Content warning: Suicide, self-harm

I tried to throw myself in front of a train on my 30th birthday. It was the 1 train at 28th St. in New York, just a couple blocks from GLAAD (Gay and Lesbian Alliance Against Defamation) where I was an assistant. That was two decades ago. I came close to attempting it twice more—once in 2014 and again in 2016. I planned it for weeks, edging closer as I waited for the train to work. Felt the calm.

On jump day, I’d back up when I felt the rumble, get a running start—then stop short. I spent an hour, two—time was gauzy—trying to get myself airborne. A chain kept pulling me up short, the kind that allows backyard dogs just so close to the fence. At the time I thought it was God. Maybe I was more afraid than I’d thought. Whatever.

It pissed me off. I felt like even more of a failure—I couldn’t even end myself right. I wanted to take every pill in my house, but I couldn’t do it. I was too afraid I’d end up profoundly disabled, but still here. So I punked out. That’s what I told myself. I’d landed in my own purgatory; I‘d found a way to end my pain, but lacked the confidence to follow through.

More research was needed to assure my success.

Reasons to jump in front of a NYC subway on your 30th birthday:

• Being ostracized by your family after coming out

• Self-loathing for not becoming the Someone you were expected to be, what your Ivy League/Fulbright path foretold

Reasons to nearly take every pill over a decade later:

• Living with still unaccepting parents as my 50th birthday careens towards me

• Realizing that, desperate to restore the family friendship I lost, I sabotaged my success just to stay in that house

Foundational reason for either method:

• Taken down by an undertow of shame

Stigma is a silencing bully. World Mental Health Awareness Week (October 7th – 13th) aims to lift the stain suicide casts. Kate Spade. Anthony Bourdain. These are public deaths that have focused collective attention on depression’s brutality. Finally. More of us are sharing experiences, confronting myths. Hopefully, we’ll be heard, felt, understood. I was hospitalized after my near attempts. I’m stabler than I’ve been in two years, even if I’m not quite happy. Yet.

Here’s What helped // And Other Things to Try with Your Depressed Person

When others understood that being suicidal didn’t mean I wanted to die.
Sounds completely illogical, I get you. I’d attempted. I must’ve wanted out. Nope. Not really. Humans have or need ways of pushing through. Our methods aren’t always healthy. Suicidal thoughts were how I coped. Most, maybe even every time, when those thoughts sparked on, I wanted many things that weren’t death: to be invisible and free; to make everything just stop; to swipe right and change a bunch of past decisions. I detested myself. Hauled around bone-deep sadness while drowning in that shame tsunami. The app I needed doesn’t exist. And the world doesn’t pause. But I could fantasize about leaving it. And that was relief.

Compassionate listeners.
There’ve been a number of kindly homo sapiens who, hearing that I was depressed, listed the sparkly fantastic reasons I shouldn’t be: my long life ahead, people who’d miss me. I’d feel dismissed from my own story. That’s what they thought I needed. They didn’t know the certainty of my heart: I was garbage deserving of suffering. This life awaiting me sounded like a sentence to years of kicks in the face. My brain kept a ledger of how I’d failed those same people who’d mourn my death. Being reminded that they’d miss me layered on guilty pressure.

Being suicidal didn’t mean I wanted to die.
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I never wanted to hurt my people. But they weren’t living in my skin, in my torture. I couldn’t live for them. The most valuable listeners were capable of hearing the whole truth—they wanted details about my suicidal thoughts. They didn’t try to fix me. Without engulfing me in their worry, they’d ask what problem I envisioned solving by dying. They knew talking about suicide wasn’t the action.

Talking meant I was alive. Being alive kept open the possibility of creating a plan to keep me safe. Understandably, this commitment to listening is difficult. If you’re that listener, know your limits. Care for yourself while keeping your person well.

Just be there.
After my last hospitalization in 2016, a crew of friends encircled me. Together, they coordinated my post-discharge safety net: exchanged emails, checked if I’d gotten out of bed, encouraged me to try to leave my apartment. There were daily texts that made me laugh. Their efforts seemed irrational to me; I felt unworthy. But the messages and invites were soothing. Honestly, at times what I needed most was to just not be alone, to have another person near while I journaled, watched tv.

Helping through tough moments.
Suicide can be a slow building impulse, a moment of breaking the final straw. Depression warps and lies. It pulls me into spiraling webs of self-hatred. I’d lose my keys then get angry at my stupidity. That’s why I’m an embarrassment and I haven’t done anything with my life and I’m a fuck up and won’t ever be anything more and I don’t deserve to live. Multiple times, daily.

My every action was a test of my earthly value. Having someone gently walk me through my thoughts— “Gail, how did losing keys become a reason to die?”—dislodged me. Afterwards, I saw the loss for what it was. Knowing you’ll guide them through life’s hiccups can change a lot for your person.

Hugs. Seriously. Lots.
My best friend would text during her work day, asking if I needed a hug. We’d meet-up and she’d deliver! She’d check in before returning to work. She’d tell me she loved me. Just having those 15 minutes in my future could get me moving on days I preferred to hibernate and let my brain spin.

The world doesn’t pause. But I could fantasize about leaving it. And that was relief.
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Therapy and meds.
Drugs are good. They can be. Meds at least helped me begin functioning. Leaving my bed became slightly less onerous. I could shower, get to therapy. Think about this: It’s someone’s job to just listen to you. Finding the right fit might take time, which can suck. But, once I did, I felt safer. My darkness found a sheltered place with her, even those deeper thoughts I kept from friends. Most importantly, I got diagnoses explaining the ways that my illness bamboozles my mind.

Placed in a DBT (Dialectical Behavioral Therapy) group, I learned tools to manage my condition.

Maybe try gathering therapy resources for your person. Don’t push. Let them take time. Let them talk about any resistance they might have. Again, listen. Explore what might make it easier. Also, consider who your person is and how to make therapy comfortable. As a blacktina lesbian, a gay-friendly therapist of color was non-negotiable for me. Sometimes therapists without this background were unintentionally offensive, didn’t grasp the weight of particular issues. Therapy became stressful. Reach out for suggestions in seeking appropriate care.

An empathetic family is the greatest support. Unfortunately, my family wasn’t. The willingness to educate yourself for a relative is tremendously loving. There are dozens of useful sites and organizations. But one of the best sources is your person.

