Why 'Suicide Alternatives' Are My Best Suicide Prevention

At last count, I’ve wanted to die on more than 7,300 days of my life. I’ve spent only six of those days in a psychiatric hospital, setting that hospital’s record for shortest involuntary commitment.

How can a person who deals with such frequent thoughts of suicide have completed college, hold a job and maintain a career? How can she rebound from job losses during two economic downturns? How can she own a home, live a life? In short: how can she be as successful as I am?

Wanting to die is, it turns out, not terribly unusual. People want to die because they’ve committed what they consider to be an unpardonable social sin, because they’ve failed in some way at work, because their spouse has ended their marriage or they’ve experienced too many bereavements.

Wanting to die is a pretty reasonable reaction to lots of terrible life circumstances. I’ve been there, done it all, and I’m still alive. As are lots of people.

So the real question is how and why do some of us keep going when we frequently want to die? The answer lies in a mix of motivations and solutions we practice.

Here are a few of the “alternatives to suicide” I have used over the 40-plus years since I first wanted to die:

1. Escape.

Binge watch television. Binge read fiction. Write revenge-themed novels. Stare at the ocean. Stare out the window.

2. Exhaust myself.

Long, long hours at the gym, on a trail, up a mountain, on the bike, in a kayak.

3. Become engaged in something.

Use some creative skill. Pet the cat or dog. Arrange wildflowers into a bouquet. Shop an hour for $5 worth of gift wrap and ribbon. Anything that’s not about the feelings inside of me.

4. Encourage myself.

Mark every little step forward. Create a to-do list so detailed that I count it progress when I finish my shower, my breakfast or my commute. Remind myself during times when I feel without hope that the God in whom I believe has promised me “a hope and a future” (Jeremiah 29:11) even if that comes far in the future, when I finally arrive in the country where God wipes away every tear (Revelation 21:4).

5. Extend myself.

Extend myself for others, even when I feel like I have nothing to extend. Facebook COO Sheryl Sandberg, in “Option B” — her book about surviving the grief she experienced after her husband’s death — says one tool she learned was to log three ways she had influenced others for the good. For me, this works. I offer kindness. Volunteer. Show a colleague a new skill.

6. Remember.

At one point, my best suicide preventive was recalling that I would have killed myself if I’d tried the particular method I’d considered at age 19. Some years later, I held to the memory of a voice (that I know as God) telling me, “If you don’t have a reason to live until spring, plant bulbs.” I still plant bulbs, lots of them, almost every year.

7. Walk through my rituals.

Daily routines that never change can keep you going. For me, these include alarm at 6. Coffee. Oat cereal with milk and berries. The print newspaper. The chair where the Bible and journal and planner wait. They resume in the late evening, when 9 p.m. brings on hot tea, the buzzing electric toothbrush, jammies and a book by the bed.

8. Protect myself.

At the worst, I just keep myself safe. I call the friend who is willing to come over, so I’m not alone. I text the person who will remind me I don’t always feel this terrible. I check in with a suicide hotline or the Crisis Text Line when I need to say things that even the best friend shouldn’t hear.

(And by the way, the hotline care strategy is to listen first, then help the caller identify any circle of belonging and choose even one thing the caller will do in the next 24 hours other than end their own lives. That is to say: name notwithstanding, “suicide prevention” hotlines are designed not to prevent suicide, but to help us find alternatives to suicide that will allow us to choose life for another day. And the evidence is that they work.)

Suicide Alternatives Versus Suicide Prevention

None of these is a suicide “prevention” strategy. Suicide “prevention,” as we practice it today in the US, trains thousands of “gatekeepers” to peer into the lives around them for “signs” of suicidality. It urges them to push people like me toward professionals who hold the keys to locked wards, where we can be almost perfectly protected against self-harm.

Ironically, we have trained so many people to be on guard against “symptoms” that ordinary human supports have become much less available to people experiencing challenges. Today, I have to carefully consider any potential confidant. Is this a person who will (with or without professional qualifications) assess me to be a danger to myself, call police for a midnight “welfare check,” insist I need to take a medication that time has proven doesn’t work for me? Will they shuttle me toward another locked ward?

I’d personally rather hold my tongue than risk the professional suicide that an inpatient event provides. I’ve only just rebuilt a new career after my one-and-only psych hospital stay more than a decade ago.

People who have lost loved ones to suicide, professionals who have lost patients to suicide — even those who have temporarily protected family, friends, and patients from one episode of suicidality — don’t know even a percent as much about eluding suicide as those of us who have stood this battle for years. My friends and I don’t “prevent” suicide. But we each maintain our personal lists of “alternatives to suicide” that we put into practice when the urge hits. Even when it hits really often.

Why We Need to Focus on ‘Alternatives’ Instead

The suicide rate in the US remains staggeringly high. For more than 7,300 days of my life, waking up the next morning required me to make a conscious choice to diligently pursue something — anything — other than my impulse to die.

Perhaps it’s time to reconsider our “suicide prevention” approach. Maybe the best teachers of how to avoid suicide will be not the people who are afraid someone else will die, but those of us who can explain how and why we regularly choose to live.

Carlene Hill Byron is a nonprofit fundraiser who has worked as a writer, marketing communications specialist, or public relations officer for nearly four decades. Her paper, “Suicide Learning from Global Perspectives,” was presented at the 2015 NAMI-North Carolina state conference.

A version of this article was previously published on the author’s blog.