Have you ever thought about committing suicide? I have. Have I had a plan? Yes. Have I attempted it? No. Why?
Two factors I think. The love of my kids and being unwilling to leave behind the psychological trauma that I know they would carry.
My thoughts of suicide always followed the coming down from and off of mood-altering drugs.
As a former RN I was aware that my brain chemistry, specifically dopamine, was depleted; that because I had supplied my brain with artificial dopamine through drugs, my mind had stopped producing its own brain chemicals. The result of this dopamine depletion was making me feel hopeless, unable to see the light in anything, making suicide an option to provide me relief from extreme mental pain.
Suicide also occurs during active addiction due to an anesthetized brain. Impulse-control regulation is off-center, and if intense psychological pain is present for whatever reason, a person is more likely to follow through on suicidal ideation.
Having experienced decades of substance-use disorder, I knew the suicidal thoughts would abate, with time. I even learned what helped: extreme exercise to expedite my brain to equilibrium, and community. Never isolate—we need connection to others; it is built into our very existence as human beings. That fact has protected our survival for centuries. We are not built to be alone.
I have never been diagnosed with severe mental illness, but because I have a strong recurring addiction history, I am statistically at higher risk of suicide than the average person, according to Dr. Carolyn C. Ross in “Suicide: One of Addictions Hidden Risks,” a Psychology Today blog post.
Depression and other mood disorders are the number one risk factor for suicide, but alcohol and drug abuse—even without depression—are a close second. In fact, research has shown that the strongest predictor of suicide is alcoholism, not a psychiatric diagnosis. People with substance-use disorders are about six times more likely to commit suicide than the general population.
That brings me to my style of performing interventions.
I am not an arm-twisting, hold-a-gun-to–your-head interventionist. I achieve high success rates with the expression of love and no shame communicated by a group of family and friends who care for my patient.
Saying “I will never speak to you again if you do not go to treatment” not only decreases the odds of long-term recovery—even if the person does go to treatment—but is dangerous. Leaving an alcoholic /addict alone physically or psychology through complete shunning if she refuses treatment increases theodds of suicide. The person many times will try to quit on her own or go on a bender. Either way, she is in the minefield of suicide.
Boundaries and doors left open with love go much further in predicting a person’s odds of accepting help in the future and can help decrease the odds of suicide.
Boundaries are different for every group I work with. Boundaries need thoughtful consideration and should be realistic. An example: You are always welcome in my home, but if I suspect you are under the influence, I will ask you to leave and come back next time sober. Ultimately this approach is more human and helpful in achieving the goal of the addict/alcoholic seeking treatment.
You would not shun a family member with metastatic cancer who was refusing medical care.
A text saying “I love you still and am willing to help you get treatment” following an intervention where the person refused help is far more effective and safer than estrangement.
I know this can be hard if you have experienced many negative life events due to a person’s substance-use disorder. You can distance yourself, but please do it with love and leave the door open. Your loved one will be far safer from suicide, the ultimate tragic side effect of addiction.
One time, I had dropped off a patient at one of my favorite rehabs. My little dog rushed through the doors. “Just follow Lucy,” I told the patient. All five pounds of Lucy were exuding excitement—her eyes bright and tail wagging. I think her indescribable cuteness gives my patients hope and distracts themat this very scary moment in their lives. She has sat in their laps during the drive to rehab, looked back at them as they retrievedtheir luggage, and, with only body language, said, “Hurry up,follow me to heaven on earth,” as she eagerly waited for us to open the door.
I dropped off the patient with the intake counselor. “I will be right back,” I said. “Lucy wants to see her friends.
I opened the doors to the intake department, and she ran to one of her favorite cubicles, where Mike has sat at for 13 years, dispensing hope over the phone to potential patients and their families.
His chair was empty. “Is Mike off today?” I asked another intake counselor.
The look on her face and her hesitation about my question was a harbinger of something I was sure I did not want to hear.
“He committed suicide a few days ago, he jumped . . . ”
My first thought was, “This is not possible.”
But he had relapsed after years of sobriety. The devil really never stops chasing us addicts and alcoholics.
Mike was the third high-functioning alcoholic/addict friend I have lost to suicide since I have been in recovery.
Lucy, being blessed with no frontal brain lobes, just ran to another cubicle.
I was silent in my mind.
I returned to say goodbye to my patient. We hugged, and both of us held each other for a long time. She was scared. I was the last familiar person to her. I whispered encouragement into her ear. I continued to hold her close and think of Mike. Not everyone survives this disease.
If an intervention is not successful at the moment the group has set up, please do not abandon the person completely.
We are a fragile population, living with this still-maligned and misunderstood disease.
Love always . . .
Joani Gammill, AIS