I've never considered suicide or acute self-harm. I tell you this the same way I would tell you my pupils are larger than normal - I can see pretty well in the dark and bright light often hurts my eyes. Neither bring me any particular pride or shame - they're just the way I happen to be formed.
Personal safety - or something like it - is marked on my treatment plan (which is in my car and it's cold in the garage or I'd quote it exactly) but it says something about understanding how to not hurt myself in the future.
"I don't," I objected when I watched the intake therapist make rapid slashes across those boxes, looking up at her with my sternest frown.
"Think of your long-term health," she insisted. "Excessive sleep and lack of activity can cause cardiovascular issues. Diabetes. You aren't doing your health any favors." I shrugged, not really having a valid argument and deciding it wasn't worth the debate.
But I read this Buzzfeed article with a sense of sickness and sadness and rage. It was my goal to journal through my experience to not only express this for me, but also to provide a data point for anyone struggling with mental health and considering more intensive treatment. My path took me through a great primary care doctor and then to this partial hospitalization program. And it's useful so far - I feel like I'm doing the work and making some progress.
I'd encourage people - even (especially?) those younger than my 37 years - to consider this treatment approach. To know thyself better, gather some strategies to better cope with all the crap involved with being an adult. To recognize joy and actively search for it.
I have been asked - many, many times by many, many people - if I have thoughts of hurting myself or anyone else.
And I can honestly (and repeatedly) answer that I do not. And I think - maybe - that could be part of what's kept this experience so empowering and healthy for me.
I listen to many people in the program stumble over the 'suicidal ideation' pronunciation and think 'those aren't your words' and I have a habit of questioning the truth of something when a person makes an odd word choice. It would feel more authentic to me if a person said "I tried to kill myself" or "I cut my arm when I'm feeling overwhelmed." But robotically reporting, "I'm here because of suicide... suicidal ideation..." I feel a frown want to replace my default supportive expression.
"Hey," I poked my head in the door of the therapists' office one day, about an hour before the program was due to end, "I'm going to head out - my head hurts and we're going to play a game and it's just not for me."
The therapist laughed, nodded and made a note on a post-it. "No problem," she confirmed. "Just sign out on the sheet, OK? Oh, Katie," she said, and I'd turned to face her again, "are you safe?"
Not really knowing what she meant - did I feel comfortable in the program? Was I going to relapse into bad behavior and nap my brains out when I left? - I simply nodded, smiled and departed.
I don't know what would have happened if I'd said I wasn't - that I felt fragile and had thoughts I couldn't control. People have told stories about arriving "upstairs" where the inpatient unit is after a family member made a concerned call to police. Or after saying something threatening at work.
Most of me is so glad they're getting help - that I get to see them joke and laugh in a program they're free to leave at any time. But that helplessness of being somewhere they didn't like, unable to leave, strikes a scary chord with me.
But I wanted to be clear that I don't approach this experience with that particularly burden. I don't have advice on how to authentically engage in treatment - to be open and honest - with a possible threat of losing autonomy. I don't like to think my therapists or nurses or psychiatrists are capable of taking advantage of someone at their most vulnerable. But I don't know - and I literally ache with regret if someone is searching for answers and faces those fears.
I will say this - there is help. Even if you're afraid. Even if you've had a terrible experience in the past. You are worthy of healing and love, joy and peace. Find someone you trust and - perhaps more importantly - trust yourself. Those of us who struggle with depression or anxiety or suicidal ideation are capable of enduring miserable challenges and great pain. So we can totally figure this out.
And if there's anything I can do, please reach out.