Suicide Watch [Special Edition]

March 8, 2018

J. Doe is a pseudonym for anonymous contributions to Healers Magazine. The following is the first installation in the five-part memoirs of a brave woman faced with bipolar depression. Click here to read part two, here to read part three, or here to read part four.

Taking the first sip of my suicide cocktail shocked me more than anything I’d ever done. I spilled a few inches of water from a pint-sized Poland Spring bottle, popped in a sampling of “anti” drugs—anti-anxiety, anti-depression, anti-convulsion—followed by some of the sleep aids, barbiturates, muscle relaxants and painkillers I’d squirreled away, suspecting this day would come. I shook the bottle, counted to two hundred until the chunks of pills almost disappeared, then one shake for good luck, like the extra candle on a birthday cake. Without pausing I took a big swallow. It was disgusting.

An abstract painting with different shades of blue.

“Rolling in the Deep” by Shadab Khan

It didn’t matter. After a lifetime spent scared to death of death, it was life that now terrified me and I’d taken control of my fate with one gross gulp on a hot summer day, behind the steering wheel of my 1999 cabernet Windstar minivan in a Walmart parking lot. It was merely a symbolic start, since I didn’t intend to die looking out over a sea of superstore macadam. Still, it was a first step and I took it without flinching. I was instantly tipsy with power.

Two more tentative sips and I knew I’d been wrong. Taste did matter. A drastic overhaul was needed or I’d never finish the first bottle and keep it down.

This first concoction was an aperitif of sorts. I still wanted to drive to a beach twenty minutes back toward home and didn’t want to cause an accident like the man in the news who parked his SUV on the train tracks, stabbed himself, changed his mind about dying and fled the vehicle right before it was hit by a train. Eleven passengers were killed and the man was indicted for murder. I had no intention of taking anyone out with me or instead of me.

My first executive decision as an empowered lame-duck human came on the heels of an epiphany: In the tradition of prisoners facing execution, I was entitled to the last meal of my choice. Had speed of digestion not been a factor my chin would soon be dripping with butter and my mouth filled with a tender lobster tail. I hate to brag but I’m kind of known for my tenacity and technique when it comes to ripping apart a crustacean to hunt down every morsel of meat, roe and that green stuff in the head known to appall onlookers. This gluttonous spectacle ends with succulent souvenirs splotching my shirt, and my husband Joe invariably quipping, “This is why we’ll never get invited to the Kennedys’ for dinner.”

My eating habits are a secret source of pride. They prove I am no femme fatale who delicately plucks easy pickings from a claw with the designated fork. The fact that I’m willing to work so hard to get at the good stuff may be why I’m still alive—that and some mammoth miscalculations

Being in a rush to get my enervated life over with, I opted to skip the shellfish and splurge on pomegranate juice, usually too expensive to justify, and a big bag of my favorite candy, Pixy Stix, usually too fattening and juvenile to justify. Today I didn’t need justification. This was my last supper. Shots of pomegranate juice with Pixy Stix chasers it would be. Perfect, especially if I got a disproportionate number of purples and reds.

I’m pretty sure fruit juice and powdered candy straws don’t come up first during post-mortem speculation about what someone was thinking right before firing that fatal shot, tightening that noose or jumping off that rooftop. But I bet the final thoughts of most people on the verge of doing themselves in are less dire and dramatic than anyone outside those haunted heads might imagine. The deciding may be tortuous, but once your mind’s made up, the relief of resolution takes over—and relief, as my smartest high school friend insightfully put it at age seventeen, is the best emotion. It freed me up to divert my attention from how indescribably horrible it felt to be so agitated that no amount of kicking, shaking like a wet dog, gulping for air or screaming epithets would stop my skin from crawling unbearably. It had a life of its own and I had to crawl out it.

Now I knew what could cure me: pomegranate juice, Pixy Stix, pills, razor blade, the beach.

I couldn’t face the exhausting vastness of Walmart again so, seat belt buckled, bottle secured in a drink holder and eyes on the speedometer, I turned left onto the busy commercial road and made a bee line for a small, manageable grocery store with bare cement floors and cashiers who rang up prices by hand. Before getting out of the car I sneaked another sip for fortification. That clinched it. The irony made me smile. Dying is okay but I’ll be damned if I’m going to drink something that tastes bad.

Priorities are hard to keep straight when every nerve in your body is exposed and a boa constrictor is squeezing the logic out of you. Maybe it’s what heroin addicts experience when they need a fix so bad they’ll give blow jobs to potentially violent strangers in dark alleys for a few bucks. If I knew I could buy something guaranteed to make me feel better, I might be skulking around alleyways too.

No one wants to want to die, I don’t think, unless happiness isn’t a foreseeable option. For a long time before and after that sunny June afternoon I believed it was. I’d race to the bathroom every morning, flip open that day’s little plastic drug compartment and swallow its ever-growing assortment of tablets and pills, then count the minutes for everything to click into place. Instead, the failure of one promising alternative after another eroded hope and reduced the likelihood of seeking an alternative to eventual suicide. Suddenly, without knowing how or when it happened, “today could be the day” referred not to the possibility of happiness but to the possibility of death. Pondering that possibility became as automatic as chewing and swallowing.

A habitual way of thinking is harder to break than a single bad habit, like slurping your soup. One is comparable to transplanting a brain, the other to removing a wart. The problem is systemic and the longer you’ve had it, the longer it takes to fix it, and the less likely you are to trust that it’s fixable. The futility becomes palpable and pathological.

Trying to make sense of my distorted perceptions makes me wonder if bizarre thought patterns are hard-wired at conception with a circuit marked “suicide”—a defect built into our motherboards that lies dormant unless tapped by biochemistry, external circumstances or both.

With happiness no longer seeming a viable outcome, my decision was made for me. There was nothing tortuous about it. The only question was when.

Until that morning, a Tuesday, I didn’t know it would be so soon. I had expected to drive nearly three hours round-trip the next day for my third appointment with the psychiatrist my therapist found for me when, after ten months of even-keeled sessions without so much as a shed tear, I started channeling Sybil of multiple-personality fame. Not that a cast of characters with numerous names and egos was fighting for survival inside me, but the explosive eruption of intense mood swings that seemed physical, not emotional, felt like at least a few aliens were burrowing around in there. One minute I’d plummet into despair, obsessively plot my suicide, write farewell notes and practice cutting veins in my wrist with razor blades, just enough to draw blood and prove I could do it for real; an hour later I’d be hyper-energized, running around the house from one task to another, totally engaged in each but seldom finishing any.

These multiple obsessions were what I learned to settle for in lieu of contentment and joy. When I was engrossed I was distracted from the cyclone of negative thoughts that uprooted and spun away with my sense of self. Even when I did manage to get my footing, I didn’t know which way to run—toward life or toward death. Life being what it was, death won out, but the path wasn’t a yellow brick road that showed me the way. It was as circuitous as my thoughts and moods. That “what if?” is hard to shake. What if tomorrow is better? What if I ruin my kids’ lives? What if I end up brain dead instead of dead dead? Curiosity may kills cats but it keeps humans alive.

A few weeks before trying to kill myself, an obsession posing as a passion held me captive for two solid weeks of back-to-back-to-back twelve-hour days of manual labor. The goal was to convert a storage room into a downstairs bedroom for elderly cousins at their nearby summer home so they wouldn’t have to navigate fifteen stairs. I was also going to redecorate the attached bathroom. The lack of formal training as an interior designer didn’t faze me; I’d studied informally at the feet of the master: HGTV, the home and garden network. I was psyched to have a blank canvas and figured I would complete my masterpiece in roughly twenty hours.

I figured wrong by a long shot. Blame mania. It pushed my level of commitment over the top, giving me an endless energy supply that obliterated the need and desire for sleep, replacing them with the need and desire for perfection. Come Fourth of July weekend when the cousins arrived from “town,” as they called Manhattan, they had to be wowed. They had withdrawn their initial approval of the project, so this surprise could blow up in my face.

