Suicidal Ideation and the Importance of Getting Dressed in the Morning
Editor’s Note / Content Warning: This essay includes explicit and graphic references to suicide, suicidal ideation, and suicidal depression.
THEN: I’m dressed. You’ll have to take my word for it. Dressing is an important transition from bed and bath, fraught with small choices; socks that match, that stay up, that don’t make my ankles swell and my feet turn red, now usually diabetic socks, though thank God I don’t have diabetes. This morning I am letting my Stage Four Flat Foots roam free.
NOW: Three years later, same dilemma but halved, only have one Stage Four Flat Foot left. On Monday I will be measured up for another brace on my right foot, looking for support that does not cause sores. I will be picking up another fake foot to go with my new prosthetic left leg, at the same time. The fake foot that came with my new leg is too short for me and my size 14 shoes.
THEN: Underpants that don’t ride up into the crack of my ass, and don’t let my innocuous junk fall out, harder now that my favourite brand has been discontinued.1 In winter, a t-shirt seems necessary and I have a bevy to choose from, including self-designed Correct in this Culture, Lucky Man, and Jimmy Bang Blues Project, and lots of comfy plain cotton XXL tees which may be all I need if I’m working at home.
NOW: I’m now wearing a vest, as the British call sleeveless undershirts (not wife-beaters). I now wear suspenders and realize the importance of sleeveless undershirts if you wear braces, as the British call suspenders. The t-shirt straps keep the suspenders off your skin.
THEN: Pants I try to keep very simple; never having more than two or three pair in rotation—currently in brown, tan and green—and then one of my two or three favourite shirts, if I’m going into 213 Notre Dame to work in my office number— 622—which I found out in a recent fire drill. Because I’m in a wheelchair at work, I get to stay in my office, door closed with a wet dish towel under it. So far, I haven’t had to rely on the strength of Winnipeg fireman to carry me down the six flights of stairs.
NOW: My waist size can vary widely. From the thin of a 40 waist to the thick of a 50 waist. I need suspenders for anything past 44, because pants tend to fall down, as I once experienced at the Co-op in Gimli. I have a number of pinched nerves and sciatica. Anything tight around my waist hurts while I wear it and causes havoc a long time after. So, big waisted pants, and suspenders.
THEN: I love my pajamas, and my two robes, but I’ve had to wear them often enough in the hospital—post-surgery—and in the depression at home.2 They often send incorrect signals to my hypothalamus, messing with my circadian rhythms, with messages of illness and physical decrepitude. I change back into pajamas to rest in bed, during the day, and it’s much harder to get dressed again the second time and so on.
I am of course avoiding the rather sensational first two words in the header, trying to lighten the mood with a rather tenuous relationship between getting dressed and staying alive. I have not done much research, but figure most people get dressed before they commit suicide, though I know of one notable case where a man got dressed completely with a parka to walk down to a frozen river. He completely undressed, folding his clothes neatly beside him, lay down on the river ice and snow, one very cold blustery winter day and froze to death.
NOW: I think of getting dressed sometimes to be the writer I see in myself.3 So, I top my baggy pants and suspenders with extra large, collared shirts, always 100% cotton, and most-often white and goddamn “non-wrinkle cottons.” They must be treated with crap that makes them as uncomfortable as any polyester I’ve worn, now banished from my closet.
THEN: The link of “to be or not be” to getting dressed may be specious. My argument hinges on the concept of choice, in an effort to ameliorate fears that thinking and talking about suicide are sure signs that you are a danger to yourself and should be committed or restrained in some way for your best interest. I admit that depressives may think about suicide more often than the rest of the population, but as long as we are talking about it, we are less likely to make an attempt. It is sometimes enough just to reassure yourself that if, finally, there is absolutely no way to end the physical pain, as a human being you can choose not to be.
I expressed my dismay on hearing of a suicide one morning to a writer outside Artspace and he replied, “Well, it was her choice.” I was horrified at his response only to learn later he had been diagnosed with terminal cancer and his choices to be were much more limited. My usual thinking had been that when you are really imperiled by (or “sick with”) depression, you are not in a rational state of mind, and so it’s the illness misguiding you, and you are not capable of making an informed decision. (I have a poem that I wrote at the time, below.)
NOW: In all of this, I begin to see no blame, no shame, no judgment as a positive refrain. While the choice for medical assistance in dying (M.A.I.D.) is only available to limited terminal cases with no other way to end suffering, in Canada it is a recognition that there are times of extreme pain and suffering and offers a choice that does not involve guns, plastic bags, stepping in front of buses or trains, or car exhausts. I’m terrified of falling, so jumping from a height can’t be on my list of alternatives. I can thank writing, surely, for my continuing to breathe. But also the willingness to ask for help and my access to public mental health services. Working with medication and psychotherapy, I have had four poetry collections published since 2005.
An Unfinished Romance
(listen to the poem, read by the author)
For M.D.
I no longer sleep with knives,
Caress the edges.
I no longer braid rope, slip
the knot.
I no longer leave the car running, smell
the exhaust.
I no longer horde a cache of meds, spill
the pills.
I no longer suck the gun-barrel, finger
the trigger.
I no longer walk railway bridges, kiss
the black river.
– from Lucky Man
THEN: I have not attempted suicide since two ridiculous and unreported calls for help in boarding school. My memory may be faulty, but I think I started thinking about not being as a child, “I wish I had never been born” having been a fairly common thought (and I don’t think that unusual, even in happy families). Or uttered as a threat, as in: “I’ll kill myself (or run away, a milder version), and then you’ll be sorry.” This thinking is a long way from the emotional terrorism this may represent in adulthood, as in: “don’t leave me, or I’ll kill myself.” This is a subject for another day.
THEN & NOW: Suicide and suicidal ideation are not the same things. Suicidal ideation may be an index, a symptom to watch or manage—at worst—usually but not always, connected to depression. The level of threat may need to be monitored like the threat of forest fire, but until someone actually starts making real plans, I suggest that thinking, talking, and writing about suicide actually makes it unlikely. Which is why crisis lines are so important, as are friends and family you can actually talk to about the subject calmly without scaring the bejeezus out of them. Even if you have people to talk to, I recommend writing things down. I’m a writer, after all.
Notes
- Product placement available in exchange for cotton XXL underpants.
- I’ve never been hospitalized for depression, and usually the relief surgery provides for whatever pain my bones dish out, and the total absolution from responsibility you have in a hospital bed, bring me a great deal of comfort and peace.
- It’s more “fake it ’til you make it,’ than the Duke of Delusion.
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About the Author
Victor Enns listens to music, reads and writes poetry in Kelowna British Columbia in Canada, having moved from Gimli Manitoba to marry Michelle Hewitt, a disability activist, with MS. He is about to receive his first powered wheelchair, needed because of the severity of his osteoarthritis, which will make it much easier to accompany her on rolls around the neighborhood, and the downtown book, record, coffee and bread stores. His collection, Love & Surgery, was published by Radiant Press in 2019, and “hi8spoems” have appeared in Rattle (2020) and Grain (2021). The pandemic prompted him to expand his practice by integrating his words and visions in video podcasts, collaborating with media artist Murray Toews. “The Abject Alphabet” is available on victorenns9.com and YouTube on the Earth Mutant Network.