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I would wake up thinking: I shouldn’t be here. Warning alarms in my body and criticizing refrains in my head returned every day to remind me that I didn’t belong and I never would. I tried to shut off the alarms, to refute the refrains, but nothing that came to mind held meaning for me anymore.

Part of me could still imagine that the messages in my head might be wrong, but that thought did not stop the feelings. It didn’t even deter them. No matter what I told myself, regardless of all the medications I tried and despite decades of psychotherapy, the suicidal thoughts kept coming.

I had done all the things that a dutiful patient should. Somehow, though, I was still losing control over my life. As drug after drug failed, the only solace I had was the assumption that if things became truly unbearable, I could find an emergency exit. I reassured myself that suicide was always a possibility —a last resort —so I could feel a little less trapped.

Suicide is a permanent solution to a temporary problem, but temporary is a relative term. This episode of major depression had lasted for more than two and a half years. After making all sorts of lifestyle adjustments and spending many months trying different drugs at varying doses, the depression did not seem temporary. So, when I reached a point where there were no more low-risk, likely-to-work drugs left for me to try, the possibility of remission disappeared. All I could see through my darkened and myopic vision was the promise of suicide.

I wasn’t chasing death. I was running from depression on my own, along the only path to relief I could see. I was alone because I didn’t want my loved ones to have to continue to struggle with me and my depression. I was also alone because I didn’t know anyone who would assist me in suicide, and because the help that professionals wanted to be able to offer either didn’t exist or wasn’t helpful. People probably meant well when they tried to convince me that I was not thinking clearly, that I wasn’t myself, or that I was wrong. But none of those messages provided any comfort. If anything, they only made me feel more hopeless, alone, and powerless.

Depression had stolen so many things from me. I needed to believe there was at least one power that it could not take. My ability to destroy those alarms and refrains forever was the only power that I thought was still mine.  At the same time, I couldn’t risk another failed attempt. I could not maim myself in a way that would make living even more difficult for everyone around me.

So, as I lay in bed bundled under the covers with the shades drawn and the doors shut, I began scouring the Internet for a foolproof scheme that didn’t involve gruesome and painful violence. What I found were 20-to-1 odds against success. I read about all the ways that people have survived overdoses or poisonings, hanging attempts, wrist-slitting, gunshot wounds, and even jumps from ridiculously high places. And as I read, I had to acknowledge that unless I could find someone knowledgeable to help me get it right, there simply was no method that guaranteed relief.

I shut my laptop. The room went dark, and the warning alarms started blaring. My shoulders pressed in and up and my muscles tightened as I tried to hold back all the unwanted emotions. I cried loudly, and for a while it seemed like I couldn’t weep fast enough to breathe between the sobs. For a hopeful moment, I thought the pressure that had built up in my chest might finally block off my throat or cause my lungs to cave in.

I didn’t suffocate. Instead, I tried to mute the alarms and the wailing by burying my head under the pillows. I wanted to silence the fury and the panic and the shame, but squeezing all of that padding against my head didn’t help. The noise that was crippling me wasn’t coming through my ears. The alarms, the self-loathing refrains, the seductive lullabies of escape all sounded inside my head. I was the one responsible for all the destructive, negative messages, for all the anger and defeat, and even for all my frightened pleas for death. It was my voice. The sound was me…