At what point should you be concerned about suicidal ideation?

Discussion in 'Suicidal Thoughts and Feelings' started by Butterfly, May 26, 2016.

  1. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    I apologise to all if this is triggering and for the length of this post, but this has been something that has been playing on my mind for a long time and I really feel like I need to discuss it to get it out of my system.

    I have suffered with suicidal ideation many times over the past 12 or so years. Sometimes death is all I can think about to the point I can barely function, and at other times I have just had fleeting thoughts which I don't even batter an eyelid at. Up until 18 months ago I wouldn't have described my suicidal ideation as severe or chronic, because it has never really lasted for long in the past as I was mostly very impulsive so I never really gave anything much thought. But 18 months ago I did go through a very dark depression that lasted for the majority of 2015. It got to the point where all I could think about was how, where, when and the aftermath. I would replay my death over and over in my head. I would write mental suicide notes to the people I loved over and over in my head which escalated to the point where I was writing everything on word documents. I would replay the aftermath over and over. I knew that I couldn't act on my ideations at the time because I had bills and debts to pay but I had a rough timeline in my head but no set date as such.

    I noticed that ideations worsened when I was taking medications which stabilised my crazy moods, but I just felt numb and totally devoid of any emotion. I never really felt anything better than "okay", and quite honestly "okay" is not a good enough feeling for me to convince me to live. I wanted to feel like me again, so I stopped taking my meds 5 months ago. Within about 6 weeks I felt relatively normal and I have actually felt some positive emotions and dealt with negative ones productively. I always knew the risk I would take in that I knew I could become manic or depressed at any time. I am actually quite surprised that I have staved off depression for this long. I have had a couple of hypomanic blips that I have needed to take PRN medication for but my self management has been going well. The ideations significantly improved. Although they did not disappear completely, I could handle the fleeting thoughts and never really paid much attention to them.

    Things had been going well up until about 2 weeks ago when hypomania hit me. This has happened for a couple of reasons. One reason is because I do normally have a high period around May time anyway, and the second is that I have got a big job change coming up in just over 2 weeks time. Because I have Bipolar Disorder I am a creature of habit and routine, so I don't like change. I am of course very excited to be changing jobs because I want my career to progress and I think I will enjoy and be good at my new job, but change frightens me. I am comfortable in my current job and I know what to expect. I know the ward, the people, the speciality etc. But I am absolutely petrified of having to work with new people in a new environment. I understand most people have these anxieties, but for me, change is a really big thing and I think it is unsettling me a bit. I was beginning to get racing thoughts that escalated in me hearing them out loud in many different voices so I took my PRN meds to help with this. I think I am coming out of this now as I am a lot less agitated and wrathful. But during this period and currently as I type this, the suicidal ideations have started to hit me again in full force.

    I am not sure if this is just temporary as I come down from hypomania or if it is the start of something more sinister like a depression brewing. I sincerely hope not and hope that it doesn't last. But I suspect this is going to last until I at least get settled in my new job. But I really don't think I can handle the suicidal ideations again if they reach the intensity they did previously. They are hitting me pretty fast. All I can think of is how I will die, when, where, etc. All the same things as before. I have my method, I have my place, I have my plans financially (I would just need to physically put these into motion). I just don't have a date. I can't do it yet because I have things I need to do first.

    As I type this I do not feel particularly unstable. I feel "okay" but I still feel like "me". I understand that it's probably not a good sign that I feel like this unmedicated, but I don't think I can bare being medicated again knowing that being devoid of "me" and emotion and feeling nothing better than "okay" will make the suicidal ideations worse and I fear that if that happened I would attempt prematurely causing more mass devastation than I initially intended. Obviously I know that my suicide will hurt everybody I know and it's not a decision I have considered lightly at all. I have thought about everything and of course, I know it's going to hurt. But I am not sure I can be condemned to a life of constant mood cycles off meds or taking meds and feeling nothing with no guarantee they can stave off the cycles forever. I do honestly feel like this illness is terminal, which is partly why I decided to come off meds because I thought "fuck it, if I am going to die anyway I at least want to die being me and feeling free".

