If your ‘suicide prevention’ isn’t talking about the mental health system, you’re missing the point.

As both a suicide attempt and loss survivor, I need to climb up onto my soapbox for a minute.

Suicide attempts, from a “preventative” standpoint, are rarely, if ever, as easily prevented as calling a hotline or a loved one. “Reaching out” — while incredibly important — is not the be-all-end-all of preventative strategies.

Especially considering the fact that many of us have a history of asking for help, and not getting the care that we needed.

I understand the impulse to ask, “Didn’t they know they could call me?” I asked myself that many times when I lost one of my best friends earlier this year. But this shows a very big misunderstanding of the emotional experience that many suicide attempt survivors have described.

Speaking from my own experience, when you are in a very acute amount of emotional distress, your thought process is not as linear or composed as you might assume.

The pain in that moment can eclipse everything else — past, present, future. It’s a sort of tunnel vision in which the pain becomes too great; in those moments, I’m cognitively incapable of stepping back to get the kind of perspective I might otherwise have.

This is why I always try to remind folks that suicide attempts don’t necessarily reflect a person’s overall state, as much as it does their level of pain in that particular moment.

To put it as a metaphor, suicide attempts remind me quite a bit of heart attacks, in the emotional sense.

After a certain point, the body’s resources can no longer fend off a very acute and painful event. It is so pronounced that your brain’s reaction is to scramble and do whatever is necessary to combat that pain, as immediately as possible.

We have some autonomy when we’re in that kind of pain. But so many of our actions are ultimately driven by the visceral agony we’re in. Our systems are flooded and overwhelmed, made worse by the adrenaline, the stress hormones, and for many of us, whatever substances we might be abusing — like alcohol — in a misguided attempt to cope.

But more often than not, unlike a heart attack, it’s also a pain that’s been building for weeks, months, or even years.

When we talk about “suicide prevention,” we focus too much on trying to understand the actual attempt, and not enough on accessibility of care.

We don’t do much to ensure that the pain doesn’t become that acute in the first place. We don’t focus enough on quality of life afterward. And most importantly, we rarely interrogate the systems in place that have failed to support them long before they reached this place.

It’s as though we’ve seen someone having a heart attack, but we start asking what they had for dinner the night before, or kicking ourselves for not offering them aspirin that morning.

When we talk about addressing heart disease, we’re not just trying to intervene in the mere moments before they happen — we know that isn’t enough, which seems like common sense in this context.

We talk about the whole person, and all of the ways in which their wellbeing needs to be prioritized well before they reach a crisis point.

But suicidality is still not viewed this way. We treat suicide attempts as very deliberate choices, rather than complex reactions that we know are better addressed sooner, not just puzzled over later.

The problem is, our mental health system isn’t set up to intervene at the moment when it’s needed.

Therapists and psychiatrists are still wildly inaccessible. And if you can find one that has availability and is covered by your insurance (assuming you have insurance), it often takes weeks, even months before you can actually see them.

If that clinician isn’t competent or a good fit? That’s additional weeks, months, and even years until you find someone who meets your needs. Which doesn’t include the months it takes for those treatments to start yielding real results.

I recently wrote a reported piece about a veteran with PTSD, for whom the nearest mental health provider that took his insurance was a staggering four hours away by car. And if he hadn’t had access to a vehicle? I’m not sure he would still be alive right now.

And all this assumes that mental health care isn’t so stigmatized in your community that you feel empowered to get help sooner rather than later, which is simply not the culture we live in.

This bureaucratic nightmare, combined with stigma, is why many people with mental health struggles often don’t seek help for nearly a decade (or more) after their symptoms set in, if they seek help at all.

And that’s why I bristle at the questions I so often hear after a suicide attempt. “Why didn’t they ask for help?” is the wrong question to ask. “What were they thinking?” is the wrong question to ask.

“What did WE do to help them, as a society?” is the question here. And more specifically, what were WE thinking, when we set up our mental health system to be so inaccessible?

I want to challenge us to think about what we’re doing to change this on a substantive, systemic level. This isn’t about reaching out. This is a call-to-action.

My own suicide note years ago simply read, “I’m sorry. I just can’t do this anymore.”

Not, “I don’t want to do this.”

Not, “I don’t have any other options.”

Not, “I don’t care about my loved ones.”

I simply said, “I just can’t.” I had reached a point at which I truly believed that I could no longer physically withstand the pain that I was in.

This led me to the emergency room and, even there, I saw people desperately trying to harm themselves by any means they could, being stopped only because they were restrained by hospital staff.

And this was not because they didn’t have “help” or “options.” It wasn’t even because they weren’t asking for support. They were in the hospital — they were surrounded by people who, in theory anyway, wanted to help them.

But their pain was that unbearable, that all-consuming.

How do you bring someone back from that? And more importantly, how do you make sure they don’t return to that place?

Beyond preventing the act of attempting suicide, I want to know how we can assure them that the life they’re returning to is one in which they are truly supported.

No one should ever get to a point of experiencing that much pain. And if they do, there should be no question of what resources are in place to guide them through recovery. But our system isn’t built to intervene sooner rather than later. Our system isn’t built to create a reliable, consistent safety net afterward.

It’s certainly not interested in establishing any real quality of life, so much as it focuses on simply preventing death.

We have a “worst case scenario” mental health system, and it’s failing. Its efficacy is a game of luck at best, a roll of the dice.

If you have insurance; access to transportation; the right combination of clinicians, inpatient or outpatient programs, and/or medications; the time to commit to recovery; the persistence to keep following up with providers; the support system around you to help you when this becomes overwhelming; and the sheer energy to navigate the system that is already overburdened — maybe, just maybe you’ll survive.