Consider who your person is and how to make therapy comfortable. As a blacktina lesbian, a gay-friendly therapist of color was non-negotiable for me.
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Ask. Listen: what’s needed, what would feel good, what might be helpful.
Sometimes they may not know. Depression numbs me. Making decisions becomes exhausting. It’s ok if your person is in that place. Just let them know you’re there. Maybe help with daily tasks. Support doesn’t have to be huge.

What’s not helpful: being a dick.
Listicles of statements to avoid are at your Googling fingertips.I even found a moving podcast by survivors of suicide attempts and losses about providing support. For me, labeling the act as selfish is the most damaging. Picture saying that about a person with cancer. Bizarre, right? Depression is cancer—a beastly, soul-chomping tumor, requiring Justice League strength to survive.

Remission, cure or death are the only outcomes from either illness. Calling a suicidal person selfish heaves on even more guilt. Focuses on the emotions of others, rather than the sufferer. Hearing this, your person could isolate instead of reaching out. And that could be tragic.

Since 2016, I’ve completed programs involving daily therapy—group and individual—plus meds management. I’m calmer, sleep better, am regaining some appetite. I’ve learned a lot. Yet, I’m not cured. I’m not drinking iced lattes, paddling my golden canoe while bluebirds pay off my grad school loans. With my therapist’s help, I see my depression as a manageable illness, like diabetes. I still struggle, just not from a bear trap in a grimy cell.

Labeling suicide as selfish is the most damaging. Picture saying that about a person with cancer.
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Working out, doing things I’m good at, making decisions slowly—these help me manage. The suicidal thoughts still spark, but now they’re signals that self-care is needed. I know people who’ll treat me well, tenderly before I sink. Ultimately they offer kindness, empathy and compassion.

And I’m sure you’ve got that in you, too.

If you or someone you know is in a mental health crisis…

National Suicide Prevention Lifeline – Call 800-273-TALK (8255) to speak with a trained crisis counselor 24/7 who will listen empathetically and without judgment. Your call is confidential and free.

Crisis Text Line – Text NAMI to 741-741
Connect with a trained crisis counselor to receive free, 24/7 crisis support via text message.

By Nicole Schmidt

Content warning: suicidal ideation

My last relationship was riddled with problems — but for the year and a half we were together, I told myself that the bad times were overshadowed by the good days.

We met while I was studying overseas in New Zealand, and after I left to go back home, we decided we weren’t ready to let go of each other. In the beginning, while we were still on the same continent, everything was easy, and being together felt intuitive. He was older than me, but it didn’t seem to matter because we connected in a way I convinced myself could never be replicated with anyone else. I fell in love with his mind — he was well spoken, creative, kept me intrigued, and made me feel special.

For every good trait, however, I later learned there was a flaw that carried more weight. When he drank, which was often, he had two sides: He could be vindictive and derogatory towards me, or deeply displeased with his own life. I preferred the latter because I knew that the sadness would subside the next morning. The slurs he hurled at me, though, made themselves cozy in the back of my mind; “slut” was his go-to. He didn’t trust me around other men and constantly criticized my feelings by telling me I didn’t love him enough.

I made excuses for him by focusing on all of the times he said I was perfect, that I was the only person who made him happy. But this fixation, too, had a downside: I’d lost my ability to see just how emotionally abusive my relationship had become.

His history with chronic depression and anxiety was something we talked about often; he spent the entirety of his twenties drowning in it, unable to leave his room for days on end. He was a long way from being okay, but he assured me that things were better now. At first, I thought it was something I could handle. Still, there were times when he’d piece together his darkest thoughts and talk about leaving the world.

I’d lost my ability to see just how emotionally abusive my relationship had become.
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Tear-filled conversations about suicide often transitioned into him planning for a future he refused to think about without me in it. Those days were the hardest. They left me feeling scared and overwhelmed — like I’d taken on the sole responsibility of keeping my partner upright. His life was at a standstill before we met. He had three university degrees, but hadn’t held a steady job in years because he felt like he had nothing to work towards. Our prospective future was his first real plan, and that brought ambitions — like cutting back on drinking and finding a proper job — to the surface. He wanted to move in together after I finished my degree, maybe even get married.

But there’s an unsettling pressure that accompanies being someone’s main source of motivation and happiness. Good days became more frequent, but when he was having one of his bad days, I became what he depended on. His problems always took priority over the other things in my life, because if I wasn’t there, he made me feel guilty by telling me I didn’t care enough. It consumed most of my free time and all of my mental energy.

My instincts were screaming at me to move forward, to stop answering calls in the early hours of the morning, to refrain from constantly wondering whether he was okay. I neglected my emotions until the pressure to help him be okay — to be there whenever he needed me, to reassure him constantly of my love — finally made me see that the person who once made me feel so special had become the source of so much fear and sadness.

Still, I was scared to leave. I was afraid of what he might do if I did.

We had plans to see each other at the end of the year for the first time since I’d left, but as the date got closer I started to ask myself whether I could ever really be happy in the relationship. I knew that no one person could give him the true stability he needed, and finding any sense of balance between us seemed like an impossible task.

When I finally did leave him, I felt a sense of ease. I could breathe again. But all of those previous fears became real a few weeks later when I woke up to his name on my phone screen. When I saw his text, everything unraveled.

“It’s time to leave this behind once and for all…I’ll always love you but you did the wrong thing by me,” the message read. “All I ask is your forgiveness for what I’m about to do. It breaks my heart that I wasn’t good enough for you.”

Frantic calls and texts went unanswered. Minutes spent on hold with the police dragged on. My mind wandered. I questioned my decisions and my self-worth. I cried until my body was numb. When I finally willed myself out of bed for work, I couldn’t help but feel disconnected from everything around me. I spent the day trying to quiet my thoughts, which seemed impossible.

After 12 hours, it was the who police confirmed he was alive. They showed up on his doorstep and found him drunk and unharmed inside.

The episode was devastating and frightening — but also clarifying. Suicidal ideation is a very real issue rooted in mental illnesses too often stigmatized, and threats must always be taken seriously and handled with compassion. At the same time, the scenario forced me to understand the importance of boundaries in my life — and how toxic his dependency on me had always been.

