It Is My Choice to Take Care of Someone, Even in The Context of Suicide

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I was a teenager I think when a woman in our church suicided.  Dad pointed out the man sitting alone.

His wife just killed herself.

Dad asked me what I thought of suicide.  Imagine.  What a compliment really for a teen, to be asked her thoughts.  Being a “Feeler,” I oozed something empathic I’m sure, but still I only remember what Dad said,

I believe God has a special way of seeing these cases.

This was at a time when culturally most of the western world saw suicide as sin.  It was quite forward for Dad to say what he did again later to the grieving man in the pew.  I did not realize at the time, but now I see that people judged him and his wife for what she did.

Later in psychiatry training, my attending said,

Suicide is the most selfish act anyone can do.  It is the ultimate punishment aimed at those who still live.

I don’t know what you think, but I couldn’t help wondering.  I still do.  I think this may be true for some and not others.  I haven’t had a chance to ask them.  They’re dead.

Suicide is terrifying to a psychiatrist.  We all tremble at the thought.  Statistically we know women attempt it more than men, but men are more “successful” when they do try.  They use methods that are generally more lethal than women.  They don’t get a chance to realize that in a month or a day they will want life again.  Or an hour.  They could have lived.

In the intensive-care unit of a hospital, “unsuccessful” suicide attempts hover in life in a space where their self-injury placed them.  The nurses are kept running between medicines, treatments, physician orders and prayers for these lives that tried to die.  Sometimes, the “chronically suicidal” become familiar patients to this critical care ward and that has it’s effect on those who have spent themselves so heroically to save them.

A nurse once told me angrily about her patient who kept coming back.

I fought for that woman’s life!  I prayed over her!  I worked all night for several nights and didn’t know if she would live until much later.  And then she was transferred out to the step-down ward (to a floor where the patients aren’t in such a life-threatening condition), and that lady probably never knew what I went through to keep her alive.

Then later, she came back, and later again, almost dead but not dead.  She kept trying to kill herself!  Finally, when she was conscious again, I just told her how it is.  ‘Listen!  I fought hard for you!  You better go out there and live!  You better figure out what it is you want and go for it.  Stop trying to die!’

This lady-patient was hurting more than herself.  Suicidal thoughts and attempts are dangerous.

There was a patient who tried to use his bed-sheets as a noose before the nurse lifted his wet body from the door frame.  In the emergency room (ER) he was examined, x-rayed and determined fit to return to the ward.  Alive.  Talking to the ER physician, I learned that the reason most people die when they hang themselves isn’t because of suffocation.  It’s because they break their neck.  Done.  No more chances to choose life.  Even an hour.  My pulse was still beating on me to the rhythm of, “He could have died!  He could have died!”  This time, no broken neck.

Regardless of our culture, we are not the judges of these people who want to die.  Regardless of our emotions, their emotions before, any previous conflicts, regardless, we cannot measure their final act by degrees or intentions.

We fight together for their lives and they may or may not know about what that does to the rest of the world.  When we don’t want to fight for them any more, we should change jobs.  It is our choice, each of us.  Whether we are fighting as professionals or as a wife, brother, friend, volunteer or the hired tutor, we fight for their lives because we choose to.  If we cannot keep it up without judging, shaming, accusing the suicidal, we need to own that and take care of ourselves first.  “Can’t give what you don’t have.”

The truth is, suicidality is hard for everyone.  It is hard in ways and in people that aren’t talked about, such as the nurses or the x-ray tech who is the first to find the cervical fracture (broken neck) on film.  It is hard for the church parishioners, the person separated by seven-degrees or the grocer.  Suicidality is hard for all of us.  We give what we choose to give and remember to say, “I can’t control that,” when we can’t.  It is our choice.

Self-Care Tip #182 – Taking care of someone is your choice, even in the context of suicide.  Be a friend to yourself.

Question:  How has suicide touched your life?  Please tell me your story.