No one’s livelihood or quality of life should be left to chance.

I’m not trying to paint a bleak picture. People can and do thrive, and I’m absolutely an example of that.

But not because our system is actually successful at what it does — it’s because I am one of the lucky ones that eventually, after many years, found my way through it.

I can tell you why I attempted suicide years ago, and it’s simple: the amount of time it took to “recover” exceeded the amount of resources I had to cope.

It took eight years to get the proper diagnoses for my mental health conditions from the time I started therapy at age 17.

Which means it took eight years to find the right medications to treat my OCD, PTSD, and ADHD. And it took eight years to find a therapist that specialized in those areas — a therapist that I had to pay out-of-pocket for, because my insurance wasn’t taken by any therapists in the area who had openings for new clients.

I’m less interested in preventing the act of suicide itself, and more interested in knowing why our system is doing such a terrible job of caring for people who are struggling before, during, and after.

When we know earlier and more compassionate interventions are so critical, and when we know quality of life is exceedingly more important than simply keeping someone alive, we need to start asking why our system is set up the way it is.

We need to start demanding that something change — because our lives depend on it.

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Hey there, friend. Before you go, I want to share some resources with you.

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If you’re suicidal, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386, or reach the Crisis Text Line by texting “START” to 741741.

This isn’t just a generic “here are some numbers” plug, I promise. This is a “I want you to stay, we need you here, please don’t go just yet” plea.

Are you a loved one that wants to reach out to someone you think is struggling? Incredible. You totally should.

I have a guide here for how you can offer support in concrete ways.

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One more thing: I created this resource totally for free, but your donations help keep this labor of love going.

This blog is not sponsored by any fancy pants investors that are trying to sell you stuff.

It’s funded by readers like you via Patreon!

Every donation counts. Help keep resources like these accessible to everyone that needs them! And help buy me a cup of coffee, because I write a lot of these blogs after work, late at night, so I could definitely use the caffeine.

 

Some credits & gratitude go to… Photo by rawpixel on Unsplash. Artwork by Jessica Krcmarik.

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10 Ways to ‘Reach Out’ When You’re Struggling With Your Mental Health

I’m a mental health writer and advocate, and a suicide attempt survivor. I’ve told people on this blog many times, “Keep reaching out.” I’ve written multiple articles preaching the importance of vulnerability, defying stigma, and owning your struggles.

This is my whole thing, okay? This is what I do.

So when one of my closest friends died by suicide a few weeks ago, I wasn’t just shocked — I was completely gutted.

I thought there was never a question of whether or not my loved ones could reach out to me. But the very person who I’d talked to so often about mental health… didn’t call me.

Not even to say goodbye.

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The last night I spent with them.

In the weeks following their suicide, my grief took me to dark places. I soon began having my own suicidal thoughts. And even then, when it was my turn to “reach out”? Even after losing my friend? I began to withdraw, too.

I watched, with painful awareness, as I did much of what my friend seemed to do leading up to their suicide. I wrote myself off as a burden. I isolated myself. I got lost in my own head. And despite knowing the danger of where I found myself, I said nothing.

After an especially scary night, I realized something: No one ever explained to me how to ask for help. No one told me what “reaching out” even meant.

As my grief began to snowball, I hesitated to tell anyone I was struggling, largely because I didn’t know how. I didn’t know what to ask for, and without knowing what to ask for, it felt too complicated and futile to ask.

“Why didn’t they tell me?” is such a common refrain when we talk about suicide or mental health challenges in general. It’s easy to make this remark, because “tell someone” seems like a simple request. But in truth, it’s vague at best.

“Reaching out” is this skill we’re somehow expected to know, yet it’s never taught and rarely modeled for us.

It’s this vague, hopeful sentiment that people throw around, without ever really defining it. What are we asking people to do or say? It’s not exactly clear.

So I want to get more specific. We need to be more specific.

I don’t know if an article like this could’ve saved my friend. But what I do know is that we need to normalize asking for help and talk about what that might look like, rather than pretending it’s a simple and intuitive thing to do.

Maybe then, we can reach people sooner. We can meet them more compassionately. And we can find better ways to support them.

So if you’re struggling but you don’t know what to say? I get it.

Let’s talk about it.

1. “I’m (depressed/anxious/suicidal). I’m not sure what to ask for, but I don’t want to be alone right now.”

Sometimes we don’t know exactly what we need, or we’re unsure of what someone can offer. That’s okay; that shouldn’t discourage us from reaching out. It’s perfectly fine if you have no idea what you need or want — especially when all you can think about is how much you’re hurting.

Let someone know how you’re feeling. You might be surprised by the ways they offer to support you. And if they aren’t helpful? Keep asking until you find someone who is, or seek out a hotline (I know it can be weird to talk to a stranger, but there are some awesome hotlines out there).

2. “I’m struggling with my mental health and what I’ve been trying isn’t working. Can we (meet up/Skype/etc) on (date) and come up with a better plan?”

Feeling helpless or exhausted is part and parcel for dealing with a broken mental health system. But a team approach can make it a little more manageable. Sometimes we need a cheerleader/researcher that helps us explore our options, especially when we’re having trouble believing that we have any.

One thing you’ll also notice is that, for almost everything on this list, I suggest setting a time.

This is important for a couple reasons. The first being that it helps the person you’re talking to understand the urgency behind your ask. It can also be helpful to know that there’s an event in the near future when you can expect to receive some support. This can help us hang in there when things get bleak.

3. “I don’t feel safe by myself right now. Can you stay on the phone with me/come over until I calm down?”