    This is still very distressing for me. My heart wants to live, but my head is all kinds of fucked up. I just don't know what to do. I haven't been entirely honest with my psych about not taking my meds, but I think if I told him why he would probably understand my reasons for doing so. I have thought about writing an honest letter about why I feel the way I do and why I stopped my meds but I don't see what good it would do. The options are carrying on unmedicated with the very likely possibility I will hit a mania or depression and I can't cope with a depression like the last. Or taking my meds and still having this mindset. I just cannot honestly see a way out of this. The other issue is, none of my plans are imminent so it's not as though they can hospitalise me because I am not a current suicide risk. Sure they could hospitalise me, pump me full of meds and I would stay compliant, but it's not going to change anything.

    I don't know what to do, and I am scared. I thought I was getting past this. I honestly did. I should just be thankful I have had nearly 6 months respite from feeling completely terrible 24/7 and that I have had the chance to live, and live as Alex, the funny, caring, compassionate, kind, ambitious and thoughtful person that I am and that people love. I'd rather go out this way, than some mind numbed minion that just pushed people away towards the end and die feeling completely alone.

    What would you do in this situation? What can I do?
    Last edited: May 26, 2016
  2. SillyOldBear

    SillyOldBear Teddy Bear Fanatic Staff Member Safety & Support

    Lexi, I am not bi-polar so I have no experience there. What I would share is that I have been fighting suicidal ideation for many, many years. Even know it is a daily thought. I have many strange thoughts. Like I will be sitting on my couch, looking at my hand, and think about what it would be like to chop it off. I have never shared most of these with doctors, have never attempted suicide, or self-harmed. I just want you to understand that strange thoughts are familiar to me. And I am currently dealing with health scare of difficulty breathing and other stuff. I have found that thinking you really have a serious illness is a great way to convince you that you really want to live.

    But forgive my rant about myself. You are the one to be concerned about right now. I suspect the new job is weighing on you. When it does, please remember that the job you have now was new once. Now it is old, familiar and comfortable to you. There is no reason why the same won't happen with your new job. Please give it a chance to do so. And I do understand about wanting to feel better then just 'okay'. But maybe you could look at 'okay' as a starting point. A jumping off place to something better. Feeling 'okay' seems much better then feeling like crap. I did like your idea of writing all this down in a letter. It would give you a chance to compose your thoughts and put them down they way you want them. Then consider giving it to your therapist. It can be hard to talk to a therapist because you can't really control the conversation. But you can control the letter.

    Above all, please keep up the battle. You know you are a good person. You are worth the struggle. HUGS!
  3. sofie

    sofie Banned Member

    I could have written verbatim every single one of the sentences you wrote above. I also think that some mental illnesses are, in fact, terminal in some people. All I can say that is positive is that the fact you are questioning this tells me that you don't want to die, you want to find a way to cope without losing you in medications. I would tell the doctor that and see where it takes you. Worse case scenario, you end it later. Best case scenario, you find a medicine you can take either all the time or as needed to help when things get rough. That is the route I am taking. I decided to get a referral to a psychiatrist and give medicine another try before making any permanent choices. Good luck, Butterfly -- you are so loved and add a great deal to this site. The world would be much less without you in it.
  4. DrownedFishOnFire

    DrownedFishOnFire Quieta non movere

    Changes don't come easy to me. I plan my suicides around the same time life changes happened now I have looked back in my life. Suicidal senior year in HS. Absoutely had no plan beyond HS, enrolled last week before college classes started...suicidal when transferred college to out of state bigger school than the tiny local one I went to. Kept changing my majors/mind zillion of times. Both Mom and Dad lost their childhood homes due to foreclosure and i lived with one of them and became homeless myself refusing to settle down or be tied down to a sent me over the edge with the last attempt that sent me to hospital waking up being admitted to psych floor at a different hospital. Series of hospitalizations that summer/fall that's already fading away in my memory lane but anyhow changes and suicide for me is something in common and I'm starting to realize it is an coping mechanism for me to think, plan over and over again about it to escape more changes. My voices are the worst around changes or upheaval in routine
  5. MisterBGone


