Writing a Suicide Note to Myself

I think I deeply underestimate the effect of pain on my mental health.

Oftentimes that pain will lead me to seek out medical care.

That medical care will fall short in myriad ways.

The most damage is done when I am treated like I do not know what I am talking about(which I do, it’s my body and I’m a smart cookie).

They go on to not listen or ignore symptoms.

Systemic misgendering.

Ultimately, ineffective treatments and I have wasted hours, expending myself mentally and physically, with nothing new tried, no answers, no treatments, no referrals, no belief that it would improve, a whole mess of micro aggressions, and worsening pain.

I was writing my suicide note in my head while driving home.

I wasn’t worth listening to. I wasn’t worth respecting. I wasn’t worth treating. I was a drain on the system.

 

A creature of pure torture and it wasn’t going to get better.

Because I will always be the person that writes “LOL” when a form leaves 8 spaces for you to put your medication list.

Because I will need multiple specialists who for some reason can never coordinate their blood work requests.

Because the combined costs for the surgeries I will need to no longer squirm like a child at a funeral just at the idea of being in my body exceeds that of most suburban homes.

Because I have wanted to die as long as I can remember, and only regular therapy, medication monitoring, inpatient hospitalizations, and the occasional emergency interventions keep it from happening.

 

There’s so many stories lately about resuscitating addicts. Someone mentioned a “three strike rule,” where they’d no longer administer emergency medication.

So where does that come in with suicide? How many times do you wake someone up with a smile and tell them they aren’t worthless and sit beside them coloring and chatting as they stare off in to space and beg the universe that JUST ONCE someone would have thrown up their hands and said “well I guess they weren’t worth saving after all.” How many times do you say hello and goodbye to the staff that all knew you anyway before the EMT blacklists your house?How many interventions does it take until when a patient says “I’m worthless,” the reply is, “Well, you’ve met your mental health value quota so, yeah, you’ll have to find some worth somewhere else in life. ”

The mental health system is slow, toxically still full of stigma, and prey to every -ism.

But here I am still.

I was past three strikes years ago, folks.

I thought a line should go in my suicide note- “In lieu of flowers, please send letters to local hospitals and your congressmen.”

 

I came up with some clever lines. Even some stuff about the selfishness of suicide.
Because it’s not. It’s not about you, and you’re being arrogant if you think that. If anything, it’s selfish of you for wanting to keep someone who is suffering that much around, just so you can feel marginally better.

Things like that mindset guarantee I’m not pleasant to be around, I’m pretty sure I don’t have all that many friends, mostly acquaintances.

Profound mental illness, it turns out, is uncomfortable.

I hide behind biting sarcasm a lot. It’s actually the shield that bites back.

 

Then I got to thinking about family. Ain’t that a can of worms.

I thought about the funeral. It’d probably be at the church I grew up in and was chronically awkward in. The one that was 400 people that met in a pole barn when I was 2 and vomited on someone’s shoes and will never live down. I was there as it expanded. As it moved. As it kept rejecting me socially. I was there for the newest addition, millions upon millions of dollars raised. I toured it it when it was scaffolding, sheets of plastic and exposed concrete. I watched as it stretched a video outreach across the globe and my father would occasionally do some paint touch up work on the pastor’s massive boat.

Somehow non-denominational is its own particular denomination. Whodathunkit, it has some very traditional and conservative mindsets.

I knew that without a legally changed name and gender marker, I would be deadnamed among my family until we were all dirt.

And when I came out as pansexual I was told that “a line has been crossed in the eyes of God” if I would ever touch a woman.

And when I came out as transgender I was told that “this was an exploration” and “I will find a revelation.”

“God loves her more than we love her.”

You can change if it’s supposed to cut or be supportive depending on what you emphasize.

My dad had said in the session with my therapist that I have an “emotionally built feminine psyche” and that “guys don’t deal with these emotions.” He figured that a part of my transition goal was to get over trauma through that reasoning. He also said he has nothing but compassion for those that are internally conflicted, which I have been for a very long time.