I know this is a hard one to say. Because we often fear telling someone just how much we’re struggling, and admitting that we don’t feel safe? That’s a biggie. Obviously you can replace the word “safe” if it’s not working for you, but I always encourage people to be direct, because it’s the surest route to getting exactly what we need.

Asking someone to be present might feel especially vulnerable. It might not even feel like, in the moment, it’ll make that much of a difference. But you’re more likely to feel better with support than without any.

And remember, from everything we know about mental illness, depression is more likely to be a liar than a truth-teller (I talk about that a bunch in this blog post).

4. “I’m in a bad place, but I’m not ready to talk about it. Can you help me distract myself?”

You do not have to talk about what’s bothering you if you’re not ready.

Opening up a whole can of worms might not be the safest or best thing for you in that particular moment. And guess what? You can still reach out for help.

Sometimes we just need someone to shoot the shit with, so we aren’t stuck in our heads, making ourselves a little crazy. This is a valid and healthy thing to ask for! And it’s a subtle way of making folks aware that you’re having a rough time, without needing to go into detail.

The sooner the folks around you are aware that you’re having a hard time, the quicker they can show up to help you through it.

Early interventions are so critical for our mental health. In other words: Don’t wait for your whole basement to flood before you fix a leaky pipe — fix the pipe when you notice the problem has started.

5. “Can you check in with me (on date/every day), just to make sure I’m alright?”

I cannot say it enough — do not underestimate the value of asking for a check-in. I am such a huge fan of this as a coping skill, especially because it can be super helpful for everyone involved.

If you take nothing else away from this article, it should be this: Please ask people to check in with you. It’s such a small thing to ask for in the age of texting, but it can help us stay connected, which is freaking critical for our mental health.

(If you’ve played The Sims before, remember the social bar? That’s you. You need to fill it. Humans need to connect with other humans. It’s not just about wanting to, it’s that we actually require it to survive.)

And this can happen in so many smart ways. A few of my favorites:

  • “I haven’t been doing well. Can you text me every morning to make sure I’m okay? It would really help me.”
  • “Hey friend. I’ve been kind of sad lately — do you maybe want to Snapchat/send selfies to each other before bed every night, just to check in? It’d be nice to see your face.”
  • “I’m in a funk right now. Do you want to be self-care buddies? Like text each other once a day something that we did to care for ourselves?”
  • “I’ve been isolating myself a little lately. Can you check in with me every so often, just to make sure I didn’t fall off the face of the earth?”

Add emojis wherever fitting if you want it to feel more casual (but really, you don’t need to, there’s nothing wrong with asking for what you need!).

Asking for people to check in with you when you’re struggling is just like buckling your seatbelt when you get in a car. It’s just one extra safety measure in case things get rough.

Both can actually save lives, too. Consider this a PSA.

6. “I’m having a hard time taking care of myself. I need extra support right now around (task). Can you help?”

Maybe you need help getting to an appointment or the grocery store. Maybe you need a cheerleader to make sure you took your meds, or someone to send a selfie to to prove you got out of bed that morning. Are your dishes piling up in the sink? Do you need a study buddy? It doesn’t hurt to ask for support around tasks like these.

Sometimes these things add up when we’re struggling with our mental health. But we forget that it’s okay to ask for a hand, especially at those times when it could really make a difference.

Being an adult is already challenging. If you’re going through a rough time? It’s even harder. We all hit a point when we need some extra support. Don’t be afraid to let folks know directly how they could support you.

7. “I’ve been feeling so low. Can you remind me about what I mean to you or share a favorite memory? It would really help me.”

I used to think that asking for something like this meant I was “fishing for compliments.” And what a lousy way of looking at it…

Sometimes we need reminders that we matter! Sometimes we can’t recall the good times, and need someone to help us remember them. This is true of every single human being on the planet.

It’s such a simple request, too. If you’re the kind of person that feels nervous about making a big ask (again, I’d encourage you to challenge that assumption — it’s okay to ask for help!), this can be a small step in the right direction.

8. “I’m struggling right now and I’m afraid I’m reaching my limit. Can I give you a call tonight?”

To be honest, it wasn’t until my friend died that I finally found these words in particular.

Up until that point, I’d never been sure exactly how to raise the alarm. You know, that moment when you’re not at the end of your rope, but you’re getting there? It’s a crucial moment.

Yes, you can and you absolutely should reach out then, even if you aren’t sure if it might make a difference (spoiler alert, people might actually surprise you). I think about how much pain I could’ve avoided if I’d saw that moment for the opportunity it really was.

Listen to that little voice in the back of your mind, the one that’s trying to tell you that you’re a little too close to the edge for comfort. Listen to that nagging feeling that tells you you’re in over your head. That’s your survival instinct — and it’s an instinct you should trust.

9. “I know we don’t talk much, but I’m going through a tough time and I feel like you’re someone I can trust. Are you free to talk (day/time)?”

I wanted to include this because I realize that not all of us have people we’re close to that we confide in.

When I was a teenager, everything changed for me when I reached out to a teacher at my high school that I barely knew. She had always been incredibly kind to me, and I had a gut feeling that she would “get it.” And she did!

To this day, I still believe that she saved my life at a time when I had no one else to turn to. She connected me with a social worker, who was then able to help me access the resources I needed to recover.

While it’s important to be respectful of people’s capacities and boundaries (and be prepared, of course, if someone can’t be there for you or isn’t helpful — it’s not personal!), you might be surprised by the responses that you get.

10. “I’m suicidal. I need help right now.”

Raise the alarm.

Raise the damn alarm, friends, and be as direct as you need to be. An emergency is an emergency, whether it’s a heart attack or a self-harm risk. Harm to you in any form is reason enough to ask for help.

