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Managing thoughts of suicide & self-harm

TW: The 'real' me inside - I come with an SI warning

TW: The 'real' me inside - I come with an SI warning

I figure it's better to introduce my challenges here than in a welcome. Hopefully only people willing to hear about SI will venture here.

TW: Suicidal Ideation

Content/trigger warning

I've had thoughts of suicide since I was 12. I don't remember much of life before this time. I'm aware there are times that I haven't though as much about suicide as others, but it's always been a "yes please, that would be my preference" even during the better times.

Why am I still alive then? For two reasons:

- the emotional pain it would cause to very close family.

- the physical pain of accessible methods, and the risks of non-fatal attempts causing lifelong physical impairments.

How do I keep myself going all these years?

By focusing on how I can benefit other people's lives instead. If I'm going to put up with life, it may as well be beneficial to someone.

And to help me keep life less monotonous I look for 'interesting' things - quirky people, exploring foreign countries/cultures, trying new foods (even if i dont think I'll like them). I've never been a status-quo person.

I explain to MH supports that when life is not distressing I can carry on without seriously considering suicide as a possible option. I can say "hello there thought, I hear you but I have chosen not to act on it, things are OK". But when something sets things off kilter, its a pretty quick track back to "why am I still doing this? Do I really still have the same commitment to living? And why, for whom? Why can't I be permitted to die if that's what I want for myself?"

With decades of this under my belt, I have the ability to sit with feelings of extreme distress. And the courage to text or call someone if I need to - and I'm getting a little better at doing this *before* it gets too extreme, but I still hesitate because I don't want to burden others and the frequency of it happening during those unbalanced times is too often. I've persuaded myself a few times recently to instead call a crisis line, but waiting 30-45min in a queue can sometimes exacerbate the thoughts, and sometimes the calls might help dissipate the feelings (if i called early enough) but other times I feel worse after because of course they're going to try to give some positive outlook for the future, but it grates on me because deep down I dont want a future at all. Its actually refreshing when someone acknowledges that not liking/wanting life is OK - and instead just tries to look at how to rebalance the scales to help me cope with continuing to live despite not wanting to.

I'm not sure how un/common my way of thinking is. So much about suicide prevention is focused on short-term distress tolerance or "fixable" problems (eg situations).

What do I need from the community here...?

To be heard? To know if anyone else out there has a long enduring preference to die even when they aren't feeling active distress? And if so, has anything helped them longterm to shift that thinking?

If anyone knows of any practitioners who *specialise* in chronic SI since a young age, I'd really love to know who (if there is a way someone is allowed to??). I've tried Google searching and using online psych directories and reading bio's. I've seen many psychologists and psychiatrists in the past who haven't been able to help me shift this (even if theyve helped in other ways).

I do wonder if my neural networks for positive emotional may not have fully developed or may have atrophied due to the young age and length of time. I genuinely do not know what being happy feels like, I do not have any memory that I recall as being "happy" or joy, and I suspect this makes recovery much harder.

Im ok at the moment. Im safe. But it is exhausting.

Apologies this post is quite a bit too long.

1604 replies

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In response to: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

@AlwaysMyself honestly sounds a little like how I am with my parents when it comes to my mental health. The picture they get is always a bit shinier and less detailed than what my friends and supports get. I think in a lot of ways, by protecting my parents from their own anxieties about their kids, I'm also protecting myself from having to then manage their anxieties instead of focusing on my own.

It sucks you aren't currently able to have your own space. Is it something you'd like to aim for eventually?

I hope things have settled with your mum since yesterday 🤞

In response to: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

@Cuddlebear @Flutterbug9 @Chasingsunsets @Jynx @AuntGlow

MH GP today was really good I think, and I will see her again in 2 weeks to continue discussion & plans. She understood & accepted how/why I have come to where I am in my journey for this year, and understood easily that my experience of depression is not the 'typical' (textbook) presentation. Off her own bat, after getting the history & such, she asked if I have considered whether I might have autism 😅. I laughed (as is my nature when I have contradicting thoughts) and explained how a few different social contacts have suggested this to me over the past years, but how no GP, psychiatrist or psychologist have suggested this and that my mum doesn't think I meet criteria (although she acknowledges I have a number of traits). GP indicated strong suspicion that I may be autistic, from our 1hr appointment today and other patients she has had with quite similar description/experience of chronic depression and SI.