    Maybe it's not quite that black and white? In other words, there may be other possibilities that exist which you just haven't discovered yet... I understand the frustration. Maybe working in the industry hurts in addition to helping because you have so much information. Although, I don't believe that doctors are allowed to prescribe themselves medications, for the obvious reasons, such as abuse. But is it not also possible that it is just simply too difficult to be objective when looking at ourselves? We bring a lot of baggage into the mix. And this must influence, even if only subconsciously, our opinions. I'm not suggesting that you aren't quite right about all that you have been experiencing and the projected outcomes. I do however feel that it is possible for there to be something else out there that might help you more than you can now see. Maybe not; but may-be! I'll be pulling for you all the way. And I'm sorry it has to be this miserable. I wish we could look ahead to a day when modern medicine discovers physiological tests to determine our conditions. So that we don't have this wild game of hop-scotch, through the various disorders. Then we (or they as it may) will look back at us, and say, "Yes, look at how tied their hands were..." If only we'd have known such & such! I know I wasn't much help, but I tried. Best regards, Alex-
  6. MisterBGone


    I would second the suggestion above to tell your psychiatrist/-or whoever is prescribing you theses meds--what problems you are having. And see what they have to say...
  7. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    Thank you all for your very thoughtful and detailed replies. I really appreciate them. I really thought that nobody would reply :(

    @SillyOldBear - You are right. I think the stress of changing jobs triggered the hypomania and this is more than likely the comedown from that. I find that a stressful event triggers hypomania and then I come crashing down. When I started as a Staff Nurse 4 years ago I was very shy, withdrawn, had no confidence and anxious amongst other things. And my Bipolar and depression was very uncontrolled. I went through a terrible bout of depression whilst I was settling in and I was even referred to the crisis team for a short while and had emergency psych appointments. It really didn't start to settle down until I'd been in the job 6 months. It was a very big change for me and I was very unwell. Obviously I have grown since, the change in me is amazing if you look at the terrified 21 year old that I was to who I am now. I am now someone who people look up to as a role model and I never thought that would happen in a million years. As for feeling "okay". It is a good starting block, but because I feel completely stripped of my personality and emotions whilst on psychiatric meds I will never feel any better than "okay" and it just doesn't cut it for me. I am going to write my letter this afternoon and post it. I have my dad's birthday card to post a bit later too so it will get posted sometime this afternoon.

    @sofie - I have never wanted to die, and even though right now I feel very limited in options, I do not want to die. I have a lot to leave behind and I don't want to leave all the people I love. If it wasn't for them then I wouldn't be where I am today, that's for sure. I do deserve the chance of seeing if there are any other alternatives where I do not solely rely on meds. And I will give myself that chance. I fully intend on giving myself every chance possible of living before I make any permanent decisions. I have PRN Olanzapine for my mania/psychosis/agitation but it just zonks me out. I know that is kind of the point but it's very difficult to take it when I work shifts. I'm not using it as an excuse. I could take time off, but routine and work really keeps me focused so I feel continuing to work is more important than taking a med. Thank you for your kind words.

    @DrownedFishOnFire - Change always has and always will rock the boat for me. Even positive stress sends me a little loopy. I don't really want to run away from change but I do find it difficult to go through. I don't think the suicidal ideation is purely down to going through change through. I don't think it helps, but it is not the sole reason. I had it for the majority of last year and it got worse once my moods had stabilised. Even for the past few months the thoughts have always been fleeting and is something I think about daily but I did not feel consumed by them. But yes, they have suddenly resurfaced now the boat is being rocked.

    @MisterBGone - I don't always see things as black and white. I can do when I am in a lot of distress and it's kind of all or nothing and black and white thinking. That's why I posted this thread, because I wanted to consider the grey but I just couldn't see it at that point in time. I am someone who does believe that medications have a purpose and they have certainly served a purpose for me even thought I struggle with compliance. I am also a firm believer in therapy and learning how to self-manage. I think I have self-managed fairly well up until now and I still have a long way to go, so I am open to anything really. I just can't see how I can completely stay off meds forever and maintained stability. I really should not have stopped taking them, but I could not stand how they made me feel. The past 5 months I have felt free. I am not sure if that is because I was completely free from chemicals messing around with my brain or because at the time I made the decision to stop taking them I was at the stage where suicide was my only option, and this gave me an option to live, and to live as me. I don't know if that makes any sense. I have many fears. I know that not taking meds puts me at risk of further mania's and depressions, and medicated or not, each episode is worse than the last. They become more intense and last for longer. So stopping them wasn't a decision I made lightly. But being completely emotionally and mentally void was killing me. Not to mention the side effects of the drugs. I had terrible tremors in my hands and affected my legs every so often. It's not easy trying to draw up medicines or complete basic nursing tasks when your hands are all over the place. I am not sure if it's down to the meds or just the disease but my speech has been affected too. My words all jumble up when I speak. The right words come out but just in the wrong order. I can stutter and I can completely freeze mid sentence completely unable to get my words out. It is a pain in the ass for sure. I am going to write my letter this afternoon and post it. I am really scared, but I will do it.
  8. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    sofie likes this.
  9. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    It's gone. Posted it. Shit, shit and triple shit!
  10. sofie