I promise you, there’s someone in this world — an old friend or a future one, a family member, a therapist, even a volunteer on a hotline — who wants you to stay.

Find that person (or people), even if it takes time. Even if you have to keep asking.

Give people the chance to help you. It’s a chance that my friend deserved, and it’s a chance that you deserve.

(And if all else fails, I have this resource about going to the emergency room when you’re suicidal. I’ve personally been hospitalized twice, and while it’s not a ritzy vacation, it’s the reason I’m here today.)

Pick something from this list. Write it down, even if it’s on your hand or a sticky note. Reach out — because now you know how.

Hell, bookmark this article while you’re at it. I know I’m going to, because there are times when I need this advice, too.

If you’re struggling with your mental health, let me remind you that it’s never too soon or too late to let someone know.

And it’s never, ever too heavy, too messy, or too much to ask — even if you asked fifty times the day before.

I’d have rather had my friend “bother me” every day for the rest of my life than have to lose them forever. Their life was that precious.

And yes, so is yours.

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Hey there, friend. Before you go, I want to share some resources with you.

If you’re suicidal, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386, or reach the Crisis Text Line by texting “START” to 741741.

You can also go to the emergency room. If you’re not sure if you should or how to prepare for something like that, I’ve got an article for that, too.

This isn’t just a generic “here are some numbers” plug, this is a “I want you to stay, we need you here, please don’t go just yet” plea.

 

Screenshot 2018-03-03 at 10.35.49 AMAnd lastly…

There’s a memorial fundraiser in honor of my dear friend, Cris Alvaro. The funds raised will go to organizations that support trans mental health and racial justice.

This article is, of course, dedicated to them.

Topher, you’re still the brightest star in my galaxy. We couldn’t keep you safe. But I will never stop fighting for a world that could have.

 

Feature photo by Matthew Henry on Unsplash.

For The Mentally Ill Folks Who Didn’t Think They’d Make It This Year

The year had only just begun when I heard my psychiatrist, his voice quiet on the other end of the phone, telling me to go to the emergency room. “Will you go?” he asked me.

And I remember in that moment feeling like my cells were crawling and clawing in my body. The mere state of “being” was painful. I wanted to ask that doctor if he knew what he was asking me to do. How could he ask me to stay when everything hurt this much?

Last January, I couldn’t think of one good reason not to jump in front of the next train.

It’s December.

There were a million reasons not to.

Here’s what I would have missed: Trying my first veggie burger at Burger King. Learning I had obsessive-compulsive disorder. Eating sushi for the first time. Getting the first job that I’ve ever loved. Finding the best therapist I’ve ever had. Adopting a cat named Pancake that makes my heart so much fuller. Discovering how much I love yoga and learning more about astrology.

Buying the best pair of boots I’ve ever owned. Listening to Lorde’s best album and witnessing Kesha’s… everything.

Holding a dear friend’s hand while they waited for an ambulance. Crying with my partner when their father died. Learning a best friend’s new name. Trying out the word “no” for the first time. Looking in the mirror at my body and feeling gender euphoria for the first time. Figuring out (finally) that I actually am an introvert. Remembering what it feels like to believe in magic (and making a little magic of my own).

All the times I picked up the phone when someone needed me. All the times I said the right thing to someone that needed to hear it. All the times my being here made someone else feel like they should stay. All the times I said “I love you” and had the honor of hearing back, “I love you, too.”

All of the many, many moments this year when I woke up and thought, “I’m so glad I’m still here.”

It wasn’t easy. I relapsed spectacularly. I had to leave (what I thought was) my dream job. I almost lost my apartment along with it, and came within inch of losing everything else. I had to watch Trump celebrate his inauguration on a flickering screen in a psych ward, next to a poster from 1995 with “stress-busting” tips like, “Stop worrying so much.”

I was in that hospital for a week. In the last two days, it rained so hard that my ceiling leaked, drenching my group therapy handouts on the shelf below. You know, the handouts that were supposed to teach me how to be well again. And for a moment, I remember being flustered, thinking that maybe I should just throw them away.

I laid them out carefully to dry.

When I was discharged, I brought them home with me. And I started to rebuild, day by day.

If you’re reading this, it’s probably safe to say it wasn’t easy for you this year, either. I won’t presume to know why and I won’t tell you how to feel. But from one survivor to another, there were a couple things I wanted to shout out into the big internet void, hoping maybe the right person will read them.

Because you and I? We got through it. And the mere act of being here is a tremendous thing.

1. You are remarkably strong.

How do I know that? I guess I don’t exactly. But I have a hunch. Because it takes real strength to keep yourself alive, especially when your brain isn’t cooperating. You’ve had years now to throw in the towel, and yet, here we both are.

And yes, I suspect there were setbacks and close calls and tantrums, even, and all of that is valid. There was rage and grief, because if life is anything, it’s definitely not fair. I don’t doubt that it took everything in you, maybe even things you aren’t proud of, to keep going. And looking at where you are now, you may feel scared that you don’t have what it takes to rebuild.

But you’re here. Holy shit. You’re still here. And of all the jobs you have, staying alive is the most important one. You had the guts and resilience it took to survive this year. That was you.

Sometimes it was recklessly running into battle because, fuck it, what do I have to lose? Sometimes it was having an impulse, and choosing the less destructive one instead. And sometimes it was swallowing the pills you didn’t want to take, dragging yourself out of the bed you didn’t want to leave, or slowly sipping that nutritional shake to make sure your body had something, anything to sustain itself.

Whatever you had to do, you did it. And you should be so, so proud of that.

2. You belong here.

There have been more moments than I can count when I wondered if I ever should’ve been born. If there was really a place for me in this world. If someone like me could exist someplace like this.