Sue Johnson, clinical psychologist and founding director of the International Centre for Excellence in Emotionally Focused Therapy, told me that when partners delve into extremes, they’re often driven by insecurities and a need for control. It’s natural to rely on another person for comfort, support, and affection, she says, but there’s a very important difference between constructive and destructive dependency. “Relationships don’t work on a level of threat. Relationships work when you help people feel safe…You can’t demand someone love you.”

There’s a very important difference between constructive and destructive dependency.
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Some relationships can be consuming to the point where any real sense of perspective vanishes. Mary Andres, a professor of clinical psychology at the Rossier School of Education, described it to me as your brain going into crisis mode: When you’re busy reacting to the emotional demands in front of you, trying desperately to hold up another person, it’s easy to feel depleted. Eventually, you can reach a point where you stop using your frontal lobes, which are responsible for problem solving and judgement. Andres spoke about one woman she worked with who spoke about her own life as if she wasn’t the protagonist — her partner was front and center in every problem and every thought.

“When you’re involved with a toxic person and they’re telling you that you should be able to make them feel okay, that’s a fallacy,” Andres says. “If we listen to them, we’re letting them define our reality…It’s difficult to make decisions when you’re in that place.”

At the same time, when you have someone begging you to rescue them, to be their entire world and sense of stability, saying “no” feels morally wrong. And so walking away — the most important thing you can do in such a situation — also ironically becomes the hardest part.

But as Andres emphasizes, ending an emotionally abusive relationship isn’t selfish; it’s the best thing for both people involved. “You’re saving your own life and it might be a precursor to the other person getting the help they need. A person has to experience loss to get incentive to make a difference,” she says. “But it’s not easy.”

As for me, it’s been 10 months since I left my partner, and I still sometimes wonder whether he’s okay. But the difference is this: that thought no longer takes priority in my life, because I know that my happiness is important, too.

Leaving was difficult — but it helped me realize that staying with someone out of guilt and obligation isn’t love.

Twenty years ago on March 26, 39 bodies were found beneath purple shrouds inside a San Diego mansion. Members of Heaven’s Gate, taking a page from Derek Humphry’s 1992 how-to guide — Final Exit: The Practicalities of Self Deliverance and Assisted Suicide for the Dying — imbibed barbiturates and vodka with applesauce or pudding, tied plastic bags around their heads, lost consciousness, and were soon dead.

This marks the last cult-driven mass suicide in the United States up to the present day. In the 20 years before Heaven’s Gate, America’s new religious movements — like Jim Jones’ Peoples Temple in Jonestown and David Koresh’s Branch Davidians in Waco, Texas — had claimed more than 1,000 lives (over 900 alone just in Jonestown) either in suicide, governmental stand-offs, or a combination of both.

Meanwhile, some of the other religions that emerged around the same time, such as the Church of Scientology and the Family International (formerly the Children of God), continue to exist today with no such incidents — surfacing complicated questions about why certain new religious groups commit or incite large-scale acts of violence, while some don’t. (Certainly the majority of organized religions have a long and bloody history; killing in the name of god is one of humanity’s all-time favorite past times.)

What was it about the second half of the twentieth century that allowed for new religious movements to emerge, gain a following, and lead people to their deaths? Is the absence of such an event a testament to the evolution of our collective psyches, our law enforcement, or something else?

Why hasn’t such an event transpired in two decades?

The temporal proximity of the suicides at the Waco siege, Jonestown, and Heaven’s Gate (the details of which we’ll get to in a minute) makes it tempting to connect them on a psycho-socio-cultural level. But experts say they’ve found no correlation whatsoever — could their 20-year window be a coincidence?

“We kept looking for patterns,” Dr. J. Gordon Melton, distinguished professor of American religious history at Baylor University and author of Melton’s Encyclopedia of American Religions, told me. “But we couldn’t find any.”

The lack of a twenty-first century Waco — which had a death toll marked by suicide, but was primarily the result of violent governmental intervention — is, for Melton, due in part to a change in law enforcement tactics, as well as media coverage.

“There was a lot of pressure on the media to stop calling new religions ‘cults’ and treat them a little more even-handedly and not assume that any group that was ‘weird’ was also dangerous.”

Though familiar, the term “cult” is not terribly helpful as an analytic category, as it describes very different groups depending on who you’re talking to. In 2009, the Russian Ministry of Justice put out a list of totalitarian sects and extremist cults; Mormons made the cut. In Utah, however, 55% of the population is Mormon. This is some troubling math.

As Benjamin Zeller, an associate professor of religion at Lake Forest College and author of Heaven’s Gate: America’s UFO Religion, told me, “One man’s cult is another man’s mainstream religion.” “Cult” is a pejorative term that Zeller defines as: “Someone else’s religion that you don’t like.” Contemporary sociologists prefer to call these groups “emergent,” “alternative,” or “new religions.”

The term ‘cult’ is not terribly helpful as an analytic category, as it describes very different groups depending on who you’re talking to.

These terms are highly fluid, as religion remains a tricky thing to generalize and define. Heaven’s Gate, however, fits into any of these three categories with little resistance.

Formed in 1973, this was certainly a “new” or “emergent” religion. It had deep roots in Christianity, but with New Age twists that easily earned it the “alternative” title. These twists — such as the belief that the earth was a garden in which aliens planted souls — made outsiders consider its adherents eccentric if not “brainwashed” (another rhetorical nuisance for sociologists).

At the site of the suicides, there were plenty of bizarre details for the media to latch onto as well. Members believed they were going to evolve into aliens, and nine of the men had voluntarily been castrated in Mexico. They were all wearing uniforms — complete with black Nike sneakers — and they all had five dollars and a roll of quarters in their pockets. (Apparently this was an inside joke about always having bus fare.)

For Zeller, their peculiarities made them interesting, but not dismissible or mockable. “From the outside, it looks ridiculous,” he told me, but when examined more closely, it reveals our implicit bias toward more sanctioned, organized religions, and our intrinsic desire to Other these groups rather than understand them.

“It was never satisfying to me to just say they were ‘crazy’ or brainwashed. I think that it is too simple for us to assume that they are unlike us, and that they are ‘others,’ and we can just assume that they were irrational.

The vast majority of these people have basically what I would call everyday ordinary goals in their lives. They want to be happy, they want to feel like they are part of something which gives them meaning, they want to be able to put food on the table and have a place to sleep, they want to find success in a relationship, in love, they want to raise children, they want the same sort of boring stuff the rest of us want.

