What is and What is not a Choice in Depression

Robin Williams’s suicide has sparked many fascinating debates, from the need to break the stigma behind depression to just treating others with kindness. The debate I was surprised by and even a little cynical about was the debate regarding whether the act of suicide is a choice or not.

I feel for Robin’s family; they have lost a father, a husband and here are complete strangers arguing whether or not his suicide was a choice. I wish I didn’t have to take part but I have this compulsion to set people right, and I hope I can delicately put forward my argument and share some facts about my ongoing struggle with depression.

I’m grateful that people are being more open minded about depression but in doing so I think some people have confused the hopelessness in depression with a lack of willpower. I’ve actually been able to achieve many impossible feats while under severe mental illness or neurological disorder symptoms when exercising the muscle of willpower. I’ve managed to delay meltdowns, seizures and push myself through blood sugar crashes. I’ve stood up to crippling anxiety – although, I usually do fall victim to it – and I’ve avoided giving into impulses. My willpower has never been more needed than during intense and continuous suicidal thoughts.

A few years ago I discovered a book about cognitive behavioural therapy which is basically replacing negative and irrational thoughts with more positive ones. I took the information to heart and began to change the way I thought. Now it is a much needed defense in my fight against my mental illnesses. However, there are times when I’m more focused on the negative and am incapable of thinking more positive thoughts. The longer I’m in my depressed or anxious thoughts the more likely I will become aware that I need to utilize some CBT thoughts to help deal with my feelings. Now when I am starting to doubt myself or even when I am angry at someone and I think I hate them, I can backtrack and decide, no, I’m just angry at them.’ That is all CBT is.

I have felt some deeply intense suicidal thoughts since 2008 and even though I’m on anti-depressants they won’t go away. During the day I may be ok but when the medication wears off the thoughts seep through. The medication does nothing to control my mania and if I give completely into it and allow it to overtake me and make me spend impulsively and do all those other self-destructive habits one does in the middle of a manic episode then I will become deeply depressed again, and often suicidal. Even when I’m in a good mood I know that I have a suicidal plan. When into the middle of a depressive episode it just feels like the plan will go into effect any day now.

But time and time again I have decided to not go forward with that plan. This isn’t moderate depression, this is severe hate and loathing and misery and no one loves me and my life is hopeless and it’s just easier if…It’s serious stuff. But I go through the pain and I come out better on the other side. Sometimes after my mood lightens I’ll still be thinking mild to moderate suicidal thoughts, unless I blank those thoughts out of my mind.

So, how can suicide not be a choice when I’ve made the choice to keep living? Do you want to know what I’m still living for? Most times it’s so I can see and photograph a band. Seems silly but many times when I’ve seriously considered suicide I will then think ‘but I’ll never get to see so and so again.’ Other times it’s been my nephews. I’ve actually written out notes apologizing to them why I did it. Sometimes the physical pain is too much for me to go through. But there’s always been something else, a need to keep pushing on. I’m not in best situation. I’m unemployed and I’m unsure how much longer I’ll be eligible for the disability pension. Obviously, I need to stay on it but I’m not sure if my government will agree. I struggle with social skills and feel doubtful about getting into a romantic relationship which is what I focus on a lot when I’m depressed. And I’m living with family members and don’t know if I’ll ever be completely independent to live on my own. I’ve also got physical health problems as well as mental, and without my ADHD medication I feel stupid and that I can’t reach my potential. So, when I become severely depressed I’m focused on all those issues and I just feel it’s too much – and tell myself ‘I have a good reason to kill myself.’ Then I come down from depression and just keep going on with life.

Now I am in the ‘suicide is a choice’ camp but I feel there are certain moments in depression where one has less of a choice. There’s the extreme tiredness and lethargy, not to mention apathy you get where you can’t even get out of bed. You lose your appetite and so can barely eat. Positive thoughts become harder if not impossible to achieve. When you can eat it’s hard to make a big healthy meal for yourself so you stick with what takes the shortest time to prepare. Around people you give short terse replies and may even snap at them. And then when you feel overwhelmed you can’t stop the meltdown. You might have planned going out weeks ago with friends but now you just don’t care and can’t psyche yourself up to go or even want to go.

