What is and What is not a Choice in Depression

Robin Williams’s suicide has sparked many fascinating debates, from the need to break the stigma behind depression to just treating others with kindness. The debate I was surprised by and even a little cynical about was the debate regarding whether the act of suicide is a choice or not.

I feel for Robin’s family; they have lost a father, a husband and here are complete strangers arguing whether or not his suicide was a choice. I wish I didn’t have to take part but I have this compulsion to set people right, and I hope I can delicately put forward my argument and share some facts about my ongoing struggle with depression.

I’m grateful that people are being more open minded about depression but in doing so I think some people have confused the hopelessness in depression with a lack of willpower. I’ve actually been able to achieve many impossible feats while under severe mental illness or neurological disorder symptoms when exercising the muscle of willpower. I’ve managed to delay meltdowns, seizures and push myself through blood sugar crashes. I’ve stood up to crippling anxiety – although, I usually do fall victim to it – and I’ve avoided giving into impulses. My willpower has never been more needed than during intense and continuous suicidal thoughts.

A few years ago I discovered a book about cognitive behavioural therapy which is basically replacing negative and irrational thoughts with more positive ones. I took the information to heart and began to change the way I thought. Now it is a much needed defense in my fight against my mental illnesses. However, there are times when I’m more focused on the negative and am incapable of thinking more positive thoughts. The longer I’m in my depressed or anxious thoughts the more likely I will become aware that I need to utilize some CBT thoughts to help deal with my feelings. Now when I am starting to doubt myself or even when I am angry at someone and I think I hate them, I can backtrack and decide, no, I’m just angry at them.’ That is all CBT is.

I have felt some deeply intense suicidal thoughts since 2008 and even though I’m on anti-depressants they won’t go away. During the day I may be ok but when the medication wears off the thoughts seep through. The medication does nothing to control my mania and if I give completely into it and allow it to overtake me and make me spend impulsively and do all those other self-destructive habits one does in the middle of a manic episode then I will become deeply depressed again, and often suicidal. Even when I’m in a good mood I know that I have a suicidal plan. When into the middle of a depressive episode it just feels like the plan will go into effect any day now.

But time and time again I have decided to not go forward with that plan. This isn’t moderate depression, this is severe hate and loathing and misery and no one loves me and my life is hopeless and it’s just easier if…It’s serious stuff. But I go through the pain and I come out better on the other side. Sometimes after my mood lightens I’ll still be thinking mild to moderate suicidal thoughts, unless I blank those thoughts out of my mind.

So, how can suicide not be a choice when I’ve made the choice to keep living? Do you want to know what I’m still living for? Most times it’s so I can see and photograph a band. Seems silly but many times when I’ve seriously considered suicide I will then think ‘but I’ll never get to see so and so again.’ Other times it’s been my nephews. I’ve actually written out notes apologizing to them why I did it. Sometimes the physical pain is too much for me to go through. But there’s always been something else, a need to keep pushing on. I’m not in best situation. I’m unemployed and I’m unsure how much longer I’ll be eligible for the disability pension. Obviously, I need to stay on it but I’m not sure if my government will agree. I struggle with social skills and feel doubtful about getting into a romantic relationship which is what I focus on a lot when I’m depressed. And I’m living with family members and don’t know if I’ll ever be completely independent to live on my own. I’ve also got physical health problems as well as mental, and without my ADHD medication I feel stupid and that I can’t reach my potential. So, when I become severely depressed I’m focused on all those issues and I just feel it’s too much – and tell myself ‘I have a good reason to kill myself.’ Then I come down from depression and just keep going on with life.

Now I am in the ‘suicide is a choice’ camp but I feel there are certain moments in depression where one has less of a choice. There’s the extreme tiredness and lethargy, not to mention apathy you get where you can’t even get out of bed. You lose your appetite and so can barely eat. Positive thoughts become harder if not impossible to achieve. When you can eat it’s hard to make a big healthy meal for yourself so you stick with what takes the shortest time to prepare. Around people you give short terse replies and may even snap at them. And then when you feel overwhelmed you can’t stop the meltdown. You might have planned going out weeks ago with friends but now you just don’t care and can’t psyche yourself up to go or even want to go.

