Should the Right to Die Include Mental Health?

 death blog

 

It was 1988 when my mom wrote the first in a series of letters to our Prime Minister at the time, Brian Mulroney, regarding being able to end her terminal illness in a manner in which she had some control. It was in 1989 that she contacted the Right to Die organization based in Oregon and after numerous rounds of correspondence was mailed a book written by the founder about euthanasia. This book was not only a memoir but contained information about certain drugs and the amounts that would be required to overdose. The letters and pleas continued, to no avail, and after battling cancer for six long years and deteriorating to the point of having no quality of life, on September 10th 1990, she took a lethal overdose of pills in the comfort of her home. She had spoken multiple times about this plan over the previous months and made it quite clear she had no intention of dying in hospital.  She already had a DNR (Do Not Resuscitate) order and wanted to have some control over the last moments of her life.

She lay in her bed for hours but had merely slipped into a coma which caused enough concern that she was transported to the hospital. When I arrived at the hospital and saw her lying motionless, she looked so peaceful, like she had fallen into the deepest of sleeps. She remained comatose for almost a week before shocking everyone and waking up, which no one could explain given that they said the number of pills that she had consumed would have killed a horse. She had nothing but painkillers and IV fluids and continued to rapidly decline. There was one more failed attempt in hospital before the last one finally brought her the peace she was so desperately seeking. That was October 5th, 1990. She had written nearly 100 letters.

In February 2015, the Supreme Court of Canada made physician assisted suicide (Euthanasia) fully available to all mentally competent Canadians with terminal illnesses. Prior to the ruling, assisted suicide was illegal in Canada and punishable by up to 14 years in prison. There are strict laws governing the process, such as assisted suicide not being available to minors and only available to those residents eligible for Canadian healthcare. It cannot be used to relieve the suffering of any mental illness or long-term disability and patients are not allowed to arrange to consent in advance to dying, for example in cases of dementia or Alzheimer’s. This protocol has sparked debates in many areas but none as big as when a parliamentary committee recommended that people with mental illness be eligible to seek euthanasia to end their lives in the same manner of those with a terminal illness.

An estimated 90% of suicides in North America are associated with some form of mental illness.

The Netherlands was the first country to legalize euthanasia in cases of terminal illnesses 13 years ago, and in that time, the practice has become legal in Belgium, Luxembourg and Switzerland as well as in five U.S. states…Washington, Oregon, Vermont, Montana and New Mexico. In Germany, doctors are able to provide patients with the necessary drugs for a medicinal suicide, but are not allowed to take any part of the actual suicide, such as guiding the patients or supporting their hand. The feelings are mixed when it comes to people’s beliefs of right and wrong, but if you have ever watched another human being slowly, painfully, rot away with not an ounce of dignity left, it might just open your eyes to the reasoning.

Assisted suicide based on psychological suffering is permitted in the Netherlands, Belgium and Quebec. A 2015 Netherlands euthanasia report stated that there were 5306 assisted deaths that year, with 41 being for psychiatric reasons, and 81 for dementia. In early 2012, a group called the Life-Ending Clinic went into operation for people whose doctors refused to assist in their suicides. The clinic has pushed the moral debate to its highest peak by helping people with chronic depression to die, and allowing some dementia patients to sign a euthanasia declaration in the early stages of their disease. In the past five years the number of assisted suicides has doubled and in Belgium it has increased almost 150%, amongst which has included people who have had autism, anorexia, borderline personality disorder, chronic fatigue syndrome and chronic depression. In two of the more famous cases, the women had suffered from multiple mental illnesses over the years, tried pills, therapy and everything else possible before giving up on the thought of their lives ever improving. Should doctors respect their wishes to die in the same way they would respect the wishes of a patient with stage four cancer?