It’s just that the majority of them, they want it in such a way that none of the existing religions worked [for them]. The people who join new religions are looking for something they can’t find anywhere else, and they tend to want solutions which seem more extreme to the rest of us.”

Heaven’s Gate’s was founded by Bonnie Lu Nettles and Marshall Herff Applewhite, who called themselves “Ti” and “Do,” pronounced like the musical notes. They met in 1972 at the Houston hospital in which Nettles was a nurse. Applewhite was going through a divorce; he had recently been fired as a music teacher for having an affair with a student.

Nettles’ knowledge of mysticism attracted Applewhite, who, despite being raised Presbyterian (and briefly attending seminary school) was interested in other forms of spirituality; at their first meeting, Nettles read Applewhite’s astrological chart. They were the only two dedicated members until 1975, when they became involved with Clarence Klug — he was at the helm of a metaphysical group called “Self-Initiation” — and the L.A. metaphysical scene. After a couple dozen people left Klug’s group to join Nettles and Applewhite, momentum built. At their height a few years later, Heaven’s Gate had several hundred members.

Heaven’s Gate’s doctrine changed throughout the years, but adherents consistently preached asceticism, denying themselves anything that engaged too much with their humanness, such as having sex or eating for pleasure. Ultimately their goal was to enter the “Evolutionary Level Above Human,” a material ascendance into space and a metamorphosis from human flesh into a nongendered body that Applewhite described in a recruitment video as a “very attractive extraterrestrial.” This migration was necessary because, in one of their more confusing beliefs, the earth was going to be “recycled”; in other words, our planet was slated for a kind of watered-down Armageddon.

It is too simple for us to assume that they are unlike us, and that they are ‘others.’

Heaven’s Gate members originally believed a UFO would take them away. Later they predicted they’d ascend after being martyred. Applewhite and Nettles had long predicted they’d be killed for their beliefs and then come back to life, fulfilling the role of “the Two” in Revelation who are killed by a beast, rise three days later, and are taken up to heaven in a cloud.

Eventually all the remaining members chose to take their own lives. (Except for Nettles, who never got the chance, as she died of liver cancer in 1985.)

Applewhite harbored notions that he would be assassinated, most likely by the U.S. government, a fear which, in part, fueled his eventual suicide. His fears had precedence: The incident at Ruby Ridge in 1992 and the Waco siege the following year were evidence that clashes between alternative groups and the government could be deadly.

The Weaver family at Ruby Ridge in Idaho and the Branch Davidians — led by David Koresh in Waco, Texas — had both been illegally stockpiling weapons for the apocalypse. When the FBI intervened at Ruby Ridge, and Alcohol, Tobacco, and Firearms (ATF) agents intervened in Waco, long, violent standoffs ensued, resulting in 79 (including a dog) combined deaths.

Heaven’s Gate members however, were already determined to depart their human bodies come hell, high water, or the FBI.

“Members of Heaven’s Gate came to believe the government might come and kill them and that would solve their problem for them,” explains Zeller.

“When the government did not come to kill Heaven’s Gate members, only then did they begin to embrace suicide as an option because it was clear that this wasn’t going to be done to them. Eventually they came to decide they had to do it for themselves. So, paradoxically the Branch Davidians and Waco are part of the story, but it’s because it didn’t happen with Heaven’s Gate that they had to commit suicide.”

While Heaven’s Gate members had been gathering weapons for a makeshift arsenal themselves they decided in the end — reportedly at Humphry’s recommendation — to opt instead for death by apple sauce.

Troublingly, there doesn’t seem to be much of a common thread running through the violent ends of these alternative groups — besides their violence that is — which leaves us reasoning in circles.

Melton explained to me that after the Waco siege:

“Texas rangers were asked what they would have done if they had been in the same position that the ATFs were in, and they said, ‘We would have knocked on the door and arrested David Koresh and we would have taken him away and that’d be it. We would not have used the kind of force that the ATFs used.’

Then you have [Heaven’s Gate]. It peaked at 200 members…and then it just kept whittling down and you were left in the end with a group of people that were ready to commit suicide.”

Between the time Applewhite first approached the other members of Heaven’s Gate about collective suicide and the actual event, only a couple of members chose to leave.

The 1978 mass suicide by over 900 members of the Peoples Temple in Jonestown is, again, not easily compared to Heaven’s Gate, other than in the manner of their deaths — suicide by poison. But while members of Heaven’s Gate believed they were choosing life instead of death, Jim Jones told the members of the Peoples Temple that they were about to be attacked, presumably by the government, and that what they were doing was a “revolutionary act.”

There doesn’t seem to be much of a common thread running through the violent ends of these alternative groups — besides their violence.

Many of those who drank Jones’ grape-flavored cyanide, however, were children, which smacks more of murder than of suicide. All the members of Heaven’s Gate were adults; Applewhite didn’t think children could make decisions about entering the “Evolutionary Level Above Human.”

Heaven’s Gate also tended to attract members of the counterculture of the ‘60s and ‘70s who, according to Zeller:

“… ended up becoming religious or spiritual seekers; they start looking for other options. Most people who join new religions end up having experimented with other new religions or other alternative religious practices beforehand. Obviously there always has to be a group which is a person’s first group they join, but often people then leave that group and join another one.”

Meanwhile Jonestown mostly recruited from some of the most vulnerable populations, including the elderly Black community, women, children, and working class people. A comprehensive 2005 study — Demographics and the Black Religious Culture of Peoples Temple — by San Diego found that:

“African Americans had long supported the Temple with contributions, tithes and wages while living in California, but in Jonestown it was clear that the Social Security checks of black senior citizens made up the primary source of income for almost a year…”

While the human mind loves to compulsively organize and codify our experiences to make sense of our world — particularly violent acts under the auspices of religion — helpful patterns between these emergent religions have yet to materialize.

Instead, it can be far more fruitful to look at the similarities in which outsiders interacted with these groups.

“Cultists are people too,” Zeller summarized. Of course individual crimes — such as financial predation in the Church of Scientology and the rampant child abuse in the Branch Davidians and the Catholic Church — should be investigated and prosecuted, but demonizing some groups only strengthens the “us” and “them” dynamic, which is tenuous considering the subjectivity of the way we apply categories. “There’s no real way to define cult and exclude religion and vice versa,” Zeller explained.

