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TRIGGER WARNING: If you are struggling with suicidal thoughts or behavior, this may not be the post for you. For immediate help, please visit the National Suicide Prevention Lifeline.

I hate being told what not to say. Don’t you?

But after overdosing earlier this month, I realized people like you who have to deal with people like me––which sure as hell isn’t easy––might appreciate some pointers. So, take them or leave them, but here they are.

First, let’s distinguish between suicidal and parasuicidal behavior. Hemingway’s metaphor describes it best:

“Death is like an old whore in a bar––I’ll buy her a drink but I won’t go upstairs with her.”

When I overdosed, I didn’t take enough pills to die. I researched what would happen if I took too many and measured my intake. It wasn’t a true suicide attempt because I wasn’t committed to Suicide.

I only agreed to a first date.

I’m surprised I made it this long before caving. He’d been asking me out for thirteen years.

Asking.

Pleading.

Wearing me down.

And, for half my life, I had said no.

Sometimes, I’d let him buy me a drink because it was easier than resisting. The next day, I’d have to cover the cuts on my wrists so my teachers, then bosses, then fellow moms wouldn’t see that I had flirted with him.

When I thought he was getting too handsy a couple years back, I went to the ER.

But this time, I let him take me out. And if things went further, if I ended up committing to him, I really didn’t care. I’d given up telling him no.

That’s parasuicidal. Not getting in bed with Suicide. Not yet. Just flirting.

Giving him attention, not trying to get yours.

Which leads me to the first thing you shouldn’t say to your suicidal/parasuicidal loved one.

1. “You’re doing this for the attention.”

Say this all you want, but not to their faces. When my psychiatrist told me this, I heard, “You didn’t prove to me you’re in pain. Swallow the whole bottle, then we’ll talk.”

This comment belittles. It invalidates. It encourages them to make the next attempt stick.

Instead…

“I’m sorry you’re in so much pain that you felt this was your only option.”

This validates the hurt but not their actions. This also gently reminds them that death is not their only option and invites them to look for others.

2. “You have x, y, and z to live for.”

Don’t tell a mom she has her child to live for. Motherhood may be her greatest stressor. Don’t tell them they are blessed to have their great career. It might be the very thing they want to escape. Don’t say their family depends on them. That might be their heaviest burden.

No list of things to live for will convince a person to keep on living.

Instead…

“I see that x is overwhelming you. How can I help alleviate some of that stress?”

Insist on helping if you can.

3. “What did I do to make you this way?”

This goes for parents, spouses, and other influential family members. Whether or not you realize it, you are asking the person who is sick and suffering to identify the past root their own problem and absolve you of any blame for it. It’s a fruitless question no good answer.

Instead…

“This is the side effect of being the incredible person you are. You are gifted in x, are sensitive to y, are capable of z, because of the way you are wired. Remember that this is only a small part of you.”

A lot of people who suffer from depression, or other mental illnesses for that matter, are actually pretty talented. They aren’t remarkable because they are sick, they are sick because they are remarkable. The book, Living With Intensity describes how many gifted children, adolescents, and adults have been diagnosed with ADHD, OCD, and depression because they are hyper sensitive to the world around them––as if they see everything in HD when others see in black and white. Beauty is crisper for these people, but hurt is sharper too.

In their pain, remind them of that unique quality that is only theirs.

4. “If you continue to behave this way, they will take away your kids, job, etc.”

Threatening a depressed person with dire consequences if they refuse to stop being depressed is counterproductive.

Instead…

“I’m taking you to the doctor/hospital/therapist.”

Offer a solution, not a threat.

5. “Don’t ever do this to us again.”

This is like asking someone in remission from cancer never to get cancer again. I know, I know, this isn’t cancer. But I think there is a grave and prevalent misunderstanding about the lack of choice the suicidal have in their behavior.

Saying no to Suicide when he nags persistently takes a strength that no one has infinite supply of. You see your loved one’s bad behavior. You didn’t see the months or years they silently fought to prevent it.

Not to mention, this comment makes you the victim and the suicide survivor the villain. You are also in pain, sure. Please, talk to someone, but someone else.

Instead…

“Your death won’t make our lives better.”

It sounds dumb to say, but they have a deeply held belief that suicide will improve the lives of those around us.

I was shocked at the fear in my husband’s voice when he shook me awake hours after I overdosed. He was devastated. He even took the day off work. It made no sense. I was doing him a favor.

They are convinced they are your greatest burden. Suicide swears to alleviate it.

I hope this helps!

Ps. I apologize for the sheer length of this post. My goodness, it’s so long, I wouldn’t read it.