He challenged me to find one person who was truly happy having done this, 10 years out, figuring that anyone who was transgender would just be so conflicted that they’d never really improve their lives.

Months later my mother was teary eyed when she asked me if I thought I was still saved.

She said “I have to hold onto the thought that you might still be in heaven.”

I wondered at the hellfire that was currently eating her alive, fresh and meaty and ripe, right on this plane of existence.

I thought of all this while I plotted my suicide note. The idea I could be so wrong, so broken that I would be cursed to brimstone and damnation had such a hold on her heart. I fumed.

I spewed. You know, in my head.

Then I craved. I wanted someone to read the note at my funeral. Read the note at the church I was raised in.

I wanted someone to tell them that this is not the gospel. Christ’s blood was spilled so no more has to be.

 

I got home.

I took some medication.

I pet fuzzy animals.

I relaxed on the bed.

I felt a little bit better.

 

Then I got angry.

Angry enough to do some good.

When you are low enough that you’ve almost stopped feeling bad, stopped feeling anything, you can find angry.

You can tap into it.

 

I realized that no one is going to do my advocacy for me.

I may already be fighting hard.

I will have to fight every damn day.

And it will keep hurting.

But I can’t give up and leave my mantle for another, they must carry their own.

I have to be vulnerable.

I have to do it myself.

I have to tell my story myself.

I have to live long enough to improve MY life myself.

To show who I am.

To prove it.

Maybe only to myself.

And still…

There was an incredibly powerful exercise that I did once in a group session with other alcoholics and addicts. It was about the first step-admitting you are powerless. It was recommended by one of our peers, who said his sponsor guided him through it. He gave us all an index card and told us to number one through ten, leaving two lines for each number.

Then he said “I want you to think of ten of the worst things you did while you were drinking, and write them down. Leave an empty line.”

Our leader, Bob, was feeling sassy, so he timed people. The first person completed his in 27 seconds. Others needed to think a little harder. I was in the middle of the pack.

Then he gave us the key for the exercise.

After every statement, we had to write “and still I kept drinking.”

We had to confront the fact that not only did we facilitate these terrible experiences, we chose our demon again. And again. And again.

So for me it would start out a bit like:

I broke a goddamn toilet, and still I kept drinking.
I was sleepwalking naked, and still I kept drinking.
I let the horses out in the middle of the night, and still I kept drinking.
And so on.

It occurred to me recently that this same method could be modified a bit for other situations. I thought of my parents, the spiritual abuse they put me through, and how I’d keep crawling back to them.

So here’s another list. Yeah, it’s different, because the first reflects more personal choice rather than something being done to or with you. It was still a key moment for me to process this list, though. I think it’ll help give me strength.

1. They taught me how to tie a noose when I was really young*, and still I gave them more chances.
2. They told me I was getting fat, and still I gave them more chances.
3. They had me work for the family business in a shop from an incredibly young age, and still I gave them more chances.
4. They made me write pages from the Bible every day to improve my handwriting, until I developed carpal tunnel, and still I gave them more chances.
5. They held me to such high standards that it was impossible to ever succeed or feel like I could be good enough, and still I gave them more chances.
6. They stayed close with my exes even though it made me uncomfortable, and still I gave them more chances.
7. They put down my perfectly healthy dog unexpectedly without telling me while I was away in the hospital, and still I gave them more chances.
8. They left bible pages open about raising godly children after finding a dildo at age 16, and still I gave them more chances.
9. They guilt tripped me for how I was making them feel by choosing to live in my car rather than with them during a complicated time, and later gave me a mattress shoved behind a couch as a bedroom, and still I gave them more chances.
10. They refused to let me see a therapist or get medication for my depression, then insisted on a Christian counselor when it became court mandated after my first institutionalization, and had him perform an exorcism on me, and still I gave them more chances.

