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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 Hello my friend. How are you? I’m sorry I’m so unwell and am struggling. I want to come to the forums as for me it’s a core support but I don’t really want to burden people who are already doing it tough.

I’ve not improved. Each day I exist and takes all my energy to get through. I’m safe but exhausted. I have no real life and I’ve tried so hard. My supports have exited me with nothing else in place and I’ve tried a lot of places. Nothing around thwt fits me. 😞

How is the taper going? Have you started with peer worker? You mentioned you were going to be doing things related to the study too have you started the tests or paperwork with GP?


Have you been doing craft and had some social time?

Have been missing you but I think of you everyday even when I’m absent x

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

@Shaz51 Hello sweet. I’m glad there was one on last night. How are you?

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 lovely. How are you doing? I just responded to a post with all these questions for you and in this older post you had already provided answers to most!

Really glad group meeting went well. You’ve mentioned it quite a few times and it really sounds like a decent group. I’m really happy you have that especially right now.

That’s great you’ve got the paperwork done. This is progressing really well at the moment. I’m really looking forward to hearing about the trial if you share once it starts. How long does it go for? If on placebo what happens once the trial is done? If the trial is successful would you have access to the treatment? I’m so glad there’s intensive psychotherapy involved. It’s something I would like to try but can’t afford it. The combination of medicine and psychotherapy is said to have much better results too. Obviously we won’t know if you are in the placebo or medicine group but this trial sounds really good.

I presume you’ve now done paperwork for the peer support. Looking forward to hearing how that goes. Do they come to you?

The RC group doesn’t require anyone to mask. If you don’t feel well it’s totally ok to say so. You’ll find people being very supportive. It’s a group of people with chronic mental illness and medical conditions plus very stressful life circumstances. There’s a lot of empathy and understanding in my experience. Hopefully registration will open soon. They don’t start until sometime in February and we don’t know a date yet.

Im glad this week has been better for you than the weeks before. I’m so glad your taper is not brutal like mine. I know it’s very hard for you too and am grateful your taper is have the supports you have. You deserve it.

At the moment she’s doing 3 days till Easter. She’s not through a company she’s self employed and does have a business but it’s just her. I’d much rather just have her because she knows me I feel safe with her and she’s reliable too.

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

Hi @Cuddlebear @AlwaysMyself After morning that I managed to get almost nothing done, events of this afternoon have left me feeling flat with mix of feeling angry, annoyed and frustrated. The proverbial Hxxd against the wall. I’m safe. Atm wondering I bother at times

hoping today hasn’t been kind to you both

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 , @AlwaysMyself , @Cuddlebear , @Till23 , @Ru-bee @Back4Bikkies @Bow

someone is here all the time my friends xx

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

Hi @Cuddlebear ,

I am glad you are here when you feel up to it - end especially when you need support and companionship. I do not mind at all if every post you had was when you felt negative. Whilst I wish you felt better (because who doesn't want that, right?), I am so so glad you know you can come here and tell us that it is not the case. I feel that the time people most need to most support and friendship and care and someone to talk to is when they are not feeling well - so I would love it if you felt and knew that you are welcome to share these feelings with me anytime and everytime - as long as it doesn't make you feel worse that is! I do wish I could give you my phone number so you would have the option just call to chat when feeling glum (yes yes, I know this is not allowed and will never be allowed, never fear) or upset and needing to hear some supporting voices. Then I could even chat whilst driving or doing housework or painting!

( @Till23 @Flutterbug9 in case of interest also)

The clinical trial (assuming no problem with my medicals) will consist of:

- 2x "preparation" sessions (get to know the therapists and talk over what may happen and goals, history, etc)

- 3x cycle of treatment, each 3 weeks:

- 1st week - dosage day (up to 8 hours) with therapists under the influence of the medication (or 'comparator' med)

- 2nd week - integrative psychotherapy session (not sure how long they are? 1-2 hours I think?)

- 3rd week - nothing. Unless needing an additional psychotherapy session, in which case this can be provided.

So all up the treatment is over the course of about 3 months.

But because it is a research trial, there is also follow-up surveys for 6 months to see if the impacts are lasting or not in the medium-term.

If I do not get the active treatment during the trial, they unfortunately do not have the funding to provide the active treatment. They are reliant upon volunteer therapists. However, after the survey post-treatment period has ended (6 months later) I could then do the treatment privately out of my own costs. And I found out this week the pdoc leading the one I am signed up to do has just received their authority to prescribe it in private practice 😍 so if I do need to do it privately I can pay to have the same pdoc doing it - who I will already know and knows me and my history etc etc.

I do not know if my private health fund would cover any of the costs - but I could ask, since I have paid fees for many many years and almost never used my hospital cover and whilst it is not done as an inpatient, sometimes they will give permissions for intensive treatments done outpatient on a case-by-case basis I have heard? The full cost I don't know for sure yet, but I have read is often $20-30k because of how many hours with a pdoc is required for dosage days and psychotherapy sessions. I am not sure if this is with or without any medicare rebates on those psychotherapy sessions - I guess that would be a few hundred dollars only though if it was because you can only claim 1 per day and the dosage days would not be covered under medicare.

I have heard that even some of the patients not receiving the active medication are still benefiting (at least in the short term?) from the intensive psychotherapy. As you say, for many people it is normally financially prohibitive.

I recall you have some additional medical conditions, but don't recall if any of them would be in the "exclusion list" for the clinical trials. They are being done all around Australia. For the one I am doing, these are the non-MH exclusions:

- Unstable diabetes. (Stable is fine though!)
- Moderate – severe hepatic failure
- Moderate – severe renal failure
- Severe cardiovascular disease

- (heart-based issues) ventricular arrhythmia, or prolongnation of QTc

- Wolff-Parkinson-White syndrome

- epilepsy

- moderate-severe TBI (traumatic brain injury)

- stroke or TIA

- moderate-severe drug or alcohol dependence

- bmi not within research trial range (but I doubt this would be a problem for private practice)

- need to be able to come off MAOI/SNRI/SSRI, if taking

If you think it is worth discussing as an option with your doctors, I can see other places doing trials:

- Mindlife clinic (northern beaches NSW)

- Monash University (VIC)

But there may also be other clinical/research trials around that are also suitable options - the benefit being you don't pay for it. You can do keyword searches here (e.g. "depression" "cPTSD") https://www.anzctr.org.au/TrialSearch.aspx .

I wish the idea of the clinical trial had been mentioned to me a year ago when I reached out to the health systems for options. It's only because my mother mentioned to me that someone she knows of had it in USA with good result. Thats what got me looking at whether it was available, and thus the clinical trials.

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 was just opening up a tab for your thread when I saw this post here too. I hear you. I am going to read and respond. *hugs* in the meantime.

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

When I log back on I’ll have a read of that info about your trial. Be good to read the info, thanks for the tag (not)

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 Hello 🙂 It sounds like you are having a rough day too. It’s ok there’s days where just surviving the day is a big accomplishment. It’s especially so when events develop that don’t go well despite best efforts.

I can understand though having those feelings. I too live with them daily. It’s hard and feels to me at least that I’m just existing. I’m glad you are safe. Thats important.

My day has been second by second. Nothing changes even when I try. If I had the financial resources I’d be able to access proper quality and timely mental health support but that's not the case.

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

@Shaz51 @Hello lovely. How are you? I hope your day is going well.

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