That’s been an open wound from the moment I realized I wasn’t like most people (though, to be truthful, I have to wonder if there was ever a time I didn’t feel that way). I was queer, I was transgender, I was traumatized, I was sensitive, and by most accounts, I was crazy.

I certainly wasn’t the kid my parents were expecting. And I was never going to be the kind of person this world was built for.

I was lucky to find people, though, who taught me that while this world wasn’t built for us, it doesn’t mean there isn’t a place for us here.

And we might be a little rough around the edges. We might be a little wild, a little unsteady, and a little weird. But we find ways to grow no matter where we’re planted. Some of us make art, create zines, speak in poems. Some of us throw our bodies on the line for shit that matters. We speak truth to power, we stare down our fears and our demons, we exist despite everything that tells us we should not.

We show up for one another. We take up space. And we keep trying, knowing that there are kids like us growing up in the world that are going to need us to look up to.

We keep trying for them, the way we wished someone had been there for us.

…one of them was probably born, just now. (Let’s hope they find themselves a little faster than it took for us to find ourselves.)

This is the legacy we’re here to build, the legacy we’ll someday hand down to them.

3. Please be gentle with yourself.

Be gentle. Be soft.

There is an inner child within all of us, I think. Someone who’s doing their best in a scary world they were never prepared to enter. Someone who, every day, is hanging on tight as life does what it does best — changes.

And just when we think it’s settled, it changes some more. Sometimes for the best, but often for the hell of it, and almost never in the ways that we expect.

You are allowed to make mistakes. You are allowed to be messy, emotional, unsure. You are allowed to be afraid (in fact, I’d be surprised if you weren’t). And being human in all of these ways? That doesn’t make you “too much,” no matter what anyone else says.

You deserve compassion. You deserve patience, understanding. You deserve all the space and support you require to grow.

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It’s easy to ruminate on what you wish you’d done, or the ways in which you disappointed yourself or someone else. That’s a feeling I know all too well; I think everyone, especially folks with mental health struggles, knows how that feels (which isn’t exactly comforting, but hey, at least you’re in good company).

I hope that when you find yourself going there, you remember what I’m telling you now: You are worthy of kindness and care. And whenever you can, I hope you’ll give yourself permission to receive it.

4. You aren’t alone.

I don’t say this to you as an empty platitude or promise. I say this because it’s the truth.

Mental illness and trauma can so easily cut us off from our connection to the outside world, making everything and everyone feel like it’s a million miles away.

But feeling lonely is not the same as being alone. And I can almost guarantee you that someone out there has walked in those same shoes before — or at least wears the same size.

This year, I was finally diagnosed with “pure obsessional,” a very difficult form of obsessive-compulsive disorder. I spent a lot of years with painful and confusing obsessions that I couldn’t control — and it convinced me that I was some kind of monster, the sort of monster that no one could ever understand.

When I got my diagnosis, a whole new world slowly opened up to me. I started to learn just how many people in the world were a lot like me, even people that I knew and talked to every day.

Shame and stigma are like a fog sometimes. We can see ourselves and our struggles so clearly, but it’s difficult to see anybody else. But that doesn’t mean other folks aren’t out there.

And if you keep searching, keep reaching out, the figures in the distance will become clearer. There is someone that’s been waiting for your story.

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I know it’s terrifying to venture out into that fog, not knowing who’s out there. I know it’s scary to be vulnerable, to ask for help, or to share a piece of yourself with someone else. More than once, I’ve wished I could gather up the words I just said and shove them all back into my mouth.

But then someone says those words — “I thought I was the only one,” “You feel that way, too?” or my personal favorite, “YES!” with a bunch of frantic hand motions or snapping — and it suddenly feels worth it. Or at the very least, it gives us just enough courage to keep venturing out.

So here’s to this year and everything it took for us to survive it.

And the next one, too, whatever it may bring. Here’s to another year of stumbling through the fog. Here’s to all the people who waved their flashlights, giving us something to follow; here’s to all the shoulders we cried on, and the right words that came at the right time.

For what it’s worth — and I really hope it’s worth something — some very tender boy in California (hello, that’s me!) sends his love. You survived. And I, for one, am so glad that you did.

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What I Wish My Loved Ones Understood About Being Suicidal

My mother hit the nail on the head when she said that I didn’t come with an instruction manual.

If I did, I’d request that it include at least one chapter on suicide – because none of us, including me, were prepared for how to deal with suicidal thoughts and actions. As it turns out, mental illness would drive me to the end of my rope on more than one occasion.

The truth is that no one prepares you for that phone call, the one when your loved one is on the other end of the line saying, “I just can’t do this anymore.”

No one prepares you for that moment when they hang up abruptly, and you have to make a quick decision that might save their life.

I’ve been the person who both got the call and made the call – suicidee and suicidal, if you will – and I know what it feels like to be both on the ledge and the one trying to talk someone down.

But if you’ve only ever been the one on the ground, you might not understand what it looks like from way up there. It’s difficult to understand and even more difficult to empathize with a person who is suicidal, having never been there before.

And while I can’t give you an instruction manual, I can tell you what it feels like to be there.

Here’s what I wish you knew:

1. Please don’t pretend to understand what it’s like if you don’t actually get it.

I know that you’re just trying to connect with me, but I can see through the nonsense from a mile away. I know when you can’t actually relate to what I’m going through. I know when you’re just pretending.

In this moment, I just want you to be here for me. I want you to hold space for me to be vulnerable, to feel pain, to be afraid. Let me know that you’re here with me. Remind me that I have options, and ask me if I want to talk through them. Give me the chance to unpack what’s been hurting me. Remind me that you’re here.

