The following is a long form article on the topic of suicide and bipolar disorder by Julie A. Fast

 

I have a very different view of suicide. For many people it’s something shameful and scary. For me, it’s a side effect of an illness. I won’t mince words here. Bipolar disorder has a 10-20% death rate. People with bipolar disorder kill themselves because suicide is a part of the illness. I have had suicidal thoughts for all of my adult life. I have them because I have bipolar disorder. I don’t have them because something is wrong with my life.

If you have suicidal thoughts – you have them because you have an illness. There is nothing wrong with you.

You have an illness that has suicidal thoughts as a symptom. If you love someone with bipolar disorder who has suicidal thoughts, it’s important for you to know that this is completely normal behavior for someone with bipolar disorder. It’s a part of the illness.

I’ve learned to control these thoughts- and I stay alive. The first step in preventing suicide is to accept that suicidal thoughts are normal if you have bipolar disorder and they do NOT have to be acted on. They have to be seen as a sign that you’re sick and need to treat bipolar disorder first.  I have years of writings on this topic as I get suicidal so easily. I ready what I wrote from many years again and am amazed as always at how this illness never changes.

**** 2004 ****

I had a tough (very tough) time writing my last book. I was sick off and on for five months. The pressure of the deadlines was just too intense for my brain. It couldn’t handle the stress. I have managed this illness for many years with my Health Cards and I thought I knew my limits – but the book was simply too strong for me. I had to use the Cards constantly just to finish the book on time, but I did it. I created five new Health Cards to help me through the writing process and even though I was sick the whole time, I finished the book.

I had a two month hypomanic episode brought on by the anti-depressant I took because the book was making me depressed – and then had suicidal/psychotic depression off and on for a few more months. It was a terrible time! I’m telling you about this because it’s proof that suicidal thoughts are manufactured by a sick bipolar brain. They are not real. They are not a sign that I needed to kill myself. They are a sign that I took on too much. I triggered the suicidal thoughts by working too much. It’s totally normal that I was suicidal while writing the book. I’m almost 40 years old and have had suicidal thoughts all of my adult life- they are always triggered by something I do. They are simply a sign that I need to make changes in order to get back to stability.

I’ve taught myself not to be surprised by suicidal thoughts. They’re still terrible and scary- but they’re not unfamiliar. If you have suicidal thoughts, how long have you had them? If you’re like me, they show up when you do too much, don’t sleep enough, hang around the wrong people, drink and try to write a full length book in less than five months!

I’ve learned the language I use when I’m suicidal. I’m very familiar with what my thoughts say, how I feel and what my mind tells me to do. I have it all written down on the Health Cards so that I can read the cards and say to myself- oh yes, this is SO familiar. I have been here before. I don’t need to kill myself, I need to help myself get well.

Tips for Treating and Preventing Suicidal Thoughts

Know the difference between passive and active suicidal thoughts.

Passive suicidal thoughts sound like this:

• I wish I could/would die
• Things would be easier if I were dead
• I wish I would get hit by a bus
• I want to get cancer and die
• I’d rather be dead
• Life would be easier if I were dead
• You see yourself get killed or attacked – such as seeing yourself get hit by a car or attacked by a dog

Active suicidal thoughts sound and look like this:

• I’m going to get a gun and kill myself
• I’m going to take a bottle of pills
• I’m going to slash my wrists
• I’m going to kill myself
• I’m going to run my car into that pole
• I’m going to step in front of a train
• I’m going to jump off a bridge
• You set dates and times
• You create a whole plan in your head

As you can see, passive thoughts are a wish, active thoughts are an action. Naturally, active thoughts are much more serious and must be treated with medications immediately. Or, if you suspect that the medications caused the thoughts, you must talk with your doctor about a medication change immediately.

Don’t mess around with this.

Active thoughts are a sign that your brain is completely malfunctioning and has to get back on track. You will usually need professional, medical help to do this.

Passive thoughts are a sign that you need help as well- talk with your doctor about these passive thoughts. Check your medications- look at your lifestyle. Passive thoughts are often a sign that you’re stressed and something is triggering the thoughts. Active suicidal thoughts mean that you have crossed the line and need immediate help for bipolar disorder from a professional. Active thoughts do NOT mean your life needs to end. They simply mean that bipolar disorder is raging and you need help.

