***Trigger Warning: Suicide & Abuse***
I remember it like it was yesterday the first time I considered suicide since I was a small child.
It was a gloomy winter night during the first year of medical school. New city, new neighborhood, new house, new school, new friends, new life. I didn’t realize I was mentally drowning until I sat in our bathtub and thought about how easy and peaceful it would be to just drown.
My husband was out of the house at one of his medical school extracurriculars. I wondered what it would be like if he came home and saw that I had drowned. Would he miss me? Would my family? Would anyone care that I was gone?
This time my response was different than when I had previously considered suicide as a child; scared out of my mind hiding in my closet from my abusive parent. As a child I decided I couldn’t kill myself because I thought I would get in even worse trouble with my parent.
This time another thought processes saved my life. The knowledge that my husband would miss me. That at least some of my new medical school classmates would wonder where I am.
These thoughts motivated me to grab my phone and text a simple “help” to my husband.
Since then, I haven’t had another suicidal thought, even though my emotions have continued to overwhelm me during difficult academic or life challenges.
My imposter syndrome frequently tries to run my life, whispering in my ear that I’m not good enough to be in medical school. It says that it must have been a mistake that I was accepted. How could they have possibly chosen me over the thousands of other students who applied?
You are not alone if you ever had a thought like this. It is actually a pretty common experience to want to end it all when individuals are experiencing overwhelming stress or trauma in their lives. This thought is called the "call of the void" and is a trauma response which tells our brain that there is a possibility of ending the stress/pain. On one hand this can be helpful because it can open the mind to the possibility of pain ending, so one can then focus on new ways to overcome the struggle.
However, if you see your self thinking about suicide more often and actually coming up with a PLAN please call someone you trust and go to the nearest Emergency Room
You can also call to help you through that moment: 988 or go to https://suicidepreventionlifeline.org
When you speak with the Doctor in the Emergency Room here are some of the things we consider:
1. What are the unmodifiable risk factors (things we can not change) this person has to commit suicide?
- Trauma (past or current)
- Adverse Childhood Experiences (ACEs)
- Significant Racism, Sexism, or any hate regarding your sexuality, gender, or disability
- Recent Triggering Event (loss of job, relationship, or home)
- New or worsening medical illness or prognosis
- History of self injury (cutting, burning)
2. Are any of these risk factors modifiable?
- Feeling like one doesn't have a purpose
- Feeling like one doesn't have a future
- Current Strong emotions: anger, frustration, or hopelessness
- Having access to weapons and firearms
- Having no social support
Learn more at: Suicide Prevention Translating Evidence Practice
3.Are there Protective Factors that can prevent suicide completion:
- Having close relationships with others that you are willing to live for
- Having & regularly visiting with a Therapist, Mental Health Councilor, or Psychiatrist
- Having a religion or culture that looks down upon suicide completion
- Feeling like you have a purpose or a goal to complete
4. The Health Care Provider decides the "Risk Level" of Suicide Completion (death):
This helps dictates whether you are allowed to go home with additional support systems, or are to be admitted into an in-patient hospital to protect yourself.
It is important to note that you can have a CHOICE to VOLUNTARILY admit yourself to the hospital if you are worried you might hurt yourself or others. All you do is sign a paper in the Emergency Room that says you choose to be voluntarily admitted. If you choose to not sign in voluntarily and the team believes you are at risk by leaving the hospital the team may choose to admit you INVOLUNTARILY.
Watch Below video on insights after talking to military recruits struggling with suicide
***This Blog Post is for educational purposes only and is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. This does not imply a doctor-patient relationship. All opinions are the opinions of the writer and not reflective of any institution or employer. Please follow up with your health provider and therapist for any additional questions or support.***