The Window Sill

I had been out of my intensive treatment program for almost 6 months. I was substantially better. Yet, after a night out, I ran home, up to the top level of my apartment building, kicked out the window screen, and perched myself on the window sill. As I sat there sobbing, trying to catch gulps of air through my tears, I tried to work up the courage. I was going to jump.

But I didn’t.

If I had, this would have been my second attempt. And while most people think this is so crazy, or focus on how detrimental suicide is to the people who love you (I know this, and ultimately this is the reason I stepped off the ledge), what they don’t realize is what it is like to be in such tremendous pain that you don’t feel anything anymore. And for me, as someone who self-harmed, it was about trying to feel something, anything.

I am still here today, but I can’t tell you that I don’t still have those days, that I don’t still have the thought cross my mind. And my rational mind can still tell me that I’m being irrational, while my illness stubbornly still sees suicide or self harm as an option.

An Epidemic

A recent report from the World Health Organization (WHO) says that one person dies by suicide every 40 seconds. This means that close to 800,000 people die by suicide every year. This is more than those lost to malaria, breast cancer, or war and homicide. Today, suicide is the second-leading cause of death for 15-29 year olds, after road accidents.

Just thinking about this overwhelms me. The sheer amount of pain this represents is immeasurable. WHO also finds that for every suicide, there are many more attempts of suicide. Further, suicide rates are higher for vulnerable groups who tend to experience discrimination. For example, refugees, immigrants, LGBTQ individuals, indigenous peoples, and prisoners. This is a global public health issue, and is one that is having a disparate impact on the most vulnerable in our society. What frustrates me is that suicide is preventable. And there many low-cost interventions that can save lives.

I acknowledge the privilege that I have to be able to afford high-quality treatment and medications. I also acknowledge that as a white, middle-class, cis-gender, heterosexual women with a higher education, I am also privileged. Because of these things I do not face the level of discrimination that underrepresented groups do face. Because I am not isolated as a result of my identities, I experience a sense of connectedness – a major preventative factor against suicide. I am not othered by society, and I also know how to access helpful resources.

How Can We Help?

The majority of the conversation about World Suicide Prevention Awareness Month is often how to help a friend or loved one who is either displaying suicidal behavior or who has divulged suicidal thoughts. But this is a conversation of privilege. I was able to use my smart phone that night on the window sill to contact my therapist, I was able to take my emergency sedative that I could afford to pay for, I was able to seek safety in my apartment. I was able to seek support from other people who have an understanding and knowledge about mental health. And while my experience is important, as is every experience of someone with a mental illness, I know I am at an advantage.

This is why I have made the choice to highlight the groups that don’t normally get talked about when we discuss suicide prevention. And as weird as it sounds, I thought of these people when I decided to step off the ledge and close the window. I thought about how if I did not have all of those things I listed above, I probably would have taken my own life that night.

A part of my healing process has been using the energy and good days that I do have to help others. Whether this is by telling my story or attending mental health events in the community, I am able to make my pain have a purpose. And that makes me feel like I’m worth something. Like there is a reason for me to be here on this earth.

So I ask you to acknowledge your privilege. And understand that by doing so, you aren’t giving anything up. Instead you are recognizing that other people do not have the advantages that you have. It is accepting that any initiatives or programs to help these groups will only help to bring them to an equal position to that which you are standing in right now.

If you think you have nothing in common with these groups, think about the human brain. An organ thats structure is maintained in every person, regardless of race, gender, religion, sexual orientation, etc. An organ that can experience the same mental illness that you or a loved one may experience. That’s chemistry, anatomy, irrefutable scientific fact. Connect to their humanity. By supporting and giving back to these communities, we can help to alleviate many of the risk factors that contribute to their higher suicide rate. Equality isn’t just about laws, equal treatment, or financial wellness – it is also about deserving to live a life without pain. And personally, I think every human being deserves that.

General Resources

Mental Illness, Stigma, and the Dangers of Not Getting Help

So I’ve been putting this one off. And even as I sit here and begin to write I feel uneasy. Even though I am very open about my mental health, I still experience internally imposed and externally received stigma. I fully believe that it is part of what makes me who I am. Yet, I know it can make people uncomfortable and cause them to trust you less. And sometimes others even dismiss you as just being, “crazy.” This is the first blog about my mental health (cue the deep breathing exercises).

I myself had a very public major depressive episode, and eventual break. I know this still colors the perceptions that those around me have of me. And I still experience blame. There are people who say it is my fault and that I could have controlled it if I wanted to. I know that much of this stems from ignorance and lack of knowledge. But what I honestly must say to those people is, “kindly, fuck you.”

In this post I argue that my expletives are warranted. I know what can happen when you ignore your mental health – when hide that you are in pain. Today I’m not going to present you with my full story. Instead I will discuss the dangers of not getting help and the hindering role stigma plays in that process.  

Stigma & Unconscious Bias

A CDC study found that 57% of adults believed that people were caring and sympathetic to persons with mental illness. But, only 25% of adults suffering from mental illness believed that people were caring and sympathetic towards them. Something called the Dunning-Kruger effect could explain this gap. This is the cognitive bias where people who are incompetent at something are not able to recognize their own incompetence.

