When you deal with anxiety, it's hard to stop yourself from also feeling sad and hopeless. There are a few reasons for this, and for myself, I've found that this has happened to me because dealing with constant anxiety can be extremely exhausting. But I've also found that this has happened to me because the overwhelming feelings and constant worry that go along with anxiety are negative feelings by nature. It's hard to feel positive feelings about anything when you're overcome with anxiety. (Note: This post contains a trigger warning.)

Lately, I have been thinking about what it looks like when someone experiences mostly invisible illnesses, like anxiety and depression, and feels suicidal. Depression and anxiety are not always visible. People have expressed to me their surprise that I have dealt with chronic anxiety for a long time. But it's true, and I guess at some point I became really good at always acting like everything was fine. (Note: this post contains a trigger warning.)

Anxiety disorders and suicidality are connected, but when I think about how anxiety is perceived by society, I think about what I've seen on tv and in movies. I've seen so many shows where anxiety was portrayed with someone sweating a lot on a first date or being unable to speak when asked to talk in public. Some forms of anxiety are even used for comedy, like in "Parks and Recreation" where Leslie's mom meets a former love interest whose anxiety led to a comedy of errors after Leslie brings him to a party. There isn't anything wrong with these portrayals, but it is striking to me that none of the imagery associated with an anxiety disorder implies suicidality. (Note: This post contains a trigger warning.)

Treating anxiety and suicidality may not be something you think about, but anxiety is a heterogeneous disorder, encompassing a wide array of symptoms and consequently requiring distinct treatments. Although people often think of depression being involved in suicide, fewer realize that different types of anxiety contribute to suicide as well. Social anxiety, emotional dysregulation, and distress intolerance are associated with suicidal thoughts in adolescents. Panic disorder also increases the risk of suicide and is associated with higher levels of impulsivity, depression, and hopelessness. Higher suicide risk has also been demonstrated in individuals with OCD.  

Actor and comedian Robin McLaurin Williams died by apparent suicide in his California home on August 11, 2014. His death has shocked and saddened millions all over the world. I'm personally stunned. I grew up with his performances, starting with Mork & Mindy on television when I was a kid. It's a tragic, tragic loss. We took a hard punch on this one, and we'll be feeling it for quite some time. When a high profile person takes their own life, it triggers the debate about suicide itself. Is suicide selfish? Is it cowardly? How can anyone do that, anyway? And, most importantly, why didn't they ask for mental health help? How come they didn't make a different choice?

I come up against this wall plenty, in treating anxiety: Combating the sense of hopelessness, of powerlessness, that only too often accompanies the worst symptoms of anxiety disorders. How do I not get stuck when simply feeling things seems way above my pay grade? "If you know neither yourself nor your enemy, you will always endanger yourself." -The Art of War

Tomorrow is Judgment Day, according to the followers of Harold Camping. Believers say they will be taken up to Heaven, while the rest of us anxiously await the apocalypse, come October 21 2011. I have to ask: If the end of the world is tomorrow, why don't more of us believe it? Anxiety and ego strength The answer says a lot about the way people deal with self-doubt, anxiety. And this is just one example of catastrophic, prepare-thyselves thinking.

I'm somewhat reluctant to blog about suicide, but I have decided to put a few thoughts down. They're rushed, unfinished thoughts because that's the nature of the situation: a friend attempted suicide a few days ago. As I sat at the computer, contemplating what to say this week, I couldn't think about much else.