    sofie Banned Member

    NO!! YES YES YES YES -- You did something that took INCREDIBLY bravery, courage, and desire for a better existence -- you did a GREAT thing!! I am SO happy for you! I will pray that the doctor receives it and understands your point well.
  11. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    @sofie I literally bared my soul in that letter and I am very frightened of the repercussions it is gonna have! But it was honest and truthful at least. I hope it gets there on Tuesday. I am literally gonna be on tenterhooks.
  12. MisterBGone


    @Butterfly- Good job! That's so great... I'm proud of you. A doctor can only do what he or she is able to, given the amount of information that is provided him or her. And in the absence of this--he or she is left to then, "fill in the blanks!" At least this way, you have some better editorial control over your case.:) Especially considering the nature of the acuteness of your symptoms. The best way is not always the easiest. But I think you have made a wise choice and a correct decision. It's okay to be nervous. That's quite natural, in fact! Just try not to let it consume you. Nothing good that that will do! And what's done is done. So, let it be (easy for me to say...)!
  13. sofie

    sofie Banned Member

    I am glad you bared your soul. I know for me the weight of my secrets on my life is far worse than the weight of any repercussions from sharing those secrets.....does not make it any easier to share and I am very poor at that, but I know it is the truth that secrets are poison on our souls. You can do this :)
  14. MisterBGone


    And I do understand you, completely. Well, without experiencing many of the things my self; in the absence of that, you have explained it in such a way so as to allow me to comprehend your troubles. Or at least the psychology of the struggles one encounters when dealing with such dilemmas. I hope that you included some of the most pertinent cliff notes in your letter to your doctor. Such as the speech & side effect issues. Even if he or she can't help with the former, or any other problem concerning you, hopefully they can refer you to somebody that can... Take care!
  15. Freya

    Freya Loves SF Staff Member ADMIN

    I am really proud that you wrote the letter - being honest is a frickin bitch sometimes - hard as hell and incredibly scary - but it is the only real step you can make toward getting better when it comes to doctors and stuff. I know you cannot stop the thoughts - maybe they will always be there - but that doesn't mean that things can't get better and a thought is only as powerful as you allow it to be. YOU, on the other hand, are incredibly powerful - strong and smart and brave.
  16. Wastingecho

    Wastingecho Well-Known Member

    I don't think you understand how courageous you truly are

    I could never even write a letter like that much less send it

    Use the amazing strength from that moment as you go forward
  17. SillyOldBear

    SillyOldBear Teddy Bear Fanatic Staff Member Safety & Support

    Wonderful job Butterfly. It took real courage. Am proud of you. And hopefully that letter is the start of better things.
  18. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    Thank you all for your kind words. I don't feel very brave. I am feeling very stupid and I really wish I could retract the letter now but there's nothing I can do now except sit, wait, worry and catastrophise until I hear back from my psych. I stated in the letter how desperate I am and that I really feel that this is the last chance to save my life.
  19. MisterBGone


    Well, if that is the truth then that is the very best thing that you could possibly do! And I marvel--absolutely marvel at the way in which you've managed to maintain yourself. If only I could do that so well... It's very human to feel the way you do right now. But just try to let it go. Even if you were to reverse this, then you'd just be right back in the same boat as before you'd made this post. I'd just say, "forget it! & bring it on, doc..." But that's because I am difficult-
  20. Butterfly

    Butterfly Resident SF Sims Enthusiast Staff Alumni SF Author SF Supporter

    I feel relieved that I have done but I am worried. Worried for so many reasons. I know what will be will be, and that's what I'm worried about!