Twenty years after the effective death of Heaven’s Gate, Zeller is still interested in getting inside the members’ minds. In the inescapable dichotomy of “us” and “them,” he explores, to the best of his ability, the latter:

“They made very different choices which look frightening and perhaps ridiculous to us, but we need to understand why they made those choices. We need to understand why they believed and acted the way they did. And then, if we choose to believe it was nonsense, so be it. I don’t think they were right; I have no interest in joining them. However, in my study of them, I’ve come to understand why for them it made sense, and I think that’s important when we look more broadly around the world at all sorts of groups.”

Those who can’t ‘pass’ as reasonably sane are given less agency, respect, and dignity as they navigate psychiatric care.

I ’m being buckled into a stretcher; restraints are being placed around my ankles when a nurse walks by.

“You don’t really have to use all the restraints,” she says to the EMT, gesturing to me with a wink. “He’s one of the good ones.”

Not like the screamer down the hall, who the nurses took up ignoring after a while. Not like the runner who tried to make a break for it past the security guard. Not like the kicker who had to be sedated after an IV mishap. Not like the cutter who tried to self-harm during the shift change.

When I was in the emergency room, I learned that if I was good, I got as many juice boxes as I wanted and Ativan — a benzodiazepine designed to help those with anxiety — every few hours. On the dot. The nurses would smile at me and bring me extra blankets; the doctors would comment on how “bright,” “articulate,” and “lucid” I was.

They liked me. They liked me because unlike the others, I was relatable, almost familiar — had we met under different circumstances, we might even be friends.

They liked me. They liked me because unlike the others, I was relatable.
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Once a doctor even said to me, baffled, “They aren’t sending you home?” When I shook my head, he asked, “How does someone like you end up in the emergency room, anyway?”

Someone like you.

The notion of “good ones” is a lesser-known reality about mental health, as it plays out in psychiatric settings. The good ones are compliant, friendly, “higher-functioning.” And then there are the really “crazy” ones.

The ones who are too loud, too unruly, too much.

Replace ‘Crazy’ With The Adjective You Actually Mean

I used to try so hard to be “good.” It was something I was quite adept at. It started when I was a teenager, so ashamed of my mental illness that I did everything I could to conceal it. The charade was so successful, no one believed me when I first said I was sick.

This is what happens when you’re a people-pleaser who believes your value rests in what everyone else thinks, and that belief collides with the stigma that says mentally ill people are inherently less valuable. If they are seen for what they “really are.”

I kept it up for years. I played the role well. Too well.

I’m in the emergency room for being deeply suicidal — prompting an intervention by loved ones — and a medical doctor now immediately wants to send me back home.

The attending nurse dotes on me like I’m her long lost nephew. She offers me a special lasagna dish they don’t usually serve, she says, because she remembers that I’m vegetarian and the usual veggie option is terrible. The screamer down the hall is sobbing, “HELP, HELP, OH GOD, PLEASE HELP,” but the nurse realizes she’s forgotten my juice box, and she dashes off quickly to get it.

As if it’s the most important thing in the world. As if the only people that matter are the “good ones.”

That moment will stand out in my mind forever. It was the moment when I realized that as long as we divide mentally ill people up into “good” and “bad” — or with coded language like “high-functioning” and “low-functioning” — we replicate the oppressive hierarchies that harm all of us.

The internalized stigma that compelled me to “perform” sanity was the same stigma that can lead to neglect and abuse in psychiatric settings, and further marginalize the most vulnerable mentally ill people.

Maybe that nurse had a reason for getting the juice box instead of going two rooms down to check on the person who was screaming for help. I can never really know.

But what I do know is that these hierarchies exist — illustrated in many interactions just like that one — and my participation in that hierarchy, both to my own benefit and detriment, has very real consequences.

The internalized stigma that compelled me to 'perform' sanity was the same stigma that can lead to neglect and abuse in psychiatric settings, and further marginalize the most vulnerable mentally ill people.
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Trying to be “good” may have gotten me more blankets or special lasagna, but it says something sinister about how the stigma around mental illness operates.

Here’s what I’ve learned — and why I believe we need a more nuanced conversation about privilege and power as it shows up in mentally ill folks.

I Have (Some) Privilege Because I’m Positioned As The “Exception”

I struggle with severe mental illness and that, of course, comes with significant marginalization and strife. But because I’m so often perceived as friendly and functional, and therefore a kind of “exceptional” mentally ill person, I still benefit at the expense of other mentally ill people.

Namely, because I’m positioned as not “like them,” I am often treated better as they are simultaneously othered.

We see this kind of ableism most distinctly when we categorically divide up disabled people into “higher” and “lower” functioning — which can be a coded way of saying, “These are the people that can conform to society’s expectations of what a ‘typical’ person should be, and these are the people who fail to do that.”

I directly benefit from the ableist assumption that I am “exceptional” because I often present in the narrow way society holds up as the ideal — an ideal that expects psychiatrically disabled people to conceal their disabilities.

I directly benefit from the ableist assumption that I am ‘exceptional.’
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It seems to me that we want mentally ill people to not only be passive, but invisible for the comfort of neurotypical people, and especially for the ease of clinicians.

As long as I’m considered relatable, compliant, and friendly, I can expect to be treated with a lot more dignity than my other mentally ill counterparts. Kind of like the Zooey Deschanel of mental illness, where mental illness makes me brilliant and quirky — not a burden or someone to be feared or mistrusted.

And let’s be real — my success as a mentally ill writer rests heavily on the perception that I am just the “right” amount of “crazy.” The kind that inspires, the kind that allows me to give a TED Talk to a packed audience; not the kind that terrifies you while you’re on the metro because I’m talking to myself.

(But for the record? I, like most mentally ill people, have had moments of both.)

I have to acknowledge that while I do experience oppression as a mentally ill person, I am treated with more compassion, have access to more resources, and have the trust and faith of my clinicians because I can “pass” as reasonably sane in most situations.

As long as I’m considered relatable, compliant, and friendly, I can expect to be treated with a lot more dignity than my other mentally ill counterparts.
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On the other side of the coin, the people who can’t live up to this ideal are perceived as “difficult” — often written off, misdiagnosed, or pushed off onto other clinicians — and are given less agency, respect, and dignity as they navigate psychiatric care.