It was day one of the makeover and I was clearing everything out of the room so Joe and I could paint. After removing a heavy heap of moth-eaten blankets from the closet floor and disintegrated men’s shirts from the overhead shelf, I stood on a chair to check a spot invisible to me from my five-foot-two vantage point. A can of food, its label undecipherable, had oozed black gunk that glued the can firmly to the shelf alongside a racy paperback featuring a practically naked blond on its cover and characters described inside as “negroes”— like Sylvester, the family’s long-dead servant who was the last person to occupy the room.

By the time my marathon mission began, these brilliant, independent cousins had become too stooped to reach above the first shelf of kitchen cabinets to rescue cans of food, boxes of pasta and containers of spices. Standing on a chair again I found more exploded cans of mystery foods, jars of bacteria-filled delicacies and solid blocks of spices with fibrous strands woven through them.

Instead of balking at the overwhelming find I was invigorated by it. The purpose and enthusiasm lacking for too long were back. I dove in, removing everything from each cabinet, scraping off mildewed shelf paper, scouring the exposed wood with every product I could find, painstakingly washing each salvageable spice jar, can of food, bag of whatever, box of tea and baking ingredient while tossing containers whose contents had leaked out or turned to dust. I repainted the red planks of the bathroom floor. I brought in two beds, bought bedding, converted Pottery Barn sheets into curtains by hand, polished the wood floors and scrubbed every presumed-permanent stain from the dated kitchen linoleum and counters.

This all would have been too tedious to tackle in normal-person mode, but I was in a frenzy, driven by a force I didn’t dare to, or care to, resist. I found classical cassettes next to an old tape player and toiled serenely to the music long after Joe called nightly to tell me how late it was. He saw cause for concern where I saw a labor of love. There was nothing tiresome or overboard about it to me. I was grateful for an obsession. Like a brutal soldier bullying a lagging POW into marching on, it shoved me forward. If I felt a twinge of boredom or fatigue at the prospect of taking out, washing and wiping dry yet another bottle of peppercorns used to deter rodents when the house was closed for the season, it was banished without effort or awareness.

Pangs of future guilt overcame any momentary reticence and got me back on track. If I saw a stain on a shelf I absolutely had to jump down from the chair, get the wet cloth and silver metallic scouring pad, scrub and scrub the stain away then wipe the shelf clean before I could get back to what I’d been doing. The only way to relieve the slithering creepy-crawly sensation under my skin was to surrender to the compulsion.

Finally, after acceding to countless compulsions, the kitchen, bath and bedroom were finished except for cleaning up after myself. The next day I unveiled the project to our generation of local cousins, who were duly impressed. I basked in glory for exactly one afternoon. That night the wind abruptly went out of my sails, leaving me flapping in the breeze.

The prospect of a final day of cleanup weighed me down like cement feet, but I dragged myself back to the house the next morning, thinking it was natural to experience the kind of letdown professional athletes do after winning the Super Bowl or World Series or Stanley Cup. “Okay, we did it; now what?”

Instead of slipping back into the resigned state of detached social anxiety that had plagued me for a few years, I shifted into overdrive. The high octane that had fueled me was still in the tank but I couldn’t harness its power. It controlled me, propelling me in one direction, then, before I could get my bearings, another. This happened again and again until I was a pinball pinging from bumper to bumper, the machine’s flippers controlled by a reckless player intent on tilting. I was buffeted simultaneously by an unprecedented level of agitation and an unprecedented level of despair. My panic that this frantic feeling was permanent made me forget I’d ever felt anything else.

I had started therapy about a year earlier for the first time since 1979 because of a numbness that robbed me of emotions, interests and hope, just like it had back then. I didn’t mope or cry. I wasn’t sad. I wasn’t anything, especially happy. In jettisoning the bad emotions the baby was thrown out with the bathwater. In that stagnant state it took a long time to recognize that the whirlpool of turmoil that almost sucked me under twenty-eight years earlier was swirling me in circles again.

Convinced that my condition was being exacerbated by Joe’s apparent symptoms of clinical depression, I didn’t seek an evaluation or treatment right away. Instead, a couple of concerned relatives and I tried to get him into therapy. They had no reason to be concerned about me, since on the outside I was the same good-natured, joke-cracking, injustice-crusading person they thought they knew. But Joe’s demeanor and behavior had observably changed since a work-related trauma two years earlier that undermined his confidence and identity. His refusal to acknowledge this impact worried those closest to him but had a detrimental impact on me. If things weren’t going well and he didn’t think it was his problem, who did that leave?

On top of whatever biochemical predators were eating away at me, I bore the brunt of his negativity, which further usurped my confidence and certitude. I resented that, and he resented my resentment. We were living a cold war of sorts until I finally risked his wrath and our marriage by insisting that he let a professional decide if he truly was clinically depressed and required medication and counseling. I would go for evaluation too, partly as a show of support, partly to prove I wasn’t the problem, and secretly because deep down I knew I was in trouble.

Making my way down our HMO’s list of participating psychiatrists I discovered that half weren’t taking new patients, had specialties that excluded us or didn’t participate in the plan anymore. Thanks largely to the exorbitant cost of becoming a physician versus low reimbursement rates by insurance companies, it’s hard to find psychiatrists anymore who accept insurance or do therapy. Most restrict their practices to the somatic side of mental illness—shorter sessions, more patients—while leaving therapy to psychologists, social workers and other non-MDs. I was far down the list when I found a practice with a woman who would see me and a man who would see Joe.

On September 1, 2006, we went to their offices for simultaneous appointments. I knew Joe would come out with a prescription but wasn’t sure about myself, since years earlier I became suicidal after a few months on an antidepressant, a not-uncommon paradox mainly affecting children and teens. My doctor talked to me for a half-hour tops. Joe was already in the waiting room when I finished. Guess who came out with a prescription and who came out gloating?

I was prescribed an antidepressant from a different family than what I’d been on before, but the doctor irresponsibly didn’t bother with the standard checklist that helps determine if the depression stands alone or is the low end of a bipolar disorder cycle.

The Mood Disorder Questionnaire is easily found in medical literature and on any number of websites. It asks if there’s ever been a period of time when you weren’t your usual self (yes) and…

  • you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble? (yes)
  • you were so irritable that you shouted at people or started fights or arguments? (no)
  • you felt much more self-confident than usual? (yes)
  • you got much less sleep than usual and found you didn’t really miss it? (yes)
  • you were much more talkative or spoke much faster than usual? (yes)
  • thoughts raced through your head or you couldn’t slow your mind down? (yes)
  • you were so easily distracted by things around you that you had trouble concentrating or staying on track? (yes)
  • you had much more energy than usual? (yes)
  • you were much more active or did many more things than usual? (yes)
  • you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night? (yes)
  • you were much more interested in sex than usual? (no)
  • you did things that were unusual for you or that other people might have thought were excessive, foolish or risky? (yes)
  • spending money got you or your family into trouble? (no)

If you answered yes to more than one of the above, have several of these ever happened during the same period of time? (yes)

How much of a problem did any of these cause you—like being unable to work; having family, money or legal troubles; getting into arguments or fights? (minor problem)

According to the interpretation section, a score of seven or more, plus positive responses to the last two questions, “certainly suggests bipolar disorder is a possibility and should be considered and discussed with a professional.” My score was nearly double that.

Psychiatrists are supposed to know that bipolar people typically seek treatment toward the low end of their mood spectrum, which makes sense considering that the high end can be euphoric, and who goes to a doctor because they feel too good? I assumed this psychiatrist knew what she was doing and didn’t question her diagnostic ability, ignoring what I’d preached in my consumer column about the importance of advocating for yourself. I did ask, perhaps presumptuously, how she could stand not doing therapy, to me the most interesting aspect of the profession by far. “I have to make a living,” she confided.

The hallmarks of regular clinical depression and bipolar depression are the same: extreme sadness or numbness, loss of interest in things you used to enjoy, irrational guilt and regret, social withdrawal, difficulty concentrating, feelings of worthlessness and hopelessness, physical symptoms real or imagined, insomnia, a loss of libido, the kitchen sink, and my soon-to-be personal favorite: a death wish and suicidal ideation.

