You publish something online about feeling suicidal, and you quickly realize the topic upsets people. After the last essay, posted both here and on my personal site (WillSpirit!) I received many kind emails and comments, which was sweet and gratifying. But I also heard some expressions of alarm.
Since suicidal depression has haunted my life since my mother died in a psychiatric hospital when I was six, it hardly shocks me. But the average person doesn’t share my lifelong relationship with oppressive sorrow and the insistent urge for relief, and so feels uncomfortable with the topic. On the other hand, the sentiments expressed in many of the responses show that some readers suffer with similar darkness.
Although I do feel a bit exposed after the last essay, it’s hard for me to feel shame about suicidal thoughts. Partly because they feel familiar, and partly because they seem predictable. Who wouldn’t feel suicidal after an upbringing like mine?
Who indeed? The Adverse Childhood Experience (ACE) Study demonstrated that the risk of suicide attempts is strongly linked with formative adversity. Compared to a person with an ACE Score of zero, a person with a score of seven or higher is 31 times more likely to attempt suicide as an adult. What this means, in practical terms, is that 35% of adults with very high ACE Scores have already attempted to end their own lives. Since my own score is at least seven, I see no reason to apologize for my despair.
(The ACE Score, by the way, is a rough instrument: it counts the number of categories of adversity without regard for severity or repetition of incidents, and certain kinds of trauma may be missed completely. For instance, loss of a parent to suicide or murder counts the same as loss to divorce, but few of us would view those situations as equivalent. Thus a low score doesn’t mean that childhood was easy or without damaging effects. There is also doubtless an interplay between individual susceptibility and trauma severity. This brings up the issue of “dandelion” versus “orchid” children, which is worth reading about–see David Dobbs’s 2009 article in The Atlantic.)
What about the 65% of adults with ACE scores in the seven-or-above range who haven’t (yet) attempted suicide? Are they all thriving? Stable and well-adjusted? Sadly, I doubt it. Take the example of my sister. She certainly had an adverse upbringing, but she never once mentioned feeling suicidal. She suffered from depression but seemed disinclined to actively take her life. And yet she died at age 58 of alcoholism. She killed herself without ever voicing a desire for self-elimination. In fact, even as death approached she insisted she would keep on living; she never faced the reality of declining health. Despite her life-affirming proclamations, she drank right up to the end.
Adversity in early years spurs a variety of coping mechanisms, most of which are unhealthy when continued over the long run. Substance abuse, suicidality, cutting, over-eating, sexual promiscuity, overwork, and many others can damage one’s body, one’s mind, and one’s relationships. But although they look isolating, life-denying, and/or nonsensical to uninformed observers, seen through the lens of intense emotional pain they make perfect sense. In a 2010 article, Vincent Felitti and colleagues explained that seemingly self destructive behaviors represent “unconsciously attempted solutions to problems dating back to the earliest years but hidden by time, by shame, by secrecy, and by social taboos against exploring certain areas of life experience.”
When I describe suicidal thoughts online, I’m attempting to serve both personal and collective purposes. First, I’m exploring my own life experience and working to resolve my difficulties. Second, I’m doing my tiny part to break down the social taboos that keep us trapped in an unhealed past. That’s what I tell myself anyway.
My goal isn’t to shock or alarm. It isn’t to garner support, either, though I do appreciate all the loving concern. Instead, I want to stare my demons down and understand how they operate, while challenging our culture to acknowledge both the prevalence of despair and the reality that mistreated children often grow into tormented adults. Rather than compounding low self-esteem by accusing those who came from difficult backgrounds of weakness, perhaps we should honor them for doing the best they can in a competitive society after an unsupportive upbringing.