People often think when you have suicidal thoughts you're a sad, struggling person always looking down at the ground . But the truth is I spend a lot of time looking up. I literally chase rainbows and sunsets and clouds.

I want to make you laugh. I want to see your joy. I'm not a pessimist with a shitty outlook. I'm an optimist with a shitty disease. I'm filled with pain and anxiety, and also love and gratitude and silliness too.

Though the world tries to see it a certain way, this disease isn't just one thing, if it was we would have figured out how to conquer it by now.

For me, my brain decided long ago that in order to live in this world and feel safe I needed to know I didn't have to stay, and though these thoughts began as a protective friend they have grown into a bully, a bully I continue to question and push back on, a bully that is exhausting, a bully that part of me still wants to be friends with.

And someone else living with these thoughts has a completely different story than this one, so if you can, listen to theirs too because the more we listen the closer we'll get to actual suicide prevention

And if we're going to talk about suicide prevention this month but not bring up living with suicidal ideation and the lack of resources and spaces to talk about these thoughts, then we're not doing much good.

We need to talk about Suicidal Thought Management, what to do the first time or the millionth time you have a suicidal thought, how to tell people about them, deconstruct them, question them, knowing that in a lot of ways there is a normalcy to these thoughts. We need to really talk about the prevalence of these thoughts, the different intensities, how to manage them, how to listen to someone who is having them.

If we take away the fear, maybe we can help people figure out which kind of help they need and whether their thoughts are active or passive. Sometimes suicidal thoughts mean you need to go to the hospital, sometimes they mean you need to go to a therapist, or talk to a loved one, sometimes they just happen, and sometimes there is a need behind them that has to be addressed.

Depression isn't the only reason people have suicidal thoughts, but that's how we bill it.

In the past few years, we as a society have gotten better at talking about suicide. Media and individuals have started talking about it with more compassion and less judgement.

But we have a long way to go in how we react when people talk about suicidal thoughts.

We are good at mourning someone and saying how wonderful they were. We're not so good at being there as they talk honestly about struggling with their brain.

And once again the people we are leaving out of the conversation are the people who do live with these thoughts, somehow forgetting the value, intelligence, experience and skills they add to the conversation around real suicide prevention.

Want to truly understand something? Listen to the people who live with it daily. Ask questions. Check in that they're safe. And then instead of just breathing a sigh of relief, take a minute to realize that living with this disease requires so much more than just being safe.

People often refer to someone talking about suicidal thoughts as "a cry for help or attention," but it is actually a brave battle cry. They are saying I am letting you know what I need, I am letting myself say I need help.

If you're struggling with these thoughts right now, know there is no shame in them. And know your battle cry deserves to be heard and supported. And I hope that maybe one day the work of educating loved ones and professionals won't be entirely on your shoulders.

And know there are many of us like you out here, we are delightful humans, you are a delightful human, and you are worthy of love, relief, and a place to share your pain. We all are.

Some end with “I’ll check on you in ten minutes.”

Tonight’s ended with me saying “I promise if you ever tell me you are in love with a guy named Weasel, I won’t laugh or scream.”

“Will you faint?” He asked.

"No, I will ask if he makes you happy and if you say yes, I will say ‘Then I’m happy.'"

This boy and me, yes we are mother and son but more than that we are Deena and Rafi, and I see how much of a special relationship that is.

Ending it all destroys that, solves nothing, passes along this suffering onto him.

I know this and yet this voice inside says “You need to go.”

Is it possible to get rid of this voice?

Yes, I am told, but it will take time. A lot of time.

And I want to yell “What about all this fucking time I’ve already put in?”

And so I do yell that, in my car, alone, and I do my best to hang on and do what I need to do to get healthy, to be here for the day my son brings home a Weasel or whatever else makes him happy.

The above is from 10 years ago today, a bedtime conversation based on an old Foxtrot comic collection of mine my son was reading. These 10 years since have been a long battle but have also contained thousands of beautiful moments like this.

I think people who haven’t experienced chronic suicidal thoughts or haven’t lost someone to suicide, assume when someone dies by suicide it is because they are severely depressed, or they don’t have a life that is full of love, joy, and connection. Or that they are not aware they do. This is not true. I am, and most people, are well aware of it and profoundly profoundly grateful for it.

But, the shitty thing is your brain doesn’t fucking care how your heart feels, no, in my case my sick brain will just get louder and more convincing.

But today, in this moment, my brain and heart are on the same page, and I am filled with gratitude; for this kid that's now an adult, for every silly moment about a weasel or anything else I've had with him, for all I've been given in being his mom.

- Abigail Thomas, What Comes Next and How to Like It

When I was in the psych hospital a few years back, on the book shelf was What Comes Next and How to Like It. At first I thought from the name, that it was some sort of super positive self help book and I rolled my eyes and thought "Geez, read the room." Then a couple days later, out of boredom, I opened the book, which turned out to be a beautiful memoir filled with truth, and humor, and grief, and anger, and joy and I read it and I connected with it so much at a time I wasn't connecting with much else.

I've been thinking about the above quote from the book the past couple days. This has been the roughest year I’ve had mental illness-wise. A year of struggling so much with my brain and taking many ineffective psych meds with so many undesirableside effects. I seem to often get the side effects without any of the intended relief. Recently, I was on a med that didn't work but had a side effect where I always felt like I had to pee even if I didn't, so not only was the med not working, now my vagina had anxiety.