With regards to mental illnesses, the biggest issues are whether legalized euthanasia can lead to a suicidal frame of mind based on a desire to escape prolonged suffering, and whether a person suffering from chronic mental illness has the capacity to make such a life and death decision. Given that mental illness can distort thinking and impair judgment, perhaps on the finality of the consequences, we have to question is it the rational mind speaking or the voice of the illness. “Right to Die” advocates point out that doctor assisted suicide would be less traumatic than a hanging or gunshot, for everyone involved. The protesters say that accepting euthanasia as an option for the mentally ill would create a presumption of sanity for those who attempt suicide or request assisted suicide as candidates are supposed to be mentally competent to make an informed and voluntary decision. Statistics say almost all people who die by suicide have mental health problems and there lies the conundrum.

Having had three failed suicide attempts myself, I question if I would even be here if euthanasia was available here in Canada for chronic depression. I wonder where this debate will take us in the future, but for now, I continue to fight.

 

 

 

Lost In the Darkness of the Jungle

 

dark jungle

 

They say that without darkness there is no light, yet I see not even a glimmer of light right now, like it has dissipated into tiny particles and scattered into obscurity, leaving me surrounded in a blanket of gloom.  I feel like I have been dropped off in to the depths of the jungle with no flashlight or compass, nor the light of the stars to guide me, with a deadline to somehow make my way out and back to a place where the light shines again. It feels like every step I take is through the thickest bush lined with vines of thorns and branches of spikes. I glance up hoping for even a glimmer of light to help light my trail but the density of the leaves form an umbrella of shade. I start a climb uphill only to have the earth give away under my feet. I have no sense of direction and feel like I have been wandering the same path in circles, or perhaps just always heading the wrong way, yet I keep walking.

I feel lost. Lost in every possible way; lost to the point that even if I was handed a map, I am not sure I could find my way out. Maybe I have been lost in this darkness for so long it has become my comfort. Perhaps a part of me doesn’t want to find a way out, not because it is easier to stay but because it is what is familiar to me and the unknown is frightening. Maybe there is an invisible string that pulls me back every time I follow that flash of light because I have unfinished business here. It might even be that I have convinced myself that without light I will finally succumb to the darkness, in which somewhere lays the only peace I can see. Why do the answers come so much easier in the shadows than in the light?

I am grasping for hope. Grasping on to anyone or anything that can help to fuel the reserve in my empty tank; probing for any reason, any purpose to continue this trek. I have looked and pulled from within for so long there is very little self-reliance left.  There is no unlimited stockpile of strength hidden somewhere deep within. There are not enough learned behavioral techniques in my mind to overcome the ingrained negativities that keep drawing me back into the darkness. I clutch on to anything I can…words, pictures, memories…anything that can provide a hint of this elusive thing called hope. I rely on my empathy for others to encourage myself to continue on this journey, after all, I may want out of the jungle but I certainly am not willing to drag someone in there with me to accomplish that.

I am afraid. Afraid that perhaps this jungle is actually my home; that there is no beaten path for me to follow or make to find my way home, and that the darkness is actually where I belong. I am afraid that no matter how hard I try or how far I travel that I may never find that glimpse of light, that smidgen of hope that is bright enough or strong enough to guide my way. I am scared of looking up to the jungle always covering the night skies, fearful to look forward because I can’t see far enough through the thick brush to see my hand in front of my face, and looking behind me all I see are the trails of cuts and bruises that have gotten me to this point. I am afraid that my thoughts are far too at home in this place and that the darkness has always felt comfortable for me and perhaps the needle on my compass is just pointed here.

I can’t at this point even say why I continue to walk this unlit, beaten track, or why I continue to plod through the mud and stumble over the uneven ground. I don’t know why I insist in looking up in the hopes that there is a crack in the canopy where just enough light will peek through to at least point me in the right direction when time and again, the blackness is all encompassing. I stumble forward, unguided, trip over broken branches and fall right back to the place where I started, yet despite the mud weighing me down, regardless of the cuts and bruises incurred with each fall, I continue to rise. I somehow manage to stand back up time and again, after losing my bearings, and keep searching for this seemingly elusive path of light.