It was a pretty frequent pattern that I’d get sick of them and run off, or end up in a mental institution. But I always crawled back, and was always made to feel broken and wrong.

The last couple weeks, I kept getting little barbs from my Mom that indicated that she knew about the transition although I hadn’t had the guts to come out directly to them. Things like telling me how I was the feminine version of my dad, or how girly looking my hair was coming along to be, or how “a girl can dress up pretty and wear makeup and heels and have fun but when a boy does it it’s weird.”

It got to the point that I just walked out the door and left their property after she said something like that. Stopped talking to her. I texted her and said if she wanted to talk, I was meeting with my therapist and she could join, so she did.

She claimed she didn’t have a clue about the transition. She said that when she looks at me she sees “a very confused young person.” When my therapist gave me a chance to express how I was feeling, all I could come up with for a minute was “tense,” and she jumped in saying “And I’m devastated.” Not only did she continue to deadname and misgender me after we explained my wishes, she actively tried to correct my therapist and fiance when they were using the right ones. She asked my fiancé if he was okay with this, and after contorting her face in disgust when he said yes, asked “WHY?!?!” When he explained that his love had nothing to do with my gender, she said “Wow, so anybody can do what they want if they love ‘em.”

There’s another therapy session scheduled.

I added to the list number 11. They invalidated my choices about my gender and sexuality.

Any chances from here on out are to be supervised by a professional.

*It actually wasn’t until very recently that I realized this was fucked up. I mentioned something about it in passing on Facebook and a number of friends jumped in saying how gross that it was. I had been under the impression it was fairly normal, like a Boy Scout thing or whatnot.

23 Pills and a Biweekly Injection*

That’s what it takes to keep me in operating condition.

Not particularly fantastic operating condition, either.

I creak, I groan, I piss and moan.

But I’m still alive.

And these *very expensive* pills are to blame for that. They can be a bit of a curse. It’s obnoxious to go pick them up all the time, my insurance doesn’t allow the pharmacy’s prescription syncing service because they hate progress or something. It takes me about an hour and a half for me to watch a comedy special and prepare the next three weeks of pill cases. It’d take less time if I were singularly focused, yes, but I’d also get so angry that I’d probably start chucking pills at passing cars. Truly though, cars don’t pass by my apartment often enough to let out that rage so I might feebly try to anger-juggle the bottles or some shit like that.

I used to swallow pills one at a time.
A few overdose attempts and having a regimen like this managed to train me out of that.

I also used to swallow Cheerios like pills when I was a kid. I’m not exactly sure why I felt I needed the practice, but I can’t argue with the results. I’m a real pro.

My psychiatrist appointment yesterday brought up my starting Testosterone. It all had happened so quickly, that he hadn’t even been informed yet. He was definitely surprised, but also said, “well maybe we’ve hit a root issue here and once you’re further along, we can start to back you off on stuff again.” That’d be nice. Maybe regular human doses and such!

A few months ago I weaned off Abilify because of drowsiness and weight. It went fine for awhile, then I tanked. So we are trying its new big brother, Rexulti, which is more potent so you take a lower dose and get less side effects. It’s also retails at around $1,100.

Yeah, I want off meds. It sucks that I have to take them. However, I have confronted the fact that I do not have a normal brain. I will never be able to be free of them and have a decent quality of life.

I doubt I’d be able to go off them for 6 months and physically survive, actually.

So, 23 pills and a biweekly injection.

I continue into the fray. I depend on them. They are my sword and shield in a harsh forest full of monsters.

When it comes to advocacy and stigma, I won’t say “I am medicated, hear me roar!” I don’t think we need more associations of crazy.

I might say “I am medicated, watch me manage!”

 

 

 

 

 

*Some are supplements, and none are fun.