Today's the first day of suicide prevention month. I live with chronic suicidal ideation, and this is the first suicide prevention month in many years, where I actually have had some relief from the thoughts. This past month, most of the time the thoughts have been more of a quiet hum then an out of control scream.

I got to this place of some relief because of two things

1. Luck - The fact that I am alive is because I was lucky enough to survive a suicide attempt. That surviving suicidal thoughts requires so much luck will always be heartbreaking to me, that we can say yes to living thousands of times, over and over and over again, and no just once and our life can be over, will always seem so cruel

2. I am also at this place of a bit better because of all the treatments that didn't work, or partially worked, or worked enough to get me to the next thing. Living with chronic suicidal ideation and other mental illnesses is rarely about one treatment,but is a patchwork quilt of meds, and skills, and treatments, and hospitals, and doctors, and therapists, and people and things that give you purpose and connection and help you hold on.

Doing all these things with very mixed results has, for me, been a long frustrating experiment while barely hanging on. But figuring out what hasn't worked has gotten me closer to what might work. I've learned that as much as it absolutely sucks, you gotta have the faith to take that wrong med or that not fully effective med to get to the one that works. I've also learned, and man do I hate it, to way lower my expectations about how well something will work or how long it will last.

I am experiencing relief now and I am doing my best to make the most of it because brains are tricky and it can get worse. What a waste it would be to not fully take in the better.

And it is because I have benefited from both these places and believe in their worth that I find it necessary to call out their problems, problems that unfortunately, are increasing.

I believe we're at a place where society is becoming more and more supportive, empathetic, and understanding about mental health. But because mental health systems seem to be choosing profit over people, the system is getting worse and worse.

Here are a few startling and horrific examples in my own life just from the past few months.

Before I offer them, I just want to say that I have a phenomenal therapist, as I have dealt with chronic mental illness and lots of issues with medication,my therapist has offered to meet with, to talk with, to email with every psychiatrist I've seen, and about 10% of psychiatrists have took her up on this. Because she is not a doctor they often don't view her expertise as something that can be beneficial to them.

Three things of many that have happened since May:

1. In May, I was at my absolute worst. And after much convincing by my therapist and others in my life, I went to the psychiatric hospital. I let them know that I was not safe and that I wanted to end my life and that my therapist recommend I get admitted.

For the last many visits to the psychiatric hospital, I have taken a friend with me. Because the minute you walk in to a psych er, most of the staff doesn't believe you to be a reliable narrator of your own life. And also, you don't always get treated with the same dignity that you would get in an emergency room for non-psych related issue. I bring the same friend with me everytime because she wears a cardigan and used to be in finance so I assume they'll take me more seriously. After the staff asked me questions, they came back and told me that they were not gonna admit me, that the doctor refused to. By the way this doctor never even saw me, he just read a summary. I said that I was not safe. They said you're not getting admitted. My friend in the cardigan said she is not safe, she's not going to make it. They said you're not getting admitted. We left the hospital. Had I been alone I don't think I would have survived this experience of being told we don't care if you live or die. My therapist then called the emergency department and told them that I had access to means and was not safe and the doctor who never saw me said, we're not going to admit her.

The worst part of this experience wasn't what happened to me, which was really awful, damaging, and not okay But at least I knew enough to know that this is not the only experience that can take place when goung into the psych hospital. But I worry about the other people this doctor had turned away, ones who were coming there for the first time and who will never return to a psych hospital if they need to again. And therefore he's made the world less safe and less survivable for those with mental illness

2. While talking to a psychiatrist in Tucson in July he said to me "Obviously your son doesn't matter to you enough to stop considering suicide."

That sentence. It tore me apart. Could you imagine "Obviously your son doesn't matter to you enough to stop having cancer."

3. Also in Tucson every morning and night, you would fill out a little paper, and you would write if you were having any suicidal ideation. These are common forms in psych hospitals, and I almost always check yes to suicidal ideation, because it's there at some volume, and one night while doing it, the nurse said to me, "You know, if you check that they can send you back to the more severe unit here. And I said "No, I'm leaving in a couple days, this is just something I always have." and she said, "Well, they could just take you out of the dining hall one night and take you back to that other and not let you leave. Change it, change it now" And she coerced me into changing it, to not honestly report how I was because if I didn't change it, she would have to do what they always do when you mark it, which is to follow-up and let someone know, and this way if I didn't mark it , she wouldn't have to do that work.

Here's the thing I got some help in Tucson. I got some relief through ketamine, and through one of the therapists I met with and through some other things. And I can see that and appreciate that, and I do. A lot. But I shouldn't have to go through these other dehumanizing, unsafe experiences to get there. And once again, I worry about the person who's been to less places than me and doesn't know that when they're being told something, that it's not okay and not correct. And that there are helpful psychiatrists and hospitals but you have to work really hard, why too hard when your not well, to find them.

People like to make jokes about inmates running the asylum, but if we actually put past mental health patients in charge of psych facilities, they would probably be healthier, safer places where those who need help were more likely to go and more likely to get the care they deserve.

Places where Lindsay could have got the help she was begging for