 

 

 

Is the New Method of Suicide Note Online?

 laptop writing

 

 

I have been passively suicidal for most of my life and actively suicidal three times. I know what it feels like to be carrying a burden so heavy your legs can no longer hold you up. I understand what it is like to see nothing but darkness and pain in your future and to have lost every last ounce of hope. I realize the amount of pain you have to be in to get here; to reach the point where death seems like your only option, the only way out. Without getting into the gritty details, let’s just say with my last attempt was meticulous and organized. To me, suicide is a very personal and private thing and I do not want to traumatize anyone more than they may already be. I wanted to make sure the authorities found me and not leave that scar upon my friends. I think most suicidal people would tell you they are not trying to hurt anyone, they just don’t know how else to end their pain. To them, this is the only way out.

That being said, I ponder the people who are determined to make their suicide public. What drives them to jump in front of a train packed with commuters at rush hour? Is there any maliciousness towards others? Why not wait for a cargo train or an empty one? Why affect the lives of others intentionally? Have you felt so invisible your entire life that you felt this method of suicide would draw some attention to you for the five minutes of “fame” you will get as they mention you once on the news or in the papers? Do you feel that because you are in so much pain, then others should be too? These are questions that remain unanswered because there is no one left to answer them.

Technology has done so much for our society and we have come so far in such a short time. The internet has provided endless amounts of information and resources. It has connected people across the world, whether it is family or new found friends. The advancements are rapidly changing and many things become fads until the next new thing is available. We were once excited about the fact we could make a video and put it on the internet for the world to watch at any time but now that is “old”, as the latest and greatest allows you to post live and to show the world a piece of your life at the very present moment. Sadly, there seems to be no limit to what people share, or what people are willing to watch, hence the alarming raise in the number of online live suicides. Again, what motivates someone to share both the preparations for and the last moments of your life with the entire world, and what kind of twisted individual do you have to be to sit and passively watch?

The examples were certainly not difficult to find.

A 12 year old girl, who had previously broadcast a few times that a family member had tried to rape her, hangs herself from a tree, live streaming the whole 40 minute video. Not only did people watch her live, but many of those people online actually encouraged her to kill herself.

Another girl who had spent her life being bounced around foster care hung herself from the shower door of her bathroom, while 1000 people watched her make her preparations, many ridiculed her. A friend saw it and alerted police but they did not arrive in time.

A 20 year old university student went on a message board and offered to kill himself online if he could get help setting up the live video stream. 200 viewers watched as he chased down pills with vodka, barricaded his dorm room door and then set fire to it while he waited to die lying under a blanket. No one online called 911.

Those who turn on their webcams during the darkest, most desperate moments of their lives must feel a need for someone to bear witness to them, or perhaps wish that somebody out of the thousands watching the suicide would care enough to intervene and alert the authorities. They feel like finally their name will be heard and remembered, however within minutes of the video being taken down, most of the viewers will have already forgotten their name.

The internet provides an outlet to suffer in public, to share pain and gain the attention desperately needed, however in these cases, perhaps the internet is just the new form of suicide note. Even though social media sites “prohibit” the promotion of suicide or self- injury and ask viewers to report to authorities immediately, there is no enforcement or regulation for these things. It is impossible for the sites to monitor everything which shifts the burden to the community to help stop bad things from happening. There are now groups of volunteers who monitor many of these live sites hoping to intervene before it’s too late, or perhaps before it is even started.

What I find deplorable are the ones that watch. Are people so disconnected and desensitized that they can sit in the comfort of their homes and not only watch, but encourage a child to kill themselves. Unfortunately it isn’t surprising that online viewer’s tap into these streams, it is almost human nature. There’s no such thing as an accident without a crowd gathering and standing on tiptoes in order to see the person lying on the ground, or people slowing down to stare at the car accident.. Violence and destruction are everywhere in society, from the news to the entertainment industry. Perhaps there is a fascination with other peoples pain because it’s only one gesture removed from our own, or maybe it is just bystander apathy, which basically is a social phenomenon where people are less likely to help someone in need if there are other people present. We are all relying on someone else to make the first move, to differentiate themselves from the crowd, when in fact we should all feel a moral responsibility to help someone at risk, whether you take it seriously or not. How is it going to sit in your mind years from now that someone who was seriously sick killed themselves while you egged them on?