Why I’ve Just Begun Being A ‘Good’ Mentally Ill Person

You know when you learn about something for the first time, and then suddenly it keeps popping up everywhere(that’s called the Baader-Meinhof Phenomenon, by the way, and I bet you’ll hear that somewhere else soon)… That’s been happening with the writer Sam Dylan Finch for me. He represents a slice of who I crave to become. He is the beautiful butterfly of a feminist, transgender, and mental illness advocate and writer. I am barely building the chrysalis where I will liquify into the goop of my potential.

When this article popped up on my Facebook feed today, I took notice. I read it. I re-read it. I went to work in a residential psychiatric facility. I had Kool Aid thrown on my new shirt. I kept someone from harming themselves but not from destroying their wooden bed frame. I guided a woman to the floor and used my hand to prevent her from hitting her head as she had a seizure. I came back home. I read it again. I starting writing this. I read it again.

I see myself in it. Then I look, and I see myself in it again. I look a little deeper, and there I am. I’m existing at all different levels in this piece, just as I’ve related to the mental health system at all different levels.

 
As a child

The first time I said I wanted to kill myself, I was on the playground. It was second grade. The recess monitor abruptly replied “No you don’t” and I continued to hang between the bars, imagining a vast expanse between me and the ground. I doubt she told anyone. I suppose if she had, there might have been some earlier intervention, and my life might have gone a little differently.

My parents didn’t really “believe” in mental illness. They saw me struggle. They saw me come home crying. They saw me gain weight. They prayed. They kept their distance, because I was pushing them away and they thought it was the right thing to do.

I wasn’t quite right, socially. I wouldn’t get diagnosed with Asperger’s until I was 19, but all the signs were there. However, I made good grades. I excelled in every subject I touched, except PE, where I was clumsy, apathetic, and unpopular. But when is came to Science or English I basked in the attention of teachers and other authority figures. These were the only people I could seem to talk to. My peers were just out of reach of my awkward rumblings. Somehow I was okay with that for awhile. Increasingly, I isolated. Increasingly, I became more and more difficult to reach out to.

This is how I slipped through the cracks.

 
As a patient

The seeds of potential in me had long been choked out by thorny tendrils of mental illness and substance abuse by the time my grandfather died. I had dropped out of engineering school and semi-flunked out of community college. I was living with my sister, drinking heavily and pretending that it was okay.

The years of 2012 to 2015 remain fuzzy to me. It’s hard to clarify timelines, or which hospitalization happened in what order. I went to treatment centers somewhere between eight and a dozen times, I believe. Some were partial programs, where I learned coping skills during day classes and then drank at night. Some were full hospitalizations, with varying levels of functioning. Once I was in the ICU for three days, knocked out following a suicide attempt. I had Electro Convulsive Therapy, also colloquially referred to as shock treatment(this is part of why by brain is so scrambled).

I started writing about my experiences not long ago, transcribing hospital records and frenzied scribbles in notebooks that are entirely free from metal binding or staples. I found statements from the psychiatrist in one of the partial programs I did. He said “I do not know how much she will get out of our program as it is impossible for her to think with any kind of speed.” This was a kick to the gut, which, coincidentally, also happened during my shift at work. I have never once been accused of being slow, it’s nearly universal that people who interact with me will make some off hand comment about how I seem smart within minutes of meeting me. It hurt to read. At that time, I was assessed with a GAF, or Global Assessment of Functioning, of 40. The scale goes to 100, for reference.

I have been a “bad” mentally ill person. Bruises from fighting against the restraints(I have no memory of this.) Someone trying to drag a necessary response out of me, but I was too busy staring at a crayon with tears running down my cheeks. Not waking up for any reason but to go to the bathroom, for days. Not remembering who or where I am. Being awakened for a blood pressure check to the croons of “well you’re just wrapped up like a burrito!” which became decidedly less charmed when we both(!) realized I was actually naked in my blanket burrito.