But bipolar disorder is a pendulum that swings along a spectrum from depression at one end, and mania or less extreme hypomania at the other. The manic end manifests itself as euphoria or extreme agitation. Mine feels like a nerve being drilled by a dentist. I prayed for a taste of euphoria instead. But unchecked euphoria can give way to devastating symptoms and behaviors. Psychosis for instance. Delusions of grandeur. Feelings of invulnerability. Impulsiveness. People gamble away their life savings, leave their spouses, get into fist fights. Kill themselves.

Treating bipolar disorder with an antidepressant but no mood stabilizer, as the doctor who evaluated me did, can lead to suicidal thoughts and trigger mania. Misdiagnosis means mistreatment, which eventually catches up with you. It’s like going to the emergency room with abdominal pains, being sent home with an antacid and having your appendix burst a few hours later.

Therapy is the other component of treatment for clinical depression, which is what I was told I had, so my next step was to find a therapist. I never thought I’d entrust myself to anyone without “doctor” in front of his or her name, but I couldn’t find a psychiatrist—a medical doctor—who did therapy and participated in my insurance plan. Nor could I find a participating psychologist—doctor of philosophy—to take me on as a patient. Clinical social workers were the next rung down the mental-health hierarchy. They had master’s degrees and licenses but no “doctor” to convince me they were smarter than I was and thus qualified to save me when I was failing to save myself.

After a few sessions with Malcolm Dankner, a social worker on my insurance plan who was recommended by a friend’s therapist who wasn’t, I chastised myself for being such a snob. Joe and I had seen him briefly a year earlier for preemptive marriage counseling when we were about to become empty-nesters on the heels of career upheaval. We liked him. He had thirty years of experience, an irreverent sense of humor and outspoken political views that jibed with our own liberal leanings. When I realized I needed individual therapy I decided to go with a known quantity and stopped shopping for an M.D. or Ph.D.

If anything Mal and I got along too well, our relationship more like a budding friendship than a professional alliance. We acknowledged our mutual fondness then put it aside and got down to the business of bringing me back to life. Why did I need to store my emotions so far from where I could feel them? (They threatened my relationships.) Why did I avoid people and commitments? (Social anxiety caused by caring too much what people thought of me.) Why did I view myself with such disdain? (The perception that others did.) That kind of stuff.

At first I’m sure I seemed much the same person Mal had helped as half of a couple—contemplative, quick to laugh, intolerant of injustice. I knew he liked that person so I purposely kept her front and center while slowly revealing unexceptional details from the past and present that might shed light on what was happening behind the cheerful-person veneer I wore like a second skin. Since I didn’t act differently he had no way of knowing that intensifying turbulence roiled beneath the surface.

Six or seven months on an antidepressant alone and I was both hypomanic and dwelling a lot on suicide. I was overly energetic with little need for sleep. I took on project upon project until I was so overwhelmed and anxiety-ridden over my inability to complete them immediately that dying seemed the only way out. Negative thoughts commandeered my brain and blocked all the exits so every effort to resolve a problem or convince myself there were options slammed into a wall, like a self-propelled Roomba vacuum. I felt superfluous, irrelevant, unlikable, unlovable, ridiculous, unknowledgeable, unknowable. It didn’t matter that I was always invited places and on the surface seemed to be well liked. Notarized testimonials wouldn’t have made a dent in my despair or contemplation of killing myself.

If you’re depressed like the people depicted in late-night antidepressant commercials—morose, lying in bed all day ignoring children and pets—you barely have the energy to go to the bathroom let alone formulate a suicide plan and execute it. But I could fake my way through a day without eliciting the concern of family, friends or even my therapist. I had to protect my pain so I could put an end to it if it came to that. My secrets had to be safe with me.

By then I’d read and reflected enough to diagnose myself as bipolar in the eyes of the medical community. Personally, I thought all of this stemmed not from a diagnosable disorder but from being stunted developmentally in childhood. I don’t recall a time when I was certain of my place in my world or the world. No matter how far back I go, no matter where I was, what I was doing or with whom I was doing it, the one discernible constant in my life has been insecurity. I can feel exactly how it felt at age five, at age nine, at twelve, eighteen, twenty-four, thirty-six, forty-four and yesterday.

The prolonged exception is the period from about twenty-six to thirty-five—the years of a new love, a new town, pregnancy, birth and pre-school. I hated that we couldn’t afford for me to stay home with my babies instead of working, and still harbor guilt over their sometimes less than ideal daycare situations. But despite that and a terrifying health scare with my son when he was four, I was confident and happy overall. Not coincidentally, I was the center of their universe and they mine. But when my daughter started first grade I regressed to her level. I was insecure on her behalf. I was jealous on her behalf. She was smart, beautiful, personable, popular—and I lived in fear of her inevitable disappointments. So I picked up where I left off before those magical years and this is how I ended up.

Bipolar disorder, borderline personality disorder, generalized anxiety disorder, avoidant personality disorder and any other medically recognized defects mentioned as contributors to some of my symptoms at one time or another strike me as off-kilter, like forcing a piece of a jigsaw puzzle into a space that’s almost right but has one tiny protrusion that keeps it from fitting perfectly.

I’m not delusional. I’m not in denial. I’m not afraid of being stigmatized by a label. But I couldn’t accept explaining everything away with a neatly-wrapped diagnosis of mental illness. I thought that, like so many kids whose mothers and fathers weren’t the poster parents for child rearing, I just wasn’t properly prepared to cope with life. I know I was loved and I’m not big on Freudian finger-pointing, but discomfiting volatility was the norm in my house.

My mother’s still-denied anxiety issues worsened as her family grew. She was the product of an era that spawned frustration among women like her—smart women who should have gone to college, pursued fulfilling careers and had fewer children. The inevitable chaos of four kids in nine years made her a trigger-happy yeller whose contentiousness undermined our certainty about even the most obvious truths. “It’s starting to rain,” you might say, looking out the window at the drops wetting the sidewalk. “No!” she would automatically snap without looking, in a tone that tacked on an unspoken, “Don’t be ridiculous.” When she saw it was raining there was no, “I’m sorry,” or “You were right,” to validate us. The tacit “don’t be ridiculous” hung in the air a lot longer than the spoken words and took root in our heads. We were ridiculous. I am ridiculous.

My father, a mechanical engineer who escaped a coal-mining region of Pennsylvania to graduate from Columbia, contributed to our insecurities. During most of my childhood he commuted to Manhattan from suburban New Jersey, meaning long days and the travails of crowded subways and late trains. He might come home jocular, aloof or irritable. He was often peeved—at us, at my mother, at colleagues, at politicians, at stupidity. He wanted peace and quiet when he got home but more often than not walked into a hornet’s nest.

As one of my sisters put it, we might not have liked it but we knew what to expect from our mother, so in a perverse way we could count on her. While our father was generally warmer and less excitable—he also wasn’t stuck alone with us for hours—we couldn’t count on which Dad would show up. The unpredictability made us wary. Who knows if there’s a correlation but I spent my youth and most of my adulthood terrified at night that someone had broken into whatever house I was in to kill me. Yet when I got so scared I couldn’t hold it in any longer, it’s my father I’d scream for in the middle of the night, making him prove over and over again that he would keep me safe. I did that well into my teens and he always came in to reassure me with calming words and back rubs, never belittling me or complaining that he had to be at work in a few hours. He doesn’t remember any of this, despite being light years away from senility. There’s just too much to keep track of over the course of eighty years times five kids, a wife and so many others. It’s a shame though, not because he’s forgotten the most traumatic aspect of my youth, but because he can’t share my most endearing memory of him. It’s just as well that he doesn’t remember the night I hit my mother in the face when she tried to wake me up and groggily said, “Oh, sorry; I thought you were Dad.”

As the eldest child I had two years of undivided adoration clearly visible in those little 1950s snapshots with serrated edges. What I remember from my post-sibling days by the time there were three of us girls is a dearth of individual attention, reassurance, patience and interest in what I had to say—validation, to use the psych catchword. Based on the many years I resented and mistreated my sisters, and to a lesser extent my nine-year-younger brother, I figure I once had all that and lost it when they came along. I was a natural-born critic and considered it my responsibility to make everyone conform to my idea of acceptable. I suppose it’s better to have had the luxuries of being an only child, but I couldn’t roll with the punches and let it go.

