Tuesday, December 30, 2014

How to Talk to Your Loved Ones About Your Upcoming Suicide

I am in the business of preventing suicide. I'm a special kind of therapist who intervenes in a "crisis" which is a nice way of saying I talk people out of jumping off a bridge. Ideally. So the fact that I'm also secretly a suicide advocate I keep firmly on lock down.

You've no doubt heard the maxim "suicide is a permanent solution to a temporary problem" - it's true in a lot of cases. Lots of people who commit or attempt suicide are also depressed, which is a nasty disease that colours our perception of things and distorts our thinking. Still, lots of people struggle with the decision to live or die for weeks, months, and years, because most don't really want to die, they simply want to escape - from an untenable situation, or from recurring thoughts, or both - and can't think of another way out.

I believe in the right to die. I'm not depressed but I do have a chronic condition that makes me not want to live. It's called pain.

If the pain in my body suddenly transferred to yours, you would probably die of the shock. But if you have suffered from chronic pain for years and years, you've built up a tolerance, which doesn't mean you don't feel it, it only means you don't die from it. Your body can keep going but your mind may not want to. There are days when mine does not.

Pain is the first thing I experience when I wake up, the last thing I feel before I fall asleep, if I can fall asleep, and the thing that prevents me from achieving real rest when I am asleep, and real joy when I'm awake. The pain is always first.

I'm in pain first, and at work second. I'm in pain first, and in love second. I'm in pain first, and sometimes I'm in pain second and third too. If I was being chased by a bear, I'd be in pain first, and terrified second. I haven't experienced a moment of pure anything in years. Not pure joy, not pure sorrow. I was in pain on my wedding day. I was in pain at my best friend's funeral. I was in pain the day my nephew was born. I can recall random days by describing the geography of my pain, the quality of my pain, the severity of my pain.

I've just survived the holidays, and holidays are hard. I dread them. There's too much travelling, which exacerbates pain, too little sleep, which exacerbates pain, too much company, which means that I have to cover up my pain and do a lot more pretending, which is draining and yes, painful. There's so much pain around the holidays that I can't even manage to place friends or family or food or fun in second or third or fourth. Pain starts to take over my experiences completely. Holidays are misery.

There is wonderful medication available that eradicates pain, and if you've just been injured or had surgery, this option is a blessing. It allows you to get your body through a difficult time without feeling the true consequences. For me, however, it's not a realistic option. I am not having a difficult time, I am having a difficult life. I have a chronic, incurable disease, which means I will never get better. It also means that if I were to take enough medication to blunt my pain every day, I would never get out of bed. I wouldn't legally be allowed to drive, I couldn't work. I'd be too stoned to really enjoy life, and eventually I'd develop impossible to control tolerance levels, and an addiction, and years of drugs would lead to organ failure and probably new pain. I stay away from medication as much as possible because I'd rather feel pain than stop living my life, which,  believe me, is a daily testament to how much I love life. Every day I choose agony just in case there might also be a little ecstasy. I still believe. But to get me through, I also need to know that when I'm done, when I can't take anymore, I can let go.

I don't know exactly when that will be. How much pain can my body really take, and more importantly, how much can my mind withstand? I already have days when I'd rather have not woken up. I think it about how sweet it would be to just keep sleeping, to not wake up to The Pain. I try to analyze my days: was today 40% pain 60% life? Or 60-40 the other way? I need to know that when the scales tip in a way that I find insupportable, that I can choose to end it. Because otherwise, the 80% days start to feel like 100%. Heck, the 40% days do, because I feel trapped and ignored. I need to know there's a way out.

But discussing this with  my husband Sean has not been easy. It's never been easy for him to live with someone in constant pain. He is not in constant pain, and he can never really understand what it's like. I'm constantly forcing myself to higher and higher levels of pain just so that I don't slow him down too much, and he's constantly slowing himself down so that I don't burn out. So we're both making compromises and we're both getting burned. But he likes me a lot and he doesn't want to lose me, can't really think about me leaving him on purpose. And I get how he'd see that as a betrayal. When we first started talking about my suicide, he felt it as a reproach and thought he wasn't making my life "good" enough. That simply wasn't true. He's made my life so much better than I ever would have thought. He's the reason I still get out of bed in the morning. It's just that, no matter what great thing is in front of me, I can't appreciate it the way he can. I'm always babysitting the pain. Sean knows my life better than anyone. He sees my dark days, he sees the tears, the many doctors, the many surgeries, the many scars. He sees how hard I work just to be a normal person, and he knows that while I'm doing my best to look like a normal person, I'm screaming with pain inside. Every single moment of every single day. He knows my smile is never really genuine. It's 10% fake and masking pain or it's 90% fake and masking pain. He knows. Lots of people in my life know but forget. I do too good a job at pretending and they don't realize how hard I'm working just to stand upright, just to keep my breaths even, just to not pass out. I'm good at hiding, I've been pretending for a decade, but Sean knows. And he's told me lately that he has been lucky to spend any time with me at all, that he'll be grateful for whatever I can give him, and that he'll understand when I cannot. I can only hope that stays true the closer we get to the end.

Meanwhile, we soldier on with our suffering. The end is not today, and I hope not tomorrow. I'm still making short-term plans and still believe that I will be able to honour the commitments I make. I'm still trying. I'm still living.


kenju said...

Since my open heart surgery in Nov., I have been in almost constant pain of one level or another. I cannot imagine having to bear it every day, with no end in sight. I feel for those who do. Hang in there Jay.

Jude said...

Oh Jay I don't even know what to say. I can't even imagine the kind of pain you must be enduring. Is medical marijuana a help, or even an option, do you know hon?

nbrsspot.blogspot.com said...

My husband has psoriasis and he lives in itching and soreness agony all the time. There are some sort of cures but nothing that will ever take it away. So i have some idea what you are talking about.