Tw: suicide

I’m… fairly suicidal. And I don’t know what to do.

I have dealt with suicidal ideation (SI) since I was a teenager and have managed to make it to my thirties with zero suicide attempts, which considering I’m also trans, gay, and an abuse survivor, I count as a solid strength on my side. I have an arsenal of coping methods that I’ve used since I was 15 or so and suicidal thoughts began intruding. These vary from getting laid, to writing out a five year plan, to writing a long form project that I need to survive to finish, to enrolling in classes, to, a few years ago, buying a dog that I would have to live for.

The SI didn’t go away when I met my husband and we got together, but it lessened. I was always able to hold our relationship, our marriage, and our life in front of me when the idea intruded. He died in December and… this has been very very very bad. The other coping methods don’t work anymore. He is dead and I should be with him.

I’m dealing with what might be a major health crisis (may not) and I have decided that I am going to decline all medical care, should it turn out to be something that requires intervention. I told my therapist that and was told to cross that bridge when I come to it.

(I am a trans man and have started bleeding again. And not just a little - about 40-60 ml of blood every day. I am suddenly dealing with massive dysphoria, agonizing pain, as well as being told to monitor myself for hemmorhages that may kill me. I sort of hope that happens. Regardless, bleeding out a half liter of blood every month is taking its toll on me, mentally and physically.)

I have not told my therapists or doctors how suicidal I am. I have said that I want to be dead, I want to be with my husband, life doesn’t seem worth living. I haven’t said that I have been having thoughts of killing myself to make this all end. The only reason I haven’t, as far as I can tell, is that I can’t figure out a sure fire way to do it. If I knew I could, I would, but every method I have access to is highly limited for success rates.

With the health issue I am facing and my husband’s death, my GP basically said that, in his opinion, I should not and cannot make it through this, mentally, without starting psych meds. He says I need to grieve and I need to work through this, but that I cannot expect to actually be able to handle all of this going on. He prescribed me Zoloft because I said that I want to be dead and with my husband but I don’t have thoughts of self harm. IDK if this is truthful but it is true that I don’t “have a plan” which psych’s used in the past to measure me.

I have told my friends/people around me that I am having SI. They seem… remarkably unconcerned. I have stated that I wish I were with my husband and they tell me he is with me, which meshes with our belief system but isn’t what I mean. When I say things like wishing for a nuclear blast to take us out, to be hit by a train, that I would rather die quickly in the moment, etc they laugh and say they feel the same. (To be fair, who am I to judge their SI?)

But basically, I don’t know what to do for help. I haven’t started the Zoloft because it can increase suidicality (and the GP warned me about that). I don’t want to be worse than I am, but I am also in a place where I literally can’t even imagine life existing in the spring, much less working on my usual coping strategies.

I do NOT want to be forced to go in patient. I’m trans, dealing with a dysphoric medical crisis, medical complicated, etc. I went in for an evaluation earlier this month at a psych ER and, at the same time they were denying me my medications for my physical disabilities, told me they wanted to admit me indefinitely, I wouldn’t be able to check out without a 72 hour window, and I would be titrated on multiple meds at the same time, I would not have access to therapy, and I would have to go by my birth name/legal name. (I haven’t used that name since before puberty.)

My job, right now, is the only thing keeping me going. If I could work 7 days a week, I would. The ability to go into work and help my clients and do paperwork is keeping me upright. I wouldn’t be able to put pants on otherwise. An indefinite medical stay would lose me my (hourly/waged) job and, in short order, my housing as well.

My family of birth is violently abusive, so I can’t fall back on them. My husband’s family abandoned him in death and I haven’t heard from them since they got angry over his memorial services. My friends are good people, but they have their own shit going on and no one has the ability to just idk, magically find me a job and housing once I got out of the hospital.

Tl;dr: I am suicidal and dealing with a lot of shit, but really can’t do an in patient stay. Are there options for me?