I’ve dragged myself out to live music gigs when depressed. On the bright side I wasn’t terribly anxious as usual, but was angry, impatient and was so absorbed in my own ruminating thoughts that I almost got hit by a car. I would look at the crowds of people especially those in groups and just be annoyed. I would drink alcohol and get even more depressed. I’d become paranoid and feel abandoned and yet I would still drink more. I may come out of it if my photos were turning out the way I was expecting, or I’d remain depressed and leave the gig early.

Even then I would have a choice to not drink, to distract myself and turn my thoughts to something more positive. It’s difficult but not impossible. I was actually at a gig where I chose the foolish decision to drink but it did cheer me up, but my friend stayed depressed, and so only one of us enjoyed ourselves.

The only time depression has seemed impossible to control was depression brought on by a hormone imbalance. I had one of the worst weeks with getting up every morning to make sure my cat didn’t defecate in the shower, and then I had to put up with people arguing while trying to fight my own chronic feelings of depression. I actually came very close to committing suicide because I just wanted it to stop. I have been through worst periods of depression though. Having to deal with a mood disorder and a hormone disorder is like a double threat though.

I deal with other symptoms that seem uncontrollable. I have bipolar mania which makes me terribly impulsive. During the last episode I spent too much money and gave into the mania too much so when I did crash into depression it was brutal, but it passed. I actually wasn’t sure when it would end. I even considered suicide too. It was strange to me because I was taking anti-depressants. This time I’m controlling my mania by not instantly giving into impulses, even something as simple as craving food. That’s where it all starts. I be very careful when deciding my next purchases. Yes, there have still been times where it feels my brain is into control of me but I’m still able to fight against this. When I do slip though I try not to be angry at myself. I tell myself, ‘Yes, you got a bit out of control there, said some things you’d probably regret, but just stop here before it gets any worse.’

I used to lose a lot of control of my emotions too but now I take my time to respond to someone or not before I lose them for life. I used to cut ties with friends to save them from my manic rants. I’ve got better control of my anger now, or rather, I can avoid exploding at them and keep those thoughts in my head, then the little CBT officer in my head will try to soothe the angry irrational side of me.

While I do think suicide is a choice it’s more a choice people make when they feel they have no other choice left. Right now I’m choosing to keep my depression at bay while slowly releasing my mania or hypomania and not letting it out all at once or letting it do whatever it wants, so I don’t crash so hard again. And even if I do crash hard again I probably won’t end up killing myself, even when it’s the only thing on my mind.

I think I understand where people are coming from though. Suicide is a very emotional topic especially if you have experienced it. What I’ve seen a lot of lately is people reading into the statement ‘suicide is a choice’ in their own way, and it probably brings up memories of people once telling them or others it’s a selfish act which then makes them think of what most of us think of when we say someone is selfish – narcissistic really – but the selfishness in suicide is far from that. It’s like saying an autistic person is selfish. I’m autistic and I sometimes feel like I’m selfish because I don’t consider peoples emotions at first. But that is the way I’m wired. I work hard to gain more empathy but even when deeply depressed and thinking of suicide that empathy is hard to reach. What I really think people do is focus on those words and only interpret them in the way they’ve always been told them.

So, I hope now people understand by what we mean when we say suicide is a choice. Just being factual really. I’m more of a logical person than an emotional one. Like a Vulcan really. You have to make an act to kill yourself, usually when you just want to end your pain, but it’s still involves making the decision to take those pills, hang that rope or cut with that knife. When deeply depressed my choice has always been: watch a comedy until you start feeling better.

On Being A Selfish Person

I’m a selfish person. I must be – people tell me I am all the time. “You’re so self-centered,” “you need to think about people more.” My own mother said that. I mean the person who raised me thinks I’m a selfish person. She thinks I have a choice in the matter.

