mandysee_mandydo | five hundred twenty five thousand six hundred minutes (Reply)

One year ago today I tightened a belt around my neck, latched it, and lay on my bed feeling my throat convulse in an attempt to draw breaths. It all happened so fast. I was in bed by myself reading while my family was in the living room. In an instant I decided I needed to end it, saw the belt next to me, grabbed it and went right to work. I was cold, calculated, and swift to act. It was my second attempt in a week. It was highly unusual for me.

I've lived with suicidal ideation since I was around 12 years old. I am usually able to talk myself back. The closest I ever got was having a plan a few times when I was in high school. I remember one time just before going to college having to fight a strong urge to just veer off the road into a tree while I was driving. I have always talked myself down until (rather ironically) I started treating my depression with medication last February.

My depression had hit rock bottom. I was up to having as many as five intense crying spells a day without apparent trigger. I needed to do something so I scheduled an appointment with my primary care clinic. The nurse practitioner I saw prescribed Effexor (venlafaxine) and I was already feeling more hopeful. After a couple of weeks I wasn't having nearly as many crying spells and my anxiety attacks were decreasing a bit. Then it happened.

I had an overnight sleep study scheduled and the day of my appointment I was struggling in silence with suicidal ideation, but it was strong. I fully intended to overdose on one of my medications. I didn't know which one but I figured the antidepressant would work just fine. My taxi arrived and in what I now regard as a wise move I convinced myself to leave my medication home. At the time I regretted it. I was having crying spells in the taxi there and through the night. It even delayed my sleep study for part of the night. I left the next morning determined to do the deed soon, probably that weekend.

I researched my meds. Much to my disappointment, none of them had a particularly high risk of death from overdose, but my Effexor would quite possibly leave me severely brain damaged and still alive. That was unacceptable. Out of desperation that weekend, while my family lay sleeping next to me, I tried to smother myself to death with my own pillow. I was cold, calculated, and quick to act. And incredibly stupid. It would never have worked, but I was desperate and determined. Kathy insisted I tell my prescribing person at my visit that week and I did. She kept me on the medication because we figured maybe things would get better, but I promised I would talk to Kathy and her if I felt suicidal again.

The problem is that Effexor completely removed the filter I had spent over two decades building up. I was ruthlessly out to get myself. And it came on with no warning. Had I been a bit smarter and less clouded by my desperation, I might have noticed sooner that venlafaxine was found to cause a 60% increased risk in suicide over not taking the medication at all. I was having serious side effects but trying to live in silence and push through it against nearly impossible odds. The game had changed but I tried playing by the old rules. I don't recommend it.

I can't explain what I experienced in any way other than it being like Jekyll and Hyde. One moment I was deeply depressed and stagnant me. Then something would snap and I would turn my anxiety and panic inward on myself. It would instantly become clear that I had no reason to live and I needed to end it right there with whatever tools were available on hand. Cue the belt.

Thankfully Kathy walked in and found me as I lay unable to breathe. She was pissed off with me and rightfully so. I broke my promise. She insisted I go to the ER. I delayed. She insisted that I call my prescriber the next morning first thing and let her know what happened. I did my best to line up her friends to call her and help her through. I was snapped out of it and realized that what I had done was horribly wrong and she needed support that I couldn't give her. I called my prescriber first thing in the morning as promised. Her nurse told me I was to report to the ER immediately. I wrote about that experience here and will save the details to focus on the point of this post.

I wrote the previous post as my reminder to take this seriously. I left the ER with a treatment plan, which included getting on a new medication, seeing a bridge therapist until I found a regular therapist, and not being left alone for one moment. I had to follow Kathy everywhere including to work. I switched meds and very soon I had my suicide filter back and was able to calm myself and talk myself down from suicidal behavior when the urge would strike.

Suicidal ideation has not left me. I still live with it. Thankfully I have my filter back so I cope as best I can. Maybe with my upcoming psychiatric evaluation I'll get some relief. If not, I'm at least no worse off than I was before. I felt awkward and still do when family or friends try to do the helpful thing and remind me of all the reasons I have to live. It's not that I forgot those reasons and tried to commit suicide. It was that a medication improperly managed on my own part robbed me of my ability to remind myself of all the reasons I had left to live. What I took away from the experience (and what I hope anyone reading this who is dealing with suicidal thoughts will take away):

Treatment is super important to successfully managing this, and that involves medication, grounding techniques, therapy, and a good support network of family and friends;

Open, honest, timely communication with a close support person and my prescriber is high priority;

Paying attention to my own body and noticing unusual behavior as soon as possible helps me effectively manage my suicidal ideation; and

Going it alone and staying silent is not an option.

If you are thinking of suicide, know that I love you and you are not alone. Please ask for help. You can call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255) or for Text Telephone call 1-800-799-4TTY (1-800-799-4889).

If you identify as LGBT youth you can call 1-866-4-U-TREVOR. If you are transgender like me, you can call Trans Lifeline at (877) 565-8860.

For more information:
Suicide.org
American Foundation for Suicide Prevention
The Trevor Project
Trans Lifeline