* This story contains themes of severe depression and suicide

Cara sat on the floor. Her arms around her knees. Taking the form of a ball. Rocking from front to back. Over and over. The rhythm was calming. Maybe. Who knows? She didn’t. She just kept on rocking. It would take more effort to think the thought to stop, than to just keep going. In noticing the action, the action became essential. And why stop anyway? It reminded her that she was alive, and she was in pain. She’d rather not knowing she was alive. But having that knowledge spurred her on to feel more, or to feel nothing. An absence of all. The absence of all felt both unnatural and innate. She loved the pain. It was now what she knew. The idea that she might someday live without the pain was ridiculous to her. The idea gradually faded. It was a useless thought.

Today she felt the pain. Just a little. Today she knew she existed, as disgusting as that was. Some days she was numb. They were better days. Those days she lay in bed, not out of sorrow, but because there was nothing that seemed worthwhile doing. On the sad days she lay in bed and cried because of the intensity of the pain, usually staring out the window, watching nothing, for hours on end. Some days people came and went, checking on her. The professionals knew how she felt, understood to an extent. They pushed her to get up. It rarely worked. Her family had no idea what to do. They came in intermittently, just to check. They gave up trying to coax her out of bed months ago. They had seen her steady decline. Even though she had what everyone called good and bad days, the trend was downwards. The good days meant a few hours up and about, out of bed.

No one knew why there was a difference in the days between sad, numb, and functional. There appeared to be no rhyme nor reason to it. No event or upset happened on the bad days. Nothing amazing happened on the good days. The days just were. Her friends used to stop by. They tried to strike up conversations. Hugged her. Braided her hair. She sat there, responded with only “yes” and “no” and a weak smile on occasion. She never joined the conversation, and gave the same watery smile in thanks for the hugs, the hair care. Most stopped. The tenacious ones continued calling for a while. She never answered the phone. A few texted her, but getting minimal or no response, they eventually gave up. She had pushed everyone away.

Cara had moved back in with her parents several months before. She could no longer take care of herself. Her mam would come in every morning and open the curtains. She knew her daughter did not want it, but mostly didn’t fight it due to apathy. Apathy for doing. Apathy for life. Apathy for everything. When the weather was mild, the window was opened. When her mind was alert enough to register the window being open, she supposed she should like the fresh air. She neither liked nor hated it, it just was. The only thoughts she ever had about the window, were whether she would die if she jumped out of it. If she landed on her head she assumed she would. Otherwise she would have been severely injured. That would have be worse than her current state. She would have been unable to kill herself then. These thoughts did not cause any alarm within her. The feelings they evoked were similar to if she had been trying to decide whether to have Chinese or Thai take-away for dinner. On the very odd occasion she thought about her parents, she realized this would devastate them. She never seemed to carry the thought further, and was oblivious of the devastation her parents would experience if she killed herself away from the house meaning they wouldn’t be the ones to find her.

A week earlier. In the middle of the afternoon. A day that the window was open. A day that the sun was shining. She burst into laughter out of nowhere. She had no idea why. It felt so foreign to her. She still felt the exact same as before. Her body told her to laugh. And laugh. And laugh. Her mom burst into the room, a huge smile on her face. “Well isn’t this a sight to see,” she beamed. Her daughter could not reply. Within minutes the laughter turned to tears. Huge gushing tears. They kept coming, and coming. She was gulping for breath, and the snot came next. Her mother had thought in her naivety that the laughter had implied some shift in mood. It had been the first positive sign in months. In fact, she then saw, that it might actually be a negative sign. Something to bring up at the next psychiatry appointment.

Today was an appointment day. Her mam and dad lead her to the bathroom. They undressed her down to her shirt and underwear. Her dad left while her mam struggled to finish undressing her. Her dad felt helpless. He wished he could help more. He remembered back to when he used to bathe his little girl as a toddler. The fun they would have splashing and playing with toys. He loved those innocent days. There was so much hope and laughter. What had happened? Where had things gone wrong? He often lent against the door while his wife bathed their daughter, his forehead and the palms of his hands against the door, as he silently wept. He waited for his wife to call him, when their daughter had underwear and a shirt on again. He took over and finished dressing her. Husband and wife frequently looking at each other with watery smiles on their faces, both knowing the other was broken. Both trying to be there for each other. Depression was a bastard and it had stolen his daughter.