27 thoughts on “It Is My Choice to Take Care of Someone, Even in The Context of Suicide

  1. Thank you for your compassionate view on suicide, and patients who attempt to kill themselves. It is one which seems to be sadly rare, even amongst those working in mental health. I have lost count of the number of times I have been told by mental health professionals that it would be selfish of me to kill myself because of the pain it would cause those left behind. They say it as though I don’t realise that I will be hurting people. Of course I do, and of course that isn’t what I want, but sometimes you reach a point where you just cannot live with your own pain anymore, despite what it will do to others. And perhaps that is selfish, I don’t know. It is putting your own needs in front of those of others, so by that definition it is. But I have literally spent years trying to keep going because I don’t want to hurt people. At what point does it become selfish of them to guilt trip me into staying alive? In my opinion it works both ways, as effectively you are weighing up the pain of the person suffering with depression, or whatever mental health problem they have, and the pain that their death would cause those around them. And can you realistically do that – compare pain? Of course we know when we are suicidal that we will cause pain, even if we try and justify, and even fully believe, that actually people will be better off without us. But mental health professionals need to stop trying to guilt trip people into staying alive with stories of what it will do to the people who care about them, because quite frankly that doesn’t make the thoughts any less intense – it just makes you less likely to talk about them. I am far more open about my suicidal thoughts with my CPN who has never attempted to go down that route with me, than I am with professionals who have insisted on me telling them the impact I think my death would have on those surrounding me. When you are that depressed, it isn’t something you can comprehend. You just need a way out, and in my opinion those who do not attempt to judge that, whatever decision they may then feel they have to take when they have that knowledge, are far more helpful than those who immediately rush into telling you how selfish you are. That can just turn into something else to add to your list of failings.

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  3. Suicide is such a difficult subject, especially for those contemplating it or those left behind from such incident. By nature we are so judgmental, esp when it comes to suicide and the religious context of it. My husbands uncle committed a well planned suicide. It was very difficult on the family. However, at the funeral, the pastor approached the subject of this mans soul as I’m sure he knew there were many sitting in judgment. I thought he handled it with such grace, tenderness, and compassion for the family. He started off saying that he realized that everyone thought God would not forgive him, and then stated that the person that did that was a person in pain, clouded by mental illness, and was not the man inside that God (or the rest of us) knew and loved…I wish I could remember the exact words he used. Anyway, he gave the family words of assurance and hope in a time of great pain and confusion, and also hushed up those who were thinking and saying things that were not helpful to anyone. No one knows the pain of another. It is sad all the way around. Suicide is ugly, but we also don’t know what the alternative was like for that particular person…no matter what we think, we never really know. Provocative post.

  4. Hmmmm…. probably not a great time for a joke but…. I’m not real big on timing. (DQ is cringing… I can tell). The Golden Gate Bridge is the most popular place in the world to commit suicide. Over a thousand people have jumped to their death from the bridge. Over the years researchers have sought to learn what causes people to jump and the thoughts that go through their mind. Finally, someone survived the plunge and was able to give an interview upon recovering. The man went into all of the problems and battles that lead him to jump from the bridge. Interestingly, he indicated that after leaping from the bridge, all of his problems seemed insignificant except for one. “What was that one significant problem that stayed in your mind as rushed toward the water below”, the interviewer asked? The man responded, “I had just jumped from a bridge”. OK…. that wasn’t a real funny joke like the ones about the minivan and dogs… but I think it is a pretty good example of how suicidal people, because of their condition, may not grasp the finality of death until it is too late. I didn’t when I tried to kill myself. That was many years ago and it just seemed like a good way to avoid coming down after a long drug binge. Over the years, I have run into many people that have said that they are thinking of killing themselves and it seems like they are all just lacking the perspective or clarity to recognize the alternatives. Here are some things that seem to work well for me when talking to someone that might not see a way out…….. Stay calm and don’t react… anxiety and panic is contagious… anxious suicidal people are probably not good. It’s OK to lie to them… tell them it’s just between you and them or whatever… then call the suicide hot line. Lastly, although it may seem a bit counterintuitive, ask them why the haven’t killed themselves (in a non-challenging sort of way… is probably best). Amazingly, they will give you the reasons they have to live (ie. my kids need me, my dog needs me, I want to go to a party first). Again, I’m not a real doctor or even currently employed, come to think of it, but…. I have been on both sides of the tragedy caused by suicides.

