Today’s post discusses the sensitive yet important topics of depression and suicide. I have received suicide letters here in the past both as emails and blog comments (never published of course), and my hope is that by sharing my own personal story, I might be able to help others who are struggling with these issues themselves.
While I was still living in San Francisco many years ago, my friend (who was also my landlord) was diagnosed with leukemia. Due to his age and his rapidly deteriorating condition, doctors advised against chemotherapy treatment, and recommended that he instead try to enjoy his final few weeks as much as possible. I was between jobs at the time, so I took advantage of the fact that I was home more than usual, and made a point of going upstairs each day to visit him. I intended my visits to not be too long, but they always turned into hours-long events. Day by day, my friend recounted his entire life to me, as I sat next to his bed. Eventually, he was transferred back to the hospital. I made it a point to visit at 6:00 am each morning so that he could wake up with the daily newspaper, just as he did at home.
One of his main concerns at the time was about who was going to take care of Oliver, a 14 year old service dog that he had just adopted himself less than a year earlier. (Oliver’s lifelong owner had recently passed away.) I knew that he was hoping that I would offer to take the dog; I also knew that he would not ask as much directly. For me, the hesitancy was a result of having adopted a puppy from a rescue shelter just a couple of weeks earlier. My one dog family (Lily, who I said goodbye to this past weekend) had just grown to a two dog family (Alva, now my oldest)…and now we were seriously considering jumping up to a three dog family! After some talk at home, we decided that we would indeed take care of Oliver. When I told my friend/landlord, he was delighted. One of his biggest unresolved problems had been fixed, and he could relax just a little bit more, all things considered.
I write all of this because five years ago today, Oliver passed away somewhat unexpectedly (although not too unexpectedly, since he was 16 years old.) I was as close to him as you might be to a senior dog that you’ve only known for a couple of years…maybe even a little moreso, when I took into consideration all of the traumatic losses this caregiving dog experienced during his final years. And while he wasn’t in my life too long, I was absolutely devastated by his loss. Which gets me to the topic of today’s post.
Five years ago I was extremely depressed, and the loss of Oliver didn’t seem to help any. Less than a month earlier, I had (finally!) been diagnosed with rheumatoid arthritis, after a multi-year trek from doctor to doctor in which I was trying to figure out what was wrong with me. (I still remember saying, on multiple occasions, that “nothing was supposed to hurt this much.”) A little about my struggle to figure out what was wrong: during my last doctor’s visit in San Franciso, I mentioned that I thought I might have arthritis. I was told that if I had arthritis, that there was nothing that they could do for me. To this day I’m still dumbfounded at having ever received such a response. Back to my period of diagnosis, though, five years ago. On top of the incredible pain, my knee muscles had almost completely atrophied. My physical therapist was encouraging me to walk at least 15 minutes a day…not too much, but something–anything–in the hopes of reactivating my legs. I was in my early 30’s and I had to learn how to walk again? I was definitely down.
And as my physical condition continued to spiral into what seemed like oblivion, so did my emotional state. The pain! Ah, the pain that to this day sometimes is too strong to even comprehend. During my early flares, I used to have visions of a poisonous snake biting me, over and over and over again. For me, the only solution to my problems seemed to be a head transplant. Silly, I know, but that’s what I actually used to think about for hours on end…how could I possibly exchange my current body for a healthy one. (Obviously this probably wasn’t the most healthy thing to be thinking of at the time, but back them it seemed to be my one and only out.)
As days turned into months, and months turned into years, I began to realize that I was not living in some science-fiction novel. This was my body, and I couldn’t change it for another one. (I still remember that afternoon when my physical therapist tried to talk a little sense into my by telling me as much.) Cue the continually repeating stages of acceptance and denial. Things didn’t seem to get better; instead, my life became even more challenging. Not only did the methotrexate not work, but its side-effects were too much for me to bear. (I was tethered to the toilet for six and a half days a week…and as soon as my stomach got better, it was time for the next dose!) My rheumatologist ignored my pleas to change medications. “Your dose is so low, you can’t possibly be having such a strong reaction.” I figured it was time to look for help beyond my medical doctor.