Respectability politics are a real thing. And mentally ill folks are by no means immune to it.

Being Seen As ‘High-Functioning’ Can Still Be Harmful In Its Own Way

It took a long time for me to realize that being “respectable” as mentally ill hasn’t always served me.

It’s the reason that folks have reacted with disbelief when I say that my mental illnesses are severely debilitating. It’s the reason that doctors disagree about whether or not I’m dysfunctional or suicidal “enough” to be hospitalized. It’s the reason that I don’t always receive the support or care that I need, because I’m assumed to be better off than I actually am.

The first psychiatrist I ever saw said she was reluctant to prescribe any medications to me because I had good grades in school. Her words exactly: “What do you even need me for?”

We Need A Review Site For Psychiatric Hospitals — So I Built One

As a rule, before we get into the nitty-gritty of what I’ve been through, many clinicians are disarmed by my presence — some even questioning why I’m there in the first place, because I don’t “look” mentally ill.

On the whole, my treatment is a lot more competent and compassionate because I present in a way that’s more “approachable” and less “difficult,” but that doesn’t mean that I’m not presented with my own challenges.

The difference is that those challenges are still a result of stigma — namely, that mentally ill people must be dysfunctional, difficult, and unrelatable. My erasure is intrinsically bound up with the kind of ableism that ensures that “lower functioning” mentally ill folks don’t get the support that they need.

This kind of erasure ensures that I struggle to be seen as a patient, whereas other mentally ill folks struggle to be seen as human.

In other words, no one is really winning.

Being ‘Difficult’ Intersects With Other Axes Of Oppression

When we talk about who “looks” mentally ill, who presents as or is expected to be functional, who is “trustworthy,” and who is “difficult,” we can’t really ignore the fact that all of this language is situated in such a way that it plays into existing biases around race, class, gender, education, and more.

This looks like the ease with which clinicians disproportionately diagnose people of color — especially black people — with psychotic disorders, yet major depressive disorder largely goes unnoticed in these same populations due to the cultural incompetence of their clinicians.

This is why we see “difficult” women being misdiagnosed as borderline or histrionic. This is why poor folks and folks of color disproportionately wind up in prison, while white folks with class privilege (like myself) wind up in hospitals.

Who gets to be “good” and “relatable” — and conversely, who is deemed “difficult,” “crazy,” or “bad” — becomes very apparent when you take a look at who holds the most privilege and power in society.

Mental illness can and often is weaponized against the most marginalized among us, and undeniably impacts the kind of care we receive.

When I walk into an appointment with a clinician, I’m not considered “threatening” — that ER nurse can treat me like her queer little nephew because she could easily imagine that I was. It wasn’t just about how I behaved, but how I was perceived.

And when you are a college-educated, transmasculine white person, you are given the benefit of all different axes of privilege, in which people are conditioned to believe in your inherent goodness, empathy, safety, and intelligence.

Who gets to be ‘good’ and ‘relatable’ — and conversely, who is deemed ‘difficult,’ ‘crazy,’ or ‘bad’— becomes very apparent when you take a look at who holds the most privilege and power in society.
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When I was placed in the ambulance the first time I was committed, the EMT told me he’d unhook my restraints — just seconds after putting me in the ambulance — because “I probably wouldn’t punch him.”

In a single loaded statement, I was acutely aware of the fact that my perceived “safety” had everything to do with his immediate impression of me — and nothing to do with how mentally ill or unsafe I might actually be.

Much of mental health care has to do with quick assessments and judgment calls. But who gets the benefit of the doubt — and how patients are ultimately categorized, diagnosed, and cared for — can be deeply impacted by existing prejudice.

And because of that, my experiences as a mentally ill person will always be shaped by the hierarchies that exist both within this community, as well as the ones systematically designed and enforced outside of it.

I’m seen as “one of the good ones.” But that’s due, in large part, to the privileges I already have.

My experiences as a mentally ill person will always be shaped by hierarchies.
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So no, I no longer revel in being seen as the “exception” — sipping on a juice box, propped up by an extra pillow — looking for the approval of my clinicians and nurses.

I don’t delight in being anybody’s “favorite patient,” as flattering as that might seem.

I recognize my perceived “goodness” for what it actually is: Undeniably harmful, bound up in somebody else’s oppression.

By Emma Phipps

Content warning: suicidal ideation

It’s like clockwork. Every year, right in the middle of October, I find myself stricken with panic and exhaustion that has nothing to do with my job or my personal life and everything to do with one simple environmental factor. The sun is going down, and all it takes to make my stomach drop is one glance out the window to see the sky growing dark by 6:30 p.m. The feeling is primal and consuming, and it’s at the root of my seasonal affective disorder (SAD).

Once classified as its own diagnosis, SAD is now categorized as a variety of major depression that manifests in a seasonal pattern. For most, SAD occurs in the winter months, as the weather becomes colder and the days grow shorter, but some experience seasonal depression during spring and summer. The symptoms of SAD often mimic major depression, including feelings of sadness and hopelessness, increased anxiety, disrupted sleep patterns, loss of energy and motivation, changes in eating habits, and even thoughts of death.

I first noticed my SAD symptoms in my freshman year of high school when I joined the swim team. Our daily practices took place in a windowless basement pool after school, so by the time we emerged to be collected by our parents, the sky was already dark. I woke up before dawn to catch the school bus, spent the whole day inside classrooms, and missed the rest of the afternoon light during those swim practices. Soon, I started to feel almost as though it were dark all the time, and my mood darkened because of it.

Some experience seasonal depression during spring and summer.
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It wasn’t until college that I finally articulated exactly what it is that sends my brain into an anxious, depressive spiral from mid-October until April or May. As the sun rises later and sets earlier, and the nights slowly but surely consume the days, I feel in a very literal way as though darkness is surrounding me on all sides. It’s an existential claustrophobia. No matter where I turn, no matter how I try to adjust my schedule, night is there, waiting to swallow me whole.

Every symptom I experience is a byproduct of that simple fact. I panic when I realize it’s already dark and I haven’t eaten dinner yet, like I’m being chased by a force far outside my control that’s stealing daylight from me. As soon as the sun goes down, I start to lose my ability to keep track of time, thinking it to be 10:30 p.m. when it’s actually 7:45 p.m. Late evening usually finds me scurrying around my apartment anxiously trying to finish everything before bedtime, even though bedtime is still hours away.