Perceived rejection in any situation comes on quickly and takes forever to fade. It eats away at me, leaving less peace of mind with every bite. Changing the subject when I’m in mid-sentence isn’t rudeness; it’s proof that I’m boring. Choosing someone’s idea over mine doesn’t mean there were other good ideas; it means no one respects me. Meanwhile, I jump around like a frisky puppy in a pound trying to recapture the attention and affection of whoever inadvertently hurt me, and to win it from everyone else. Objective parties say I’m imagining the rejection, but I trust my intuition. That’s my mistake, they say.

Throughout my entire adult life my parents have been extremely loving, demonstratively affectionate and openly appreciative of their five children (we had a non-biological latecomer), their eventual thirteen grandchildren, and assorted spouses and partners. They grew into those roles over time, as we all grow and change. I don’t doubt that they always endeavored to be the best parents in the world, just as my husband and I do. We all fall short, and my inability to cope with the imperfections of my relatively ordinary life isn’t their fault. My analysis is speculation and my recollections could be flawed. Something congenital may have distorted my perceptions or set an unreasonably high standard for attention and affection, a need for constant reassurance.

There’s nothing in my past that’s in the same stratosphere as the real problems so many children have managed to overcome through Herculean efforts—physical abuse, sexual abuse, mental abuse, poverty, abandonment and so on. My adopted sister, whose mother and stepmother died when she was a child and whose father was an alcoholic, is ironically the only one in the family who isn’t medicated. My circumstances didn’t even approach adversity, yet I left childhood not feeling like a real person with a solid core and firm foothold on the path to adulthood. On the other hand, I’m considered to be a strong, independent person, and it isn’t all acting.

I used to think being simultaneously strong and weak, independent and dependent was a dichotomy. Now I wonder if it isn’t just a matter of degree. Maybe if the biochemical and psychological flaws of my body and mind hadn’t intersected I would have been strong enough and independent enough not to care what people thought of me or to never consider that they were thinking anything of me at all. However, I was strong enough and independent enough to be drinking a suicide cocktail and facing death alone.

I don’t know why I got to that point, and I’m not casting blame. I’m trying to figure out how I so royally fucked up my life. How I did it.

Some nine months into my treatment with Mal, when I started flitting from topic to topic too fast for him to take the lead in our ongoing pas de deux, I worried that he’d feel betrayed, a victim of a bait-and-switch scheme. A common case of clinical depression was emerging as something sinister.

One week I’d arrive at my session somber and unable to express myself coherently; the next I’d be talkative and just about as charming as I can get, which struck me as pretty damned charming within the context of my lowered expectations and hypomanic state. The keel was no longer even. During one session he looked at me quizzically and asked, “What’s that you’re doing with your leg?” I looked down. My left leg was jiggling up and down, side to side. You’ve been shaking it the whole time we’ve been talking.” I laughed, crossing my legs to make it stop. “Are you nervous?” he asked. I did a quick self-assessment. “Nope.” I concentrated on sitting still.

A few minutes later he gave me a look of concerned amusement. I followed his eyes downward. This time my right leg was dancing away. Unconcerned, I laughed again and put my knees together the way good girls wearing dresses are taught. Next it was my right hand thumping the arm of the couch, then my left annoyingly flicking the pull tab on my Diet Coke. I crossed my arms tightly. His look this time was pure concern.

“I’d like you to see a psychiatrist for re-evaluation,” he said. “Something’s going on with you.” He suggested I might need a different diagnosis or a medication other than an antidepressant, and social workers can’t prescribe drugs.

That night I was sitting on the couch watching TV when Joe asked, “Do you know you’ve been shaking your leg through the whole show?” The answer was no. Re-evaluation probably was a good idea.

Rather than take a shot in the dark again I asked Mal to find me a respected psychiatrist on or off Empire’s provider list. The same therapist who recommended Mal also recommended Dr. Erik Fink, who would go on to save my life thus far, not without near-disastrous setbacks over several years, but he definitely deserves credit for my overall upward trend.

I was initially relieved that he seemed more serious and formal than Mal, refusing to call me by my first name and introducing himself as Dr. Fink, not Erik Fink. He was polite but not especially warm, which I figured reduced the chances that I’d put him on a pedestal the way I had Mal—a good thing considering the frustration inherent in unrequited idolization. With so much confusion in my head I appreciated an authority figure telling me what to do, like a father my younger brother’s age. In real life I don’t relinquish control casually, but in this alternate reality it was comforting to trust someone else to drive.

“You present well,” he observed during my initial evaluation on May 23, 2007, just as Mal had during our first solo session in August of 2006, and as every mental health professional seen before and afterward has as well, meaning that nothing was noticeably wrong with me. I dressed well, was clean and coiffed, conversed normally, and had a good sense of humor and a curriculum vitae that showed I was a high achiever.

“I know!” I said, palms up in an I-don’t-get-it-either gesture, amazed once again how adeptly and automatically I conceal outward signs of inner deterioration. “That’s the problem.”

No one knew. To others I was chatty and personable—the external me that people expected to see and presumably liked better than they would have the inside-out me. It was a facade constructed for that purpose at an early age, not consciously but presumably to pursue my need to be universally loved. “Give the people what they want” is second nature to children, who use trial and error to find ways to endear themselves. As Plato put it, necessity is the mother of invention. I must have unwittingly concluded that being entertaining endeared me more than, say, projectile-vomiting green slime, twisting my head three hundred sixty degrees and growling, “Your mother sucks cocks in hell.” If you need an exorcist you’re probably not presenting well, but presenting well doesn’t mean you don’t need one.

Dr. Fink asked scores of questions about my background, symptoms and reasons for seeking help. So much happened so fast after that first visit that I’d forgotten what my responses were. I was reminded nearly four years later, when he generously agreed to share his notes and impressions to help me accurately view and portray myself. I had assumed that I’d initially mentioned my recent jitteriness, lack of sleep, emotional numbness and social anxiety. I had. I said that I’d had seven years of “nothingness” and social anxiety, that I didn’t look forward to anything but felt no sadness, and that I was worried about being thought of as annoying. I had racing thoughts, pressured speech, was sleeping only five hours a night, wasn’t tired and flitted from topic to topic.

More telling and more predictive of the future was what I didn’t assume or recall. I admitted that I had researched suicide online, had “been on the verge of doing something” the week before, that suicidal ideation was “a daily thing,” and that I would kill myself if I could guarantee it would work. Later in that same evaluation visit I contradicted myself and said, “I would never do it.” Ambivalence in black and white.

About an hour into our session he said he suspected I had bipolar disorder, possibly with aspects of certain personality disorders thrown in. “This is getting serious,” I remember thinking, startled in spite of my own similar suspicions. He ordered lab work and, apparently recognizing my need to prove things to myself after twenty-plus years as a journalist, he told me to research potential diagnoses associated with my symptoms and the medications used to treat them. Even if he was humoring me it was a good idea to give me the impression that I was a participant in a team effort.

Aside from looking into specific medications, I had already read everything I could find online and in books on the symptoms of biochemical and emotional psychiatric disorders, and recognized myself in a few diagnostic categories, or at least aspects of them. There’s no shortage of information online in the form of quizzes, blogs, support groups and medical sites.

Whatever my conclusion, I had mixed feelings about hearing it from the horse’s mouth. The news would be bad but an accurate diagnosis meant a greater chance of successful treatment. It might also absolve me of responsibility for feeling and acting the way I did, proving I wasn’t a weakling incapable of fighting my own battles with myself.

At the time I still clung to my theory that I had an amalgam of behaviors that needed treatment, not an illness unto itself. But I have to admit it was getting harder and harder to uphold that hypothesis, given the physical component and commonality of symptoms and behaviors described by sufferers and mental-health professionals alike. We couldn’t all be insecure eldest children, could we?

The symptoms of bipolar depression and mania were described consistently in every reference perused. Depression symptoms include: thoughts of death or suicide; persistent sadness, anxiety or emptiness; a sense of helplessness, hopelessness, worthlessness, pessimism, guilt; loss of interest in activities that used to be pleasurable, sex included; problems with concentration, decision-making and memory; fatigue, loss of energy; changes in weight or appetite.