  5. My maternal Grandfather committed suicide when my Mom was 8 years old. I remember her telling the story to us girls when we were old enough to understand what had happened. He had Diabetes and was extremely sick from it. This was back in the 1940s when there was little known of this disease. She said he was always in terrible pain. She remembers my Grandma calling the police to help but they wouldn’t come until “something happened’. My Mom was and still is to a certain degree bitter at them for not coming until Grandpa had suceeded in his “quest” to die. She said she blamed everyone at that time especially Grandpa for leaving her at such a young age but as she got older and realized that he was sick and in pain she accepts it better.
    It is true we tend to judge people for wanting to die. Most of us wondering what could be so wrong in their lives that would want them to no longer live. But I look at it as if you haven’t been in that position you can’t judge. What may seem minor to us could be a mountain to that person with those thoughts. It is hard on the people that are left behind to deal with the lose and the “what ifs?”
    I have seen how it affects people personally and prayer everyday that no one has to go through it.
    May God Bless everyone affected by Suicide….

  6. We were getting off the Jungle Cruise ride at Disneyland when our “guide” thanked us for joining him and reminded us to “Remember. Wherever you go, YOU are there.” It was cute and we all laughed. When I was suicidal, I thought of that reminder a lot, and I wasn’t laughing. When you are hurting emotionally (and physically, too, obviously) all you want to do is stop thinking…stop your mind from haunting you…get away from your head. Suicide seems, at the time, to be the only option, especially when medications don’t appear to be helping. And, as Bippidee said, you DO think about what it’s going to do to your family and friends. For me, it was part of the suicide thinking process, and it’s not that I didn’t care. I cared a lot, and it’s that caring that made me think that suicide was an even more logical solution. If my family didn’t have to worry about me any more, then my being gone would be a kind and loving thing to do for them.

    Of course, it’s wasn’t, when I was thinking normally again, and my family and friends have told me many, many times how grateful they were that I never carried out my plans (and they were specific). I’m grateful, too…now. I resented my husband’s offer to get whatever I needed to commit suicide while I (he demanded) called my children and explained what I was doing and why. Now I love him for it, because I didn’t call, he didn’t collect what I wanted, and I have compiled a long list of reasons why I’m glad I’m still here.

    On the other side, my daughter’s best friend kept threatening to kill herself and, when my daughter told me about it, I called her friend’s mom. I was scared. I didn’t know them well, but I couldn’t just do nothing and let this child die. It was stressful and uncomfortable, but the child got the medical and psychological help she needed, almost thirty years later she is a very successful woman, and her mother is my best friend.

    You did an incredible job of writing this entry, Sana, and I have no doubt that you have had many of us re-living parts of our lives that were – maybe still are – terribly hard. I’m exhausted just writing what I have, but the “exercise” was worth the time and effort – yours and mine. And I agree with Lisa: God bless everyone affected by suicide.