Fact is sometimes I’m not even aware about how much I should think about a person. I try my hardest, often after I realise I’ve upset them or insulted them beyond all forgiveness. I’m an honest person and don’t agree that people should hold things in or lie just so we can all better get along. I try my best to not be rude and if I’m actually aware about what I’m thinking about saying could be misinterpreted I’d rather say nothing at all. I’d rather just ignore the whole damn situation.

Most people respond more emotionally to me. I react with heightened and unregulated moods, but I’m for the most part able to analyze my own emotions, re-direct my thinking and choose my words carefully so I don’t hurt people too much. Or I just ignore the situation.

If people still get hurt by my somewhat Vulcanesque response then it’s their problem. I went to a whole lot of effort to not just vent my frustrations at them and I can do no more. I’d like them to completely detach their emotions using kolinahr and come up with the most logical solution to this little dispute that’s only happening because people are letting their emotions get the better of them.

Another thing is that I can get so absorbed in what we in autistic community call a special interest that we can completely be blind to what is happening in the world outside of it. It becomes our whole world and completely takes over our personality. Not in the same way a personality disorder does. It just changes a few characteristics around, like for example I might be playing my Batman video game for hours a day for a week and my hometown might just start looking like Arkham City. Or all I’m capable talking about are Marvel comic books and will relate almost every subject no matter how disconnected it is to it. I’m not even making this up. My whole voice, dress and mannerisms can mimic that of one of my favourite sci-fi characters without any conscious effort on my part.

Those interests become the center of our world and everything else is in the background or puts up a barrier between us getting to spend time on them. They become less important.

If you think this makes me a selfish person then fine, think that. I’ve worked very hard to build my empathic skills and there are still a few gaps. I do eventually get a basic idea of what someone must have been feeling and I learn from that and I try my best to adjust my responses based on that understanding. That’s also called emotional intelligence.

Theory of mind is when a person has a basic idea of what people will be collectively thinking about. All humans follow a pattern of behaviour and I think learning this pattern made it easier for me to gain a better theory of mind. People without autism or social development issues will have this inherit ability from a young age and be able to pick up on the feelings of others more and more as they grow. I wonder if this is where the whole ‘you know what I mean’ statement comes from. Because I have never understood what a person meant when they said it. However, I could tell they got impatient with me if I said I didn’t so I just said yes. Then when my mother said it to me it was more like, ‘come on, YOU know WHAT I MEANNNN!!’

I apologise to my mother for keep using her in examples but I must tell the truth. The truth was I was a very confused child who never quite understood why people got angry with me, and I was mostly scared into changing my behaviour. I may have been responding to what she said with exaggerated emotions when any other child might have not even blinked at her disapproving tone of voice. Bringing this up may help other parents with autistic children properly respond to them. We can’t just be brought up the same way as non-autistic children and there was hardly any education for this twenty years ago. It’s now known that certain words always make us feel threatened; saying ‘no’ is like a slap in the face. You might have well said ‘no, you little retarded monkey. My God, are you so dense. As if I would have said yes. Now go chain yourself back in the attic, you’re an embarrassment to be called my spawn.”

That might have been a slight exaggeration but I just mean we can feel threatened by fairly innocuous responses. When I say ‘no’ myself I utter it under my breath as though it’s a forbidden cursed word to use. I anticipate a challenge and when someone just accepts it I return my sword to its sheath. I still look on like a guard dog lowly growling to give a warning to not come any closer.

Socialising is an agonising business for me. I can’t usually say much after the greeting and if I do it’s an impulsive jumble of the latest subjects that has excited me. I find it difficult to make eye contact and talk at the same time or even at all. It really depends on my mood. If I’m a lot more hyper than usual I’ll probably make too much eye contact and bounce up and down on my heels, and won’t be capable of zipping my lip. My thoughts are even more randomised and it becomes excruciatingly painful to allow pauses in between talking.