The symptoms of mania include: markedly increased energy, restlessness and activity; racing thoughts and rapid speech; euphoria or extreme agitation and distractibility; a significant reduction in required sleep; unusually poor judgment leading to behaviors such as overspending, taking dangerous risks and infidelity due to increased sex drive; a denial that anything’s wrong when the symptoms feel good.

All of the above rang true to a certain extent. It wasn’t unusual for me to go through periods when I stayed up until dawn for days on end, going to bed as Joe was coming downstairs to find that the furniture had been rearranged or his workshop reorganized or the walls touched up with leftover paint. I had no choice about doing these things. I’d look at a chair, decide it had to be moved, move it, realize that the gap it left had to be filled, inch a large desk across the room, switch the location of pictures, spackle the old nail holes, paint the marks left behind the furniture that had been moved, reupholster seat cushions, lemon-oil the cabinets, alphabetize CDs, etc. Frustrated to be missing something I needed, like the night I started touching up the ceilings with the wrong white and couldn’t immediately buy the right paint, I’d stay awake waiting for the hardware store to open. By then, though, my compulsions had often waned and I would lose interest in the project forever. The same boxes full of photos dating back to the late 1980s have been moved from room to room but not into the empty albums I rushed out to buy when I couldn’t wait another day to get started. Four years later they’re part of the decor.

When racing thoughts, mood shifts and detrimental feelings such as anger and frustration became too threatening to my emotional equilibrium I defended myself by turning them off. If therapists didn’t feel the need to act as grave robbers intent on disinterring the dead, the bad stuff might have remained six feet under forever. Despite contentions that what had been buried would eventually rise unbidden like a scene from “Night of the Living Dead,” it was easier to handle the numbness, even though I knew it was abnormal and deceptive.

In a blurb about bogeymen in his book called, “Earth: A Visitor’s Guide to the Human Race,” comedian Jon Stewart of The Daily Show informs aliens of the future that human children start out in touch with their primal fears, but as they mature they learn to bury them in their subconscious—“where they can do no damage.”

Major events that previously would have sent me reeling barely raised an eyebrow. On my way home from a session with Mal one afternoon I was hit from behind at a stop sign. My pulse didn’t skip a beat and I was so disconnected from the collision that I almost kept driving. In my rearview mirror I saw a girl about my daughter’s age get out her car, so I got out too. “I’m so sorry,” she apologized, walking toward me. “It was all my fault.” The old me would have pounced on that confession in case a latent injury revealed itself. The new me consoled her and warned her never to blurt out mea culpas that could come back to haunt her in a courtroom. I didn’t care that she put a sizeable dent in the bumper of my eight-year-old car. I wouldn’t have cared if it had been a brand-new Mercedes. “Don’t worry about it,” I told her. “I’ve done the same thing myself.” (I hadn’t, yet.)

When I got home and opened the mail I found an IRS bill for $13,760 in back taxes, penalties and interest due to an innocent error on my 2005 return. The old me would have been apoplectic, immediately digging up the relevant documents, compulsively checking my rationale and computations, and writing my response. The new me put down the notice and made dinner.

A few months later one of my favorite people in the world became a cancer-riddled skeleton before my eyes. When he died I knew I was devastated but I couldn’t mourn because sadness didn’t penetrate my double-paned emotional barricade. (Yet.)

Assuming that Dr. Fink would want to medicate me from scratch, I weaned myself off my antidepressant to save time. He kicked off my treatment with a mood stabilizer, Lamictal, which can be effective if a deadly side effect similar to that flesh-eating disease doesn’t kill you before you kill yourself.

Like antidepressants, a mood stabilizer can take up to six weeks to work if it’s going to work at all, and with the potential side effects of Lamictal you had to inch your way up to the optimum dosage. Before that could happen my attention was usurped by my obsessive home-improvement project. In its wake came three weeks of brutal anxiety, hopelessness, emptiness and an inability to concentrate that made it impossible to read or finish anything I started. I gave up. I didn’t believe the Lamictal would cure me and I couldn’t wait three more weeks to find out if I was right. So I didn’t.

Back in the car, I poured a little pomegranate juice into the water and opened the bag of Pixy Stix. The preponderance of purples and reds was a pleasant surprise I took as proof that I was on the right track. After a moment of indecision I extracted a purple one, indisputably the best flavor. Next it was a sip from the water bottle, then an entire straw of the tart powder on my tongue, first purples, then reds. Never oranges. I’d rather chew my pills than eat something that tastes like baby aspirin.

Every sip gave me a little thrill. I really was doing this thing I never truly believed I’d have the guts to do. I’d been as scared of dying as the next person, until living became scarier. I’ve always thought of suicide as brave. It takes courage to stride into the great unknown, defying conventions that call it sinful, cowardly and criminal. My biggest fear was that death would restore my emotions and I’d ache forever with longing for my kids. My daughter was twenty-four and my son twenty-one. My babies. Despite that terror, suicide is how I’d expected to die for as long as I could remember, though I did think I might chicken out and have to pay someone to sneak up and shoot me in the back of the head.

The all-consuming agitation and despair that took turns toying with me since finishing the house project rose to new extremes the day before I tried to die. It was the live high-voltage wire whipping around inside me that robotically propelled me to Walmart that Tuesday. The store is in the next town over from our New England-like village at the east end of Long Island, and I’d planned to fill prescriptions there en route to my psychiatry appointment the next afternoon. I didn’t need more pills to kill myself with but couldn’t resist the temptation to have extra ammo in my eclectic, extensive arsenal. They were icing on the cake—literally overkill. But I realized Monday night that I couldn’t wait around until Wednesday to see Dr. Fink. The electrical buzzing at my core made my heart pound and my thoughts veer in all directions until they crashed into a single reality: There was no escape. My focus locked onto that realization like a guided missile.

“Let me out of here!” I silently screamed, noting the distinction I had made between “me” and “I,” as if they were separate entities. Whichever of us served as the emissary to the outside world had to plot and execute our escape before icy tendrils strangled me with the terror of a swimmer going down for the third time. If I got stuck in their grasp I’d be powerless to transcend this living hell. The sense of urgency blinded me to everything except the finish line, so I galloped toward it.

Speed put enough distance between me and the demons to let me concentrate outside myself. I used the little leeway I had to make arrangements for racing down the only path in sight. The caring words of my psychiatrist—“Call me anytime if you feel worse”—were as muted as the whistle of a distant train. “Go immediately to the nearest emergency room” remained as flat as the pages and computer screens where I’d read them. Words intended to sidetrack me were the enemy—ridiculous soldiers trying to wage a war I refused to fight. The fear of death had evaporated.

The fact that I had a bona fide diagnosis in hand means only that I sought one out when I still had hope for happiness. If those sons, daughters, spouses, parents or friends who killed themselves or tried to had realized how distorted their thinking was, they may have gotten professional help and a diagnosis of their own. All guys get upset about their girlfriends; almost none commit suicide in response. To go from upset to dead isn’t the norm.

You don’t need a recognized disorder to make you prone to suicide, though it probably gets you there faster. Stress, low self-esteem, uncontrollable anger and other logical responses to painful external circumstances, such as the scorn of peers or an abusive relationship, can reroute a seemingly healthy person from life to death. The tragedy is that their acute emotional disturbance probably would have proven temporary. The same goes for someone with a painful physical condition that could have been successfully treated over time. The trick is hanging in there long enough to realize that. But I wasn’t thinking or feeling; I was a train without a conductor barreling down the tracks on a crash course.

Anticipation kept me awake all night Monday. When I finally dozed off Tuesday morning Joe was already downstairs making breakfast. I slept until ten and woke up awed by my plans for the day and champing at the bit to get going. The enormity and finality of it all made me reflective. I rehashed my rationale, double-checked my conclusions: The kids would be better off without me. Check. Joe would be happier without me. Check. Our friends liked him better than me anyway. Check. My parents, siblings, nieces and nephews might be shocked at what a fraud their fun-loving daughter/sister/aunt turned out to be, but we didn’t see each other enough for them to miss me. Rationale intact.