As humans, I think we would all like to say we are caring to people who have a mental illness. But unfortunately, there is a deeply ingrained, unconscious bias at play. Take the following example. In the media, people are reduced to just being, “mentally ill” far too often. Instead, they should more respectfully be referred to as a, “person with a mental illness.”

By calling someone “mentally ill, you are not acknowledging that they are a person and not just that mental illness. That is a manifestation of bias. How often have you seen a news story about a, “mentally ill” person who has committed a crime? And how often do you independently associate mental illness with other behaviors that you would identify as “bad?”

A Single Story

Photo of Chimananda Ngozi Adichie with a quote that reads, "The problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story."

Let me tell you about a concept called the “single story,” created by author Chimamanda Ngozi Adichie. She uses this term to describe the overly simplistic, often stereotypical, perceptions that we form about individuals, groups, or countries. A lot of her work serves to complicate and disrupt the single stories that many people have about Africa. I think that there are also many single stories that people have about those who live with mental illness.

Let’s do an exercise. Picture a person with depression. How would you describe them? How do you know that they’re depressed? What type of person do you think that they are?

You can keep the answers to yourself, but I hope that you see a bit of what I’m getting at. I had a single story of mental illness, and because of that story, and the stigma I saw associated with it, I did not get help for almost ten years. Let me tell you why.

I was “high functioning.” I was always an “A” student, overly-involved in extracurriculars, and friends with a wide variety of people. Out of college I had a stable job, paid my bills, and was involved in my community. But I was living all this time with almost no quality of life. Six out of seven of the days of the week having thoughts of death and self-harm. This does not mean that I did not have happy moments, but that the pain I was experiencing kept me from truly valuing those moments.

So I hid what I was going through. On the one hand, I didn’t look or act like what I thought people with depression looked like. On the other hand, I didn’t want to make the important people in my life feel unvalued because of my lack of interest and extreme pain. And being in a family in which others suffered from mental illness, I didn’t want to add to any heartbreak. At one point early on I did seek help, but continued to minimize my symptoms to my doctor and to the people I cared about. I didn’t want to put my life on hold and I didn’t want to scare anyone.

The stigma of having a mental illness and stigma of taking the necessary time to treat one kept me from doing so. I didn’t see myself as sick enough to get help and I didn’t want to change what people thought of me. Eventually, I sunk into a major depressive episode. An episode that lasted over a year and a half, and that culminated with me self-harming.

Effects of Delaying Treatment

The longer that one waits to treat their mental illness, the more complicated it becomes and the harder it becomes to treat. Various preclinical studies have shown that delaying treatment of mental illness can cause untreated disorders to become more frequent, spontaneous, severe, and resistant to treatment.

Additionally, a single disorder will most likely progress to more complex comorbid disorders that are harder to treat. You will most likely begin to experience chronic physical problems such as insomnia, gastrointestinal issues, and even chemical changes to your brain and other organs.

Outside of affecting one’s health, leaving a mental illness untreated is correlated to school and job failure and early, unstable, and sometimes violent marriages. At the extreme, some experience bankruptcy or homelessness. Further, there is an increased risk of substance abuse, incarceration, accidents, and suicide.

For those with major depressive disorder, like myself, only 35% are treated within a year of first developing symptoms. For others it can take 4 years or more. Going over a decade without treatment has left me with a lot more challenges to overcome. In addition to Generalized Anxiety Disorder, I also battle PTSD, and now have been classified as having medically-resistant depression as a result of long-term chemical changes in my brain.

Creating Conversation

This isn’t meant to scare anyone, but rather underscore that both stigma and lack of conversation are detrimental to those with mental illness. By othering those who have a mental illness, we push them into a state of fear when it comes to talking about and seeking help for what they are going through. If we can make mental health a part of everyday conversation, then we will create an environment that empowers people to take care of themselves and supports them throughout that process.

Personally, I did not start to get better until I independently made the decision myself to get the real help that I needed. I sometimes think that if our culture was more open and inclusive of people with mental health issues, that I would have sought help sooner. That I would have saved myself years of being numb. But I also had to come to terms with the fact that depression was going to be a companion to me for the rest of my life. It is something that I need to work each day to address. And with that I’ve slowly started to become less ashamed. I wouldn’t be who I am today without my depression.

Irish musician Niall Breslin said something about his depression that resonates with me. Breslin said: “It’s always given me an edge, over everybody else. I truly believe it’s given me an edge, because with depression, nothing can be as bad as that day when you’re stuck in your bed and you can’t get up, and you cannot look at anybody in the eye. So that’s how it’s given me an edge.”

Getting Help

If you are struggling with any kind of emotional distress or mental illness and need to seek help, please utilize one of the resources below:

Psychology Today – Find A Therapist, Counselor – https://www.psychologytoday.com/us/therapists

National Suicide Prevention Hotline – 1-800-273-8255

National Alliance on Mental Illness Helpline – 1-800-950-NAMI (6264) or info@nami.org