Its nice to hear a doctor ask/suggest this, because it has been very much an "I don't know" thing because of the variance between what I see as 'socially' accepted concept of autism, compared to the strict/traditional DSM-criteria diganosis of autism; and how some people perceive the current thresholds for (especially female-typical-presentations) diagnosis of autism as... reduced and 'over-diagnosed'? I guess that is why I have chosen to focus more on it as "I have some autistic traits, and so I use coping/management techniques for those things the same as an autistic person would be advised", whilst being aware that there are other aspects of autism that I am less "traity" on. But female autistic friends of mine have taught me that just because I don't show my impacts externally (e.g. violent meltdowns) doesn't mean I don't experience internal equivalents - they just haven't been traditionally recognised because they are 'hidden' or masked. The support worker yesterday had also asked if I might be autistic 😅.

I don't see much value in the diagnosis of autism (as opposed to acknowledging traits & treating accordingly) except for where the recognition of this as an additional stressor/barrier/etc can help provide supports for coping with life.

@Flutterbug9 Nearer the end of the appointment I mentioned to the doctor that I do have a copy of the assessment from BDI 1-2 years ago, but that I was hesitate to supply it upfront. And whilst I was trying to find the right words to explain why I was hesitant she herself asked if it was because of inaccuracies between what I had said and what they had noted down 😅. I was really glad she offered that herself and the recognition that it does happen sometimes - I gave her the example of the non-melancholy depression with a few long episodes during my earlier life, verses the more accurate nature of it being chronic melancholy depression with a few periods (months?) of more severe depression "on top". She agreed it is best that I had not given it to her up-front before first chatting to her to give her "my picture" of it, and having spoken to her about it I feel more comfortable to give her a copy for background knowledge generally (it lists past medications, adverse life events, etc quite concisely). (It was done by the BDI for the purposes of advising GPs on treatment suitabilities and confirmation of diagnosis). I am glad you also encouraged me to not give it to her before the first appointment. Thank you; it was good advice. 😊

In response to: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

@Cuddlebear Sending lots of hugs. Do you think it is getting worse, or staying the same over the past month?

It sounds like things are certainly not feeling any better, which of course we were both hoping things would as your body adjusted to the medication levels better. 🤔

I recall they were cross-tapering -- so I assume there was a new/different medication they were trying to transition you onto. Is that still the case? (I assume how much of the new medication can be given depends on the decrease of the existing medication, to ensure not having the serotonin-syndrome toxicity that you experienced before).

Agh, I wish medication withdraw was not so nasty for your body and emotions 😢😭 - I feel for you. I am so glad you are so strong with hanging in there with the process and 'still existing'. I wonder how bad things would have to get for the doctors or you to consider whether an inpatient stay (with actual supervision and support!!) would be possible for you to help with the final stages of the tapering? Would you feel safer to continue slow tapering if you were in a properly-supported inpatient space?

I have noticed the decrease in medication this week physically; but still I am so lucky. Walking and driving is getting harder - I just have to limit how far I walk and drive. Today I had to use a disability parking space to see the GP because there was no other available parking within a 2-minute walk, and with my side-effects I knew I could not walk further than that after having driven for 40 minutes also 😩. I felt bad to take one of the disability spaces without having a permit, but thankfully I had a pen and serviette so I could leave a note on the dashboard to explain it was a temporarily inability and they could contact the GP to verify if concerned. She was very understanding and agreed that using that parking space was a legit thing to do given the effects of the medication taper currently 😊. Even then, it took 20 minutes for the dizziness and nausea to subside from the 40min drive plus 10 meter walk to her office! But I am so glad that if I am sitting still and shut my eyes it will subside 😊, and after time I can then use digital screens again also. (yep, reading/scrolling on a screen also exacerbates the dizziness! but only midly)

In response to: Re: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

Just reading @AlwaysMyself, big big apologies I haven’t been here when things have been tough, I did just see your update on seeing the MH GP, just reading now. 🫶

not my artwork hehe but I really liked it when I saw it and wanted to share it with you all 😊

 

In response to: Re: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

Sorry @AlwaysMyself for the double post 🫶, wow the appt sounds like it went really well, she sounds really nice and understanding, how did you feel in the appointment and about her?