I have been on both ends of suicidal situations and I know the anguish you can feel inside and the desperation to get any bit of attention, but posting a suicide attempt live is the ultimate cry for help, and I will never understand how anyone would take the time to not only watch someone make preparations but taunt and encourage them to carry through with that attempt, most often with fatal results. Think about it, someone’s life was in your hands and you made the conscious decision to do nothing but watch them die. It frightens me, the number of people who feel no moral obligations. We are all human.

 

 

 

 

 

 

 

 

 

 

THE STIGMA OF SUICIDE

Suicide. A single word, which invokes fear, shame, misunderstanding, anger, confusion and a stigma equaling the weight of the Titanic. It will cause who you think are your closest allies to go running, so fast, it is as if they are being chased by the burning flames of a rapidly spreading bush fire. The word is associated with selfishness, with weakness and with a lack of willpower. The reactions to the word run the gamut from “that’s ridiculous, who thinks about that” and “what is so wrong in your life”, to “how self-centered you are” and finally “I can’t deal with this”.

Suicide. The action generates feelings of grief, terror and trauma. It carries the misconception of irrationality, instability and egocentrism. It will cause your relations to judge you, hate you, love you and mourn you. It will leave them with questions that will remain unanswered for perpetuity, for the only true motivation for your action perished when your life flame extinguished.

What makes this word materialize from an assemblage of letters, to a culmination of ideations, to an objective, to a precise action of  irreversible finality? STIGMA. The topic of suicide is still taboo, disapproved and in some places, forbidden. One may be strong enough to disclose their diagnosed mental illnesses, BPD, Depression, Anxiety, Bipolar, just to name a few, however, when one reaches the absolute darkness of self-extermination, it is as if their tongues have been cut out, eliminating the capacity to  even verbalize the word suicide. The fear in sharing the darkness of the ideas and emotions that run through the self-destructive mind is so immeasurable, that letting go of the rope that has kept you from falling seems effortless. The angst of judgment, the trepidation of rejection and the fear of hospitalization often making the ability to ask for help an insurmountable chore.

The stigmatization of the word itself has to end, in order to see any reduction in the number of  actual actions. Very few wake up one morning and spontaneously choose to end their lives. Suicide is a result of traumatic and horrific experiences that have festered in the mind and soul since occurring. It is the complete and utter loss of hope, strength and desire to exist. The thought of the action becomes the only hope of ending the unremitting pain and suffering that is tearing you apart like a lion mauling its prey. The survivors you leave behind questioning why you left them, why you did not reach out for help or speak the words “I’m feeling suicidal”, yet the answers, for you, come as easily as flicking on a light switch. Fear and stigma. No one climbs a ladder from the first step to the top without the rungs in between. The same could be said for suicide. It starts at the bottom and slowly creeps up until it not only reaches the top, it jumps off and drags you with it.

What if the thoughts of suicide could be as openly discussed and accepted as the myriad of mental illnesses? What if someone could safely and honestly express those ideas and emotions with no fear of condemnation or repercussions, while still on the ladder’s lower rungs? Would it help decline the speed of the ascent or perhaps eliminate the need to reach the peril that lies atop at all. Could becoming educated, understanding and less judgmental of one single word effectively make a difference in a single life, or even in societal views? Is it possibly as straightforward and uncomplicated as that?

As a suicide survivor, I will answer the above questions from my perspective. Yes, it is as simple as that. In most instances, the people on the top rung will jump off before you even notice they started to climb. Their ascent so rapid it leaves not even an indication of a footprint. They are silent, focused and prepared, their actions usually a success. The others climb at a slower pace, leaving behind traces of their emotions and intentions while screaming ever so quietly for help. They wish for someone to hear them and provide a sanctuary for that one deadly word. These are the people that could be helped if we reduced the outside noise in our lives and took a moment to focus on the silence. Listen carefully. Pay close attention as the cries for help are there, and truly hearing and finding them could not only  be a preventative measure but actually save a life.