When my racing thoughts started chasing their own tails that morning I must have tuned them out and stared sightlessly at a wall or something because I lost an hour in there somewhere. When I snapped to attention it was noon and I was behind schedule. My death kit was already stuffed into my beach bag, so I could have left right away. Instead I drank a glass of milk chocolate Instant Breakfast to coat my stomach. Judging by the number of nights spent hovering over a toilet bowl while everyone else partied on, I knew it might not withstand the coming assault. That’s why I nixed the advice of internet pundits to dissolve my pills in vodka instead of water—no mention of pomegranate juice—for faster action.

I sneaked my beach bag out to the car, careful not to attract Joe’s attention by rattling any pills, not that I’d been attracting his attention lately. Our relationship was in a slump and our love hidden beneath layers of resentment over whose fault that was. Yelling a permanent goodbye as an afterthought on my way out the door would have cruelly disregarded our many good years, so I went up to his office and made friendly small talk, told him I was going to Riverhead to run errands and kissed him on the cheek. Then I yelled a permanent goodbye on my way out the door.

When I finally arrived at Walmart, the pharmacy was closed for lunch and wouldn’t reopen for half an hour. This hitch in the plan evoked irritability and impatience so palpable I had to force myself to focus on my heartbeat to keep from raving like a lunatic and getting hauled off by security. There were stacks of unpacked cartons next to the prescription pickup window and I laid my head on one low enough for short people. The thought that this might look strange was fleeting. I didn’t care. I cared about the clock on the wall. I cared about getting the Percocet refill Joe hadn’t needed after emergency intestinal surgery, and getting my old antidepressant refilled for good measure, bringing my prescription pill and capsule total to a couple hundred. I also had packages of over-the-counter sleep aids and whatever other drowsiness-inducing medications we had on hand for colds and allergy attacks.

I’d been surprised to read online that killing yourself requires a lot more pills than a novice like me expected. The mouthful of antidepressants I’d threatened to swallow in my twenties, during what I now identify as my first major cycle of depression and mania, probably wouldn’t have put a child to sleep for long.

Knowing more now than I did then, I spent months stockpiling everything I’d need by skipping doses of my meds, sneaking a few pills here and there from people’s medicine cabinets, saving the Xanax I’d been prescribed for flying, and rounding up every muscle relaxant, pain pill, sleeping pill and anxiety med I found in cabinets, drawers and pockets. Inside a canvas tote bag with long handles that could be tied to conceal its contents, I assembled a portable suicide kit containing plastic bags and vials full of pills and capsules; a visually pleasing little box of razor blades, each encased in a protective loop of cardboard; a tiny tube of the stuff that numbs babies’ gums when they’re teething and would hopefully work on wrists too, (death yes, pain no); gauze and adhesive tape to stop blood from dripping conspicuously in case anyone unexpectedly walked by; cigarettes and matches (why not?); cinnamon gum in case I did smoke a rare cigarette or two and couldn’t stand the taste; two Poland Spring water bottles; a pen and paper, tools of the trade I kept on hand in case a profound literary idea struck but invariably used for to-do lists; and the suicide note I’d painstakingly written inside an expensive card with a heart and the word “love” appliquéd on its front. I bought it for a wedding but decided my family deserves an expensive card on this special occasion.

I also packed the black sweater I’d wear to conceal any blood that might seep through the gauze, and the towel I’d lie on just below the high-tide line so that after I was gone the water would carry me where no one I loved would find me. I hated for anyone to discover a grotesquely bloated body with those cloudy white eyes you see in movies. Unfortunately, unless our local snappers or jellyfish had developed a taste for human flesh, I’d probably pop up intact somewhere and wanted it to be among strangers.

When I left the grocery store I noticed I was enjoying driving too much—a clear sign that I shouldn’t be driving. After thirty-five years behind the wheel, what sober person finds it fun to drive, and a minivan to boot? Luckily I’d hit the turnoff from the Main Road—cleverly named for the main road on our peninsula ninety miles east of Manhattan—onto the less-traveled back road flanked by postcard-inspiring creeks and wetlands. Egrets to the left, swans and osprey nests to the right. Sailboats under way right offshore. Clammers exploiting the low tide, something I’d loed to do when I still loved doing anything.

The beach now visible in front of the cousins’ house where I’d toiled so tirelessly was the only place I could imagine doing this. It stretches across three family homesteads and is the centerpiece of one of the most breathtaking spots in an area rife with breathtaking spots. The paradox of performing the ultimate act of self-loathing in a location I loved so much elicited another ironic smile, probably goofier than the first now that I was undeniably impaired. There’s a spiritual rightness about the place. Furthermore it was June 26 and I knew no one would be around until Fourth of July weekend.

I pulled the minivan as far up onto the grass as low-hanging branches would allow on the side of the yard not visible from the street. The house next door on that side belongs to cousins who spend part of the year in Nepal and were still over there. There is no house on the other side, just a long stretch of marshland running almost a quarter-mile to an inlet. Next to the Nepal cousins is the venerable patriarchal home of my husband’s father’s family, which was empty while being restored by California cousins who had just brought it back into the family after twenty-three years. The coast was clear, literally and figuratively.

Getting out of the car wasn’t routine. I reached over to the passenger-side floor to grab my beach bag and purse, then swung my legs around and spryly hopped down from the minivan’s raised step. I landed hard enough to lose my balance, catch my foot on a tree root and trip headlong into a clumsy trot to keep from falling. “What a fucking moron,” I said out loud in a sing-song mocking tone.

Bag and purse surprisingly still in hand, I wove my way back to the car around a mine field of exposed roots. I decided there was no reason to lug my purse to the beach, since I wouldn’t be needing cash, my BJ’s card or lipstick—already applied that morning along with a tasteful touch of eyeliner and mascara. (A dead girl wants to look her best, after all.) As soon as I’d tossed my purse onto the gas pedal I remembered my cell phone was in it, a stray thought that elicited a hazy moment of truth: Would I be needing a cell phone?

“Do I need my phone?” Five words, fourteen letters and a question mark sobered me up momentarily like a slap in the face, enabling me to fathom the implications of the answer. Yes or no? Simple on the surface but potentially a matter of life and death. “No” meant I was rejecting a life line to the outside world I planned to leave behind. “Yes” told me I wanted to reserve the option of calling for help, meaning I had doubts about my commitment.

I leaned against the hood of the car so I could stay upright to ponder this modern-day conundrum, relevant only since the advent of cell phones. Before that I would have had to drag my limp self to the nearest phone booth a mile away, claw my way into an upright position and produce a quarter to insert in the money slot. Chances are I would have died of fatigue halfway there or been squished by a potato truck. Those were the days.

I made my mind up quickly by sidestepping the larger issue like I had the tree roots. I decided the question didn’t have to be deep if I didn’t want it to be, and I didn’t. Maybe I’d feel like calling an old friend or ordering a pizza. I shoved the phone to the bottom of my funky lime green beach bag with sequined flowers. I’d splurged on it before I lost interest in shopping, one of my last pleasures to go.

Pulling a beach towel from the back seat, I made sure the keys were in the ignition for Joe, yanked my water/juice bottle from the cup holder, closed all the doors and steered myself toward the water like a feisty filly making for the barn at feeding time. I was aware of stumbling along gracelessly and knew I’d slur my words if I spoke, not that anyone would hear or that I would have noticed. My period of sobriety had soared past.

Since I’d already staked out my location it took only a few minutes to spread out my towel slightly below the seaweed and shells marking the high tide line. The sun was still bright over the bay so I could bask in it and see the water at the same time. It was more than hot enough for a bathing suit but I’d worn comfortable dark shorts and a T-shirt instead, not wanting to be found both half naked and bloated, which wouldn’t be a good look with or without lipstick.

I twisted the water bottle into the sand, then positioned the beach bag where I could easily reach into it when I needed reinforcements. Rather than dump all the vials, bags and zippered cases onto the towel and risk losing track of the order and quantity of pills I’d worked out, I planned to set up a smorgasbord and dig in. I’d go back for seconds and thirds or however many trips it took. But for now I just wanted to soak up the ambience. I closed my eyes and took a big whiff of the clean, warm breeze tinged with a tantalizing hint of seaweed and shellfish.

