I wrote an essay here last summer about my first (and albeit more serious) suicide attempt. At the time, I was feeling pretty hopeful. I had just graduated from a residential program, I was well-medicated (though I had no idea how important this was), I was stable, my weekly therapy sessions felt like victory laps. In other words, I had made it — made it out, made it through, made it past the wreck of insanity that had been the last year of my life.
I didn’t talk much about diagnosis’ or meds in my previous essay; this essay is pretty much all about both of those things. When I was in the hospital following my suicide attempt, I was diagnosed with Borderline Personality Disorder. (I no longer have this; all the hard therapy work I did in residential paid off in that regard.) Lithium is sometimes prescribed to treat borderline, specifically if suicidal impulses are a prominent symptom. For me, chronic suicidality was my biggest borderline symptom. I started lithium that September.
Because of my pervasive instability while in treatment, the doctor I saw there said she wasn’t sure if Lithium was helping. Actually, I was told that meds may not be an answer for me at all and I may not need to take them. By the time the doctor came round to me with this conclusion, though, I was getting ready to discharge from the facility. I told her I would probably go off of the Lithium once I got settled, after leaving. And I did.
My psychiatrist at home was more than happy to taper me off of Lithium. I had a good argument — “but my kidneys! risk of long-term damage! other doctor said it was unnecessary!” — which I hardly needed. After all, I was still diagnosed primarily with a personality disorder (this was before it was removed) and personality disorders respond to therapy, not drugs.
I was taking 1200mg and she had me taper down by 300mg at a time — 2 weeks at 900, 2 weeks at 600, a month at 300. The first two weeks went fine. The next two weeks, things were starting to fall apart. By the fifth week, I decided to stop taking the drug entirely, rationalizing 300mg is essentially the same as 0mg. By the 6th week, I was suicidal, not managing even small stressors, appropriately, crying all the time. Reluctantly, I agreed to start taking 300mg again until I could meet with my psychiatrist.
I got hypomanic. In retrospect, that was far from the first time I’d experienced hypomania, but it was the first time that it occurred in a context that would make someone suspect bipolar disorder. You know? I’d been running around like an ultra-productive, deeply hilarious beheaded chicken periodically since high school, but when you’re taking a medication that’s often prescribed for bipolar — and you stop it — and then you start running around like a beheaded chicken — then people start wondering if you’re bipolar.
Hypomania feels good. I felt great until I didn’t, and when I didn’t, I really didn’t. I became intensely suicidal and intensely impulsive and took a recreational overdose which landed me on the hospital psych floor again, hating life. I was diagnosed bipolar type 2. The doctor there brought me back up to my full original dose of Lithium and added a low dose of Seroquel to help me stabilize.
I was stable enough for the hospitalization and the 2 weeks it took me to decide I hated taking Seroquel and wanted to stop taking it. I tried to quit twice, cold turkey, and it made me so sick both times that I resumed taking it within two days both times. Sadly, I think this was enough to catapult me into the next level of my crisis, my own personal hell, and the antecedent for my second (very, very pathetic) suicide attempt.
Did you know mania can be expressed as being incredibly, incredibly angry? I didn’t, until it happened to me. Apparently it’s not uncommon. I suddenly not only hated everyone, I had an excess of energy with which to hate them. Then I was walking in the woods at night with my dog, singing out loud. Then I was at the beach at night in the pouring rain, no coat (just a tiny tank top), laughing out loud, chasing seagulls with my dog. (My dog, in retrospect, probably loved the mania.) I realized I couldn’t slow my thoughts down; I remember having this ridiculously frantic inner monologue about meditation and mindfulness and how I could think of seven different mindfulness practices at once but I couldn’t still my mind long enough to do even half of one of them.
The mania turned mixed. I was terrified that I was about to start hallucinating. I was scared I was going to hurt myself. I yelled at my therapist, expressing maybe a third of what was going through my head during our session. He wrote court papers for me to be placed on a 72-hour observation, which were granted. I yelled at the hospital staff, I refused to work with them, I refused to go to groups, I slammed the door on the psychiatrist. Everything was “f*** this” and “f*** that” and “this is bull****”. When my hold expired, they didn’t want to file commitment on me, so I went home.
I went home on a Tuesday. On Wednesday, I told my therapist that my head was still buzzing. On Thursday, my work called me and asked if I would be coming back. I told them the truth, which I hated, which was that I didn’t think I could. I went home, watched Netflix and cried, and became increasingly more despondent. I went to church with a friend and when I came home, I let my dog out and fed him and then walked to the nearest open liquor store. I got there 15 minutes before closing, bought a bottle of the cheapest whiskey I could find, and proceeded to try to give myself alcohol poisoning.
I wanted to die, but I didn’t want to decide to die; I just wanted to pass out and drown in my own puke. But this particular whiskey was absolutely disgusting and there was a point that I realized if I drank more, I would just throw everything up immediately and I was not drunk even enough to puke willingly. (I hate, hate, hate throwing up.) So I was desperately sad. I didn’t sleep at all that night; I talked to some friends, and I talked to an on-call counselor, and once the hangover hit around 5, I spent a lot of time curled up on my bathroom floor. I figured when the hangover dry heaves chilled out, I would take the remaining Lithium I had and hope that it killed me. Instead, I called the on-call number again, and talked with a really lovely therapist who maybe saved my life — or at least my kidneys. Basically she said she still had hope for me and I said I was more suicidal than I had ever been in my life and we both agreed I needed help and to go to the hospital. And I did.
I didn’t tell anyone that I had been trying to kill myself with the alcohol; it was such a pathetically failed and poorly thought out attempt that I was embarrassed. But that’s what I had been trying to do, when I’m honest with myself about it.
I spent another week and a half in the hospital. They switched the Seroquel to something else I tolerate better. I was relatively more compliant with the hospital staff that time around. My diagnosis was upgraded to bipolar type I, due to the severity of my manic/mixed episode. I was released from the hospital 15 days ago, and I’ve been stable enough since. I have no job, and I had to move back in with my parents, but at least I keep my coat on in the rain, you know? At least I’m not singing in the woods.
I’m not going to try to kill myself anymore. The thing about this attempt was that it felt so sad to me that it talked me out of trying again. I decided to live, hungover and emotional in the ER cubicle that Friday morning. The ambivalence I posted about before is a thing of the past.