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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

What did you use for moulds @AlwaysMyself and what did you make out of resin

I am happy for you that it is working out for you

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

@Till23 I want to make some moulds out of silicone, but awaiting that to arrive (couldn't buy in-store). However we made a mould out of "Alginate" (https://www.spotlightstores.com/art-craft/art-supplies/resin-art-supplies/pebeo-gedeo-moulding-alginate/80555668) -- it is only a "temporary mould" product, it says lasts for about 3 castings. We did one casting of Plaster of Paris (cheap) and one of Resin. The mould itself was quite good in terms of the detail it captured - we did a miniature "log" that I had bought from a DnD brand of minis.

Since there was extra substance mixed than needed, we also filled some silicone moulds I had (from cake decorating supplies) to test out too - which worked well, especially the resin. Plaster of Paris the issue was still the bubbles, and it set a bit too fast which added to the issue of getting it into all the corners and getting out trapped air lol -- need more water next time (or a humid day).

I will take a photo and upload from my phone. 😊

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

That sounds interesting and successful @AlwaysMyself

I am old so I do not know what DnD is - I can only think of Dungeons and Dragons

I don't think I've ever worked with Plaster of Paris for craft, so I am not familiar with it's use in for things like making figurines

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

@Till23 Dungeons and Dragons is correct. However my friends have difficulty imagining it all and remembering the layout descriptions, so we use visual drawing and physical pieces/token to represent things on the map.

This is the inside of the Alginate mould.

 you can see some of the texture of the log lines.

Here is the resin reproduction (clear) and the original item:

 

I like how my gnome turned out:

 

 

 

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

I can't see the photos yet @AlwaysMyself

I know of DnD but have absolutely no idea how it is played.

I'll wait for the photos

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

@AuntGlow , tagging you as I can see you are on tonight, but also understand you may not have time to respond and/or may want to think more before responding.

Also welcome for anyone else reading along to respond and throw in their thoughts/experience/knowledge as I know a lot of you do have experience (personal and/or professional) in this type of thing.

I was wondering... if you were to look at chronic anhedonia from a perspective of a background with potentially childhood-trauma and chronic psychological distress, how would you go about treating it other than the "usual" advice of "do things you used to like", "exercise & healthy eating", "take time to savour/notice" / "gratitudes", or medication?

Specifically the anhedonia, if it were not necessarily linked to depressive/negative or anxiety thought patterns. And not just the pre-thought / expectation of something being non-pleasurable, but the absence of it when actually doing the activities. And long-term, not just initially of course.

I think I might see what I can find on this topic, but I suspect a lot of it will be hidden away behind paywalls in academic journals.

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

Hello lovely!! @AlwaysMyself

How are you feeling? Thank you for tagging me, and I promise I haven't forgotten about your previous posts. 🫶

Okay, so, I have thoughts on this!! But I don't want to give you incorrect information, so I am going to go to my uni library online and research the relationship between anhedonia and childhood trauma, and get back to you!

My sense is that neural plasticity and creating safety in the body through somatic work would be helpful with this - to help create new opportunities for the body and mind to have genuine joyful experiences.

Let's chat more tomorrow. 💖

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

@AuntGlow I'm actually wondering whether we should create a thread for the topic of exploring chronic anhedonia research & treatment? Also happy to instead keep it here. Just wondering if we kept it generic whether it would also benefit others too and thus be more visible for them.

I might be lacking in productive work I can do today so far, and I might have seen a link to the work digital library which I had no idea I could access as a non-clinical staff. 😅. Of course I realise this on my final day!!

I found this article interesting: Abnormal habenula functional connectivity characterizes treatment-resistant depression (https://www.clinicalkey.com.au/#!/content/1-s2.0-S2213158222000559). I shall print to read later. The summary intro is what caught my attention as it resonated with my experience/theory:

"The TRD group demonstrated hyperconnectivity of the left habenula to the left precuneus cortex and the right precentral gyrus, compared to the TSD group, and to the right precuneus cortex, compared to the TSD and HC groups. In contrast, TSD demonstrated hypoconnectivity than HC for both connectivity measures. These connectivity values were significantly higher in patients with a history of suicidal ideation."

"The habenula is a small midbrain structure in the pineal region divided into two nuclear complexes, the medial and the lateral habenula. Of those two compartments, the lateral habenula is thought to play a major role in the encoding of aversive stimuli and is strongly connected to both the reward system and motor regions ( Hu et al.2020 ). There are a growing number of neuroimaging studies that suggest that abnormal lateral habenula function could be involved in the pathogenesis of psychiatric disorders, including MDD ( Gosnell et al.2019Skandalakis et al.2018Zhu et al. ). More specifically, evidence suggests that the lateral habenula is highly involved in the induction of depression-like symptoms, as the processing of negative-valence information ( Yang et al., 2018 ) and anhedonia ( Coccurello, 2019 ). Abnormalities in the lateral habenula are shown to be particularly associated with reward processing underlying anhedonia, or diminished sensitivity to rewarding stimuli, in depression ( Coccurello, 2019 ). Circuitry wise, it may influence neurotransmission between dopaminergic neurons in the ventral tegmental area and the medial prefrontal cortex (mPFC) ( Browne et al.2018 )."

There seems to be a lot of positive research about the anaesthetic treatment for TRD for anhedonia, but the only place I know that can administer that is the Black Dog Institute in Sydney -- and I have only ever thought of it as for someone who had very severe depression that was non-functional. I also know it is very expensive treatment. But perhaps if i can't access PAT next year or if it does not help, then it could be an option worth exploring.

I feel my depression is "mild" on my own internal scale of experience over the past 20-25 years of having depression. But when I complete the DASS or HAM-D I get "extremely severe" and "severe" (respectively) for Depression (I get normal for anxiety and usually normal-mild for stress). In my reading yesterday I saw a lot of the research used SHAPS for anhedonia, so I did that scale and scored 11 (out of 14), where scores of 3+ are considered anhedonia -- this did not surprise me, since I identify anhedonia as the major root issue for my depression. And yet, despite knowing that I felt so much worse as a teenager with depression, I still score in the Severe range based on my current symptoms? I know I self-manage it quite well, and in fact don't have a lot of the negative thought self-talk/beliefs that people with depression typically have. I guess it is sort-of validating that according to a population-normalised scale my experience is considered severe, even if I feel it is mild compared to what I have previously experienced 😅.

Interested to read/learn more about the somatic approaches, and whether they can stimulate the positive feelings from "nothing" (rather than just elevate the small-feelings to be more conscious).

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 Hello my beautiful friend. How are you? I am so happy you got some beautiful flowers from work colleagues. 🙂

The markets sounded like a really good thing to do. Always some cool things to look at.

I’m not doing well at all. Nothing planned. It’s terribly hot here. Everything seems very hard for me.

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

@Cuddlebear 🥰😍🤗🤗🤗

I was wondering whether your absence was due to not coping well or whether (optimisistic view) it might have meant you were OK and out doing some enjoyable things instead (i can always hope on your behalf).

I am at work still, but has been a slow day as i have run out of work to help with -- my last day.

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