I’m usually fine to just chat to people about my interests, or the news, if I’m actually going out and doing something, or my cats, but when someone says something unexpected which my oppositional brain just pegs as a good opportunity to show that I’m an individual with my own opinions, I might end up in the middle of an argument and the other person either gets exasperated and gives up or launches an offensive of their own in which in this passionate moment I will refuse to back down. Sometimes I will be impossibly to convince, even if my opinion is completely ludicrous. And yes, it has been. Basically, when someone is manic they feel like they are in a higher state of enlightenment and everyone else is just too stupid to get it. They’re just being unreasonable and deliberately disagreeing with you, refusing to open their minds up to greater ideas that challenge our conventional ways of thinking, and the laws of physics sometimes. There’s a whole lot more to it but I won’t go into it, and yes, I do become manic. I possibly have been while writing this post.

I can live with the arguments, even though they throw me off what I was going to talk about because I must be prepared for everything. I don’t do well with change. Yes, even such a small change as someone bringing up a topic or responding in such a way I didn’t expect. How dare they!

The social drama is where I really get stuck. It’s when people are angry enough to stop talking to me or having lasting negative feelings toward me. I might have personally insulted them, at least in their mind or I may have just…pissed them off. The only way I know how to get out of it is to explain the situation rationally. “Oh you thought I…no, that’s not what I meant at all,” or “I was acting that way because…” It doesn’t have the desired effect which befuddles me because I’m putting out factual information, without any feelings involved. I think the correct way to do it is say something like ‘man, you’ve been so good at putting up with me. Wow, you are strong to just ignore me and then be a complete passive aggressive bastard. Yes I was wrong and you were right. I suppose if I want things to work out I should just grovel on hand and knee for your forgiveness and essentially lie and say that none of it was your fault and it was all down to me – you know, the one with a goddamned social communication delay. How could I just miss those cues. I mean, it’s not like I’m autistic, or anything.” Woops.

Some sarcasm may have been used in the above paragraph. Oh my God, I can actually do sarcasm! Does this mean I no longer have the autisms?

Sorry. I’m venting.

I’m basically saying that I don’t agree with many social conventions, especially the one where I have to continually stroke a person’s ego just so they like me. I’d rather just go through friendships in a trial and error way. As a child I had no interest to be social, I was pressured into wanting it because people thought it would make me happy. It’s made me see that people are bullies, not willing to listen to reason, you must always agree with them even if you are smarter and think they can control you. That’s not all from one person. I’ve had good times with friends too. Early in my social development my skills were so poor I didn’t want to be more than a drinking buddy with people. But now I operate from a strict ‘Kiss and Make Up’ policy i.e I want to be able to maturely discuss our disagreements and not just go back to pretending everything is normal between us. I grew up having none of that until I moved out and lived with my sister. We apologised to each other and explained why we got so mad in the first place. Now I won’t take anything less. And if people aren’t willing to talk through our problems then I’ll completely close myself to them by not discussing any personal matters. I’ve been hurt so many times before and I’m just not going to risk getting hurt again.

For now, I’m happy to be the lone wolf. My interests keep me occupied and my strong will helps me be a rational person even when deep down my emotions are screaming out to be heard. The whole ‘willpower’ thing I actually borrowed from The Green Lantern film and is not based on any peer reviewed science studies. It basically helps me deal with my emotional responses.

I like having friends. I like having a good time with them but I think for now I’ll just have what I call a superficial relationship with them. The drinking buddy is back. I don’t really want to know someone enough to discover how much they irritate me because almost everyone does.

I know I’m not being willfully selfish. I have autism which means I have a bit of a wonky theory of mind ability and don’t always empathise when I should, but I’m not incapable of it. I feel guilty when I realise when I should have been thinking about another person more and I keep trying to do better. But in order for friendships to work both people have to do their part to let the other know that they care about them at all. You’d think finding someone with the equal amount of mental health problems would make this an almost symbiotic relationship but as it turns out it’s like arguing with yourself. It’s like that evil voice in your head that tells you you’re no good that you try your best to ignore, but when it’s from another person you just feel like giving into it. You’re right, I am selfish. I’m horrible. I care only for myself. So, why do you even like me?

Is there any point for me to keep trying to make friends when I keep being reminded time and time again that I don’t always care about them? Seems pretty unfair to keep putting myself out there when I can’t reciprocate enough emotional understanding they require to actually feel loved.