Her father had been on the train coming home from work a few weeks earlier. He had a seat near the front of the car. There were two women, around his daughter’s age, standing chatting close by. He wasn’t in the habit of eavesdropping, but when he heard the word ‘depression’ he couldn’t help it. It was quickly apparent that these two did not believe in depression. He was fed up with this bullshit. Maybe he should stop believing in heart disease that had killed his father years earlier. Maybe his father would rise from the dead. He tried to tune it out and read his newspaper but he couldn’t.
“Excuse me. Excuse me,” he shouted.
The women, and most of the other passengers in the car turned to look at him.
“Do either of you have a loved one who suffers from depression?” he asked in an accusatory tone.
“Well my mother always says she’s depressed. She just needs to pick herself up,” the closer of the two women answered with a sneer.
“Do either of you know someone with clinical depression?” he clarified.
The women looked at each other and then back at him.
“No,” said the other woman.
She looked embarrassed but not remorseful.
“Until you do, you’d do well to keep your thoughts to yourself,” he spat back.
He knew the women hadn’t been converted, but at least he’d shut them up for the rest of the journey. As he went to get off the train, a woman about his age grabbed him by the wrist.
She said in little more than a whisper “Thank you. My husband has been sick for years,” she smiled gently at him, let go of his wrist and looked down again.
As he stepped off the train he was glad he had spoken up, even if he had only made one person feel better. When he got home that evening all those good thoughts melted away. Cara was having a particularly bad day.

Things continued as they had been, with good days and bad days. The good days became fewer, the bad more frequent. Her psychiatrist decided it was time to hospitalize her. She wasn’t as nervous as many people would be. She simply didn’t notice or care what was going on around her. She spent the first several days in bed most of the time. After about a week, the changes to her medications began to take effect just a little. Enough for her to feel able to get out of bed. The staff noticed the positive change. In fact the change meant she got out of bed more and could think more clearly. Her numbness and misery had lifted, but her thinking was still distorted. She saw opportunties for suicide everywhere. Cables for computers. Cheeking her meds. This involved hiding her pills in her cheek or under her tongue and pretending to swollow them. She told the staff about these ideas. They were impressed by her honesty, but started mouth checks on her anyway. All the time she was thinking of how she might actually kill herself. There were many safety measures. The were no gaps in between hand rails and the walls. No hooks anywhere. The shower simply had an on off button that was flush with the wall. Hers scalded her. The closet hands no rails, just shelves. And on and on.

When she was in bed she looked around the room constantly. She came up with a plan. When her depression had initially started a year ago she had watched many documentaries and read many articles about depression. She had still been well enough then to have an interest in getting better. She remembered that in many of the psych wards had doors whose tops were slanted so there was a gap at the top. No one could hang a noose. The doors in her psych ward were straight at the top and went all the way up to the doorframe. If she could figure out how to make a noose, she could you the door.

Over the next few days she was a model patient. There was talk of when she might be released. She was far from ready yet, but plans for her release were being put in place. Talk of temporary residential treatment. All the while she was figuring out her next steps. She knew she would have to use bedsheets, but how. They were too bulky. It would be impossible to tie them together and make a noose. She finally realized if she could smuggle a scissors out of the arts and crafts room, she could cut the sheets up making her work easy. It would be difficult getting the scissors. The staff were so careful about safety. Sometimes they took their eyes off the ball for a few minutes and forgot to count the scissors at the end of group. She would have to try to get one that way.

