Monday, June 7, 2010


It was rather pathetic. I sat with a noose around my neck. My husband sat in a chair on the other side of the room, a book in his hand, I don't know whether or not he was reading it.

I looked up to the plant hook in the ceiling. The plant that it holds is rather large. My husband told me that the plant hook would not hold my weight, and that the computer cord that I had tied around my neck would not hold my weight either. I had not yet removed the plant. I would have to do that before I hooked the noose around my neck to the hook in the ceiling. I did not believe my husband about the noose cord or the plant hook not holding my weight. I thought I could strangle myself just fine. But I did think about how much pain I would have to go through before I lost consciousness and the fear of the pain stopped me.

There were a lot of pills in the kitchen. I wondered how many pills I could swallow before my husband took them away. And then I thought about the consequences. I could swallow just enough so that my stomach would probably have to be pumped at the hospital. There would be no real danger, they would do it as a precaution. And if I swallowed the pills I might be hospitalized on a psychiatric unit. They would try to change my medication, maybe by adding some sort of anti-depressant or mood stabilizer that would certainly have an unforeseen side effect. The stay in the hospital did not worry me, it was how they would monkey with my medication that worried me. I haven't been suicidal for six months, but they might try to medicate me strongly just to avoid another relapse. I don't want to live over medicated.

I didn't feel sad when I thought about killing myself. I felt at the end of my rope. I felt no love of live, no passion, no plans, no future, no love of self, no caring for anyone in my family. I just wanted to leave it all behind. Mostly, I felt like I was a failure. I certainly did not feel like my life had any meaning or purpose. I was also certainly in an altered state of mind. It was very close to being psychotic. I was not at all feeling like myself. Life was a dream, that was why it was so easy it seemed to end it. Nothing was real. So when my husband suggested that I take a dose of the antipsychotic drug trilifon, I said yes, knowing that it would alter my point of view. Because it takes about 45 minutes to work I added a small dose of klonopin. The klonopin would have the effect of relaxing me.

I knew the trilifon had started to work when, a little later on, I thought of a news story I had read on the BBC that I wanted to tell my husband about. In Iran they had just hung a 16 year old unmarried girl for promiscuity. The 51 year old man she said had raped her three times got a few lashes. And then, a little later on from that, I started to cry and say that I was so scared, scared about everything. That I could feel scared and fragile was a big step forward. It meant a return to me of a wide range of emotions. When I was suicidal I was emotionless.

This day had all the makings of a catastrophe. The night before I had fallen asleep at 7:30 pm and then woke at 3am. I could not get back to sleep and get the 10 to 12 hours that I usually must have on my particular combination of medication. Then I went to church. I went to church for about 3 hours. First I went to an education group, then the worship service, then the social coffee hour afterwords. I could not leave early because my husband was committed to take photographs of the members during coffee hour. People had been phone called at home, they were counting on us being in church and being useful. I had to stay and I had to act "normal" and socially outgoing. I laughed and smiled and made small talk when I felt like I had nothing left in me. I milked myself dry. And when I came home, in the back of my mind was the worry that the next day I had to talk to my prescription nurse about a bill totaling over a thousand dollars that came in the mail. They are trying to bill me going back to 2006 and because I have never received a single bill from them for her before, I had assumed that the combination of my insurance and medicare money that they were receiving was sufficient. This amount had been sufficient for the therapist who is part of their office that I used a while ago. If I had known that there would be extra bills from my medication nurse I would have never used her so frequently and for such long sessions. But the worst problem, before I became suicidal, was not lack of sleep and not social stress and not worry over a large bill that stinks of being unethical. It was that my period, for whatever reason, is late this month. My tubes are tied so I doubt that I am pregnant. I am going through prolonged PMS and I wonder how out of whack my hormones are.

In my last session with my therapist he said that on day one, when I walked through his door, he knew that my life had meaning and purpose. It sounded really nice and special until I asked him if he told all his patients this. And yes, he believes that every life has meaning and purpose. I bet that there are very few patients who are canny enough to ask him, "do you tell everyone this uplifting news?" Instead, they think that he sees something invisible in them, some quality that they do not know they possess, that somehow elevates them and separates them from the rest of humanity. If you are told your life has meaning and purpose, and that the person telling you this can see it, you think "ah, I must be doing something right". At least, when he first told me, that was my initial reaction.

I told the therapist that believing every life had meaning and purpose was a religious point of view. He said that he did not consider himself an especially religious person. He said that even atheists feel this way. Otherwise, there would be many people like Hitler or a Stalin sending people off to the gas chambers. I told him what I heard that the agnostic author H.G. Wells wrote, that in the heart of every atheist is an empty space in the shape of God. He said he would have to Google that quote.

