How My Thoughts of Suicide Strengthened My Empathy As a Therapist


Editor’s note: If you experience suicidal thoughts or have lost someone to suicide, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741741.

There are many people whom death has never tempted to end their pain by suicide. They are the blessed, who have never felt the agony and anguish of acute or chronic anxiety and depression. Given their perspective through the lens of stability, it makes sense many of them deem suicide a “cop out” or a cowardly act. However, had they ever spun in the maelstrom of bad genetics, social stressors and lost hope, they would be more likely to understand suicidal people do not lack resilience or a backbone stronger than the mental illness that makes death a more attractive option. I’m not sure what insights those short-sighted souls possess that permits them to judge anyone who only sees black when peering into their future. Perhaps it is a total lack of insight that allows for such egregious absence of empathy.

It was my charge as a psychiatric screener to determine the necessity of involuntary commitments for people drowning in mental illness, and it saddens me that I committed many people whom I met on what had to be among their worst of days. As a psychotherapist, I have formed long-term relationships with clients gripped by chronic suicidality, often wondering if I would see them again after they left my room. I pride myself on being sensitive to those struggling with suicide because of professional understanding, but my empathy is amplified because of my own grapple with thoughts of suicide to escape panic disorder only six years ago.

Whenever I drive long distances, sit in claustrophobic city traffic or am engulfed by movie theater darkness, I remember when such triumphs were made impossible by the consequences of a panic attack I experienced on the New Jersey Turnpike with my unsuspecting daughter in the passenger seat. On the outside, I appeared rock solid, but on the inside, I melted into a pile of numbness, nausea and depersonalization. On that day, I experienced no obvious external pressure. It was not as though I had endured a sustained period of homelessness, or had been recently diagnosed with terminal illness. All I had to do was see Emily play in a soccer tournament. I arrived at the arena a drenched mess in need of escape from threats unseen but surely felt. I called her mom, from whom I was divorced, begged her to meet Emily at the tournament. I cried my way home. For the entirety of my getaway ride, I labeled myself “weak,” “failure” and “deadbeat dad,” piling insults on top of panic that locked me in my bedroom for two subsequent days.

I was unemployed at the time, having been removed from my school social worker job by a statewide reduction-in-force. Although unemployment benefits came through, much was eaten by child support and bills, with pittance left for me. I was unaware of the toll my stressors took on me, and I paid no heed to my father’s history of social anxiety, or my mother’s battle with major depression. I was ignorant of the fact a mental illness healer could be stricken with so aggressive a mental illness. Only when I attempted to leave my apartment to visit friends two days later did I realize only a pittance of myself remained. After sitting debilitated behind the wheel for 20 minutes, I called my friends, told them I had a cold and buried myself back in bed.

It would be hyperbolic to say thoughts of death devoured me that very day. In truth, my initial attack was a salvo in a burgeoning war with mental illness which, like many wars, had its share of alternating victories and defeats. There were times I was able to shove panic into retreat and return to functionality, only to be annihilated by an attack fiercer than any that had preceded. Soon, dread of subsequent attacks set in, and I learned panic disorder employs a combination of guerrilla warfare and terrorism. Under the new governing law of panic, I was permitted a few seconds of calm when I woke each morning, as if my enemy fled only to be stricken by realization it lurked and would strike at will. For me, it was not a question of if an attack would occur, but when, and I was consumed by thoughts about who would laugh at me as I unraveled in front of an audience of judges. Unable to drive to my doctor, I was granted a prescription for an antidepressant, which after a few weeks decreased my symptom intensity, albeit not enough to make the world benign. Only home was void of malignancy, and although it was my haven, it soon became my prison.

I was uncomfortable discussing my condition with anyone because illness of the mind is oft misinterpreted. Friends referred to my behavior as “doing the hermit thing;” my father nullified my symptoms by suggesting “you have nothing to be nervous about;” the mother of my children appealed to family court for full custody on the grounds of my “insanity.” It would be months before I divulged this thing about which even I had limited understanding, and my silence left me lonely.

Although home, or proximity to it, kept physical symptoms at bay, the disorder lingered outside my door, ready to ambush me if I ventured too far. The moment I imagined a new job, panic disorder cuffed me with “what if” questions. Executive functioning in my higher brain had been debilitated by lies, suppositions and visions of the worst possible outcome that relegated me to a creature of constant fight or flight.

Isolated, misunderstood and afraid my dysfunctional thought patterns would never change, the “terrorism” aspect of panic disorder darkened my mood. I deemed it impossible thoughts over which I had no control would ever leave, and I wondered how it was plausible I could change behaviors I never initiated. Because my thoughts were beyond my control, I was shackled by helplessness and stigma.

Soon, when I contemplated my future, I saw myself unable to attend a job for fear of being frozen by fear and publicly humiliated; my vulnerability and flaw exposed to a world unwilling to tolerate my imperfections if I wouldn’t. It was unclear to me then that I was the judge. I projected every horrible thing I had ever thought about myself onto the world around me; lousy husband, absent father, academic fraud. Unbeknownst to me, much of my panic stemmed from a poorly formed sense of self, and a cluster of false beliefs I used to punish myself for imperfection; and so, it continued.

There were days when I predicted an elderly version of me lying on cold pavement, jingling a few coins in a paper
cup, desperate for more. Both the cup and I were empty, and within the black of my prognostication, I felt teased by the comfort of death. Although I had not decided on how or when, I knew why, and my personal “why” made it clear suicide is neither selfish nor cowardly. It is by no means cowardly to give away the most valuable gift one has ever received. Writing about it now stirs memories of the many times I was called to prisons because inmates threatened to kill themselves when faced with years of incarceration. Often, I dismissed their claims as an attempt to replace jail with hospitalization. Today, I curse the ignorance that blocked belief mental prisons are as inescapable as those of concrete and barbed wire.

That period in my life taught me about the potency of acute suicidal states. Had I ended my life then, all who know and love me would have been shocked, for I was never chronically suicidal. I had not gone through the torture of those who died by suicide after years of depression, mitigated functioning and a few previous failed attempts. Mine was the kind of suicidal state experienced by those who do not easily rebound from job loss, romantic breakups or other “here and now” stress. Some people perceive such causes of suicide as ludicrous, but there is no such thing. Hopelessness is the single most lethal variable in the acutely suicidal, and like others, I had reached that point. After my months of silence, I was fortunate to have been taken seriously by several key people who encouraged me to therapy and offered me their ears.

Every step I took from the dark of my bedroom was accompanied by a backward glance to make sure my safe place was still there, much the same way a child who explores looks back to make sure Mom is still there. It took years for me to get back on highways, feel safe in crowds, to live. But I am living now, because existing is simply not enough, and the man once too afraid to drive the highway has since cruised the ocean with his wife who aligned herself with him in his war.

I am a psychotherapist, a family systems theorist and I leave my house whenever the hell I want to, but I always remember panic disorder once made death more attractive than life, and regardless of my achievements, I am as vulnerable to mental illness as anyone else. Because of that, I will never discount even the vaguest expression of suicidal thought uttered by a person in pain, because even one receptive ear — or one supportive word — instills hope, and hope breeds life.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255, the Trevor Project at 1-866-488-7386 or reach the Crisis Text Line by texting “START” to 741741.

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Getty Images photo via mattjeacock


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