Listen and don’t judge.

If you haven’t been suicidal before or if you haven’t experienced depression like this, that’s okay. I don’t actually need you to have some kind of insider knowledge. I don’t need you to be able to relate to everything I’m saying and feeling.

I just need you to be here with me right now. I called you, of all the people I could’ve called, for a reason.

2. I don’t need you to fix this.

If I’m at rock bottom, the reality is that my situation is one that won’t be fixed in a single night. Crises like these aren’t about fixing things – it’s about being my support, helping me to hang in there when it seems like there’s nothing worth holding on for.

By all means, offer resources and coping strategies with me, and be sure to ask if that’s helpful for me. But if you enter into this conversation with the expectation that you can fix all of my problems, it’s just going to create a whole lot of stress for us both.

If there were some kind of immediate solution to my crisis, believe me, I would’ve chosen that before I ever considered suicide. The reality is, it’s going to take a lot to pull through.

Rather than promising a solution, promise me that I won’t have to go through this alone — and mean that when you say it.

3. The fact that I told you what I’m feeling is a really huge deal.

Being suicidal is one of the most vulnerable positions a human being can be in. It’s also one of the most difficult things you can endure. It took a lot of courage to talk about what I’m going through. Honor that courage.

And remember: I chose you. Of all the people I could call at this moment, I trusted you. That means something.

Instead of ending my life, I called on you. You mattered enough to be the person that I picked up the phone for. You mattered enough to be the face that I looked for in my darkest hour. You mattered enough to be the voice that I wanted to hear.

Being suicidal doesn’t mean I don’t care enough about you to stay — the fact that I’m including you now means that I care very deeply about you. Please don’t forget that.

4. Take me seriously.

I wish I didn’t have to say this, but you need to take everything I’m saying very seriously. I need you to operate from a place of belief — believe that I’m in pain, believe that I’m in danger, and believe that this is urgent and requires your attention.

I say this for a few reasons.

For one, suicidal people can sound detached. They can sound resigned. There isn’t always desperation or urgency in their voice. We don’t always respond emotionally in the ways you might expect. That doesn’t mean this experience is less real or sincere.

Instead, ask questions, and pay attention to these factors: Is there a plan? Are there means to carry out that plan? Is there an intended time to carry out that plan? And do they intend to take their own life?

(This guide is a pretty important resource for understanding how to respond to someone who is suicidal. I wish all my loved ones had read it before I made that call.)

The other reason that I ask that you take me seriously is because, sadly, many people assume that when someone shares that they’re suicidal, they’re only doing so for attention. But the reality is, a person in this much pain needs attention.

When the mere suggestion of someone taking their own life comes into play, there’s no question of how seriously you should take them. Take me seriously, because this is serious.

5. Telling me that there’s hope when I feel hopeless isn’t always helpful.

Do tell me about concrete alternatives, resources, and options that I have in my position. But don’t give me empty promises of how beautiful life is or other poetic ideas that you think will inspire me to keep on living.

If I could comprehend that kind of optimism right now, I probably wouldn’t be in this position.

Remember: My depression doesn’t just affect my mood — it affects my thoughts. Sometimes, I’m just not capable of seeing the big picture, or I’m in too much pain for that big picture to matter.

I don’t want to hear about how great life is. Because for me, in this moment, it’s anything but. And you reminding me of what I can’t feel and understand will only make me feel more alienated and more alone.

6. My feeling this way isn’t your fault.

Please, please, please don’t blame yourself for how I’m feeling in this moment. Could’ve, should’ve, and would’ve scenarios will only make us both feel worse. Instead, focus on the here and now, and how to get us through this.

7. My pain is valid.

You may not understand my pain, but that doesn’t mean it isn’t valid. Don’t tell me that I don’t have a reason to be depressed or suicidal. Don’t tell me my life is too good to throw away. Don’t tell me that there are people out there with worse problems than mine.

I don’t deserve to be punished or made to feel guilty just because I’m having a difficult time in my life.

Validate my pain. Acknowledge my suffering. And know that, for me, it’s very real. Real enough to make me contemplate suicide.

8. I may not be ready for what you have to say (right now), but it could mean everything to me later on.

Talking to a suicidal person can sometimes feel like talking to a brick wall. The truth is, I’m not always ready to hear what you have to say. Your messages of support, love, and warmth may go right over my head. I’m in a dark place and I can’t always see the light from where I’m at.

But I’ll tell you what: I remember the people who talked me off the ledge years and years ago. I remember what they said to me to this day. And even though, in that moment, I couldn’t really grasp what they told me, it came back to me.

I remembered it in therapy. I remembered it the next time I was hurting. I remembered it in recovery. And those words that, at first, meant nothing to me eventually came to mean everything.

What you’re saying to me is never in vain. Because while it may not resonate at the time, it could be the affirmation that I cling to weeks, months, years down the line. Sometimes it takes a while before the message really sinks in.

Give me time. I’ll thank you later.

/

Have a suicidal loved one and not sure what to do? Read this guide from the National Suicide Prevention Lifeline or, if you need immediate assistance, give them a call at 1-800-273-TALK (8255).

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A much shorter version of this piece originally appeared at Ravishly.

As a Suicide Attempt Survivor, I’m Still Waiting For Stories of Resilience On TV

Approximately 92-95% of suicide attempts end in survival.

I didn’t know this, though, when I tried to end my life almost eight years ago. I’d only ever heard of stories that ended in death or in hospital beds. I’d only ever seen them as a plot twist on a television program or tragedy porn in the news. To me, people who attempted suicide overwhelmingly ended up in the ground, or on occasion in psych wards, but there was never any life to be lived afterward.