That Friday evening after my therapy session I discussed this idea that every life has meaning and purpose with my husband and he said that this is indeed a religious concept, because to believe it, you have to have faith. And as he said this, I wondered about that word, faith. If a life is miserable, and the person is paralyzed and sickened horribly by their mental illness, to say that their life has meaning and purpose is not to look at the dry, social facts. That they are utterly dependent on social services, that they are not producing anything, and that they are experiencing intense suffering. They may not have even one person in this world who truly loves them, except maybe, for the strangers who practice compassion and love towards others as a way of life. Life can be hard. It would be understandable that such a person in this condition would have a difficult time believing that their life had meaning and purpose. It would take an outside pair of eyes, one that had faith in the future, and faith in the sacredness of life, to try to convince someone who was so down and out that their life was not as it may feel internally. The fact that life has merit even when we severely doubt ourselves and we are doubted by the people around us has to often, be taken, on faith. And this faith feels to me to be a cornerstone of many religions.

In Andrew Solomon's excellent book on depression, "Noonday Demon" he meets an institutionalized, partially paralyzed, mentally ill person who Andrew thinks is a possible candidate for euthanasia. The patient says that he is so miserable and helpless that he would like to die except that he cannot physically take his own life. It was clear to me that Andrew, while feeling compassion towards this lonely man, could not see in front of him a life with "meaning and purpose". Andrew has been clearly taught, in his experience with sickness and suffering, that there is a point where suicide is a reasonable option. In fact, Andrew keeps a bottle of pills just so he can one day have an out, should he decide he ever needs one. From my point of view, Andrews life is full of meaning and purpose - he can write. Boy, can he write well. His prose is effortless and beautiful. But he sees a wall that others may not see. He believes that you can know only so much pain and then life is not worth living. Beyond this wall life has no meaning and purpose, and he wonders, after meeting the unhappy institutionalized patient whether this man's back is up against he wall.

It was rather chilling for me to be inside of the head of man who looks at another man and thinks, "you would be better off dead". Andrew believes he is looking at a life that has no redeeming value. The coldness of a wish to murder is hidden in the midst of his warm compassion for the other man's suffering. Perhaps Andrew puts himself in the other man's shoes, and thinks, "I could not stand living such a life, therefore, such a life is meaningless." After all, Andrew did say that he avoided a hospitalization in a psychiatric ward by instead going on a sailing ship in the Mediterranean with a few friends. Andrew is used to a certain quality of life, we get that from the book. He is used to a certain level of productivity and professional respectability. And oh, we get the information that Andrew has a lot of friends.

Most certainly Andrew has been persuaded by his interview with the man in the institution that there is no hope for the future. The patient has no hope, and so, Andrew has no hope either. Faith in the sacredness of life is defeated by simple argument and showmanship. Because the man says, my life is not sacred and worthy of being saved, Andrew is persuaded, into thinking, this life is not sacred and worthy of being saved.

Andrew is not, in my view, a religious man, although I would say that he is a spiritual man. He has much compassion and writes with a broad range of emotion. You can't help but say to yourself, "this author has life and spirit, and he knows it". But at times he lacks faith and hope. Andrew never discusses his religious views in his writing. But clearly he sees places where the presence of a loving God is absent. And where a loving God is absent, the conclusion Andrew seems to draw, is that death has a right to be present. I would say that Andrew has a tenuous relationship with God, at best.

Andrew has so much going for him, despite also having a mental illness (the author of a book about depression has experience with depression) that from my point of view his life is full of meaning and purpose. His mental illness is less disabling then my own, although not less painful. And his intellect is far superior to my own (schooling at Yale and Oxford). But I know, that in the midst of his depression, probably Andrew can feel like his life lacks meaning and purpose. (That is why he keeps his bottle of pills). It would take a leap of faith to convince a seriously depressed and suicidal person otherwise. When he feels well Andrew can easily make the leap of faith and see, especially in a social sense, that his life has meaning and purpose. But when he is mentally ill this may be hard to do. That is why it is important to tell mentally ill people that their lives have meaning and purpose, because it may not be clear to them from their point of view. My therapist has stumbled upon this phenomena. But he cannot say that the meaning and purpose isn't grounded in faith and religion.

There are certainly humble lives that may have no other saving grace socially other than that they are spiritual and religious lives. Monks and nuns that retreat from society to pray and meditate are left alone by society, we don't say, their lives aren't filled with meaning and purpose because we respect that they are spending their time strengthening a connection to God. But they aren't having babies, and they aren't producing goods, and they aren't educating themselves in a conventional sense, and they aren't improving the world, other than perhaps, taking care of those that society thinks have no meaning and purpose. The homeless. The poor. The criminal. The whores.

