What I have learned from my suicidal patients

When I was young I nearly succeeding is ending my life (early teens) and at that moment I knew I didn't truly want to die, but I so desperately needed the pain to end. So going down wasn't an answer, I had to keep going up no matter what and I tried to find any reason I could to keep going. This didn't stop my attempts, but it slowed them down some, and so I floated in a destructive despair for years while I tried to figure things out.

I have seen other people turn things around for themselves and it really turned out to be that everyone that did was looking for something important. And I don't mean figuratively here, they actually took real action, real effort to find something, anything, any reason to keep going.

And that is why I know this is so hard, because when you are in the deep end of despair, the last thing you have motivation for is to put effort into something that will make you feel better in a few years, or even tomorrow. But it's the only way out that I found.

Eventually I found a number of reasons that I really needed to stay alive. None of them on their own were enough, but I found that all of them together were enough on some days to get me out of bed or to put the knife down. That's not much motivation or hope, but it was a start. And I kept adding a little bit at a time. I reminded myself constantly, especially at my worst, that it's better to pull a splinter out than leave it in. I will feel better if I trust what I have already proven is true, even if I don't feel it right now. Especially if I don't feel it...

So, what is real hope? Something you know is true, even if you don't feel like believing it's true. There are people that would be better off for you being alive than dead. That is a grain of sand of hope for others that gives you something back. It's a start.

I made rules for myself, things I could say to myself, some multiple times a day. These things are all true, and I've proved them to myself time and time again, and I use them to overcome despair and overwhelming emotions that will wreck my day. Here's a few.

-Everything is ok right now. I am fine.

I say this when I feel like everything is going to fall apart today. But right now, in this moment, then next 30 seconds or whatever, it's ok and this is true every time I say it. I have a house, food, I have a wife and kids, I have work. Right now, in this moment everything is ok. It can get me out of the worst moments.

-I can do this one thing. (I don't have to face everything right now)

This is how I get myself out of bed and into the shower every day. (I say, "I can take a shower, I can handle this one thing") Even though I am no longer suicidal (a life altering thing) I still deal with massive waves of emotions that I must battle, but I win every battle one at a time. I remind myself that I like sitting under the warm shower and I will enjoy it when I am done. And I know it's better that my kids see a functional adult, and my co-workers don't have a smelly bum next to them. All of this are tiny things to look forward to in the future that help me do something right now.

-Don't make things worse.

I say this to convince myself not to make a destructive decision, because it will make tomorrow harder for me. Something as simple as drinking too much, or staying up too late with entertainment, anything that will make tomorrow harder is just going to allow despair to creep back in.

-I don't get to have this.

There are some things (as I have gotten older) I realize I just don't get to have, and I need to be ok with this. And often times that means, I don't get to feel happy right now. I can feel happy later. This helps me make better long term decisions.

-It's worth doing this.

I remind myself that every time I have done the right thing it has paid off. I know I will feel better at the end of the day if I get work done instead of collapsing into bed. Even if I feel horrible all day, I will be better off and grateful for making the decision later.

-I am scared of this so I have to do it.

Most of what stopped me from doing things that helped me vs things that hurt me was I was scared to do them. But the few times I was in a corner and had to do something scary, I was grateful I had made it through afterwards. So now if I can do something scary without my back in a corner, then I know I will be better off later. (something that can be scary is just talking to my wife about something personal, it doesn't have to be a big thing to be scary) I don't use this rule to make foolish decisions, I logically know I shouldn't do "everything" that I am scared of...

-There are people that need me today.

I have found that the most important element to turning things around was to do _more_ in my life not less. Less is staying in bed all day because I just can't move. And this has been a lot of days for me. I figured this was better than offing myself, and that is true. And when I put myself in a position where people needed, something that is really hard to do, it gave me motivation to keep going. It's frequently scary and unpleasant, but I have proved it works at helping me stay alive.

-I did poorly and things didn't go well. I am sorry and I will try and do better.

I found that if I openly acknowledge my failures to myself, that I can face them better. And if I admit them openly to others, I always (so far) have gotten support and understanding. This has been a life line when I have fallen apart and I simply couldn't do what I should have done. I say sorry to people and tell them what I will do to fix what I messed up. This is humbling but helps with my other rule "don't make things worse".

-Get something done, anything.

I found that if I can get myself to do _anything_ at all done, it will make nearly impossible tasks look a little more possible. This applies to work but also with my relationships. There are things I really want to turn around with my marriage, but right now I just can't. But I have made progress in the past, and I know that if I can get one thing better, it will be better for both of us. Success of any kind seems to be a lubricant for more success, and getting started is so hard and painful that sometimes all I can do is just one tiny, tiny thing. And I have to remember that that is really valuable, and that I should do it.

I imagine other people will make their own rules and find things in their life worth living for. You just can't give up and you have to actively look for something good.

This got really long, but maybe there is something here that will help someone else. Sorry if this didn't answer your question well.

Don’t talk to me about active theories based on an unreliable internet post.

Don’t talk to me about your theories on what constitutes “serious suicide planning” in the context of obviously absurd theories about apples garbage auto correct mechanism.

>There is support out there for people who truly want things >to change.

A lifetime of experience tells me otherwise. What is out there is insufficient. I don't need promises of a brighter future. I don't need cheerleading. I don't need vague ideas of what should be or what someone believes can be. I need practical realities now.

>Do you not at least want to find out if you could have made >a difference?

This is deeply offensive and makes me want to scream. I DID make a difference in the ways I could. I spent my life helping in my work and doing what I could in my personal life. I walked the talk of social issues. I was ethical and honest. That I am now needing help, needing rescue rather than being the rescuer. You don't ask a drowning person to hold up a sign as they go under to highlight the dangers of swimming in the ocean. That I don't have the bandwidth to add MORE work and stress to an already overwhelmed life does not diminish that. I did my part.

End of line.

Certain psychedelics like psilocybin are 5-HT2C agonists, which is responsible for the anxiety, dysphoria and nausea that some people experience when they consume it.

> Are 5-HT2A and 5-HT2C related to 5-HT2B at all?

You'd really need to look at in vivo binding profiles when it comes to serotonergic drugs. Some drugs are selective for other receptor subtypes compared to 5-HT2B, others aren't. Almost all antidepressants are tested for 5-HT2B affinity because of the association with heart disease and birth defects, and because of the lawsuits that resulted from them.