My sleep schedule suffers from there — either I want to go to bed far too early, or the confusion causes me to stay up far too late. The lethargy and exhaustion always lead me to sleep in, sometimes passing out for as long as 14 hours, which only makes it harder to fall asleep the next night. The longer the cycle persists, the more lopsided my schedule becomes, making me sleep through the morning and miss more of that precious daylight.

Lots of intersecting factors increased my likelihood of suffering from SAD. According to the National Institute for Mental Health, seasonal depression is four times more likely to occur in women, and younger adults are at higher risk as well. My family has a long history of mental health issues, especially depression. All of those factors combined put people like me at much higher risk.

When I bring it up among my friends, there seems to be a general misconception that my altered mood comes from the cold weather or the impending holidays. Though those factors can exacerbate symptoms of SAD for some, they’ve never been my primary complaints. I don’t find biting cold any more uncomfortable than scorching heat, and the holidays have always been a bright spot in those darker months. For me, it all comes down to light — or lack thereof.

And according to most scientists, lack of sunlight is at the root of all seasonal depression. One study, published in the medical journal The Lancet in 2002, found that the brain produced less serotonin, the neurotransmitter thought to be responsible for our happiness and sense of wellbeing, in winter than in seasons when sunlight lasts longer. Other studies suggest that it’s an imbalance in melatonin, not serotonin, that causes seasonal depression. Either way, the resulting symptoms are somewhat similar, since melatonin is the chemical responsible for regulating circadian rhythms, and its disruption in winter months could account for SAD sufferers’ feelings of lethargy and near-constant exhaustion.

The anxiety caused by the encroaching darkness is, for me, always accompanied by those feelings of lethargy and exhaustion. I lose all my motivation and have to force myself to socialize. Going to the gym or walking to the grocery store seem like herculean tasks. It just seems easier to stay in bed, eating take-out and rewatching Parks and Recreation for the tenth time. Unfortunately, all of those things just end up contributing to the depression and the anxiety until I gradually slip into a state of mind that’s frightening and far less likely to happen to me at other times of year.

Suicidal thoughts and ideation aren’t uncommon for SAD sufferers, and when I first started getting them in high school, they terrified me. I would be at the top of a flight of stairs, and the thought would come unbidden into my head that it would be a good idea to hurl myself downwards. As time went on, the ideation evolved and got more creative — ”Go sit in the snow and wait for death to take you! Lie down in the street and let traffic do its thing!” — and it took me a while to realize that it always started rearing its ugly head at around the same time each year.

According to most scientists, lack of sunlight is at the root of all seasonal depression.
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The suicidal ideation certainly doesn’t alleviate the feeling of being relentlessly pursued by a dark force, but as I’ve learned to live with my illness, I’ve become better at remembering that it’s a result of faulty brain chemistry. Any time the ideas pop into my head, I remind myself that I definitely want to live. But I wasn’t always so good at dealing with it, and there were times when I thought I might somehow be irreparably broken inside.

Maybe I would have been able to figure out what was going on with me a little sooner if SAD was better understood and treated as less of a superficial problem. Many people I’ve talked to think it all comes down to physical discomfort. Few know about the chemical shifts that occur in our brains when we’re exposed to less daylight. The acronym, too, is, admittedly, a little problematic — I have SAD, but that doesn’t mean I’m just sad. The cocktail of emotions and mood states that come with SAD are complicated, and they differ from person to person.

Too many people suffer for years the way I did, ignorant to what’s happening in their brains and believing that they have to get through it alone, chalking it up to a case of “winter doldrums.” But once you understand, things start to get better.

As with all mental illnesses, the more we talk about seasonal depression, the more people will understand and accept it. It’s treatable in a number of ways, including light therapy, medication, vitamin supplements, and talk therapy. For me, talking to a therapist has made the biggest difference. And though light therapy and medication are too expensive for me, my therapist suggested some more cost-effective solutions, like sticking to a steady sleep schedule and regular exercise, both of which have helped a lot.

The one good thing to come out of my seasonal depression has been my profound love of spring. It goes beyond the stereotypical appreciation of blooming flowers and warmer weather. It almost reaches back to ancient religious celebrations of rebirth; I’m finally alive again, having escaped a seemingly inescapable darkness, turning my face upwards to soak up the sun.

I grew up against the sprawling backdrop of the cornfields, in a college town 75 miles west of Chicago. Despite my physical disability, my father made sure that I had a normal childhood — the kind that feels like the perfect home movie when you look back years later as an adult. We chased lightning bugs in the summer and sledded down snow hills in the winter.

Life was simple.

And then my father was diagnosed with sinus cancer and died by suicide about a month after finishing treatment. After that, things weren’t so simple anymore.

People talk about all the things that happened before the suicide . . . what led to it, the warning signs, etc. But what about what happens after? The devastation. The people who are left behind to reassemble the shattered pieces of a life they thought they knew. A life they know, down to the very core of their being, will never be the same. Ever again.

How are we supposed to cope? How can survivors even begin to make sense of all the pain and confusion? That gnawing, sinking feeling in your heart? It just won’t go away. Where’s the instruction manual for navigating this dark, unfriendly terrain?

My father’s death wasn’t pretty. His death was ugly, the kind of ugly that makes you just want to run away. It’s the kind of ugly so dark and unimaginable, you never see it coming. The kind that can make you feel like you’ll be lost forever in a sea of grief. It renders you powerless as its tide pulls you out farther and farther, and you begin to wonder if you’ll ever make it back alive.

How are we supposed to cope? How can survivors even begin to make sense of all the pain and confusion? That gnawing, sinking feeling in your heart?
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There were no final days spent sitting by his bedside, where we all were able to say everything we wanted to say to each other. There was no comforting hospice care. Those loose ends left dangling at the end of every life? They weren’t neatly tied up in a pretty box with a bow on top; in fact, many of those loose ends are still dangling more than a decade later, whipping around wildly in the air.

He got to say all his goodbyes in a letter he left us. We didn’t. He got his “closure.” We didn’t. Instead, he left us with open, gaping wounds. People say that with suicide, a letter is helpful. They say that the survivors who get one are lucky, as not everyone leaves their words behind. But my father’s letter just painted a confusing portrait of a man who, it turns out, I didn’t even know — a portrait of a man who wasn’t my father.