Interesting that she brought up autism, although you said it wouldn’t change much re a diagnosis I was wondering if you connect with it or do you feel it is something else?

Side note 🙂 I was watching a reel on insta recently and thought of you explaining trauma responses and intellectualising, I was wondering if you have come across stuff about this stuff also. Would just be interested in your thoughts (not saying this is you etc as my disclaimer 😊) just thought it was interesting. 🌻

Hows is everyone’s night going? @Flutterbug9 @Cuddlebear

In response to: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

@Cuddlebear sadly bulk-billing psychiatrists are so rare in private practice. 😭. Did I ever mention that I used to work for one once? No surprise they were in very high demand - and that was over 10 years ago! I think demand for psychiatry has only increased since then too 😓. There really does need to be more no-gap psychology & psychiatry services; and especially for those who have chronic MH and disability and are on government pensions. I have been extremely lucky to have come from family with secure income that could afford to pay for it during my teen years; I cannot imagine how I would be if I did not have that. Actually, I can imagine - I wouldn't have made it through.

It got me curious, and this telehealth psychiatry practice (https://telethoughts.com.au/ and also https://psych2u.com.au/online-psychiatry/ ) does advertise they will bulk-bill in some instances. I wonder if it would be worth you (or you GP or support worker on your behalf) contacting them with an outline of your situation re: accessibility and finance and MH, to see if any of their doctors would be willing to bulk-bill you ongoing?

I know it can feel scary to "put yourself out there", but the worst is they say "no" - and that's not really any loss compared to never asking.

Medicare have incentives (item 294) for bulk-billing remote/rural, Indigenous, and Residential Aged Care clients, which means Medicare will pay an additional 50% on top. I wonder whether even if they won't bulkbill you, whether they would consider only charging that same 50% out-of-pocket 🤔.

Do you think a bulk-billing telehealth psychologist would be helpful? Even if you can't afford it beyond the 10 sessions that Medicare will cover, would it be better than nothing to help you through currently?

There are psychologist who specialise in psychotherapy.

I am glad Recovery Club will be back for you again this month, as I know that has been a helpful support for you. *hugs*

In response to: Re: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning


@Jynx wrote:

I think in a lot of ways, by protecting my parents from their own anxieties about their kids, I'm also protecting myself from having to then manage their anxieties instead of focusing on my own.

It sucks you aren't currently able to have your own space. Is it something you'd like to aim for eventually?

I hope things have settled with your mum since yesterday 🤞


Definitely with regard to "protecting myself from having to manage them" @Jynx . Thank goodness I don't have anxiety myself! 😅 I don't have to be anxious about their anxiety -- I can rationally accept that it is their responsibility to manage it, but I can also limit it by not letting them know about it. I'm not sure how it would go down if I suggested she could contact one of the SI-support orgs for carers for support -- I don't think she ever would because of her own training and "knowledge". She is not a good role model for "seeking support" 😅; she is very self-reliant -- something I have come to realise in reflections with my counsellor on why I have always defaulted to self-reliance and not telling people (even her!) about things in childhood haha. Yeah, didn't have a role model for it!

Re: a space of my own. I mean, currently I have 'my own space' in the broad sense. We have separate living areas, even though we interact every day (whether in passing or sit down to watch TV or chat). I moved back home because I wasn't coping with life and needed more support/help at home (including social contact).

