Saturday, March 22, 2014

On suicide

I recently had a little bit of a scare. I was getting ready for work one Saturday morning, in a piss poor mood, when I thought of suicide. I wanted to take all of my prescription sleeping pills, go to sleep, and never wake up. I didn't do it, and I didn't even reach for the bottle. But I was nonetheless serious, very serious. I've had thoughts of suicide over the years that weren't serious, that amounted to a "what would I do IF I were suicidal?" and I went through a long period years ago where I actually was suicidal, and made two abortive attempts (chickened out on one after writing the note, and didn't take enough pills on the other, probably in part because I hadn't been able to say goodbye to anyone). Point is, I can tell when a suicidal thought and desire of mine is serious, and when it's not.

This was serious.

The full impact of what I had thought, and it's implications, didn't start to hit me for several hours. At first I didn't even realize the biggest part: I wasn't scared. I had very calmly had a serious desire to kill myself, along with a plan, without any fear. Always before I'd been at least somewhat agitated by fear when thinking of suicide seriously, but not this time. Not this time.

It wasn't hard to pinpoint a likely cause for the thought. I had recently had to stop taking Lunesta for a sleep aid because of financial concerns. At or near the beginning of the year our insurance stops covering as much for prescriptions and other things while it forces us to meet our deductible (our rather high deductible). As a result, the last time I tried renewing the Lunesta, I was being charged $336 out of pocket (there's no generic version). A phone call to insurance yielded no change. I had to turn it down, as I couldn't afford that. Thus it was that the next time I saw my psychiatrist (not long after, I only had to deal with a few days of poor sleep) we switched my sleeping aid prescription to Ambien (generic version, yay). Way, way cheaper. Only about $10 out of pocket.

I started with the Ambien on a Wednesday night, and had my mood decline until I had my suicidal thought on the following Saturday. The information inserts that come with such medications always warn you that if you experiencing new or worsening depression, or suicidal thoughts, you should contact your doctor. I didn't stop taking it immediately though, because that can also have adverse effects. So, I called Monday morning, and was advised that I could and should discontinue the Ambien. Instead, they put me on a prescription for seroquel. I'd tried that one before for sleep, and it wasn't as good as could be, so the dose was doubled this time.

I do wish I could afford the Lunesta, as the seroquel still doesn't help as much with the sleep as I'd like. But it does help, and I'm not suicidal. So it's a good thing.

Coincidentally, when I was in Barnes and Noble this past Friday, I spotted a book called "Stay: A History of Suicide and the Philosophies Against It," by Jennifer Michael Hecht. From the Amazon description:

Worldwide, more people die by suicide than by murder, and many more are left behind to grieve. Despite distressing statistics that show suicide rates rising, the subject, long a taboo, is infrequently talked about. In this sweeping intellectual and cultural history, poet and historian Jennifer Michael Hecht channels her grief for two friends lost to suicide into a search for history’s most persuasive arguments against the irretrievable act, arguments she hopes to bring back into public consciousness. 
From the Stoics and the Bible to Dante, Shakespeare, Wittgenstein, and such twentieth-century writers as John Berryman, Hecht recasts the narrative of our “secular age” in new terms. She shows how religious prohibitions against self-killing were replaced by the Enlightenment’s insistence on the rights of the individual, even when those rights had troubling applications. This transition, she movingly argues, resulted in a profound cultural and moral loss: the loss of shared, secular, logical arguments against suicide. By examining how people in other times have found powerful reasons to stay alive when suicide seems a tempting choice, she makes a persuasive intellectual and moral case against suicide.
I read a little bit while I was there, and figured that it seemed interesting. She objects to the idea that people have a right to suicide (though I noticed she might not be against assisted suicide when dealing with a terminal illness), and I'd kinda like to see what she has to say in defense of her position. Could be useful if medication or depression ever brings suicidal thoughts to my mind again. Maybe I'll take some time and examine the question in my own mind, and see if I can come up with an ethical stance prohibiting suicide (or maybe I'll end up agreeing with other philosophers that there is an individual right to kill oneself; one shouldn't start out with a preconceived conclusion).

Before I sign off on this post, let me just reiterate to the concerned out there: I'm not suicidal. This was an aberration apparently brought on by a new medication (or possibly it's interaction with other medications), and I got better after stopping that medication. I write about it here as part of my commitment to talking about mental illness openly and honestly, in an effort to de-stigmatize it, and to hopefully help people realize that an illness of the brain is no less an illness than that of any other part of the body.

Also, I'm grateful to my wife for helping me through this. All of this.

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