Why do people with mental illness kill themselves when all they have to do is reach out for help?
As some of you may remember, I recently went off my mood stabilizing medication in order to get pregnant. At first it was fine. I felt pretty okay. But things soon started to deteriorate. I felt less and less okay. In fact, I was decidedly Not Okay At All. Finally, in fear and desperation, I sent my psychiatrist an email at 2 am explaining that I didn’t feel I would be able to wait until my appointment two weeks away and asking if he could do a phone appointment because I felt like I was in crisis. I actually used those words – in crisis. When he responded he said he was uncomfortable with a phone appointment but could move my appointment up a week.
I agreed to the new appointment date but it soon became obvious I needed to be seen sooner. I emailed my doctor back and said I would be willing to drive to his alternate office (he has a local office and a remote office) in order to see him sooner, that I didn’t think I could wait. I told him my mood and my thoughts had turned, and I quote, “strikingly dark.” He responded by telling me that he was out of state and that the following Friday was the soonest he would be available.
He did not agree to even a short phone conversation in order to assess my actual mental state to be sure I could handle waiting a week for help and he did not offer an alternate doctor for me to contact in his absence.
My doctor is not a bad doctor. This is not an instance of choosing what my insurance will cover or what I can afford out of pocket. I chose him because of his lengthy credentials. For example, he was the president of the Vermont chapter of the American Psychiatric Association. I like him very much. When we meet I feel understood and heard and like he will help me to be well.
And so if a good doctor can say, in essence, “I hear you saying you’re not fine but I think you are fine and I’ll see you in a week”, then what are the bad doctors doing? And if a doctor tells a patient “I don’t think you are in the state of mind right now that you are telling me you are in” what is that patient going to do the next time they feel in crisis? Knowing that their own doctor won’t take them seriously, even if the crisis is bigger and uglier the next time, are they going to still reach out? I can tell you that I likely will not and I am a bit of a loud mouth advocate for myself.
Don’t be alarmed by this story, my mood has shifted slightly, though I hardly feel well. I have a large system of support thanks to being a loud-mouthed sick person, and I’m far too much of a trumpet blower to silently contemplate suicide. I have kicked my self-care habits into overdrive with some small amount of apology and am prepared to hunker through whatever else may come until Friday.
Though I will say that my first though waking up this morning was, “It’s only Monday….”
Our system is broken. Our priorities are wrong. We would rather pick up the pieces than prevent a tragedy. Not just in issues of mental health either, but in everything. We’d rather treat than prevent. Tiny episodes like this is one reason why the news is filled with stories of mentally ill people who have killed themselves or others, or done other unthinkable things. Perhaps they did reach out. Perhaps they used their own strong words to try and get someone to hear them, to help them. Perhaps, unlike me, they weren’t able to wait a week.