The ability for me to move out in the future is dependant mostly upon my mental health, but also do a degree as to if I cannot work - then how financially dependant upon my mother to fund things am I willing to be. Whilst I live with her, the "additional cost" of having me there is less than the income I receive from renting out my apartment - thus giving me a small amount of money to pay for food or supports on top (not enough to cover anywhere near all of it once my work leave runs out, but a small contribution at least). If I can get centrelink payments (or DSP if prolonged) then that will mean I have a little more to contribute towards the costs -- but still not enough to pay for my living & support costs even whilst living with my mother. If I can get that PLUS the NDIS to help with payments for my supports, then I may not be reliant upon my mother supplementing my financial shortfall for basic living (medical, housing, food, bills) whilst at her place.

...so no, I don't see it as a realistic option unless I am able to return to work to earn an income and get NDIS for supports to help me cope with life and living independently. (my income alone even as a well-paid part-timer will not cover living alone in my own apartment with supports). The irony of owning an apartment and not being able to live in it.

In response to: Re: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning


@Chasingsunsets wrote:

how did you feel in the appointment and about her?

Interesting that she brought up autism, although you said it wouldn’t change much re a diagnosis I was wondering if you connect with it or do you feel it is something else?

Side note 🙂 I was watching a reel on insta recently and thought of you explaining trauma responses and intellectualising, I was wondering if you have come across stuff about this stuff also. Would just be interested in your thoughts (not saying this is you etc as my disclaimer 😊) just thought it was interesting. 🌻


I got a good sense / comfortable talking with her @Chasingsunsets ; or as comfortable as I ever am with talking about mental health? I don't get anxious or anything, but I am aware that I don't feel "comfortable" when talking about it -- but I suspect that is me just "keeping feelings and thoughts at bay"? I do realise that I self-sooth with fiddling or rubbing my arms/thumbs whenever talking about my own MH or experiencing any level of distress 😅 which yes I acknowledge is probably also one of those typical autistic traits (I probably go beyond "normal" in my unconscious actions, and then at some stage I realise what I am doing but since it helps there is not need to not do it).

I honestly don't know if I was "born" with these autistic traits or if they developed as a response to life experience. I have a very vague memory of wondering when I was a pre-teen of whether I could be autistic and if I were "how would I know?" I think this is because I felt different to others around me and didn't feel connected or resonate with them -- but again, is this "born with" or "depression"? (I knew what autism was since I was 10 because I had a childhood friend with autism, and it was explained to me when I was 10). The thing is... I never noticed that friend was "weird" 😅 (or, weird to other people?) - but I'm not sure if that is because I was non-judgemental and accepting, or perhaps because those traits didn't feel at all weird to me?

I haven't read much about trauma & intellectualising -- other than what was linked to on Cap's thread. If you find it again - post the link? I would be interested. It's hard to get out of my head and out of automatic positive self-talk and reframing which I do whenever any thoughts or feelings start to emerge re: trauma. 😅. Its "unlearning" to now have to control myself to not automatically shutdown those thought patterns and allow myself to acknowledge how I feel (even if I understand why and know that feelings aren't always reflective of the current situation).

In response to: Re: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

@AlwaysMyself BDI???
For decades friends and family have commented about OCD related actions by me. I don’t have OCD. Things align with autistic traits. I’ve put most down to impact on my brain due to traumatic life events

looking forward to reading any and all information that relates to this area, that you are ok to share

hoping the dizziness settles quickly and stops having impact of your ability for using screen based items

In response to: Re: TW: The 'real' me inside - I come with an SI warning

Re: TW: The 'real' me inside - I come with an SI warning

@Flutterbug9 Black Dog Institute.

I am aware I have some mildly-OCD traits and childhood behaviours also. And patterns right -- patterns just feel right. Is that OCD? Is that ASD? Who knows! It just is for me lol. 😋. I try not to place any "judgement" on my traits -- just let them be "this is how it is -- what do I do now?" Sometimes these traits can have benefits, not just challenges. 😊 Seeing patterns & interconnections multiple-steps-ahead is super-handy for data and business analysis work, for example. 😊

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