Friends and Family Members 

It’s very scary when someone you love is suicidal. The best tip I can give is that you see the suicidal thoughts and behaviors as something very clinical that needs to be treated professionally. It’s important that you don’t get caught up in what the person is saying. The Health Cards and both of my upcoming books Loving Someone with Bipolar Disorder and Take Charge of Bipolar Disorder  talk about what I call the Bipolar Conversation and how you can prevent it. This is the number one technique I teach people who want to help someone who is suicidal. No matter what a person says when they are sick, you have to stay focused on treating bipolar disorder first. It’s so important that friends and family members keep talking and asking questions. Letting things go because you don’t know what to say or how to help can end in the death of someone you love. You have to be a bulldog when it comes to getting help for a suicidal person.

Questions to gently ask someone you think is suicidal

• Are you suicidal? I have worries about this and want to talk with you about the topic openly.
• Have you thought about killing yourself? I am ok with hearing your real thoughts and am here to support you and get you the help you need.
• Do you have a plan? I ask this question because saying something out loud means that we can discuss suicidal thoughts openly as symptoms that you are sick and need help.
• Do you ever see yourself getting killed? I ask this because I have learned that some suicidal thoughts are confusing and don’t always involve a plan.
• Are you scared you will get killed? I can imagine it is hard to have suicidal thoughts, but I am learning from Julie that they are normal for people with bipolar disorder and we can talk about them openly so that you can get help.
• Are you scared you will kill yourself?  It must be scary to have an illness that changes your thinking. I am here to help and make sure that you are taken care of by a health care professional who knows what to do.
• What does it feel like when you’re suicidal?  I ask this to learn more about your experiences with bipolar disorder. You can also tell me what I can do to help you when the suicidal thoughts arrive.
• Have you talked to your doctor?  I have learned that suicidal thoughts are part of an illness. They are not personal and they can be treated as symptoms. I hear that you are suicidal and would like to help you talk with someone who knows what to do.
• When was your last suicidal thought?  I am here if you want to talk about your suicidal thoughts. I will learn more and can be a support for you.
• What can we do right now to get you help?  I am worried about your health. Suicidal thoughts simply mean that the bipolar is raging and we can get you help for bipolar disorder.

The answers will determine the action you take. It really can be up to you to get help for the person. You may feel embarrassed or impotent when someone is severely ill, but if you know for sure they’re suicidal and have thought of killing themselves, then it’s up to you to get them to the hospital. Period.

Silence is Dangerous 

Silence is NOT a good sign. Someone who has been very sick and showing it through crying and talking is NOT better if they suddenly stop crying and stop telling you what they are going through.  They are possibly much more ill and have just reached such a point of numbness that there is no more crying left and they just want it all to end. This numbness can be seen by others as the end of the crisis, but it’s not. It may be the beginning of something much more serious.

Keep going with your questions and attentions until the person who is ill gets help. This can save lives. You may be tired and worn out from the sick person, but if you don’t keep a constant vigil until you’re sure the suicidal thoughts are over, the person may commit suicide. Treat is as you would any serious illness. Suicidal thoughts arise from chemical changes in the brain. It’s no different than a person with diabetes having trouble with insulin.

If you’re suicidal right now, please read this: 

As I say in Bipolar Happens!  and all of my books- Suicidal thoughts are normal when you’re sick. They’re a symptom just as joint pain is a symptom of arthritis. They’re a sign that you need immediate help. They’re not a sign that your life is a mess and you’d be better off dead. Your sick brain wants you to think this, but it’s not true. Every single person who makes it through a suicidal episode will tell you the same thing – they were not thinking rationally when they were suicidal and they’re so glad they did not kill themselves. You can’t see this now because the illness won’t let you.

If you’re having any of the following thoughts then you need to talk with a doctor immediately and get some medical help for your malfunctioning brain:

• I wish I were dead.
• Things would be better if I were dead.
• Things will never get better and I’ll stay sick like this forever.
• I can’t live like this anymore. I want to die.
• I wish someone would kill me.
• I wish I would get hit by a car.
• I’m going to run my car into that pole.
• I want to end it all. This pain is too much. I’m going to take all of these pills.
• I wish I would get cancer and die.
• I wish I could go to sleep and never wake up.
• I don’t want to live any more.
• Bipolar disorder has taken too much for me and I can’t live with it anymore.
• No one loves me and no one will care if I’m dead anyway. Death is a solution to all of this pain.
• I truly would rather be dead than live like this.
• I will never find love, so why keep trying?
• My brain will not let me live my life.
• I can’t live with this illness anymore.
• I’m going to get a big hose and put it in the exhaust pipe of my car and put it through one of the windows and just go to sleep and never have to live with this pain again.
• I’m going to go get a gun and just end it finally.
• I’m going to stick my head in the oven.
• I’m going to get really sick so I can die.
• I want to be dead.

