One of the first and big questions with mental illness when being evaluated by any kind of professional is the sensitive subject of suicide. My experience with this subject is maybe a little different than some other people so I think it is a good idea to share how it has played into my journey through schizoaffective disorder.
When asked by psychiatrists or therapists if I have have ever been suicidal, I always had a difficult time processing and answering that question. I was never what I thought was suicidal in that I never thought up a plan but I feel an exhaustion sometimes that just leaves me wishing I didn't have to keep going or that I could go to sleep and not wake up. I also have kind of an out-of-body impulse about certain things. It is difficult to describe this aspect of my disorder as it really feels as though there is a separate being from myself that is controlling or commanding me when it comes to voices or certain actions. I have a battle in my mind where I am screaming in desperation and anger, "no, I don't want to do that, please stop, don't make me," at this "entity.". But it can be such an overwhelming force.
The way this has usually manifest for me is In having a certain preoccupation with a couple of impulses. First, whenever I get out of the shower and use a hairdryer, I have an impulse to turn the water on and stick the hairdryer in it. Second, whenever I walk past stairs or a ledge I have an impulse to step off the edge and can see myself rolling down and lying at the bottom. Third, when driving alone I have an impulse come over me to swerve into oncoming traffic or the median or wall. It is never something I have thought about beforehand but is a split second impulse and is as I said before, as if another entity is controlling me against my will. It is very frightening. In all of these situations I also experience a derealization along with it where I feel almost as if I am separate from myself and outside of my own body, watching, like a movie. I can see what would be the result. I have derealization or depersonalization quite often, not just in relation to this scenario. It feels sad to experience life this way.
Well, a year ago, I had a moment that truly rocked me, as it was closer to the edge than I have ever come. I was struggling with feeling alone and on a Saturday afternoon decided to take a walk by some ponds near where I live. It was a beautiful fall day and it felt wonderful to be outside but I still just had all this emotion built up inside of me that I had not really processed and it was starting to break me open. I stopped at a bench by the pond and suddenly felt a rage come over me. I picked a stick up off the ground, just twirling it in my fingers and then started peeling the bark off of it in tiny strips. Suddenly, without any conscious thought, I angrily snapped the stick in half, looked down and saw the sharp point, and then felt overcome with an impulse to jam it into my wrist. I had never thought about doing something like that, and I did not head out that day with that intention or thought either. It terrified me. I fell down onto the ground, sobbing. I fortunately had the wits about me to immediately call my husband and tell him that I almost hurt myself. I felt ashamed of myself for allowing it to get to that point. He asked where I was and told me he would tell them he needed to leave work and come to get me, but I said I could get home okay, I was okay, I had come to my senses. We started looking for a therapist for me right away and I was able to find someone with expertise in scizophrenia, for the first time. It ended up being shortlived due to schedules not working out.
It is nearly impossible to find good professional support for psychotic disorders. I feel like I have to educate them and they just don't get it. I feel like even the professionals have a bias and stigma against psychosis. I have been fortunate to have good psychiatrists but I have had a rather disappointing experience with therapists understanding and supporting me with my psychotic features.
For me, it really does come down to medication. Almost every time I have problems with episodes and symptoms, it is at least partially due to my failure to be consistent with my medication. That was true of the stick incident. There is a complete difference in my thinking when my medication is adjusted properly and when I get lazy. I can feel the difference. I can't even force myself to think in that way when I am balanced. This may be different from what others with different diagnoses may need to do to manage their situation best for their individual circumstances. I believe for me, my ideation is tied more to psychosis than to depression, which is a whole different animal. While I do deal with depression at times, scizoaffective disorder is complex and encompasses many other facets, in differing combinations at different times. This is just my own story.
Please let some other person know when you are struggling. This is real. This is not your fault. It won't be like this forever. It gets better than it feels right now.
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