Suicide. How to write about such an emotive topic…?
Everyone has such strong feelings about it. If you have felt suicidal before, you understand how it feels to be in that situation. In that moment, in that state of mind, it feels like you are doing the right thing, relieving dependents of their burden and that it’s the only solution.
If you have not felt suicidal before but perhaps have lost a loved one to suicide, it feels like the most selfish act. The person gets to ‘escape’ and the loved one’s lives are ruined forever.
Over time, with my clinical and personal experiences with mental health, I have come to appreciate all sides of suicide.
Since I started working in psychiatry in 2007, I have lost 4 patients to suicide, that I am aware of. The first patient was within my first 6 months of being a medical officer and I remember it haunting me for months afterwards. I spent so many hours thinking ‘What didn’t I pick up? What could I have done differently? How could I not save her after she had done so well?’
The second patient had been in a psychiatric hospital for 2 years and tried killing himself weekly. He had had such a terrible life, I could understand his need for relief.
The third patient was a mother who came out from the UK for treatment in South Africa following a serious suicide attempt. The NHS discharged her the very same day so her family explored alternative treatment options and South Africa was the best option. She did so well in treatment and found her passion for living again. After 3 months of treatment, I sent her back to the UK. Her psychologist and I had ongoing online sessions with her and we both saw her mood slipping backwards. We desperately contacted family and healthcare workers, letting them know that we were worried about her but it all fell on deaf ears, I assume that there was ‘compassion fatigue’. The psychologist and I felt helpless. We waited and eventually got the call. She had jumped off a bridge.
My most recent loss was one of my most long standing and favourite patients. He had a dreadful childhood and was living with HIV since the early 90’s. His childhood tormented him and had attempted suicide hundreds of times since the 80’s. I treated him for 7 years and eventually one of his attempts was successful. I am sure he has found some relief in the next phase of his life.
Three weeks ago, a patient contacted me over the weekend. I saw her early Monday morning and she told me a story about how she had woken up on the Friday and decided that she had achieved what she wanted in life. She got up, wrote a note to her husband and drove and drove. The plan was to jump off the Storms River Bridge. She drove with the radio blaring, listening to the news to try drown out her thoughts and validate her decision. Her husband found her note and tried to contact her but she did not answer. He managed to trace her phone and called the police. My patient got to Storms River Bridge, walked along it and looked over the edge. She had decided not to end her life and we have been unpacking this event over the past few weeks.
This year has been a hard year for everyone and I think the strain caught up with her. She was not depressed, she had finished her PhD but had not been able to start the next chapter of her life due to COVID-19. She felt like a burden to her husband and had an extremely traumatic childhood. Her parents were divorced, her older sister battled with addiction and after years of trying to save her, her sister died in jail.
My patient said that she always felt that her peers and friends had a ‘naïve optimism’ about the world. She looks back on that day and feels that it was so out of sorts with how she is feeling now. She describes an enormous sense of relief and I know she has so much more good to give to this world.
Don’t feel pressured to go through with things just because you feel ashamed for not completing them. There is always help. Always hope. Always support. Always relief from your pain. Always more love. Always a solution. Always a silver lining. Always more that you can give to this world.