Thoughts on Suicide

I lost a client to suicide last year and I had to sort through some painful feelings as a doctor.  Was there something else that I could have done? Was there something else that I should have said?  I naturally turned inward and searched myself, and I suspect that many loved ones did this as well.  As a physician who has taken care of cancer patients over the decades of my medical practice, it was not unusual for me to lose a patient if they died from their cancer.  This happened occasionally, despite my efforts, and despite the efforts of the cancer teams that I worked with.  Sometimes cancer is a fatal illness.  Sometimes depression is, too.

I have never had cancer, but I have certainly had periods in my life when I battled depression.  Psychiatrists call this major depressive disorder, or MDD.  As an illness, MDD is often treated with a variety of antidepressant drugs, which at times can be helpful.  Depression is pictured by the mental health industry as an illness of the brain, caused by a ‘chemical imbalance’ or a deficiency in certain compounds called neurotransmitters, like serotonin.  The medically accepted treatment of MDD is to dull the symptoms of depression by chemically correcting the molecular deficiency,.

But sometimes, depression is really a symptom that evolves in the wake of trauma.  Depression that surfaces after trauma can be a fatal illness too.  While antidepressants might reduce symptoms in some people, pills cannot heal trauma.  Trauma leaves behind a harmful pattern of mental processing, where we think badly about ourselves, and we lose our sense of hope.  In the middle of this sadness and hopelessness, it is quite natural for us to experience thoughts like “I wish I wasn’t here”.  I was a doctor, early in my career, when these thoughts began to well up for me.  It was actually at a self-help group where I heard a woman say, “Suicidal thoughts are not normal: they are a symptom of depression!”  A light came on inside me at that moment, and I realized that I was actually experiencing the symptoms of depression. I eventually reached out to a psychiatrist, who started me on antidepressants.  The medicine helped me feel somewhat better.   However, there was a kind of healing that I really needed that was not to be found in a pill.

I once saw a T-shirt  that said “Be Kind: you never know what someone is going through”. I would add (to this deeply true statement: “unless you ask”.  I ask people all the time.  I look back with regret on a few times when I didn’t ask, and then lost someone to their depression.  Just putting suicidality into words and sharing it with someone can have the effect of taking you out of the feeling, for a moment.  There is a huge difference between being suicidal, and objectively noticing your own suicidal thoughts, from the outside.  And there is even a greater breakthrough when we share our hidden feelings with someone who is compassionate, and with someone who knows what these feelings really mean.  What suicidal feelings really mean is this: my life is unbearably painful. Wanting to die is a human response to a human condition.  And it is also something that can heal.

Like antidepressants, ketamine has been used as a drug in the field of mental health to treat depression, and to even treat suicidality.    In this arena, ketamine, which works on the glutamate system in the brain, can have a rapid effect (in hours or days) to provide relief from these feelings.  But like antidepressant pills, the drug ketamine is not able to heal trauma by itself.

But ketamine has some other critically helpful effects. Besides the alteration of brain chemistry with the glutamate system, ketamine also makes it possible to heal the effects of trauma, if that is your intention.  This is because ketamine creates a temporary state of flexibility (“neuroplasticity”) where it becomes possible for us to think about our lives in a completely different way.  When ketamine as a medicine is combined with therapy, deep healing can occur.  The combination of ketamine plus therapy is known as “Ketamine Assisted Psychotherapy” (or KAP, for short). KAP isn’t just talk therapy.  KAP is an experience.  KAP sessions often turn into experiences that contain meaning, producing insights that give relief and lasting change.  For example, in KAP sessions, people might report feeling less fearful, as they experience themselves in a new courageous way. Others might report the experience of grief, as they process a loss from the past. It is said that it takes an experience to heal an experience. This is the real healing power that people find in KAP.

KAP is not a medical "drug procedure". In some ways, KAP is  more like a kind of spiritual ceremony that is done for personal work, where clients invite self-healing for trauma. This is kind of difficult personal exploration becomes possible if it is done with a knowledgeable guide.  If this kind of healing calls out to you, I encourage you to explore a consultation with a KAP provider.

If you are actively considering suicide,  or struggling with harming yourself at this moment, I encourage you to reach out to Crisis services, which can be reached  by dialing or texting 988. The 988 Suicide & Crisis Lifeline connects you to trained crisis counselors 24/7. They can help anyone thinking about suicide, struggling with substance use, experiencing a mental health crisis, or any other kind of emotional distress. You can also call, text or chat 988 if you are worried about someone you care about who may need crisis support.

Gregory Loewen DO FCCP is located in Buffalo NY, and is a leading provider of KAP, in the community, working closely with an allied team of trauma therapists, offering a compassionate and expert approach to this innovative treatment. If you’re exploring options, a consultation might be the next step to learn about whether KAP could be right for you.