  7. someone emailed me today asking that i post her comment anonymously:
    Skimming The Waters…
    There are those lives that have succeeded, to a given purpose. Even, at different stages and of different levels of connected identities; those transformations overlap and fuse into a reality. Those living realities are working and constantly develop into a strengthened experience and steps to expand future possibilities. So the abilities are broadened and are readily tangible to acquire.
    Then…there are the ones who definately know; “The Pain Of Life”.
    The heartfelt anguish; that undues all sanity…breaking apart all reasoning…to reflect;… to pray;… to hope;…or even…to breathe.
    The soul wailing, as, if it is in a sound-proof chamber…No one;…able to hear or touch that inner core of emotion.
    With the crushing blow of the prevailing intensity; the weight consuming all assurance; in energy to reason… Drained and Overpowered…Life Becomes A Burden….
    There are many difficulties and hardships we all face in our lifetime. Some very difficult challenges to endure, for many of us. The degree; to where a person contemplates on taking their life depends on the individual’s emotional and spiritual factors in those specific areas of their living. Not all avenues of therapy in counseling, prescriptions or other outside influences will reach that inner chamber of pain and turmoil. It has to be just that right remedy at just the right time to make that person awaken to an inner strength… to desire to take a needed step to pull themselves out of their despair!!! It is not an overnight solution for their suffering they have endured. It is not a quick change for their self-worth and guilt; they also carry.
    The inner negative messages of low self-esteem or guilt in some peoples lives have been so prominent throughout their years; that it has become their daily guides. Some have been through molestations, rapes, beatings, non-affection, demeaning aggression, drugs and many other addictive surroundings where there were no structural positive influence in their upbringing. There are so many people who have been abused since babies – and people wonder why the youth & others are so messed up!!! The television programs and music also, is a destructive Giant in so many lives!!! Creating attitudes of mistrust, indifference, hatred, perplexities, self-reliance & self interests, perversions of every kind—breaking every Commandment Of Almighty GOD. We cannot expect for a quick answer of relief for these lives…There Is’nt!!! The Gifts Of Sincerity; Tenderness; Patience; A Listening Ear & Caring Heart; and Lots Of Prayer!!!! Each Life Is So Very Precious To The LORD JESUS!!!!…I know of these things; because I myself had been, also, a victim of pain…I took an overdose of pills….I Have This Life Now…To Live Each Day; To Appreciate The Breath & My Heartbeat… I Have Been Given; To See The Beauty In Little Things; To Enjoy Each Day, As A Special Given Day; To Help Others, Where I May; and To Pray and Be Thankful!!! I hope this writing will help restore others, in living their Life… they are intended to live!!! I pray that Each Life will be healed—it really can be—My Life Now Has Definite Meaning & I Want To Live…As Long As I Can!!! “Anonymously Written”.

  8. I do not believe in coincidence – God-incidence is more descriptive of the chain of events that brought me to your comment box this evening. I receivied your “invitation” to this site by reading the comments you left on my site recently. I always try to drop by the sites of those who visit mine. So thank you!

    I am in agreement with Bippidee: The thought that suicide could be perceived as the ultimate act of selfishness and revenge is as far from one’s thought as is possible – at least it was for me. In my post, “Dear Paula,” which you responded to this evening, I briefly alluded to my own suicidal ideation when I was quite young. I can tell you that the main reasoning around my decision is that I truly believed that I would be saving my family and friends from the source of so much misery.

    Any time since then that I have felt so low, I try before it is too late, to remember when I felt that way in the past, and I remember just that: the feeling is in the PAST now. Feelings are transitory, always changing and life keeps moving – whether we want it to or not. It’s sort of like the weather in Texas: if you don’t like it, then wait a minute. Convince yourself to hold on just a minute longer, because the future is unknowable – you will never know what it can bring; it’s probably a good idea to stick around and find out.

    Mental health professionals can be of tremendous help, but also do great harm. I have experience with both varieties and various permutations thereof, but on the whole, my experiences have been good. As you so correctly state, self-care is important, and family an friends can also be of tremendous aid in getting their loved one the help that is needed. Persistance is key. Any who feel that there is a “blanket approach” to treating suicidal perons is making, in my estimation, a huge mistake. Each person is unique, and their needs are likewise unique, therefore the treatment has to be individualized. I recognize that in emergency situations that is not always possible, but an alert professional will be able to make reasonable judgements, and be ready and able to change tactics as the need arises.

    I owe both you and God a debt of gratitude tonight – you for inviting me here, and God for bringing me! it is surely no accident that the very day I complete that letter to myself, that I would then come here and read this thoughtful and thought-provoking post!

    • Keep A Hold of Christ JESUS’s Tender Guiding Hand and Know That HE Is Ever Present!!! You My Child Are Very Precious To HIM!!!! Bless Your Journey and HIS Inner Peace & Loving Prosperity Be Upon You & Your Love Ones…unto HIS Soon Return….

