By Anonymous in Washington, DC
The first time I remember wanting to die was in early childhood. I grew up in a rural area of the Appalachian foothills where I was encouraged to explore and ask questions about nature. One autumn day when I was playing outdoors, I noticed the vastness of the sky and mountains that surrounded me. Suddenly, I felt trapped within the endless patchwork of red, yellow, and orange trees. Instead of exploring, I wanted to escape. My father noticed that I had started to cry, but I didn’t have the words to explain. All I could say was that the trees made me feel sad about living forever. Relieved when he told me that people do not actually live forever, I stopped crying and went back to playing. I think that moment was the beginning of my lifelong death wish.
I have spent the past four decades hoping that my death will come sooner rather than later. Although I have some ideas about where my desire for death comes from, I cannot explain it fully. Maybe it’s just the way my brain is wired. I survived multiple traumas throughout childhood including clergy sexual abuse. I was exposed from an early age to my grandmother’s severe and untreated mood swings, and at age 16 I began to experience the same myself. The family dynamic I grew up with was heavily influenced by unacknowledged generational trauma. Suicidal ideation is common among trauma survivors and people with chronic psychiatric conditions, but (supposedly) it lessens with appropriate treatment.
That hasn’t been the case for me.
I have spent my entire adult life to this point trying various psychotropic drugs, psychotherapies, and alternative treatments including every kind of trauma treatment imaginable; yet my desire to die persists even in the absence of mood and PTSD symptoms.
The controversy over physician-assisted suicide for psychological suffering makes me wish that I could be less private about this aspect of my life; I can count on one hand the number of people who know aside from my therapist and psychiatrist. I hear repeatedly that psychiatric conditions are not terminal illnesses, there is always hope for an improved quality of life, and those who claim to suffer unbearably just need to keep looking for the “right” treatments. Usually, I stay silent instead of pointing out that chronic suicidality is not so simple. The dominant message that “suicide is a permanent solution to a temporary problem” assumes the existence of a problem. What if there is no problem except for a lifetime of suicidality?
I have a successful career in a healthcare profession that I love, and I enjoy my job on most days. My spouse and I have a happy, healthy marriage of 12 years and counting. I stay involved in my community and have meaningful friendships that have lasted for years, some for decades. I have the privilege of excellent mental healthcare, including specialty outpatient providers and a nearby inpatient trauma unit. But despite having so much to live for, abundant treatment resources and moral opposition to physician-assisted suicide, I still give serious thought to moving abroad for the purpose of dying.
I have often wondered how conversations about physician-assisted suicide might be different if the voices of chronically suicidal people were truly heard and respected. Suicide prevention efforts tend to emphasize that pain is temporary, and life improves over time. We hear the perspectives of suicide-attempt survivors who now regret their attempts. We hear from families grieving loved ones lost to suicide, including those who would have intervened to prevent a physician-assisted death if they had been given the opportunity. But the voices of the chronically suicidal are rarely heard, and when they are, they usually speak about passive suicidal ideation rather than an active desire to die without an immediate intention to make that happen. The world does not often hear from people like bioethicist Michael Nair-Collins, whose essay on chronic suicidality is a near perfect match to my own experience. In his words, “I want to die; but not today.”
Living with chronic suicidality does not necessarily mean that one supports physician-assisted suicide for mental health conditions specifically or any condition at all. However, arguments both for and against read differently to a person who has this lived experience. Most articles on this topic leave me questioning whether opponents would regard me as a fully autonomous adult or whether proponents would recognize my life as possessing inherent worth.
