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How I Stayed Alive When My Brain Was Trying to Kill Me — Book Review

When I saw How I Stayed Alive When My Brain Was Trying to Kill Me sitting on a shelf in my library, I couldn’t help grabbing it. The title is a work of pure genius. In an instant, I was identifying with the author (Susan Rose Blauner) and wanting to know what worked for her.

She subtitles it “One Person’s Guide to Suicide Prevention.” Her hope, expressed in the introduction, is that when depressed people or those with suicidal thoughts read her book, they’ll find something useful to keep them going. The book, therefore, is specially focused on NOT committing suicide. But I think it’s helpful for those dealing with depression even if they’re not suicidal.

If you’re not depressed and are thinking about not finishing this, skip to the “Helping a Suicidal Thinker” section.

So You Think You Want to Die?

She explains up front that she’s basing this book on a set of beliefs about suicide and suicidal thinking:

  1. Most suicidal thinkers don’t want to die; they just want their feelings to change or go away [emphasis mine. and when you think they won’t go another way, you figure the death should end it, right?]
  2. Every single feeling we experience eventually does change — with or without any help from us. They never stay the same or at the same intensity.
  3. Feelings and thoughts come from electrochemical impulses in the brain. [this is important for understanding that something might be physiologically wrong but fixable.]
  4. It is possible to outthink the brain, actively change feelings and eventually eliminate suicidal thoughts.
  5. The reality of suicide is far different from the fantasy. Most suicidal thinkers romanticize their death by suicide, failing to realize that any suicidal gesture or attempt can result in permanent brain, kidney, or liver damage, loss of limbs, blindness…or even death.

Blauner believes that when talking about suicide and our thoughts and feelings we should be very careful to use our words to shape our reality. She dislikes the word “suicidal” when applied to a person, because she believes the idea of a suicidal state is harder to break out of than her alternative. She suggests using the phrases “having suicidal thoughts” or “thoughts of suicide” instead. That reminds us that these are thoughts…they’re something we can work to overcome.

As someone who made 3 suicidal gestures, she also explains that when she came to the point she really didn’t want to die. She wanted things to be different, she wanted these things to go away, but after she’d taken the pills always ended up calling for help…even if she thought this time she’d go through with it.

Despite having made…I guess “gestures” is the proper word for them…I’ve found that the two times in my life I thought I was really going to die (one involving real choking…the kind where you don’t make a sound…and one involving a head-on car crash that I narrowly avoided) I fought like hell/drove like hell. I was angry and I wasn’t going to let this happen.

Tricks of the Depression-Defeating Trade

Blauner scatters these throughout How I Stayed Alive as tricks she’s learned through her time in therapy. Many are related to cognitive behavioral therapy, which I’ve found quite helpful. Others involve getting help…which is surprisingly hard to do when you’re depressed.

For example, Trick #5 is Feelings vs. Facts. The short version is that when you’re starting to feel things, you ask whether they’re in line with the facts of the situation.

To use a real-life example, sometimes I feel like my life isn’t worth living. If I remember to do it, this method helps me come up with some answers to that feeling. I might point out that while I can’t tell if my life is worth living it’s too early to know. Or that even if I can’t come up with a reason to live it overall, there’s nothing to say it’s not worth living today. Or that if I believe human life is valuable that extends to me as well. Or just that I have something exciting coming up in a few days or weeks.

That particular trick works best if the answers come from within you, not from other people. They can help you come up with answers, but if someone tells me my life is worth living it doesn’t mean nearly as much as coming to that conclusion myself.

Other “tricks” include Healthy Diversions, Service — Helping Others, Movement and Exercise, and practical things like Asking for Help, Therapy, and Crisis Planning.

Suicidal Crisis Plans

Blauner strongly encourages those with frequent suicidal thoughts to come up with a just-in-case crisis plan. The idea is that when you’re getting to the point of killing yourself, you can call or visit the people on this plan (there are a lot of backup people in case your top picks aren’t home) to help you defuse the situation and possibly get yourself help.

After the top people you’ve chosen (and talked with about this beforehand so they’re more prepared), you add your therapist (if you’re seeing one), suicide hotlines, local hospitals. During a particularly rough year, the author’s plan included getting herself hospitalized if it came to that. Yours may not need to, but she explained to all the people on the plan that this was what she wanted and collected local hospital numbers.

Then, there’s the smaller crisis plan. When you’re having some mildly suicidal feelings which you’re afraid might snowflake and snowball out of control, you can turn to your smaller crisis plan. It includes simple things like stopping and breathing, using the tricks of the trade (above) that you find most helpful, trying some of your favorite activities, etc.

At the bottom of the smaller crisis, include a few numbers for the people on your suicide plan. If your plan doesn’t work, they’re still there for you to talk to them. Even suicide hotlines are willing to work with you if you’re “only” having thoughts. Don’t be afraid to bother them.

Helping the Suicidal Thinker

Almost another book in itself, this section of How I Stayed Alive is meant for those who are, well, helping people with suicidal thoughts.

It covers which responses are helpful and which aren’t, why people can’t “just get over” their suicidal thoughts, and what you can offer the depressed people in your life. She includes the warning signs and risk factors which might lead you to encourage someone to get help.

She encourages families to talk, to listen well, to respect boundaries and privacy (without being sworn to a secrecy that might keep you from helping the suicidal person). She explains what is an isn’t helpful when talking to someone depressed.

This section is something which I’d like to see more people read. I’m fortunate enough to have a psychologist for a MIL and a husband who was raised by one. But a number of my friends have been told by their families “Don’t feel this way” or “You should try harder.” Not helpful.

To Buy or Not to Buy?

