Suicidal behavior vs suicidal ideation
What’s the difference?
I believe the difference between suicidal behavior and suicidal ideation is in the planning. In my last post, I announced that I am experiencing a mixed episode. A relapse. What great timing!
My fellow mental health advocate, Natasha Tracy writes openly about these types of issues. She wrote a piece- filled with statistics but also a non-scientific gauge for you to determine just how suicidal you may be. Again, it’s not scientific approach- but it may help in helping you arm yourself with some courage to ask for help. You can find it here.
I’d like to insert a trigger warning here, as I know of many of you are sensitive (for many different reasons) this time of year.
What does suicidal ideation look like?
It’s thoughts. Intrusive thoughts specifically- there being no trigger. Sometimes there is. An example of non-triggering would be you driving happily, listening to your favourite jam on the radio and then see yourself drive off the cliff. Yip. That’s a thought. There’s no real impulse there. You’d feel all the butterflies and the fear of doing that yes, but it came out of nowhere first.
So it’s scary, but there’s no real impulse to do something about it. It comes and goes. Like a sudden gust of wind or a speeding fine. Once the need to want to kill yourself and you try to plan it, this concept changes to suicidal behavior.
So, suicidal behavior?
Now this is a different story- and also where things get a lot scarier. Look, I’m not going to lie. Both are scary to live with. And I’m not saying that it’s okay to have or live with suicidal thoughts or ruminate on it and not do anything about it. You must reach out. But I want to explain the differences, and how you can empower yourself, with this knowledge to take the right steps, with urgency.
Suicidal behaviour (usually) happens when you’re triggered (feel compelled to act) and you think of ways to make those plans happen. It’s that simple, which it is that dangerous.
I live with suicidal ideation or thoughts of self-harm daily. It doesn’t really shock me that much anymore, although it has made me sad in the past few months because I really felt alive. This, especially with regards to my sobriety. I imagined that they would go away. Perhaps I should research a bit more into that next year.
Anyway, compared to last year, I have been much busier. We moved to a new town, my business was growing, but it also meant I had to learn some painful business (stressful) lessons. As does everyone else!
I was also dealing with a lot of personal anguish and writing a book about some of these pains. Some of it had not healed. Some were public and others not. It was a mess of lessons and life that threw me to the lion pit of triggerdom.
And that’s when I snapped
I had a meltdown in a mall, in a different town while my husband tried to support me. There were tears and onlookers – ugh- hate that, just let me cry in peace! And then I saw the Old Mutual sign. As we spoke, like a parallel conversation, a thought appeared “hey, you know haven’t sorted your life policies out yet. So, if anything happens…” I knew exactly what that anything was.
I went to the nearest coffee shop and ate something- trying to distract myself by eating. Duh. But I knew it had begun: the race to the end.
After that thought entered, the floodgate of suicide impulses rushed in. Around every corner. Simple things. Messy, violent- all leading to the calm and quiet I longed for. I had pushed off the feeling of wanting to get away – or the quiet- I had been craving. “No people, Yvette. No people” But no, I don’t listen.
The “shadows” I ‘ve been seeing also become more prominent. You know, when you think you see something in the corner of your eye- but then there’s nothing there?
Paranoia. That was creepy. Pun intended.
I think what scared me the most were the distant voices. Okay, I don’t quite know what to call them. It often felt like I heard sounds, but when I asked if someone else heard them, then they’d say no. A few times, I’d hear something right next to me!
So all of this “crazy” and I still make space for others?
Yes. I did. I shouldn’t have. But I did. After my meltdown, I drove back home (5-hour drive). It was terrible. With every overtake car or truck attempt, my heart would race. Actually, my heart would be racing all the time.
I answered Whatsapps, messages and calls. Because others needed me- and I didn’t know how to care for my own issues at that point. It was like the quiet nagging became loud suddenly. I say suddenly, but it’s never really sudden.
Two nights after I got home, randomly I told my husband, “I think you should hide the pills.” He didn’t hear me whisper and asked me to repeat and I just said “nevermind”.
You know when pregnant women start tidying or packing the nurseries for their babies before they are due? It’s called nesting. Well, that’s what I started doing- but called it redecorating. Okay, some was redecorating. But the other times I was quite aware of the fact that I need to sort out the house so that it is easier for them for when I’m gone.
Yep. It was that “real”. By that time I had cancelled all events and didn’t want to see anyone. I had withdrawn from my friends- even online.
One evening, I made contact with my therapist (I messaged her in the evening and by the next morning she arranged a new psychiatrist as my other one was in a different town). After a three day waiting period, I was hospitalized. My suicidal behavior was just too much.
But back to the post topic: suicidal behavior.
Plans are made
Plans can be small whispers with real ways of hurting yourself. I think the key is self-awareness because I was aware enough to know the signs. The problem was not listening to that voice! Perhaps enjoying sobriety too much? haha!
One of the things that came up in my sessions with my new psychiatrist was if I let anyone know why I was decorating or decluttering for that specific purpose. No one really knew the full story. Many people experience this. One could argue that it’s shame but to me, it was a bit different. You know, I just didn’t feel like carrying someone else’s reaction- good or bad. It’s always such a gamble when one shares personal stuff- always vulnerable, always gaping wounds or ugly scars. I had enough of my own to carry. I just wanted “gone”. To be “gone”.
I was in the clinic for a week- that’s how much my medical aid allowed as I used some out of hospital sessions. To see my psychiatrist get a little teary to see me go, also made me think a bit. Geez, I must really be too far gone. I told her in my sessions that I feel like a sick dog, acting strangely before it dies.
Dramatic and triggering but it was the truth. That is in itself suicidal behavior. I knew what my triggers were, so I decided to inflict some pain that hit at the core.
But, like some kinda miracle- a cloud lifted. The noises and voices stopped and that irritability too. I wouldn’t say that the suicidal behavior went back to suicidal ideation… Because that could be seen as a demotion or a downgrade. haha
I think what I have learned is that not every episode will manifest in the same way, and their effects, and however ugly they may be, is not the same. As a supporter of someone who lives with mental illness, you too need to be able to identify the signs- see when your partner or loved one is not him or herself. When is it the illness talking or withdrawing? Not your partner.
We are all always in repair.
Please go to the Emergency unit of your nearest hospital should you need help.