So if you are at the top and at risk of immediate of danger, hospitalization or intervention is a must. If you are at the bottom and feel yourself gradually and uncontrollably making that ascent, STOP. Reach out. Scream it, shout it, write it. Express it without shame or fear of repercussions from the ignorant. Know that someone, somewhere is not only listening, but hears you. Know that as much as you feel it, you are never alone. Know that by reaching out, your voice can start a momentum so powerful it instills the same fearlessness in the masses.

Destigmatizing begins with you, right here, right now. After all, it is only a word.

 

 

 

 

 

 

You’ve Got This!

You think you can’t. You can’t possibly take any more. It feels painful and exhausting to take your next breath. You are encompassed in a darkness so black not even a star could shine through. You feel like your last finger is losing its grip on the rope that you’ve held on to for so long. Hope a thought so obscure it seems as unattainable as your chances of touching a rainbow. You feel defeated. You feel you have fought so many battles but in the end you have lost the war. You feel alone, misunderstood, judged and empty. You feel your present moment is a reflection of the only moments to come. You are afraid, and this fear is as real as if you had been robbed of your valuables while you slept. You were robbed. Perhaps someone stole your trust, your sense of value and self, your innocence or your ability to believe in others and yourself. It is a violation that has been inflicted on you by a person or situation out of your control, which in turn, makes you angry, yet you don’t have a proper outlet, so you internalize. You negate the kind things others say; you negate anything kind you try to think about yourself. You feel like there is a demolition man in your head leaving a path of destruction while he plows through your thoughts.

Well stop! You are not your thoughts. Your mind is lying to you. You are so much stronger than you could possibly imagine. Just when you think you don’t have an ounce left to fight with, you dig into a reserve you did not know existed in you as it has not been necessary until this moment. You are not your negative thoughts. They do not define you or control you. You are an undiscovered gem worth sifting through the bullshit to get to the brilliance.

You are needed. Your story, your voice are both worthy of being heard. You deserve to be able to be speak how you feel without apprehension of ignorance and judgement. You are valued simply because you exist. You are your own thoughts, not the ones that have been fed to you and encouraged by others.

You are not alone. As much as you feel that way, know there are others at this very moment feeling the very same as you. There are places for you to feel safe, and to allow yourself to trust and be trusted. From Sicknotweak.com to #Imnotashamed the community of support for you has grown immensely in a short period of time. People who will listen and not judge. People with an illness. People who care. People who understand.

So giving up is not an option. It simply isn’t, so put it out of your mind. You will feel better. You will succeed, you will love yourself and others. Your depression, or anxiety or whatever else is not you. You have a disease and you are worth taking the same time to care about yourself as you would if you had cancer. You are worth giving yourself the same love, affection and respect as you do to everyone around you.

You are the change you want to be in yourself.

You’ve got this!

