whole object of this post? To talk openly and without shame?
So: for the last year or so I’ve been experiencing thoughts of and impulses towards suicide. Sometimes they’re quite strong. Occasionally scarily so. I don’t know where they’re coming from – there doesn’t seem to be an obvious cause to them. There’s nothing that’s particularly stressing me, at least beyond reason, and nothing in my past I’ve been able to identify that might have created any latent trauma. So it didn’t – and doesn’t – make a lot of sense to me, and for quite a few months I didn’t dare speak to anyone about these thoughts and feelings. They’d go away, I reasoned. It was just a passing thing. No point scaring people or looking like an attention-seeker (that’s been a big worry and is a worry in respect of this post: am I really writing this for #TimeToTalk Day or just because I want the attention? You decide!).
But in the end, when it became clear this wasn’t going away, at least for now, I made the decision to talk. I’m glad I did. I thought about it for a long time. I didn’t want to create worry, obviously – but at the same time I was conscious of the many reports of suicides that catch family and loved ones completely off guard. How many times people are left saying, “We didn’t know” and, perhaps more painfully, “We don’t understand why”.
Sometimes there isn’t a clear ‘why’. As I said, in my case I don’t understand why. But still, after much thought – and much second-guessing the thought – I talked to my wife Suzanne, who handled it magnificently, and together we decided I should inform my work. I work shifts and sometimes alone, and it seemed reasonable to raise it with them. They put a few simple measures in place (for example I don’t work alone any more) to protect both me and my colleagues until this passes.
I also went to my doctor, who referred me to the local mental health crisis team. They asked me questions to make sure I didn’t have any immediate plans and gave me some details on how to take care of myself, as well as some contact details for further support.
I’ve also taken a few steps to make sure I don’t put myself at unnecessary risk – so there are certain places and situations that I will now generally avoid if I’m on my own, so I’m not vulnerable to sudden temptation. Huh. Strange word, but there it is.
Weirdly, I still have the hypochondria. And if you can reconcile those two you’re doing better than I am.
I think, though, on balance, I’m doing okay.
If there’s a point to all this rambling, I think it’s this: talking about all this stuff is hard. Even for me, and I’m comparatively open about myself by nature. But it’s especially hard to talk about suicidal thoughts to people who you know care about you – particularly when you can’t fully explain where those thoughts are coming from. They may be scared. Scared that they’ll lose you, of course, but also scared that they might not know how to help you. They’ll want to understand why you feel like you do, because they’ll reason that if they can understand, they can help. The people who care about you – and there are people who care about you, by the way – want to protect you and make sure you’re okay.
So yes, it’s hard, but it helped. It really did. I can’t and wouldn’t tell you how you should handle things if you’re in a similar place to me. I can only tell you what worked for me. And that was talking. It hasn’t solved the problem: it’s not a cure. But it’s helped me feel supported; it’s helped me feel confident that things are in place should anything happen; and it’s also given me places to turn to make sure – as sure as possible – that nothing does. It hasn’t stopped the thoughts but it’s helped me feel more secure about things, as odd as that might sound.
So I’m very much an advocate for talking. I recommend it. It can be to family, to friends, to colleagues. And if these aren’t suitable for you there are professionals you can speak to: your GP, your local mental health team, or you can search for private counsellors in your area. They will charge, of course, but many are willing to discuss your needs and negotiate something suitable for you, so don’t be afraid to ask them.
And there are the Samaritans in the UK and Ireland, who you can contact on 116123 or email at email@example.com (firstname.lastname@example.org in the Republic of Ireland). After turning to them a number of times recently, I honestly can’t praise these people enough.
Keep in mind that although the Samaritans are often associated with suicidality, you can ring them to talk about anything that’s troubling you: you don’t have to be suicidal to call them.
If you’re in the US, the National Suicide Prevention Lifeline can be contacted on 1-800-273-8255, and in Australia the 24-hour Lifeline is at 13 11 14.
(There’s a more complete list of national crisis numbers at https://en.m.wikipedia.org/wiki/List_of_suicide_crisis_lines.)
I’m going to stop there. This is probably the longest post on the Internet by now. I hope that at least this serves as one person’s experience of talking – of ‘reaching out’, as we appear to have to say these days (see even in the grip of mental health shit I can still be pedantic about language) – as something that can, genuinely, help. Like I said it won’t cure things, but it can help you put things into perspective, and it can help other people know how to support you.
Thanks for reading.