We Need to Talk About Chronic Illness and Suicidal Thoughts

It’s really shit when you have days, weeks, months when you don’t want to exist. It’s even more shit when you feel unable to talk about that feeling, for fear of the panic and upset that it might cause for those close to you or professionals you speak to. Society has taught us that feeling suicidal is irrational, frantic, urgent, scary. Sometimes it is all of those things, but often it’s fleeting thoughts, feelings of wanting to “disappear,” or having no feelings at all. It can be slow and passive and not look like wanting to hurt yourself or making a plan to. When I first had thoughts about finding it too hard to live with my chronic illnesses, I think I scared myself. I felt deeply guilty and people’s minimizations of my illnesses popped into my head.

Phrases like, “At least you don’t have cancer,” “At least they’re not life-threatening,” made me feel like I was so ungrateful for considering that life is too hard. Not only can they become life-threatening, but they have been life-ruining, and if the soul-crushing brutality of living with them isn’t a threat to my life, then I don’t know what is.

I’ve been writing this on and off for years – it’s a sensitive topic and a complex one and I don’t want anyone to interpret my feelings around it as fact. It won’t be a perfect or complete piece of writing on all the feelings around chronic illness and suicidality. As ever, I can only write about my personal experiences and the stories that people have told me over the years, as well as the amazing writers who have shared their feelings (see: this post and this one by the amazing Aisha Mirza). I cried with relief when I read their writing – finally seeing a candid conversation, especially between friends, about not wanting to live felt validating and energizing.

I have only ever had very apathetic suicidal thoughts in my head – no actual intent, no action plan – which is important to distinguish, because of course having a plan can make you more at risk. At my lowest point, I didn’t look after myself, I got deep into an unhealthy relationship and shut actual friends out. I drank a lot, I didn’t sleep a lot and I thought things like, “I wouldn’t care if a car ran me over today.”

These days, the thoughts usually appear during periods of bad pain, more medical intervention, or new diagnoses and symptoms. It’s always a hard feeling to describe but ultimately, it’s not being able to see past this point in time. It’s not being able to see a future for myself, just a black hole in which everything gets worse and worse. It’s imagining awful situations that haven’t happened yet – not being able to have a family, deciding not to have a family and regretting it, symptoms worsening, my benign tumors turning cancerous, developing another incurable illness. It starts with thoughts that have regularly become catastrophized and continues to spiral into awful anxieties and things that could happen but may not. It’s a cold, blank, dark space where it feels like lying still and letting these thoughts consume me is the only outcome.

When you’re jumping through medical hoops with your physical chronic illnesses, it is very rare that any professional will ask you how you’re feeling. In my experience, they have literally never mentioned that chronic illness can cause depression and anxiety or considered that having numerous conditions with complicated treatments and painful procedures creates trauma that can become unbearable to live with. That being said, many mental health professionals have a very limited understanding of chronic illness. It is a tremendously difficult area to navigate and can be so exhausting.

I am absolutely not a mental health professional. This is very much just one human’s account of her feelings, and it may not align with your experiences at all. But through my experiences and those of working within a Mental Health Team, there are definitely good ways and bad ways to treat people who are feeling suicidal. The pressure should never be on friends or family to support people feeling suicidal as they may not have the capacity, but I thought I would share some of the ways I work through my own feelings and help others work through theirs when they disclose to me that they are feeling suicidal.

Do not act as if wanting to end your life is an irrational thought. We live in an exhausting, hectic, overwhelming world that is very difficult to live in for some. Not wanting to be a part of that world is completely rational, no matter what has caused the feeling. For some people, the worst thing you can say to them is that they should be thankful for the life they have or think about the people who love them. I know it can be hard to hear from someone that they are feeling like they don’t want to live, but it is not a reflection on you and it is not about your attitude to life. Acknowledging that it makes sense for them to feel like that and validating what has led them there is a good first step.

Ask if they feel able to keep themselves safe. Always a good question to ask because it can indicate the risk level they’re feeling and help you provide them with some support.

Talk about options. Sometimes people just cannot see the next step, so the next step seems to be not living anymore. There are always options. You can talk about those, whether it be taking sick leave from work, sorting out practical life issues that may have led to suicidal feelings, or literally what to do in the next 10 minutes. It could be drinking a glass of water, it could be going to sleep, it could be stepping outside.

Ask what they need. Asking what they need is included in the options talk, but it’s good to explicitly ask. They may need something that feels gargantuan because of their state of mind but is achievable with support. It’s important to try and understand that even if a need seems basic or simple, it can feel like the hardest or worst thing to someone who is in a suicidal state of mind.

Today I feel like I don’t want to exist, and I know that is a perfectly rational thing for me to feel. My illnesses affect every single aspect of my life and create more worry and stress in every one of those aspects. They interrupt all progress, steal all joy, and sometimes it feels unfair that I have to keep on living. Today, I thought about my own options. The next step was crying, a lot. Did it make me feel better? Not really. But eventually, I stopped crying and the next step was feeding myself. I gathered the strength to write this, and after this, I will lie in bed and scroll aimlessly through my phone. We live with so much pressure to do big, important things that it can be hard to only think about these tiny steps but in these low moments, they are crucial.

When you live with an incurable illness, there is no guarantee that you will ever feel better. But there is the guarantee that you will feel better than your lowest point, at least for a while. All you can think about is your next steps and on a good day, let yourself think about more than that. Chronic illness and suicidality is an incredibly complicated and nuanced topic and one that isn’t spoken about enough. I hope we can share more and I hope that this writing resonates with someone and makes them feel less alone.