A poetic line popped into my head. “Smell the sea and cease to be.” It was profound; I was sure of it—so sure that I remember it plain as day from a day when I don’t remember much of anything. It definitely loses something in the translation from loopy to literary and I’ve put my finger on what that something is: profundity. That afternoon, however, I celebrated my creativity with a pomegranate toast and two of the valium I didn’t dissolve because I know exactly how they affect me and wanted to control their intake separately.

Each sip made it easier to continue, the pills having the same elephant-tranquilizer effect that half a Quaalude did back in the ’70s, when I weighed ninety-nine pounds and couldn’t handle more than a single sloe gin fizz. The short span between Quaalude ingestion and prostration was spent plowing headlong into whatever or whoever happened to be in my way, bouncing off and charging forward again until I hit the next wall, tree or person.

To the amazement of friends who thought I already moved and talked too fast even for a Northerner, my drug of choice was amphetamines, specifically the strong Dexedrine capsules known as black beauties. I took one when I had to waitress or study all night, and they worked. I was the most outgoing, organized and sincerely caring waitress ever, which translated into big tips that touched me so deeply I’d get teary. Studying while speeding was fascinating, with every previously ho-hum detail jumping off the page and etching its amazing self into my brain long enough to ace the exam or paper.

When I look back now I think I was self-medicating to combat undiagnosed behavioral-disorder symptoms such as chronic boredom and emptiness, social anxiety and a fish-out-of-water feeling wherever I was, though I’m incongruously most comfortable in water.

At the juncture between life and death, the idea of taking more and more pills grew more and more appealing. I was happy, and I hadn’t been able to say that in a very long time. I kept sipping, eating Pixy Stix and popping Valium straight from the vial with Joe’s name on its label. He’d had his own issues, diagnosed by me as post-traumatic stress disorder after getting screwed three years earlier by the company we helped build and were preparing to buy.

As I stared at the bay that had yielded so many dinners during my twenty-seven years in this beautiful village, the little swells began to look like fins, flashing me back to the first time I tried to wrest shellfish from the sea—a horrifying experience that established my suburban-girl ignorance and gave my husband a bona fide fish story to crack up the locals.

It was a month after our 1980 arrival and we’d bought an inflatable boat to paddle around in behind our rental house, where tall grass anchored by thousands of mussels grew around a small cove off the bay. I put my plastic bucket in the bow—even a five-foot inflatable has a bow and stern, not a front and back, I’d been gently but firmly informed—pushed it forward and gingerly stepped in, landing heavily on my ass, sinking lower in the water than anticipated but still able to reach over the side to paddle. I made my way to the grass and used it to pull me along, prying off tight clusters of mussels and dropping them into the bucket. Inwardly I was shouting, “Look at me! Look at me!” like a little girl showing off for her parents. I may not have been the first in my family to go to college but I’m pretty sure I was the first to harvest her own seafood.

When I saw a fin a few feet from the boat I figured it was an optical illusion, a shimmer of light on a ripple. When I saw the second, third, tenth, twentieth, I knew I was going to die—not an appealing prospect back then. The boat was fifty feet from shore, surrounded now by dozens of small sharks, and it could be popped like a balloon. A poem I wrote in high school was coming true.

Balloon Man

The funny old balloon man

reaches up to destroy

all proof of his existence

with a silver pin.

My demise might be a fin instead of a pin, but I was pretty sure all proof of my existence was about to be destroyed. One plastic paddle wasn’t going to save me.

On the off chance the sharks hadn’t noticed me yet I didn’t scream; I whimpered. All I had wanted was mussels in red sauce over a mountain of linguini. Now I’d be the red sauce. “Look at me!” became a plea instead of a boast.

Thinking I might be able to leap to safety if I could evade the fins long enough, I frantically yanked at the grass to inch the boat forward. I closed my eyes, hoping I’d be calmer if I couldn’t see death coming, which sometimes works in dreams but didn’t work in real life any better than it did when my friends pressured me into riding the world’s biggest roller coaster when I was sixteen. Petrified, I squeezed my eyes shut the second I sat down, but the darkness yielded to psychedelic fireworks. When we stopped, the attendant pried my fingers from the bar one by one.

There were no colors this time, and when I risked opening my eyes I saw I was barely a yard from the sandy patch where I’d “put in,” another nautical term I can now throw around with impunity. Since there were no longer any fins in sight I knew the sharks were about to attack from below so I dug my paddle into the muck and pole-vaulted onto the beach. Abandoning boat and shellfish offshore, I ran shrieking up the path to our house. I was crying hysterically by the time I collapsed on the kitchen floor.

Joe, then my future husband, listened as I blubbered my traumatic tale between pants and sobs. When I was finished, instead of racing to the phone to call whoever handles shark attacks in these parts, he just stood there. “You really thought they were sharks?” he asked incredulously, with a smirk of condescension or amusement. “They were sharks,” I insisted, puzzled by his cavalier attitude. “I saw their fins.”

“They must have been bunker,” he laughed. I didn’t know what bunker were, (baitfish, as it turns out), but he’d spent part of each summer here since birth so I began to believe him and sense the magnitude of my blunder. I’d suffered a near-death experience at the hands, or fins, of imaginary sharks. I’d lost our boat and our dinner. Thankfully, Joe was willing to wade into bunker-infested waters to rescue the boat and bucket of mussels. They were delicious. Soon I could tell a steamer from a hard clam and an oyster from a scallop. I could dig clams with my toes and steamers with my hands. The bunker story became one of my own cocktail party favorites.

Sitting on my towel I was moved by the natural beauty surrounding me. Even during my numbest numbness and lowest lows I didn’t totally lose my appreciation for aesthetically pleasing things, like a rectangle of Bazooka bubble gum in its wrapper, the turquoise Caribbean seen from a plane, orange tulips, the impossible iridescent colors of pheasants. But my appreciation had been marginalized.

Now beauty was beautiful again. I wistfully looked across the bay at the opposite fork, the world-famous Hamptons, and was grateful to be on the low-key peaceful side of the pond, where we leave front doors wide open and keys in our cars. Where beaches are empty on Tuesday afternoons.

It was unforeseen glitches that made a mockery of my vow to my therapist never to be one of those people who “attempts” suicide. How lame, I’d thought, smugly convinced that anyone who failed must not have been trying. I was trying hard but I hadn’t factored a few variables into the equation of what plus what equals a painless, uninterrupted death.

The first glitch was an attack of conscience. As I sat there enjoying the water view and my sodden memories, a panicky realization hit me: I had to write a second note reassuring my daughter and therapist that killing myself had nothing to do with disagreements we’d had in the past few days; otherwise they might feel guilty forever.

So before dissolving the rest of the pills, I pulled pen and paper from my bag and wrote what began as a perfectly legible, coherent letter absolving them of blame. Then my addled brain sentimentally noted that there were a lot of other good people in my life who deserved recognition. Parents, siblings, cousins. friends. Even my insurance broker came to mind. He had recently given us five thousand dollars out of his own pocket to correct a mistake that was really the insurance company’s fault. The nobility of that gesture almost made me weep in my maudlin mindset.

I vaguely recall making a mental list of deserving souls, but when my husband showed me the letter weeks later it turned out I had actually written all this down. By the middle of the page, one word was written on top of the other so only an occasional name could be made out. Sure enough, my insurance broker was there.

This was the fourth suicide note I’d written. The first two had been months earlier, when Joe was away and the night demons got me, as they have regularly since I was a kid. I grew to middle-age assuming that everyone had a witching hour that plagued them with bad thoughts, untethering them from the ground like a rising hot-air balloon. That’s when I’d count close friends and come up with zero; it’s when I’d question the state of my marriage, the love of my children, the closeness of my siblings, my abilities, if I’d ever feel whole and grown up. The worst was falling asleep on the couch watching TV and waking up disoriented in the middle of the night, not knowing if it was the thoughts that roused me or I who roused the thoughts.

That’s what happened the night Joe was away. I was sleeping on the couch because I was too scared to be upstairs with no safe escape route from prowlers who knew I was alone and whom our dog Elmo would welcome with open tongue. His harmlessness was common knowledge in the neighborhood, which he roamed freely whenever he outwitted us, which was embarrassingly often.

