“I know that you are not suicidal. But you are at risk for suicide. Let’s talk about how we manage that risk.”
I am at risk for suicide? No one has ever said that to me before.
Let me back up. I have been making the rounds for my annual doctor’s visits, and I’m enjoying all the accolades I’m getting. I’m not going to lie . . . I was motivated to schedule this year’s appointments simply so I could have the victory of announcing that I quit metformin and hit a healthy BMI. I feel like someone should give me a trophy. I expect celebration. We did our normal chitchat thing about life, and my physician looked at my vitals and commented that 2018 must have been a wonderful year.
It was. Oh, my goodness, 2018 was a wonderful year.
But in the interest of full disclosure, there was that whole PTSD relapse thing that happened in the spring. I told her about the onset – the anniversary of the shooting, Marshall County, Parkland. I described the symptoms: panic attacks, flashbacks, dissociative episodes, weight loss, nightmares. The fear, the isolation, the irritability and strained relationships. We talked about my lessons learned, my recovery process, my delicately balanced new life, and my safety net. I have told this story a lot – it is no secret. And I marveled to her (I do this a lot) that I didn’t understand how sick I was when I was going through it. But in retrospect, I was very sick. And now I feel lucky to be alive.
“Were you suicidal?” she asked.
“Not actively.” I explained. I’ve never been actively suicidal. But until about June of last year, I was almost always been passively suicidal. I always wished my brother had killed me. But I’ve never wanted to kill myself.
That’s when she said the thing. “I know that you are not suicidal. But you are at risk for suicide. Let’s talk about how we manage that risk.”
In the past four or five years, science has gotten a smarter about the long term effects of trauma. But I’m not sure that most people have made the connection between science and the actual people. When a mass shooting happens, there’s an awareness that people get shot or killed, and that those are life changing things. But there doesn’t seem to be much thinking about what life is like for the rest of us who witness these events - the ones who walk out of the school with our hands on our heads. To be quite honest, that is part of the reason I have started to be more vocal in the last year. Somebody’s got to say this stuff out loud!! This year, there were some high profile suicides of school shooting survivors, and there were a lot of “Where are they now?” discussions of Columbine survivors around their 20th anniversary. Suddenly people are a little more aware. Now, the idea that surviving a mass shooting would affect someone for the rest of his/her life should not be a shock to any thoughtful person, but somehow it is just starting to sink in.
For all of us. Because honestly, I’d never given any thought to the idea that my PTSD could relapse until it did. Somehow I thought that was just “the bad part of my life” that I’ve gotten past. It didn’t occur to me that the symptoms could come back! And I never thought about the fact that I am at risk for suicide until my doctor pointed it out. But that doesn’t mean it’s not true.
Here’s the real of it. My PTSD could kill me.
My doctor talked for a couple of minutes about PTSD and suicide risk. It’s a biological disorder, and people’s brains are damaged by extreme and/or prolonged stress. It’s not about self-control. It’s not about being strong. It’s not about being brave. It’s not about having coping skills. It’s not about caring about other people, or selfishness. It’s not even about proximity to the trauma. It’s about synapses and neurochemistry and genetics. I know these things intellectually – I have degrees in this! But for the first time it really sunk in: I have a disease and I cannot control it.
“Exactly. She said. You and I both know that you can’t control a chronic illness. But you can manage it. What is your plan to manage it?”
The truth is, I don’t know. I’ve been thinking about this since that visit, and I still don’t know.
Over the last two decades, I have had good days and bad days. I’ve had challenges, and setbacks. But I hadn’t had a full-on relapse of my PTSD until February 2018. It lasted about five months. During that period of time, I tried to ask for help. It felt like I was screaming in a crowded room, and no one heard me. If they did hear me, they did not take me seriously. If they took me seriously, they did not know what to do. And so I relapsed. I’m grateful for that experience, because it taught me that I do have a safety net. If I crash and burn, I have wonderful people in my life who will scrape me off the ground. More importantly, I know who they are. Based on the last year, I can make a list of 10 or 12 people in my life I would call if I started thinking about hurting myself. These are people who I know beyond a shadow of a doubt would show up for me. Because they did. (Not everybody can say that.)
But I also learned to distinguish between a safety net and a support system. A safety net will catch you when you fall, but a support system holds you up that you don’t crash and burn in the first place. I don’t have a great support system yet. I don’t have friends who check in on me when there are mass shootings in the news. I don’t have many people in my life who say “Hey. You’ve been a little sour lately. I want you to talk to me.” or “I haven’t heard from you in a while and wanted to make sure you’re okay.”
That is not to say I don’t have good friends. I have amazing people in my life. But they are busy, and I am busy, and they are not quite up in my business enough to yank me out behind that damn wall I build when I am afraid. And I don’t know how to reach out for support - I have carried so many of these things alone for so long . . . I don’t know how to ask for help, or how to gracefully receive it when it’s offered. I’m not good at being vulnerable. I do not like to share this stuff. It’s easier to pretend I’m okay.
But easy things are not always healthy things. I don’t want to relapse, and I don’t want to die. PTSD has taken a lot of lives, and I do not intend to be one of them. So I’m going to keep practicing. I’m going to keep reaching out. I’m going to keep trying to be vulnerable. If history is any indication, I’ll suck at it, and people around me will respond in all sorts of shockingly unhelpful ways. But I will get better at it over time, and my most special people will get better at it, too. And we will be healthier together.
I am very different than I was a year ago. I keep different company. I have different friends. I am more willing to share my limitations, and I am more open about who I am than I have ever been. I’m also more settled and hopeful than I’ve ever been. This Kelly Firesheets woman is a handful sometimes, but I like her. I like her life. I think I will keep it.