Then there’s the egotistical nature of depression. I was quoted in one of my charts as saying that I was the worst person in the world. God, how arrogant. But to truly believe, right down to the base of you, that that is true, is absolutely wrecking. It reflects in everything about you. You don’t care about a damn thing. Eating, showering, moving, taking meds, appointments. You have to be pried out of wherever you are in order to be forced to do anything. And there’s 25 other people on the unit in various stages of recovery that need to be handled too. And guess what? Staff would do a phenomenal damn job. And I’d still be back in three months again.

I have also been the “good” mentally ill person. I was grinned at and asked what I’m doing for the next art competition by about 5 staff during one stay. I always made sure to give them a baffled look and respond “The 16 hour days from the LAST one landed me back HERE again, what makes you think I wanna do more giant art?!?!” I’ve been the bright, relatable, engaged one, who will hold a conversation while meticulously coloring. I’ve been asked what hair color I’m gonna do next, and quipped about how I hope they don’t get to see it. I’ve made a girl nod sheepishly when I asked if she was pregnant the last time I was there.

There was a point where I was a revolving door patient, but I was liked. I was cared about. They prescribed the name brand stuff and made sure to give me a stack of samples on my way out the door. They signed special notes in the cards that we all got with our Christmas bags. They tell me to come back and visit sometime when I’m NOT suicidal. Give them an update. Maybe someday I will.

 
As a provider

Things have changed a bit lately, and I’ve turned the corner well enough to be able to actually work in the mental health field as a care provider, and that provides a different perspective.

One, you have to consider your safety at all times. Allowing your preconceived notions about who might be a “good” patient to lower your guard just means that you will be attacked. Yay, you didn’t suspect it! That probably means your injuries are worse.

 

Two, your patients crave connection, and the staff will most likely try to connect to the ones they relate to most. This means the “mostly normal” one who has a substance abuse problem is going to get better treatment than the person with schizophrenia. This is an unfortunate reality of bias. I try to compensate for it every day, but it’s something that workers need to be actively conscious of.

Three, the mental health field is othering as all get out. I have Borderline Personality Disorder. Every-Single-Training that I went through specifically called out people like me. There were multiple instances of failure to use person-first language, “You might be dealing with schizophrenics or borderlines.” This occurred in the class that brought up using person-first language. Even in Van Safety, the watered down two hour driver’s ed class, “One in four people have experienced a mental illness, there’s seven of you in here, I bet at least one of you has anxiety or something, raise your hands.”

The “Trauma Informed Care” training referred to individuals with trauma as “broken” and says that we are to be there for them while they put themselves back together. THIS IS THE APPROVED CURRICULUM OF TRAUMA. INFORMED. CARE. Broken. Seriously. I was mildly uncomfortably during most of the training, but he had provided coloring sheets so I was keeping pretty chill. Some people were stepping out because the videos were triggering. But the second he said that, my brain went on a loop. Broken, broken, broken. I scribbled it all over my carefully and brightly colored paper. I went up to him afterward and expressed my concerns. He diplomatically explained that this is how traumatized individuals are to be viewed through this approved and regulated curriculum which cannot be changed.

I guarantee you, every time I had a concern in one of these classes, I brought it up the the trainer afterwards. I can also guarantee you that I was not the first to notice or be made uncomfortable. I was probably not the first to complain either. There are systemic mindset issues in the field of mental health. Fortunately, the type of people drawn towards that kind of work are usually compassionate and often touched by mental illness in their own life somewhere, so they make efforts to improve. Awareness is where it starts though.

Okay, what was it, four? This is tough work. You will be kicked, punched, spat at, and insulted on a regular basis. Anyone that doesn’t do this is a welcome respite.

So yes, being able to function as a somewhat “basic human” can make you a “good” mentally ill person.

The thing is, high functioning, low functioning, a number on a GAF scale, these are indicators of illness, of danger. If you have a GAF of 20(which you do, if you are clearly suicidal) you are Stage 4, man. Appropriate interventions are planned and made to save your damn life.

That guy screaming for help? He could have established attention seeking behaviors.

You never really know.