For the lowest of the low, monks and nuns never give up on the fact that these lives have meaning and purpose. People whose lives are seeped in religion see meaning and purpose everywhere. For that partially paralyzed mentally ill person in the institution that Andrew interviewed, and so pitied, they would see a soul and a life with meaning and purpose. Monks and nuns would not expect him to contribute to society or become famous or rich. They would expect him to simply live and enjoy life. And they would tell him the secret that they have learned that lifts them up from suffering, that all life has meaning and purpose to a higher power. Perhaps they would say that all life is seeped in that higher power, life is sacred, and to know this and to see it all around you is to be lifted automatically from suffering.

It is impossible to feel that the sick mentally ill person's life has meaning and purpose without the fact that someone loves them, and that their life is valuable to someone. Whether that someone is God (and you are relying more on faith than fact), or a sister or brother or mother or father, it does not matter. You are conferred meaning and purpose, it is given to you either from a notion deep inside, which is faith driven (something along the lines that "I am sacred"), or it is socially driven, when there are authors who write books about you (while you are alive or while you are dead) which all suggest "this life has meaning and purpose". I just finished a second biography on Abraham Lincoln, and boy, did I get knocked in the head that this life was full of meaning and purpose. Irony is, that Lincoln was suicidal at least twice, and many times considered himself a failure. He must have wrestled with the idea that his life had meaning and purpose because he wanted so bad, for exactly that, to be true. He wanted to do something for his fellow mankind. History is great for choosing whose life has meaning and purpose, and whose life has none. There is no other force that is so merciless.

I know that when I was suicidal and very depressed yesterday I did not internally feel it, but now that my normal emotional senses are back I realize that I am stuck like a fly in a web of a social network, I have people all around me who rely on me being alive. They would all say, because they love me, "Your life has meaning and purpose to Me".

When I was so sick yesterday my husband stuck to my side like glue. I remember being in the hospital and having a nurse assigned to me "one on one". It is what they do when they think the threat is great for you to commit suicide. They will let you shower but the door to the bathroom has to be open and they are standing there outside. I don't remember what happens when you pee, but they can be relentless. Probably the door is not shut all the way and they listen to you pee. There is usually no conversation. You are usually too depressed for that. But you feel the presence of a human body sticking to you like glue and it really puts a dent in your fantasies of suicide. It is hard to fantasize about suicide when there is someone there who you know will stop you. Maybe it is comforting to know that there is someone there to stop you. Frustrating, but comforting. Someone is telling you, through their stark body language mirroring you wherever you go "your life has meaning and purpose". You are so valued that I am going to stick to you like glue.

After I took my extra medication my husband said, "Let me give you tickles". So I stripped down and he scratched my back. It was not at all erotic, but it felt ever so nice. My husband believes that he has found a hidden pathway in the brain that can be used to combat depression. Back rubs. A strong form of physical touch. You can be depressed, but can you deny the pleasure? And once there is the pleasure, does this break through a little of the depression? I don't know why, in all psychiatric hospitals, they don't give therapeutic massages. My brother is a "massage therapist". He mostly does trophy wives. But wouldn't it be great if his title was really put to the test, and he gave therapy to people who are at the end of their rope? (Which, unfortunately, some trophy wives are.)

I felt very weak and fragile today. The medication nurse told me about payment plans, that nobody expects you to pay $1000 all at once, and that she personally has a three thousand dollar medical bill, but also, that being billed back to 2006 after being never billed at all was "crazy" and that she would look into it. Mixed messages. I had trouble talking to her during our session. I talked very slowly and had trouble finding my words. She said that I had been "traumatized". But she made no promises to trim the bill. I know from working with a therapist in that agency that it is entirely within their power to accept the medicare and insurance payments as whole. They do control the billing, it doesn't control them. So we shall see. Depending on her behavior, I may not continue working with her. It is too bad, as she is competent and we get along fine. My therapist however had one telephone conversation with her and can't stand her. He may be more sensitive than me. He may be a better judge of character.

I saw my mother today and helped her pick out handles for her new cabinets in her new kitchen in her new cottage on the Maine coast. I went to a website that sold glass ones. She picked clear green glass. Very pretty and very expensive.

The more time I put between me and the suicidal trouble I had yesterday the better I will be. But like my medication nurse said to me today, I have a bad mental illness and there will be rough times. She admires my use of medications to get me through crises. She predicted that I won't know smooth sailing.

Me, I'm still thinking about "meaning and purpose". I am an awful lot happier when I do think that my life has meaning and purpose. It is scary how easily I can lose my grasp on this concept.

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