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Making a Plan

Updated: Jun 21, 2023

Because my bipolar and OCD are so severe, I feel suicidal a lot of the time. My brain keeps telling me that it is time to give up and there is nothing more I can do. That I just can’t tolerate living. The tricky part is separating out whether it is my OCD talking, which means it is just obsessive thoughts that I can try to not listen to, or whether it is my depression (from the Bipolar) and I am seriously in trouble.

The reason this is important is that it is the deciding factor between whether I can keep going at home with increased supports, or whether I need to go back to the hospital where they can keep me safe. Fortunately, over the past sixteen years, my best friend Alice and I have gotten pretty good at knowing

The first thing she always asks me after we determine that I am suicidal is “do you have a plan”? If I don’t, if it’s just wishing I was dead, we can definitely work through it at home. I might need a change in my meds or I might need increased counseling appointments, but I am not in danger at this point

If I do have a plan, the next question is, could it cause trouble. Is it lethal. Some of my plans are irrational, or wouldn’t do enough damage to even make sense. Other plans, like slicing my throat open with my blender blade, well, that’s pretty serious. At this point, Alice tries to remind me how much it would impact my friends and family, especially my mom to find me all bloody and dead. Sometimes that works…but not often. Usually at this point I am beyond the point of no return.

The final question is, “Do you have intent?” In other words, are these just thoughts in your head, or are you really planning on killing yourself. This is hard, because when I’m really serious about it I want to lie so that she won’t save my life. Fortunately, we know each other so well, that she can tell when I’m lying.

Also, there’s always at least a small part of me that wants to live, just not be struggling so much, my brain is just playing tricks on me. When we get to this point, the hospital is the only option. We’ve tried having me live with my mom where she can watch my every move and keep me safe, but that’s not viable and truly just isn’t the level of care I need at that point.

Why don’t we just jump to the hospital first? Well, there are a lot of disadvantages to going to the hospital. First of all, it can be very traumatic. They take away all your rights, watch everything you do, and do not always treat you kindly.

Plus, it is a very difficult transition to go from being in the hospital where they do everything for you to back home where you have to cook, clean, do laundry, work, etc, which is even more difficult when you’re already feeling terrible.

Plus, it doesn’t fix the problem. It keeps you safe in the moment, which we will be eternally grateful for, but they frequently change all of your medicine, which is not great science, and who knows what side effects you’ll get.

So that’s how we decide. I wish I could say I would never be hospitalized again, but that’s not rational. My disease gets out of control and we don’t have a choice. But in the meantime, I am so grateful for Alice and all her hours of helping me make good choices. Today, I am glad to be alive.

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