There was never a single story that said to me, “You can survive. And then you can truly live.”

Imagine my surprise, then, when I woke up alone, head pounding, room spinning. There was no point of reference. What do you do when you survive? Where do you go? Later that night, I googled “suicide survivor,” but back then everything I found was for people who’d lost someone – never for someone who’d nearly lost themselves.

I went to bed. I got up the next morning, went to class. When I saw my therapist a few days later, I mentioned it in passing, ashamed of my failure, trying to remain casual and unaffected and distant. She asked me how I felt now and I said I felt nothing. 92-95% failure rate – I know that years later – but in that moment I thought I must be the only one who could fuck up something that should be so straightforward.

Stop your own heart. There must be a thousand different ways to do it. I’ve seen this on television a million times, I told my therapist, teenagers like me who dramatically and precisely erase themselves. She asked me how I did it, and I told her just like a teenager I saw on Dateline. It was supposed to be quick. It was supposed to be simple.

“I don’t know how I messed this up.” My hands curled into two perfect fists.

She asked me if I was going to try again and I told her, “What’s the use?” I was embarrassed. And you can’t 5150 someone who’s too embarrassed to try, who’s treating the whole ordeal like nothing more than a terrible faux pas, something to be forgotten. Someone who isn’t dangerous anymore, just humiliated.

Television, with its drama and sensationalism, didn’t prepare me to live. It didn’t prepare me for the next morning, when my life was still the same as I’d left it.

Television only prepared me for trying. It allowed me to imagine the vindication and justice of succeeding – portraying suicide as triumph, suicide as revenge, suicide as release, suicide as justified, suicide as beautiful tragedy, suicide as an art form, even, as the answer – but it never prepared me to survive, for everything after.

No one told me how to rebuild my life. No one told me how to take the fragmented pieces of myself and thread them back together. I was only taught how to die, and never how to live.

Find me a story of a survivor who’s glad to be one. Give me a survivor who gets their own damn show, where suicide isn’t just a plot twist for shock value but the genuine truth of their struggle.

Give me the 13 Reasons Why of the 92-95% of people who wake up and have to face a world they weren’t expecting to see again, see a reflection they’d already parted ways with.

Give me the stories of teenagers like me whose lives aren’t sensational because of how they died, but instead tremendous because of how they survived, how they lived. Give me more than trauma porn. Give me more than triggers that exploit their traumas – more than the blood in the bathtub, the wailing of the ambulance, the walls of the psych ward.

Give me their full humanity. Give me recovery, give me relapse, give me resilience.

Give me back my humanity. 

There are youth like me who wake up to a spinning room, posed with the question of how they will rebuild. They’re looking for stories like theirs to help them engage with trauma and reimagine their lives – and they’re only finding this in the form of tragedy, revenge, descent.

If the overwhelming majority of us will survive, why do our only representations confine us to madness or death?

Every single day, people like me survive. People like me live, and along the way, discover something worth living for. We grow up, we get older. We find ways to become whole. We’re so much more than our proximity to death and the pain that we’ve held in our bones. And our singular trauma doesn’t exist for the sole purpose of entertaining you, nor is it designed for your consumption.

We’re more than this. We’re larger than this.

When will I get to see a story like mine on the screen? Show me someone who lives. Show me someone who survives and goes on to truly live.

We’re still here. We’re still waiting.

We need you. You need you. If you ever need support, please consider the following crisis resources:

The National Suicide Prevention Helpline: 1-800-273-8255
The Trevor Lifeline for LGBTQIA+ youth: 1-866-488-7386
Trans Lifeline: 1-877-565-8860

Or check out my favorite mental health apps at this resource list.

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I Had Everything I Wanted – And I Still Wanted To Die

I’ve spent an hour, give or take, furiously pacing the floor of my apartment. They call this “psychomotor agitation,” though I don’t know it yet.

I feel like I can’t stand to be in my skin another second, like I’m completely wired and simultaneously the most depressed I’ve ever been. They call this a “mixed episode,” though I haven’t realized that yet.

My apartment is my sanctuary. I remember when I moved into the place – the joy I felt to be downtown, to be in the heart of things. It was full of 1920s charm. It felt surreal to be in a place so nice. I put a lot of thought into how I decorated the place, down to the candles and the twinkle lights and the succulents.

It was my safe place – was, up until that moment, when suddenly the train was coming off the rails.

I abruptly stop pacing. I know what I need to do.

I grab a pad of paper and a pen, and begin to write.

I’m sorry…

/

“But nothing was actually wrong,” I say quietly. “I wouldn’t have changed anything about my life – just how I felt.”

I’m in group therapy for the second time that day. We all sit in a circle, wearing pajamas and hospital gowns.

Bipolar disorder doesn’t give a shit about my ‘perfect’ life,” I continue. “I had everything I wanted and I still wanted to die.”

My body trembles ever so slightly.

“It can be hard to accept that these illnesses are not always within our control,” the group facilitator says. “We can feel very vulnerable when we realize this.”

Vulnerable. Vulnerable doesn’t even begin to describe the fears that have overtaken me since my breakdown.

Was it really possible that, no matter how I arranged my life – no matter what the circumstances were and how meticulously I controlled them – I could lose my mind anyway?

I could have a career that I loved, a community of friends and partners that brought me joy, and yes, the charming little apartment, but as soon as the chemicals in my brain turned on me, all of these things were irrelevant at best.

“I thought building my perfect life could keep my illness away, could keep me safe,” I tell the group. I look down at my hospital band around my wrist, a painful reminder.

I was sorely mistaken.

/

I’ve gotten too drunk. Again.

This is a new habit of mine. I’ve taken to drinking in the middle of the day, drinking alone, which everyone tells me is a bad sign.

