Living to Die: On Chronic Suicidality and the Authentic Self

United States of America

Introduction

A few months ago, I walked into my room and saw one of my belts lying on the floor. It was a D-ring belt, the kind that comes with cargo shorts, and it makes a natural noose. Seeing the belt, I placed it around my neck and tightened it. I walked to the metal clothing rod in my closet, prepared to tie the other end of the belt to the rod, drop to my knees, lean forward, and die—just as I had rehearsed. A thought occurred to me, very matter-of-factly: "well, this is it. This is the end." That simple thought was enough to shake me out of the reverie I didn't know I was in; out of the depersonalization I wasn't aware of. I was still deeply suicidal and still profoundly depressed, but more aware of myself and my surroundings. I removed the noose from my neck, laid on my bed, and wept in agony and intolerable psychic pain.

I have struggled with suicidality for years and perseverate on suicide regularly; I have cut and burned myself more often than I can recall. But this time something was different, that in retrospect I find especially frightening: there was no hesitation, or thought, or time, intervening between the stimulus of seeing the belt, and the behavior of placing it around my neck, fully intending to kill myself. It was almost as if I was watching myself as I went about the business of ending my life. Thankfully, the interrupting thought "woke me up"—if that is the right phrase—just in time to make my decision with greater clarity. I want to die; but not today.

Living with chronic suicidality, in the context of bipolar disorder with its characteristically dramatic changes in mood, energy levels, thought patterns, emotions, and behaviors, can be deeply confusing and disorienting. In particular, my understanding of my own authenticity, my true self, literally who I am, sometimes feels ephemeral, ungrounded, nebulous. This is particularly the case as I emerge from a crisis period, wondering—with no small amount of fear—why is my brain trying to kill me?

In this narrative, I explore the concept of the self, more specifically, of my self, set within the background of living with bipolar disorder. Along the way, I will share parts of my story in the hope that, if others read this and feel similar experiences, they will know they are not alone, and perhaps even may find some comfort in this knowledge.

The Allure of Death

I have manic-depression, more commonly (though in my mind, less accurately) known today as bipolar disorder. I've had it since my teens, and so the profound changes in mood, energy, and thought patterns have simply been a part of my life since my formative years and throughout my adulthood. In my case, I have experienced all the variations of mood episodes: the severe depression, where all hope is lost, all energy drained, and something like existential fatigue takes over. I am simply tired. Tired of everything, and especially, tired of living. But in this state, there is such fatigue and avolition that very few thoughts enter my mind. It is just a state of intense sadness, emptiness, hopelessness.

On the other hand, the pure, euphoric manias tend to characterize the condition earlier on and become less common later. Some of my first clearly definable mood episodes that I can recall were states of pure euphoria, highly energized and productive, exceptionally sociable, less sleep needed, coupled with a range of exceedingly dangerous behaviors, often resulting in serious injury such as broken bones.

And then there is mixed mania, a combination of both "poles": The emptiness, sadness, and psychic pain of depression, combined with agitation, anxiety, restlessness, impulsivity, and often intense anger. It is difficult to describe this condition to someone who has not experienced it. It is contradictory, disorienting, frightening, and wondrous. There is a horrible nothingness, darkness, and pain; an agitated, despairing violence in my soul, yearning for self-annihilation; yet...