In the meantime, Cara wanted to prepare for when she had the scissors. Patients were allowed to change their bedding as frequently as they liked. She went to the linen rack. She took a set of sheets for her bed and a few extra flat sheets. She wanted to change her bed in case a staff member walked by soon and noticed she wasn’t changing her sheets. When she got back to her room, she slowly and laboriously took off her old linen and started putting on the new. One of the counselors, walked by doing rounds, and poked his head in. He commented on her progress, mentioning her changing of sheets as a sign of improved functionality. She gave a huge smile. The minute he left her face became expressionless again. She was glad she had decided to bring a set of linen for her bed. She sat down on the side of her bed and looked at the sheets she had stashed in her bedside table. Her pen came into view. They were allowed have pens to journal and do puzzles. To keep them occupied. Life on the ward could quickly become boring.

She decided to mark the sheet in quarters so when she got the scissors she would be ready to cut them. She folded the first one in half and mark the middle. She folded each half in half and marked again. There were three marks separating the sheet in her-perfect quarters. She knew the pen would not be able to rip the sheets, certainly not the double hemmed edges. She would try the rest of the sheet. The pen had a sharp nib. It poked through the sheet easily. She was able to make a rip about two inches long. She was able to rip all the way down to the hem with her hands. She became excited. The hem was more trouble, but it gave too. Wow. She could do this without the scissors. When she finished quartering the first sheet, she started on the second, and then the third. She stowed the lengths of fabric back in her beside locker. She was excited for the first time in months. She lay on her bed. Her feelings shifted quickly to fear, doubt, uncertainty. Did she want to do this? How much would’ve it hurt? What if she changed her mind but it was too late? She got straight back out of bed and began pacing in her room. It was not big enough. Her agitation was overwhelming. She raced out of her room and began pacing the halls. She knew the counselors and nurses would become suspicious, so she asked to be let into the Comfort Room.

The Comfort Room was a tranquil space for patients to relax. It had soothing lights, classical music, and a TV showing beautiful scenes of nature. She lay down on the couch and pulled the weighted blanket on top of her. As she stared up at the ceiling she tried to quiet her racing mind. Maybe if she could just calm down she would think more clearly. Her anxiety did not drop at all. Her breathing was shallow and fast. Her heart raced. She began sweating. She threw the blanket off her, and started pacing again. This room was tiny compared to her bedroom. She felt closed in and everything got worse. She didn’t know what to do. Tell a counselor or nurse? Go back to her room and try to sleep on it? Kill herself now? She bolted from the room without an answer. She nearly ran into Diane, her favorite counselor.

Cara stopped, unsure what to do. She managed a grimace and choked out some bullshit aimed at placating Dana. Dana asked her to sit, and took a seat beside her. Cara calmed enough to have a vaguely coherent talk, and left promising she would talk to a staff member at any time she needed that night. She went into her room, her mind still racing. She had calmed a little. Just enough to allow her to think about what she should do. She stared up at the ceiling. She knew. No she had known all along what she would do. She waited until the next room check, which were every fifteen minutes. She tied the sheets together, fashioned a noose, tested them for strength, and then put them back where she had been hiding them. She had her back to the door feigning sleep for the next room check. They barely glanced in. The minute they were gone she put on her side light. She jumped out of bed and grabbed the sheets. She threw the knotted end over the bathroom door and closed the door. She pulled hard and it stayed in place. She grabbed up higher and pulled to make sure it would take her weight, and it did. She pulled a chair over to the door and stood on it. She could just pull the noose over her head, and around her neck. She always left the window blind open. Chicago’s beautiful skyline gave hr focus points when she was staring out the window at night. She didn’t want to kick the chair over. It would cause too much noise and they would come running.

She stood on the chair trying to prepare herself mentally. It was ridiculous to think that was possible. She looked out at the city. The placed she had lived in since birth. Thought of her parents. She knew they would be better off without her as a burden. They could get on with their lives. She turned her head face-forward. The Pink Floyd song “Goodbye Cruel World” came into her mind. She pushed the chair to one side, and fell a foot. The noose pulled at her throat. She panicked. All the what ifs raced through her mind. She wasn’t sure now. This hurt. This was petrifying. She tried to shout for help. Her voice had been stolen by the sheets. Her vision tunneled in on itself. And everything went black.

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