I’ve dragged myself out to live music gigs when depressed. On the bright side I wasn’t terribly anxious as usual, but was angry, impatient and was so absorbed in my own ruminating thoughts that I almost got hit by a car. I would look at the crowds of people especially those in groups and just be annoyed. I would drink alcohol and get even more depressed. I’d become paranoid and feel abandoned and yet I would still drink more. I may come out of it if my photos were turning out the way I was expecting, or I’d remain depressed and leave the gig early.

Even then I would have a choice to not drink, to distract myself and turn my thoughts to something more positive. It’s difficult but not impossible. I was actually at a gig where I chose the foolish decision to drink but it did cheer me up, but my friend stayed depressed, and so only one of us enjoyed ourselves.

The only time depression has seemed impossible to control was depression brought on by a hormone imbalance. I had one of the worst weeks with getting up every morning to make sure my cat didn’t defecate in the shower, and then I had to put up with people arguing while trying to fight my own chronic feelings of depression. I actually came very close to committing suicide because I just wanted it to stop. I have been through worst periods of depression though. Having to deal with a mood disorder and a hormone disorder is like a double threat though.

I deal with other symptoms that seem uncontrollable. I have bipolar mania which makes me terribly impulsive. During the last episode I spent too much money and gave into the mania too much so when I did crash into depression it was brutal, but it passed. I actually wasn’t sure when it would end. I even considered suicide too. It was strange to me because I was taking anti-depressants. This time I’m controlling my mania by not instantly giving into impulses, even something as simple as craving food. That’s where it all starts. I be very careful when deciding my next purchases. Yes, there have still been times where it feels my brain is into control of me but I’m still able to fight against this. When I do slip though I try not to be angry at myself. I tell myself, ‘Yes, you got a bit out of control there, said some things you’d probably regret, but just stop here before it gets any worse.’

I used to lose a lot of control of my emotions too but now I take my time to respond to someone or not before I lose them for life. I used to cut ties with friends to save them from my manic rants. I’ve got better control of my anger now, or rather, I can avoid exploding at them and keep those thoughts in my head, then the little CBT officer in my head will try to soothe the angry irrational side of me.

While I do think suicide is a choice it’s more a choice people make when they feel they have no other choice left. Right now I’m choosing to keep my depression at bay while slowly releasing my mania or hypomania and not letting it out all at once or letting it do whatever it wants, so I don’t crash so hard again. And even if I do crash hard again I probably won’t end up killing myself, even when it’s the only thing on my mind.

I think I understand where people are coming from though. Suicide is a very emotional topic especially if you have experienced it. What I’ve seen a lot of lately is people reading into the statement ‘suicide is a choice’ in their own way, and it probably brings up memories of people once telling them or others it’s a selfish act which then makes them think of what most of us think of when we say someone is selfish – narcissistic really – but the selfishness in suicide is far from that. It’s like saying an autistic person is selfish. I’m autistic and I sometimes feel like I’m selfish because I don’t consider peoples emotions at first. But that is the way I’m wired. I work hard to gain more empathy but even when deeply depressed and thinking of suicide that empathy is hard to reach. What I really think people do is focus on those words and only interpret them in the way they’ve always been told them.

So, I hope now people understand by what we mean when we say suicide is a choice. Just being factual really. I’m more of a logical person than an emotional one. Like a Vulcan really. You have to make an act to kill yourself, usually when you just want to end your pain, but it’s still involves making the decision to take those pills, hang that rope or cut with that knife. When deeply depressed my choice has always been: watch a comedy until you start feeling better.

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1 Comment

  1. JudgeRoy – You spoke of CBT and said, “Now when I am starting to doubt myself or even when I am angry at someone and I think I hate them, I can backtrack and decide, no, I’m just angry at them’.” That’s the key thing – and has been termed “the Sacred Pause”, which seems to me a handy name for such an important little act.

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