“Seventy-Two hours?” I scrambled to sit on the stretcher in the middle of the noisy ER. On my right, a man with swollen legs was dying of heart failure. The kid my toes were pointing to was so low on oxygen his lips were blue. Everyone had curtained-off pseudo-rooms, but I was parked at the nurse’s station in my psych-patient-green hospital gown with the only items they allowed suicidal patients: panties and a hair tie. “No, no, no. I can’t do that. I have to take care of my son. Can’t I sign out AMA?”

“Sorry, no.” Dr. Willard–who, by the way, woke me up at two in the morning–answered. “Have you heard of California Legal Section 5150?”

Sure. Aren’t we all well-versed in our state’s legal code? I shook my head.

“My attending just signed your 5150 order. Only a psychiatrist can release you once you’re no longer considered a threat to yourself.”

I internalized the eye roll. “You don’t understand. My husband’s a medical student and can’t take time off to watch my son. I have to be home this morning.”

Then he tried to encourage me with some “remember when the pilot tells you to put your oxygen mask on before your kid’s” crap. I was not comforted.

The plane was still going down.

And, in my defense, I had been putting on my oxygen mask for years. Therapy. Medication. Spiritual direction. Grief support group. Wonderful friends. Exercise.

Fine. You caught me. I had been off meds for two years to have my son, breastfeed him, then unsuccessfully carry my fourth and fifth pregnancies. Meds are important, I guess, because there I was in the ER wishing I was dead.

I awaited my transportation to whatever psych hospital had room for me. Unfortunately, it was a few cities away and ghetto as prison. After my strip search, I sat in the solitary room looking at the scuffed-up nautical mural on all four walls. I sat in there because the overworked nurses forgot about me. I sat in there studying the safety measures they implemented, crying because I wished I had gone through with it before going to the ER. I cried harder when I called my husband, E, and heard my sixteen-month-old son asking for “momma” in the background. J was asking for me and I couldn’t get to him. I couldn’t for sixty-some-odd more hours.

And if I had gone through with it, I could never get to him.

It was then that I fought, really fought, for myself. I called E back and told him to beg the med school’s dean to get me the hell out of there. He pulled strings and got the university psych hospital to hold a bed for me, a facility with real doctors and therapists and windows without locked-closed blinds and hot water (hot water!) and outpatient programs to transition into.

I agreed to extended treatment because my doctor said after a year of being on medication, the severed connections in my brain would be repaired, and I could stop taking them. Then I’d get back to watching my body fail at sustaining pregnancies.

If only.

A year later, my doctor found that my body was genetically incapable of metabolizing most of the antidepressants and antipsychotics that I had been taking. Another year later, I’m on the right mix of medication and healthier than I’ve ever been.

That doesn’t mean I don’t have bad days. A few weeks ago, I wrote this in my journal:

I’m going to lose this battle one day. I just know it….[then] my brain will stop itching in that place only a bullet can scratch.

So, yeah…no more pregnancies for me.

Oddly enough, when I tell people I can’t have any more children because I need antidepressants, they usually argue with me. Yes, argue. (Now, do I show them my batshit crazy diary? No. Maybe I should start doing that…)

“You’re so young. You have time.” Yes, I’ve only had depression for twelve years now. Maybe in twelve more, I’ll be cured and still have some eggs left. Oh, and not miscarry those babies.

“Isn’t there something you can take while pregnant? My friend was on [insert name of a medication I’m genetically incompatible with], and her baby was fine.” Sure, maybe one drug would be fine. But all five category C drugs? And, again, I have four dead babies. I’m high-risk on a multi-vitamin.

“Do you really need med–“ That’s me slapping them. No, I’m just kidding. This last one is usually worded passively if at all. But, really, do people think it was easy to tell my husband that we can’t have any more kids because I’m terrified I’ll die without medication? Trust me, I wish I could just be stronger, think brighter, fight harder.

But I’m fighting as hard as I can.

Once in awhile, you see cuts on my wrist. You don’t see all the times I fought to put the scissors, the razor, the knife down.

You see the row of pills on my counter. You don’t see the immense control it takes to swallow one instead of thirty.

You see how strapped for cash I am because I pay my therapist hundreds a month. You don’t see the courage it takes to tell her when I’m losing the battle.

Because I know if I lose people will say:

“How could she be so selfish?”

“Doesn’t she know what she did to her family?”

“She just took the easy way out.”

But if I lost a battle with any other disease, they’d say:

“She was a fighter.”

“She was a great wife, mom, sister, daughter, friend.”

“She’d rather be here with us.”

I can assure you, if–God forbid–I ever do lose, it wouldn’t be because I’m not a fighter or a good wife and mom or because I don’t want to stay.

It’d simply be because I lost.