I think that How I Stayed Alive When My Brain Was Trying to Kill Me is a must-read. Whether you’re mildly depressed, very depressed, or not depressed at all, depression will play a role somewhere in your life. It may be a family member, a friend, a coworker, a spouse, a child.

This book shows you how (some) depression works, the impact it has on a person’s life, the nature of their thoughts.

As someone dealing with lighter and heavier depression, I found it enormously helpful. I’ve never seen someone take on suicide that well before. It wasn’t just her story but it engaged her story. It helps to know that the author has been there. And that she doesn’t think suicidal thoughts are wrong, they’re just something we have to learn to overcome.

While I’d heard many of the “tricks of the trade” before, she presented them inspirationally. She made me want to do them. I also knew I wouldn’t be alone in doing them because she does them too.

As for whether it’s a must-buy, I always suggest hitting up the library first. Then you can decide if it’s good for a one-time read or something you should have around. I’m still deliberating (I do own one really helpful book, so I’m not sure if I need How I Stayed Alive around at all times, even though it takes on suicide more than the other).

If You’re Having a Crisis Right Now

Like all books about depression and working through depression, this is no substitute for actual therapy and possibly medication.

If you’re having a crisis right now and don’t have a therapist (calling them when you’re in crisis shouldn’t bother them, that’s what they’re there for) or friend/family member you can talk to, here are some numbers for getting help:

By phone in the US: 1-800-784-2433 (1-800-SUICIDE) & 1-800-273-8255 (1-800-273-TALK).

By phone in the UK: 08457 90 90 90 (Samaritans)

By phone in the Republic of Ireland: 1850 60 90 90 (Samaritans)

By phone in Canada: 1-877-822-0140 (some sites suggest this is for adults 18 and over) 1-888-821-3760 (some sites suggest this is for youth 17 and under)

Getting help by e-mail: [email protected] (There will be some delay time because each e-mail is answered by a person. The e-mails are anonymous/confidential, their system will remove your details.)

Honestly, the only way I’ve been able to reach out to one of these groups is via e-mail. When I need help, I tend to feel as though I’m going to become an unwelcome burden. Hence talking to someone on the phone is burdening them. With e-mail, I can tell myself that they’re choosingto reply.


That One Caveman June 13, 2008 at 11:48 am

Thanks for opening up a difficult topic. I’ve had problems on-and-off throughout my life. A suicidal thought cycle is a difficult thing to break, but you have to focus on stopping feeding the source problem. Thanks for sharing this resource; I hope to find it at my local library soon.

Nicole at Breaking Even, Inc. June 13, 2008 at 11:58 am

Way to tackle an important topic… I bet there is a rise in depression due to these economic times.

I’d like to urge people to get help if you need it. Being on medication and/or going to therapy doesn’t make you weak. Remember, you know what you’re feeling better than anyone.

mrsmicah June 13, 2008 at 3:20 pm

Thanks, Caveman and Nicole.

@Nicole, I agree with you 100% about therapy/medication. Best thing I ever did. When I look at where I was beforehand, I can see that if I hadn’t stopped it I would have kept spiraling down. As it was, I regained my equilibrium and made significant progress. Things aren’t perfect, but it’s like having chronic allergies compared to pneumonia. So much better.

plonkee June 13, 2008 at 4:31 pm

I’m thinking about all the people that say you know, that you shouldn’t feel depressed/suicidal/etc because you’re young, or you’re clever or.. [insert stupid reason of your choice].

I mean it’s true, but only in the same way that people shouldn’t develop other serious or life-threatening diseases. Bad stuff happens to good people all the time. Depression is just another one, but fortunately it’s treatable (if not always curable).

mrsmicah June 13, 2008 at 4:35 pm

@plonkee, or “you have so much to live for.” If you tell me that you’d like me to be part of your future, that’s a lot more encouraging.

Not as a guilt trip but as an “I love you.”

As you say, bad stuff happens to good people. Just like an apparently healthy person may have undiscovered cancer inside, someone might appear successful but feel empty.

deepali June 13, 2008 at 4:51 pm

Great post, Mrs. Micah. And an interesting book – I will pass it along to my mom (she’s a shrink).

budgets are sexy June 13, 2008 at 9:00 pm

OMG yeah that title is SO SEXY!!! I would have picked it up too….probably wouldn’t have gotten through it all (A.D.D issues and all) but i sure would have started it 🙂

Susan June 13, 2008 at 9:50 pm

Wow! Sounds like a powerful book on a difficult subject.
Thanks for adding those important help lines at the bottom.

castocreations June 14, 2008 at 10:15 pm

Being bipolar, my spirals downward can be severe and quick. I haven’t attempted suicide in a long time but the thoughts have come up and they freak me out every time.

I disagree that suicide/depression is up just because the economy isn’t doing as good – the media makes it SOUND like the economy is in a depression but if you avoid watching the news then life really isn’t that bad economically (I just wrote a blog post about this).

Also, sometimes the “good” times are almost worse … I feel guilty when I get depressed when things are supposed to be so good all around me. Or I get even more depressed because I know I should be enjoying life and I can’t.

Anyway…thanks for mentioning this book. I’m adding it to my wish list on Amazon. 🙂

Scott June 24, 2008 at 6:03 am

I’m not in crisis at the moment. I’ve not been at that stage in several years. But that’s because I’m in a relatively comfortable situation right now (more or less).

It’s only comfortable because i take things a day at a time and don’t think about the future.

If I change that, suicidal idation comes into play.

I know someday life will become uncomfortable again and I’ll get serious about suicide.

But so what?

Therefore, I have no interest in any kind of “back up plan” when crisis time arrives.

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