I began a suicide note which I worked on constantly until I had what I would call a nervous breakdown (now called a “major depressive episode.”). I began to shake and a thin, plaintiff wail began to well up inside me. With my cousin Jane rubbing my back to soothe me, I called my psychiatrist at University Hospitals. Dr. Ito listened patiently and then asked the standard questions to assess self risk:
“Have you written a note?” Yes. “Do you have a plan?” Yes.
“Do you have the means to carry out that plan?” Yes. Then she told me I needed to go to the hospital.
When one is in the grips of despair, suicide seems to make sense when viewed from within. But viewed from outside it is completely irrational. I began to think why pay bills when I wouldn’t be around to face the creditors if I didn’t? Why worry about getting groceries when I wouldn’t need to eat? Already isolated, my distorted thinking only cut me off more from reality. I did reach out to friends, who would visit when they could, but the thought of going to a psychiatric unit was terrifying. All I could think about was drugs and straight-jackets, even though in the locked unit I once worked in I had never seen a straight-jacket.
I was admitted to the psych unit at St. Luke’s Hospital in Shaker Heights, where, to my pleasant surprise, I was treated kindly and with concern for my well-being. My room was outfitted like a prison cell – no dangling cords, steel mesh covering the windows, and glaring lights outside at night.
Like it or not, I began to feel safe at St. Luke’s (not unaware that St. Luke was a physician). The nurses were unobtrusive and let me sleep for what felt like days upon arrival. The truth is I was exhausted from my weeks of obsessing about suicide. In the hospital I didn’t even think about it.
I got permission from the unit psychiatrist for my pastor to drive me to church one Sunday. Heading down a state highway, I had a sudden impulse to grab the steering wheel and force the car Jim was driving straight into oncoming traffic,but suddenly realizing that in pursuit of my selfish desire I was going to take another life along with mine – and Jim was a young husband and father. I never touched the wheel.
Even though I had a plan at home, in the delirium of wanting to take my life it never occurred to me that I might fail in my attempt and that I could end up brain dead in the garage, lying in a pool of blood at the foot of the basement stairs or mangled if I managed to plow my car into a tree.
The psych unit had its own rhythm of daily meals, group therapy or activities, and “fresh air” breaks when orderlies would take us to a rooftop terrace.
It didn’t take long before I wanted to go home. Assuring the unit psychiatrist that I was in no further danger of self harm, I was released after about ten days. On a follow-up visit with Dr. Ito, I joked about being home from the funny farm. She replied earnestly,
“I prefer to call it a hospital.” We put you there to keep you safe and to stabilize you on medication.”
One of the most difficult things to me about being trapped in suicidal ideation – the clinical term for obsessive preoccupation with self-harm – is that others who care about you can’t even get through. It’s as if you’re standing in a pit you can’t get out of – remember the basement of the house in Silence of the Lambs? – feeling absolutely hopeless and despairing, and nothing others say will help. You look at the walls of the pit you’re in and think this is where my life ends. Meanwhile your family and friends are saying, “Hey, there’s life out here – come join us!”
But you can’t. No one who has not personally experienced depression can understand what it feels like.
In November of 1996 I was in St. Luke’s again, only this time I checked myself in. I wasn’t feeling suicidal as much as I couldn’t shake off the latest wave of mounting depression. Cleveland’s weather doesn’t help; in fact, the lack of sunlight for months at a time could even be a contributing factor. Dr. Ito was well aware of this. After winter had passed she suggested I consider moving back to California, my home state.
“I think you will benefit from the sun and being able to be outdoors more.”
I have been back here for almost twenty years now. Although I go through the same ups and downs as everyone, my overall mood has improved. I remain on anti-depressants and regularly see psychiatrists and psychologists. I surround myself with friends, neighbors and people at church, all of whom are wonderfully supportive. Something Dr. Ito said to me prior to my departure has remained with me:
“If you only focus on what you have lost, you will continue to get depressed. If, instead, you take satisfaction in each bit of progress you make, you will find reasons to go on living.”