  9. I remember being around six years old and pleading with my stepdad not to kill himself. He was standing in the doorway with a large knife pressed against his chest. I cried and begged, and told him that I loved him repeatedly, and for some reason he decided to put the knife down. From the age of ten, I remember desperately wanting to die. I would lock myself in the bathroom and cry and hit myself as hard as I could on my head and pull my hair. Around that same age, I would get scissors and pins and scrape them along my wrists. When I was in middle school, I remember pleading with my mom along with my older brother, to put the gun down. She sat in her dark room, crying hysterically as she put one bullet into the chamber from the box of bullets she had sitting next to her. She finally gave the gun and bullets to my brother after some time, and I remember us having to hide them from her. There were more guns in the house, but they were in a safe, and my mom didn’t know the combination since it belonged to her boyfriend. That wasn’t the only time when my brother and I had to talk our mom out of harming herself. As I became an adult, I learned from my dad that his twin sister commited suicide when she was just nineteen years old. Two years ago, just a few days after the new year, my mom’s co-worker and really good friend commited suicide. He apparently took sleeping pills and suffocated himself. That was real hard for my mom because she felt that in some way it was her fault. I was really concerned with her during that time and kept close contact with her. I couldn’t imagine why her friend would do that. I mean, you never know what someone is going through on the inside just by looking at them. He was a real friendly guy, happy, had many friends who cared about him, and liked to joke around. He was also a PA at the mental health clinic he worked at with my mom. So many questions swirl around in your head about why he didn’t seek help or let anyone know how depressed he was. That was his job. He worked with people everyday with mental illnesses and helped them, but why couldn’t he help himself?
    This past week my younger brother’s close friend commited suicide. He was twenty-two years old. I didn’t know him personally, but when I heard about it I felt so sad and I needed to find out everything I could about him and his life. I don’t know why. Everytime I hear about such a story I just feel compelled to do research on the person to try to find out everything I can possibly find about them. My brother said he had spent time with his friend just days before his suicide. I could tell how much it is effecting my brother. He is not the type to ever show any kind of emotion and that especially worries me. A person can only hold in so much pain for so long. My brother is twenty-two and I have never seen him shed a tear, not even at our grandparents’ funerals who acted as parents to us growing up. I recently reached out to my brother after all of this happened to let him know he can call, text or whatever anytime and told him I will always answer my phone. It’s hard to really be there for family the way you want to when they live out of state, and I almost feel helpless because I wish I could be there for him physically to count on. He has battled with depression in the past and even called 911 once because he was scared he was going to kill himself. I worry so much about him, and even moreso in a time like this, and I hope he takes my words seriously and will reach out to me when he needs to.

    • oh Jjen, you have courage. what a road u have walked. i grieve w you. these life-threatening events should not have been something that a girl and her brother suffer through but they were and u keep pressing on w such grace. how do you take care of yourself when you are put through so much?
      keep on.

  10. Thank you Dr. Quijada. I guess the thing that has always kept me going is my three younger siblings. I have always felt that it is my duty to protect them, even from our own mom and her boyfriends. I have felt this way since a very young age. Now it is my own children that keep me going. I do not want them to have the feelings I had when I was growing up, and I will do everything in my power to not turn into my mom. No child deserves to be put through such traumatic events. Although two of my younger siblings are now adults, I still feel as though I can “save” them and will do anything I can to ensure that they will live a better life than I, despite everything we were put through. My siblings and children keep me pressing on.