Have you had any of these thoughts or similar thoughts? You probably have – it’s normal if you have  – because you have bipolar disorder. My whole point is that if ALL of us with bipolar disorder have the same suicidal thoughts and if ALL of us get suicidal when we’re stressed and our meds aren’t working-  then it has to be a symptom of an illness and simply can’t be something personal.

Suicidal thoughts are manufactured by a malfunctioning brain in the same way that your brain makes you think everything is wonderful when you’re manic. 

Bipolar disorder is a very, very serious illness. I don’t think it’s taken seriously enough by the people who have it and by those who love us. We are expected to live a normal life in the normal world, but for many of us, this is basically impossible and suicide is often the result. There is a death rate to bipolar disorder, but it doesn’t have to be this way. We can prevent suicide by seeing it as a sign that we need help for bipolar disorder – we have to stop seeing suicidal thoughts as a sign that we need help for our lives – we don’t.

OUR LIVES ARE FINE – BIPOLAR DISORDER IS THE PROBLEM

The best way to prevent suicidal thoughts is to stop the triggers that cause the thoughts. Down swings that turn into suicidal downswings always start somewhere. Always. They do not come out of the blue. There is a trigger and there are small signs that the down swing is starting. The Health Cards help you see these symptoms before they go too far. If you don’t have a monitoring system like the Health Cards and these downswings are not treated from the beginning then suicidal thoughts can be the result.

I know this from experience. I’ve used the Health Cards for years to help myself stay stable and when I took the second book deal before my first book was even edited, the result was illness. The book was such a huge trigger that I was not physically capable of staying stable. I know what my triggers are. Over work- deadlines, going out too much, new people in my life, drinking, and staying up late.  I knew this but I went back to old behaviors anyway due to the stress of the book. I saw all of the signs that the book was making me sick and instead of sticking with my Health Cards plan, I went in the other direction. I looked for stress relief in the wrong places. I went back to old habits and a severe downswing was the result. I’m human and lost track for a while. I didn’t use the tips on the Health Cards for a few weeks and illness was a result. The Cards truly work, but only if I follow what they say. I am happy to say I am better now and am back on track. You can get back on track too.

Once I realized that I was simply going to stay sick until the book was done, I was fine. I used the Health Cards every day from that point on and made it through the project. I was still sick, but I was fine with it because I knew it was part of the illness. And one day when I walked out of my front door on the way to a coffee shop to write a chapter that was due and had the thought, “I wish someone would murder me,” I was able to laugh a bit and say- DAMN! This is one tough illness. I really have to be careful and take care of myself today.  Can you believe that I have found a way to laugh at my stupid suicidal thoughts? I never though this was possible, but knowing they are manufactured by an ill brain helps.

Prevention is the Key

Suicidal thoughts can be treated and prevented. It just takes a plan.

• Adjust your medications – trying to treat strong suicidal thoughts on your own through therapy and other holistic methods rarely works- you need medical help when the thoughts are strong.
• Look at your lifestyle- what stressors could be causing the thoughts?
• Look at the people in your life – is someone making you ill?
• What choices are you making that could be leading to these thoughts?
• Have you asked for help from the right people?
• Have you told a professional that you’re suicidal?
• Do you have a treatment plan like the Health Cards to help you stay stable?

The best treatment for suicidal thoughts is prevention.

If you have bipolar disorder and you have suicidal thoughts, you are normal! You don’t have emotional problems. Your life is not a mess. You’re not a failure and you don’t deserve to die. You simply need help for the symptom of an illness so that you can get back to living. Bipolar disorder is an illness. It’s not your life. It’s not who you are. You can get better. 

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 Bipolar Happens! and the Health Cards

Bipolar Happens! has more tips and goes into more detail than this article. The Health Cards are my foundation for treating bipolar first. I always think I have my cards memorized, but I don’t. The illness is too tricky and I always need to read my symptoms and ideas on how to get better when I’m sick. I simply can’t always remember what I need to do. If you have the Health Cards, you can write the ideas from this article in the second column ‘What I Can Do’ and then use the tips when you start to feel suicidal.

Bipolar Disorder is an illness.

Not your life.

You can get better.

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Hi everyone. It’s amazing too read something I wrote 13 years ago and see that it is still 100% applicable. I struggle with work. I struggle with my moods. I struggle with suicidal thoughts. It’s nothing new. I have bipolar.  I accept this and am ready for the world, even when I get suicidal.

Suicidal thoughts are part of an illness. They are not personal. We do not have to listen to them, but we do need to get help. I believe in you!

Julie