I found a psychiatrist. I wasn’t too happy with his services, but I decided I was going to just focus in on the part that was helping me, as my options were very limited. (In the country where I currently reside, ‘mental’ health continues to be behind the times, especially when compared to most other countries.) I gathered my strength. I made the decision to take myself off the methotrexate, which was immediately followed by another decision to look for new rheumatologist. But then a funny thing happened – I went into remission, for almost an entire year! It was more than I could have ever hoped for. It even allowed me to write off everything that happened during the past few years as just one big bad memory. (Again, looking back, this was probably not the best reaction I could have had.)
We all know what happened next, though. My rheumatoid arthritis returned. I was completely unprepared…both physically and emotionally. My downward spiral continued, and I was reaching lows that I never knew existed. The pain increased. The depression increased. It was all just too much to handle. And this is supposed to be for life??? I often thought to myself. This is when I started thinking about a new out: suicide. (I was shocked that I was even contemplating such a thing…but for a while, it was all I could think about.) I was scared to acknowledge to myself that such thoughts were entering my mind, and I didn’t know how to reach out for help.
My thoughts gradually started moving from the general (should I commit suicide?) to the specific (how should I commit suicide?) My medicine bottles started talking to me. Or so I thought, but by that point there was so little about my life that was clear to me. The constant pain was wearing down not only my body, but also my mind. The medicine bottles on my nightstand were telling me that they had the solution that I was looking for. All that I had to do was swallow their contents. All of their contents.
And this was when my internal alarm bells really started to sound. As much as this seemed like the perfect solution to my problems at the time, I knew that there had to be something else. There had to be some other way to fix what I was going through.
I asked my partner to please hide all of my medicines, and to only give me doses as I needed them. I spoke with my sister about the thoughts that were in my head (she is a psychologist). Little by little, I started to realize that I needed to turn my path around, and find a better solution. I needed to get all of the help that I needed. Even though the task seemed to lie somewhere between very daunting and practically impossible, I made this my new goal. I knew that I probably wasn’t going to get out of the hole anytime soon, but that I had to start making the effort to do so. I had to start moving in the right direction, one day at a time.
First on my list was building a new support team of trained physical and mental health professionals. I was going to establish a support team that was right just for me. I needed (and found) a rheumatologist who was just right for me. I needed (and found) a psychologist who was right just for me. I needed (and found) a physical therapist who was right just for me. In addition, I realized that I also to include some family members and friends, those who I knew would provide me just the support and understanding that I needed. I couldn’t do this alone; I had to ask for help.
And to make a long story short…well, readers of my blog know where I am at the moment. Even though my rheumatoid arthritis continues to progress, I have figured out not only how to accept its presence in my life, but I’ve also managed to reach new emotional highs on a regular basis. The journey from “then” to “now” wasn’t easy, and it definitely wasn’t quick. But it certainly was possible. It absolutely was achievable.
This change from depressed pessimism to realistic optimism could, and has become, my new reality.
During the past few years in which I’ve been blogging, I’ve often hinted at a lot of this, but I’ve never discussed it so openly. So much of this happened before I ever started blogging, which might lead some people to believe that I’ve always been as successful at coping with the pain and disability as I currently am. But I wanted to share this today, because I know there are many other people living with RA who find themselves in the same place where I was myself, just a few short years ago.
I know, I know. It can feel like things will never change. It can feel like things will never get better. But if you make the decision today to work towards new goals of acceptance and happiness, you will begin to see positive results in the coming days and weeks; results that will only continue to grow stronger in the coming months and years.
And as I continue to face challenges in the present, from my most recent (almost completely disabling) flare, to having to say goodbye to my dog Lily this past weekend, I am certainly not going to say that dealing with these challenges is easy…but I will say that approaching them from a position of emotional strength and stability does make a world of a difference. It is this confidence, this ability to learn what is and what is not in my control, that allows me to continue to move forward, more that I could have ever previously thought was possible.
If you are depressed or if you are contemplating suicide, please reach out for help. Speak with a friend. Speak with a family member. Speak with a suicide support line. Speak with a doctor. Speak with a therapist. Speak with a psychologist. Speak with someone online. Don’t feel ashamed, and please know that things can and do get better.
Most importantly, don’t lose hope. Don’t ever lose hope!
Stay tuned…for the next adventure of Rheumatoid Arthritis Guy!