At first light my fear subsided as it always did, even though I wasn’t afraid of the dark per se, so I went upstairs to bed to continue my running debate: suicide vs. nothingness; real death vs. living death. I concentrated as hard as my decimated attention span allowed to find something positive to cheer me on, but that exercise shifted effortlessly to its polar opposite of finding something negative to abase me. That I could do with or without sunlight. A meaningless existence of self-imposed loneliness, self-loathing and the absolute conviction that there would never be a positive to supersede the many negatives gave me the clarity I sought. If nothing was going to change for the better then let’s get on with the inevitable, I decided. I grabbed the legal pad on my nightstand and started writing.

One note was to my family, the other to Mal, who deserved kudos for insights he’d managed to impart before biochemistry got the better of me—and before he washed his hands of me after my suicide attempt because “things have gotten too intense.”

Writing to Mal was easy, but I couldn’t capture words poignant and expository enough for saying goodbye to my kids. I self-edited until the paper looked like the hard copy of certain incompetent reporters whose stories I’d detested rewriting week after week as an editor. A rewrite was obviously in order but it was 5:30 a.m. and I had just remembered with a disappointing jolt that I had to pick Joe up at the airport in twelve hours. Leaving him stranded so far from home without public transportation ludicrously struck me as a greater offense than killing myself, so I postponed the long sleep in favor of the shorter version for the time being.

On some level I either wanted to be saved or just wanted attention, because I handed the letters over to Mal the next day, telling him to glean anything from them that might be useful to my treatment and then destroy them. I figured I’d be less likely to kill myself if I had to go to the trouble of writing suicide notes all over again.

In a way I was right. If I hadn’t wasted time writing that sentimental note on the beach I might have made it to my third helping of pomegranate pill juice, which should have been fatal according to my internet-assisted calculations.

In any case, the math proved moot because the next glitch came in the form of unconsciousness. Before I could ingest enough pills to permanently stop the calisthenics in my brain, I passed out on my towel. One minute I was there, the next I wasn’t, though for all I know I belted out Janis Joplin tunes and old high school cheers first. The problem wasn’t quantity versus time. It just never occurred to me that there was any rush. Had I known, I would have kept drinking and popping pills while writing my messy manifesto, and I would have stopped making practice cuts on my wrists and used my razor blade for real.

Left alone I might have come to eventually and finished the job, but unbeknownst to me a friend from the house up the beach had been in town after all and stumbled upon me asleep. There was nothing unusual about that for a sun worshiper like me so she kept walking. Several hours later she called Joe to tell him I’d been out in the sun a long time, and to make plans for us to play mixed doubles. Even wearing sunscreen I tan to a head-turning brown, so Joe wasn’t worried, but the secret of my whereabouts was blown.

When I still wasn’t home after the golden pre-dusk hour we call B.T.O.D., (best time of day), and I didn’t answer my phone, he did grow concerned. We seldom stayed at the beach that late anymore because hunger drove us homeward earlier with each passing year. We joked that we’d soon be lining up at 4 p.m. with the senior citizens waiting for the old-fashioned, incongruously named Modern Snack Bar to open for dinner. By eight o’clock or so he decided to check on me. Our friend came over when she saw him.

I have no recollection of what happened next, or what she thought was wrong with me. Did I have sunstroke? Was I drunk or sick? Had I overdosed on Pixy Stix? She couldn’t know for sure because, through the fog before blackout, I’d managed to stick to my plan to put everything away once I used it, so there were no vials out in the open to make her suspicious. But when I ran into her a month later we avoided the subject entirely, her discretion convincing me that she’d guessed the truth. We promised to play tennis soon.

There’s a tendency to attribute suicide to a single cataclysmic event or circumstance—a romance turned rancid, a cancer diagnosis, getting an “F” on a report card. But almost everyone eventually regroups to weather those storms. It’s human nature to fight back. Judging by my own experience and almost prurient interest in other people’s stories, there’s no tidy accounting of whys, no one thing to pinpoint that suddenly makes living impossible. A chronic situation is the likelier culprit—extreme anxiety, no highs, no lows, no hope, nothing to look forward to, no one you think would be better off with you around. The exceptions are there, but I do wonder how many of the instantly poor men who leapt from windows after the stock market crash of 1929 hadn’t already been leading lives of quiet desperation and were merely nudged over the edge by losing the one tangible thing left in their lives. I bet they presented well too, until they lay splattered on the sidewalk below.

Individuals may latch onto a unique circumstance such as an unkind comment by a peer as the singular reason to opt out of life, but researchers find that there are broader motives common among suicidal people. The narrower ones may be triggering events, but the groundwork appears to already have been laid.

In his book, “The Suicidal Mind,” which attributes the bottom-line cause of suicide to psychological pain he calls “psychache,” suicide researcher Edwin S. Schneidman lists “Ten Commonalities of Suicide.”

  • The common purpose of suicide is to seek a solution.
  • The common goal of suicide is cessation of consciousness.
  • The common stimulus of suicide is unbearable psychological pain.
  • The common stressor in suicide is frustrated psychological needs.
  • The common emotion in suicide is hopelessness-helplessness.
  • The common cognitive state in suicide is ambivalence.
  • The common perceptual state in suicide is constriction.
  • The common action in suicide is escape.
  • The common interpersonal act in suicide is communication of intention.
  • The common pattern in suicide is consistency of lifelong styles.

In spite of knowing all that, he writes, “We are initially thrown off the scent because suicide is an act which, by its definition, that individual has never done before, so there is no exact precedent.”

Anyone who feels responsible for not having predicted someone’s suicide ought to read the information sheets that come with antidepressants and other mental-health drugs to understand the impossible task they’ve assigned themselves.

Question: “How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?”

Answer: “Pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts or feelings.”

That’s fine if you’re monitoring yourself but how are you supposed to know if someone else’s thoughts, moods or feelings have changed unless they tell or show you, and why would they if they don’t want you to interfere?

Warning: “Call a healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse or worry you: thoughts about suicide or dying, attempts to commit suicide, new or worse depression, new or worse anxiety, feeling very agitated or restless, panic attacks, trouble sleeping, new or worse irritability,” etc.

Again, how can you tell what someone is thinking and feeling? A person intent on committing suicide is a sneak and a liar. If you have suspicions and sit him or her down for a heart-to-heart talk, you’re going to hear what you want to hear. “There’s nothing to worry about.” I feel good.” “My doctor says I’m doing better.” “Let’s have lunch next week.” What do lies matter when the ultimate betrayal of trust is at hand?

Psychiatrists with every therapeutic and medicinal option at their disposal are often taken by surprise when a patient tries to, or does, commit suicide if no verbal or behavioral clues are given beforehand, such as saying goodbye, quitting therapy or disposing of possessions.

“You can only stop someone if they let you know what’s going on,” says Dr. Fink, a longtime practitioner, associate professor and medical director of the outpatient psychiatric clinic at one of Long Island’s largest hospitals. And even then there are no guarantees. He consoles those left behind with their guilt and second-guessing by reassuring them of just that. “If you really believed they were going to do it you would have done something,” he tells them. “It’s not like you saw them there with empty bottles of pills and walked away. How much can you do? Can you stay with them twenty-four seven?”

Knowing the answers doesn’t stop medical professionals from questioning themselves or feeling guilty. Being the first line of defense in such a violent game is “very stressful,” Dr. Fink acknowledges. “You feel like you failed them.” He said that doctors sincerely like most of their patients and tend to give them the benefit of the doubt when it comes to sending them to the hospital. But losing or almost losing someone “changes the way you practice for a while,” he says. “You’re more gun shy and likelier to call the police if someone seems at risk.” I later learned that the hard way. But as horrible as that was for me, I understand the fear behind it. During one of the most devastating periods of my life, I asked Dr. Fink if he were worried that I was going to hurt myself. “I’m always worried that you’re going to hurt yourself,” he said. And I’m only one patient.

It’s especially daunting to know as he does that “people who really are serious about suicide usually only need one attempt.”

The fact that I tried to be one of those people came as a complete shock to Joe and the others who knew me best. Hell, it came as a complete shock to me, but for different reasons. I knew what had been going on inside but didn’t think I could face down my fear of death.


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