Suicide: An Insiders Perspective

Suicide. The word itself is stigmatized with weakness, and shame. We judge people who kill themselves as being selfish, people who just gave up. I mean really, what could be so wrong in ones life to drive you to actually end it? Suicide leaves a lot of unanswered questions for the survivors…the loved ones who are left wondering why, or if they could have helped. Well I hope this perspective can help you, the non-suicidal person to take a journey in the thought process of a suicidal person, so perhaps you can better understand and either be able to help or at least cope.
I am not going to speak on behalf of all suicidal people, but this is my story. First of all, you need to be made aware that most if not all people who attempt or succeed at suicide are dealing with some sort of mental illness, sometimes diagnosed, often not. Most of us have experienced moderate to severe trauma in the early stages of our lives. Most of us were in some way victimized as children or teens or young adults. The mind is an amazing tool with its own protection method by compartmentalizing things we cannot deal with at the time. It is locked somewhere in the back of our minds, and often we think that because it is locked away, it is dealt with. Sadly, that is far from the truth. These traumatized emotions sneak back out in multiple forms, some we recognize, some we do not.
I was severely traumatized multiple times until age 14. My first suicide attempt was at age 8. Yes, I know you are thinking…how can an 8 year old know what suicide is, after all at that age children hardly comprehend death…which may be true. Perhaps I didn’t understand the long term consequences of what I was doing but I knew that if you were dead you weren’t here. I remember my mom always warning me when we went to my Grandma’s house to stay away from all her pill bottles. “Pills will make you very sick and you could die”…..a statement that immediately made sense in my small mind. So I grabbed as many pills as I could and hid them in my pockets until we got home. I don’t recall the time of day or many other details, except for knowing that these pills would make me sick or die and somehow end my pain. So, I took them all. The rest is a blur really, recollections mostly through what I was told. Turns out they were high blood pressure pills and my mom had found me as I was throwing them back up. It turned into a hospital stay and numerous outpatient therapy sessions. I felt embarrassed, ashamed and was made to feel like I was selfish and mean for doing this to my parents. Keep in mind this is the late 1970’s and therapy and medications were nowhere near the standards they are today.
I had 2 other attempts in the following 15 years, obviously both failed or I would not be telling my story. Suicidal ideation is deeply inset in your mind. It can become a part of your every thought and action. We usually are self-destructive in most of our habits and relationships because we do not know any better. Our self esteem has been crushed to the point that we self-hate, we believe we are worthless and serve no purpose. We have a sense of emptiness and loneliness that we think can never be filled. We feel vulnerable, and that no one will understand why we feel this way. We feel so insignificant and lost in this big world. We have lost the ability to hope…which is essential for survival. Imagine yourself in a dark cavern with no exit, not a ray of light shining through. How long could you stay there? That is how our minds see the world…in a form of black and white instead of color. We are too ashamed to seek help or even mention the word because we are made to feel that way. We are made to feel insignificant. Our thoughts are so easily dismissed in many areas of the medical field. We often have to wait up to a year or more just to see a therapist, and I am telling you that from a suicidal mind, a day can seem like a year, so a year seems like eternity, an insurmountable wall. The overwhelming amount of pain that is involved to become suicidal drives us to the idealizations. The negative thoughts that have been burnt into our brain, emotionally and physically for years are now habitual in how we perceive ourselves, telling us that it there simply is no purpose for us.
We often have been diagnosed with some sort of mental illness, be it, depression, PTSD, Bi-Polar…the list is long on diagnoses and medications and short on preventative resources. Suicidal ideations can be common amongst these types of illnesses, but the problem lies when the door between idealization and action presents itself. Sometimes that door is opened when we relive a trauma, or have a memory from a trauma. Sometimes it is opened because our minds create it as a way to get out of the darkness. The bottom line is you can’t see it, or understand it, yet we live it daily. It becomes our sense of hope, as most of us are simply looking for some way to make the pain stop. We have tried medications, or not. We have self-medicated, or not. We have seen therapists, or not. Sometimes none of that is enough to close the door that is beckoning us out of our darkness, and that is when our thoughts may turn into actions. It could only be a 5 minute period where our brain is so irrational that we act. We could have been planning it for days, months, or even years, and something finally cuts that last piece of rope you were holding on to. That is when you choose to let go.
That being said, after 3 attempts and thousands of idealizations, I am still here fighting. Most people who end their lives are not looking to hurt other people with their actions, they are simply seeking emotional peace and see no other way to achieve it. Everyone deals with pain differently. Everyone’s coping mechanisms are different. Every person has a different length of rope. Do not judge us for not knowing where to turn, or for asking for help. Instead, perhaps take a look in the mirror and try some to put yourself in that persons shoes. Try to think how awful they must have felt to have ended their lives, and question not what you could have done differently, but what you can do now. Encourage people to end the stigma of suicide. Tell them it’s ok speak and ask for help. Be a voice for the ones who lost theirs, and if you can’t do that, at the very least stop judging something you are ignorant about.
Ignorance is not stupidity, it is the refusal to learn.