His letter left me with more questions than answers, in the end.

More consuming than even my father’s actual death, I’ve come to realize, is processing the way he died. No one wants to feel like their loved one would rather leave than stay; it’s the ultimate heartbreak, the kind that bears down on your shoulders, leaving you unable to breathe. It wasn’t supposed to be like this, he wasn’t supposed to die like that. The superhero doesn’t give up halfway through the movie — he gets up and keeps fighting. Our story, at least the chapters with him, were not supposed to end this way.

Since my father’s death, some friends and family haven’t talked much about him. It’s either because they don’t know what to say, don’t want to upset us, or, perhaps, it’s just too painful for them. But this denial, their failure to speak of him, is something I struggle to accept. How can someone be such an important part of your life and then just vanish from it? People act like my father never existed at all. Sometimes I just want to scream, “CAN’T YOU SEE IT?? HE’S STILL HERE!”

And he is here — in everything I do, in all my little quirks that remind me of him, in my red hair that he passed down to me.

More consuming than even my father’s actual death, I’ve come to realize, is processing the way he died.
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Memories are my way of keeping my father alive. They make the past feel within reach again, a necessary comfort when you feel like your life now and your life with your loved one are two completely separate existences.

The word “suicide” is like a black hole of sorts. It’s expansive, never-ending, and dark; no matter how much you talk about it, there’s always more to say. Always. I wish I could say that I know no one can relate, but unfortunately, I know far too many of you can. Suicide is the tenth leading cause of death in the United States. We are, in fact, in the middle of an epidemic, with suicide rates at a 30-year high.

So I know that many of you are grappling with what to say, trying to find the words to comfort a family member, a friend — possibly even yourself. It’s been 13 years since my father’s suicide, and I still fumble, every single day, to find the right words. So today, I will write them. Not just for my father. But for me and for you — and for the millions who live with the effect of suicide every day.

Suicide changes you forever.

The idea that a loved one died so unexpectedly and so violently shakes you to the very core of your being, and as much as you may wish to deny it, you’ll never be the same person ever again. I never really understood this until I grieved my father. Slowly, however, I realized that not only was I grieving my father’s death, but I was also grieving the loss of my “old life.”

I think, in the end, the real journey I’m on is learning to say goodbye to my old life, not just learning how to say goodbye to my father. It’s important to remember that sometimes, I — you, we — need to try saying hello to our new lives, if just to see how it feels.

And please, please continue to talk about your loved one. Whether you’re angry or sad or reminiscing about happier times, it’s important to keep your loved one with you. Keeping quiet is akin to letting the suicide win. Don’t let it. You owe it to your loved one — and most importantly, you owe it to yourself.

For the group of us who knows so intimately that life will never be the same, my heart is with you.

flickr/Eric Kilby

By Ijeoma Oluo

Two years ago today I was staring at my teenage son, my precious baby, wondering if his smile was real. Wondering if I could allow myself to take comfort in a moment of his laughter. Wondering what I could do to keep him in this world as long as possible. Wondering what I could say to counteract the voices that were telling him that he wasn’t precious, that he shouldn’t be here — the voices that had landed him in the emergency room just days earlier.

Two weeks ago today I was contacting the parents of a close friend. Listening to their distant, weary voices numbly say “thank you” when I told them how sorry I was that they had just lost their only son after decades of struggle with mental health and addiction. Two weeks ago today I was hoping beyond hope that my friend went to sleep his last night knowing that he was loved.

And today, I read a story on xoJane where a woman declared that her former friend was a burden on her mother and that her mental health issues were beyond help. She was glad that her former friend had died. “Some people are beyond help” was written in italics below the title of “My Former Friend’s Death Was a Blessing.”

I cannot put into words the rage that I feel that somebody would legitimize the idea that a life with mental illness is not worth living. I shudder and cry at the thought of somebody’s baby reading these words and seeing validation of the lies that depression has been whispering in their ear. I want to gather everyone who struggles with these thoughts and wrap them in my arms and remind them that I am so glad they still exist and that, like the voices of their illness, this article is a dangerous liar.

Coming to terms with my son’s struggles with mental illness has not been easy, and I can only imagine how much harder it has been for him. But I am grateful for every minute that he is on this planet. I am grateful for every moment of struggle and for every moment of joy. My worst day with him is better than all of my best days without him combined. And there are times that I know that he doesn’t believe that, and it breaks my heart beyond measure. But he is still here, he is still fighting for his life and his health in a world that tries to tell him that he is not worth it, that he cannot get better, that he is too big a burden. He is so fucking strong and brave and every day I am so very proud of him. He is a 14-year-old kid standing up to the grown bullies who tell him that he should be ashamed of his struggles, and that the world would be better off without him.

My son is doing much better now. Some of that is due to the very hard work that he has done, some of it is pure luck. Some people will not win their battles and it is not because they have failed or because they are better off gone. And if they are unable to win the battle against the deadly voices of depression, the world is still better for every day that they existed; they deserved hope, they deserved respect, and they deserved to be loved and fought for and mourned.

My son tells other kids at his school about his struggles in the hopes that they will know that they don’t have to go through this alone, and they are not a burden. “I know it feels like you shouldn’t trouble people with those thoughts in your head,” he says, “I used to think the same thing. But you need to talk to someone. People really do care and they can help. You aren’t too much trouble.” He does not want others to believe the lying voices as long as he did, and sometimes still does.

And he’s right, you, whoever you are — you are not too much trouble and people do care. You make the world better simply by being in it and you are worth the fight. You are worthy of love because you are you, even if you can’t see that love right now. I’m so glad that you exist, I’m so glad that you are fighting for your life, I’m so glad you are reading this right now because I wrote it for you with all of the love in my heart. If you are struggling please reach out and know that you are never alone.

National Suicide Prevention Line: 1 (800) 273–8255

Postpartum Depression Help: 1–800-PPD-MOMS

United Way Helpline: 1–800–233-HELP

The Trevor Helpline: 1–800–850–8078

Trans Lifeline: US: (877) 565–8860 Canada: (877) 330–6366

Substance Abuse & Mental Health Services Administration Helpline: 1–800–662-HELP

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