They all tell me to sober up, and I don’t listen. I don’t listen because it’s better to be drunk than to be restless, the kind of restlessness that feels like thousands of insects crawling underneath your skin.

I glance at my phone.

“We found your note, Sam,” a message reads.

The panic begins to settle in. No one was supposed to find it until after I jumped in front of the train.

“Just tell us where you are,” another message reads. “Please.”

“Almost everyone who has jumped off the Golden Gate Bridge and survived said they regretted it immediately,” someone else says.

I already know what that regret feels like.

Seven years ago, the closest I’ve ever come to death, I felt that regret after the seizure and before I blacked out.

And in that moment, the memory of that regret scares me.

/

The answer is horrifyingly simple: Lithium.

The answer is not an apartment, or a relationship, or my job – the answer is lithium, and three days into my hospitalization, the chaos in my mind begins to subside.

“How are you feeling?” the psychiatrist asks me.

“I’m getting better.”

“That’s good news,” he says. “What about the voices? Are you hearing any?”

“No,” I reply. “My head is a lot clearer now.”

I should be overjoyed that the tides are turning. But I am in shock – was this really all that it took? Was it really just brain chemicals?

I don’t know whether to be glad that the answer was so simple or fearful that it was beyond my control.

Or both.

/

In outpatient, I sit in a support group and listen to people talking about what led to their crisis.

“I lost my job.”
“I had a terrible accident and the recovery was difficult.”
“I lost my brother and mother within six months.”
“I was in a coma.”

It’s my turn.

“I was in denial about my mental illness.”

Denial, like when you ignore all the warning signs because you don’t believe you’re sick. Denial, like when you think that if you control every element of your life, it won’t affect you. Denial, like when you’re convinced that if you take your pills every day, you’re cured.

Or when you believe that if you have everything, you won’t break down.

But the truth is, you can have everything and still want to die.

Because mental illness doesn’t care about the life you’ve built. It’s only interested in what it can take away.

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To Be Transgender, Mentally Ill, And Still Alive

Content Note: Mentions of suicide, trans/homophobia, saneism

Nearly every day for the past five months, give or take, I’ve had a moment when I glance out the window onto my street and think to myself, “I was never supposed to be here.”

This feeling isn’t new to me – I’ve dealt with “survivor’s guilt” in some form for years now – but the feeling intensified when I moved to my new apartment.

You know, the apartment that I feel like I don’t deserve for some reason or another.

Here’s the honest truth: People like me? Mentally ill queer kids, the ones that get their homophobia or transphobia with a side of psychosis? The ones whose trauma isn’t just a meal but comes with an appetizer and a fucking dessert?

This world isn’t made for us.

How would I know that? I’ve lived it.

And I don’t think I would have been so persistent about ending my life all those years ago if this were a world that saw me, validated me, affirmed me. If this were a world that had a place for me. If this were a world that held space for me.

I know this because it took me years to sit beside the window instead of dangling out of it, held in place only by someone’s hand clinging desperately to my shirt collar, because to be queer was one thing but to be queer and crazy was another thing entirely.

There has never been a moment when I’ve forgotten that I am both. I’m not allowed to forget.

I remember it when the psychiatrist advises that I not pursue hormones because I could just be manic and not trans; I remember it when another trans person says to me, “I’m glad that gender identity disorder is no longer in the DSM. It’s not like trans people are crazy.”

But I am.

I remember it when I recall the mere inch that came between myself and my own death.

The names of those I knew and could’ve known that ended their lives still swirl around my brain, and all I can think about is how I’m here and they aren’t, and how senseless all of this feels.

Yes, I’m here. But it wasn’t for a lack of trying.

Sometimes the guilt is so painful that I’m convinced that some part of me is fractured – that if you peered inside, it’s almost certain that something in me is irreparably broken. That being a survivor that has watched people like me die, over and over, has left me in a permanent state of grief.

I am in a permanent state of grief.

When I have flashbacks to the moment I woke up, realizing I was still here, I find myself trembling and shaken, wondering why the world steals the light of so many queers but somehow left mine intact.

Why, after making self-annihilation my hobby for a time, should I be rendered whole in a world that despises our wholeness?

Why did I survive?

And it’s not that I believe that my life wasn’t worth sparing. It’s just that, when you watch your comrades, your community, your friends dying all around you, you can’t help but wonder why it was them and not you.

Well-meaning friends tell me, “Remember to be grateful, too.”

But what they don’t understand is that there will always be another mentally ill trans kid like me, ready to follow through on what I failed to finish.

And I can’t just feel grateful when I know, in the back of my mind, that that kid is still out there.

Maybe I feel guilty for being alive because I’m conditioned to believe that people like me aren’t meant to exist in the first place.

Every day since my attempt there’s a scene that plays out in my head, where I’m banging on the closet door, trying to stop that kid from repeating my mistakes, begging them to let me in, begging them to stay, knowing that I can’t promise them that it will get better but I can do everything in my power to create a space for us.

Just one space.

Well-meaning friends say, “Yes, it’s horrifying, but you can’t dwell on that.”

Why can’t I dwell on that?

Do you know the overwhelming trauma of existing in a world that teaches you, from day one, to resist everything that you are?

And why should they act horrified when we destroy ourselves – why should they act surprised – as if that’s not what the world was asking of us all along?

They ask me not to dwell on this as if trauma is a garment you wear, as if we can forget who we are. Please listen when I say this: I can’t forget.

Well-meaning friends ask me, “Why do you write?”

But the better question is why I stayed.

And I stayed for the same reason that I write: Because so long as this world isn’t made for us, I have to keep fighting for a better world.

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