  11. i lost a very close friend to suicide in April of 2010. it is hard to put into words the impact his choice to end his life has had on me, on my life (and i am sure, the lives of others he left behind). i am aware of the depression and sadness he fought with all of his life, but that did not, at first, alleviate the guilt and feelings of responsibility i assumed for what he ultimately felt was the only choice he had. i have yet to blame him or feel anger toward him ~ i’ve fought with depression most of my life as well so the empathy is there. unfortunately, the rampant ignorance and judgment of quite a large amount of our population compounds the stigmas surrounding both depression and suicide. walking through the experience of losing a loved one to suicide ~ whether husband, relative, or friend ~ is like walking through the fires of hell ~ so many unanswered questions, regrets, and then there is the knowledge that your person violently ended their own life. like all difficult experiences we face in life, there is the possibility of growth from the ashes. it requires strength and a willingness to walk through that fire. unfortunately for survivors of suicide (i’m referring to those left behind) we’re often chastised into feeling that our grieving, our walking through the fire is both wrong, and unnecessary. i totally disagree. like you said, caring for people is a choice, and being a friend to yourself means making sense of, or at least peace with, what may never make sense.

    • “being a friend to yourself means making sense of, or at least peace with, what may never make sense.” wonderful coin of words. said it better than me any day. thank u so so much for reading and commenting. for telling your story. as u can tell from our cohorts commenting with us, u r not alone. keep on.

  12. Im a bit off the rocks at the moment i can say im getting my uni work done 60% of my first assignment is now done its talking more time than i orignialy thought not to wory i was homeless the other day my mate kicked me out well he gave me my orders witch i did cope with ok i was very upset about it and it has really rocked my head i am at the moment i know not thinking straight suisisdedll thoughts are rife kinda muddleing my head up i suppose the brake up with my long turm friend has rocked me more than i thought it would i have to keep positive suside is a very hard subject to me someone who does this i feel ok for them i would not cry for them i would be happy for them sad at a loss of life but glad that there pain is now gone my thoughts are a bit like that many people would probably not agree with my view suiside is selfish to everybody who is left behind but would you not rather a person be out of mental pain then be alive i can speek on this i have had about 48 attempts some worse than otheres some resulting in intensive care etc it takes an extremly brave person to stand up to suiside the only reason i am this way is becuase as a kid this was my way out i was learned that one of my step borthers did this to in me saying everything i have siad we must fight suside one more death is not going change the world the one more that survives and is counted is the one that changes the world i have myself saved many peoples lives i will mention a couple there was g for example when he had to much drink i took his 48 paracetamol off him and would not let him kill himslef i saved him form that but he died a year later now there is s as wellnow this one is a bit better she wanted to kill herself she had the means had it all in frount of her and she wanted me to be the listner to it so like a fairy tale death i was playing dumb to it and i turned it round i called the bluff she threw the tablets away they would not of killed her anyway i knew that she didnt she lived becuase she had a kid and i reminded her of that and that that kid would not cope with out her i can say now she has another kid shes not totle happy but the other day for the first time she siad she was happy in life now for me that is an achivement this is one of the resons i live a lot of people that i know depend on me to pick tihngs up for them so i can say that suside i am happy for them becuase there pain is gone but in reality suiside is never the right option to go down it is not a solution to there problems i know a doctor once siad to me kevin if you go down the path of killing yourslef everyweek you will end up dieing and im not going to stop you but now if you go out there and try to buld a better life as hard as it seems i will support and help you and if you slip up witch you will going on your past i will still support you and help you so witch one do you wnat to go down and i chose the one to try and better my life

    • kevin, great to hear from you. feels like it’s been a while. this was lovely. esp,
      “if you go down the path of killing yourslef everyweek you will end up dieing and im not going to stop you but now if you go out there and try to buld a better life as hard as it seems i will support and help you and if you slip up witch you will going on your past i will still support you and help you so witch one do you wnat to go down and i chose the one to try and better my life”

      keep on mr. courage.

  13. My kids and my husband…I could never leave them. They need me, and I need them. Nothing in this world is bad enough to make me want to be without them, and them without me, no matter how much I may be hurting inside. We all need a reason to live when we are depressed. My family is my main reason. My children are my heart, my breath… The thought of them growing up without me breaks my heart.

  14. Thank you Dr. Quijada for re-visiting this subject. A man in my church this last week died by suicide. This post opened my eyes.

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