The Silence That Nearly Cost Me Everything: Why I Didn’t Reach Out Before Attempting Suicide (Twice)

Written by: Maggie Augustyn, DDS, FAAIP, FICOI

There is news of people passing; people we knew and cherished leave us with pause. The people we learned about, individuals who advanced our industry with generosity and courage, sometimes leave us in shock, disbelief, and sadness. They challenge our understanding of life and send us running home to hug the people we love. It was this very kind of news earlier this month that left our community shaken. The suicide of a prominent dentist—a scientist at heart and an educator—flooded our social media feeds with words of gratitude for his contributions and advancements in our craft. Many posts began with “It is with great sadness,” but those sentiments did not fully capture the magnitude of this loss.

Dentists consistently rank among the top occupations at risk for suicide. That stark statistic was repeated to me when I first walked through the doors of Alma Mater in 2000, two years after my first suicide attempt. At that time, it seemed fitting—at least, for me, it did. Though I kept my past hidden for almost two decades, that knowledge had a strange way of making me feel like I silently belonged. I still hear this statistic echoed, not just in random conversations with colleagues but also from esteemed peers who take the stage.

The closest report we have called Suicide Rates by Industry and Occupation1 from the CDC is one from 2016, which does not list dentists separately but rather lumps them together with other health care professionals and lists their risk as 11th in line. There is a myriad of reasons as to why. The profession is committed to achieving immaculate results under the scrutinizing eyes of patients undermining our well-being. Dentists frequently find themselves at the helm of a small business, juggling the operational demands alongside clinical responsibilities.

This dual role introduces an ever-present fear of litigation and patient complaints, intensifying the pressure to maintain client satisfaction and uphold one’s professional reputation. Negative public perceptions can further alienate dentists. In this vortex of pressures, the perfect storm emerges, where the precarious mix of technical demands, business management, and personal stressors converge, driving dental practitioners to consider untenable paths as their burdens appear insurmountable and obscure the presence of hope or support.

As much as suicidality and depression are nowhere near as shameful and hidden as they once were, there is still a lot of misunderstanding that surrounds them. I know there are some of our colleagues who wonder: What can be so bad in life that one might face it to the point of being willing to take one’s life? They ask these questions because they misunderstand and think of suicide as a single act or perhaps a response to a single situation. I also believe that, for someone who has never suffered from mental illness, it’s really hard to conceptualize that kind of darkness. It’s important to highlight that thoughts of suicide are not necessarily driven by life’s situations as much as they are driven by disease—by chemistry. And that neurochemical imbalance can’t be fixed by “shaking it off” or “snapping out of it,” no differently than high blood pressure, periodontal disease, or cancer can be willed away. Suicidality, which occurs within the category of a depressive state, is an ailment that needs treatment. Can situations bring people closer to considering suicide? Yes. But the situation is not the etiology that leads to the act.

For thirty years, I’ve navigated a landscape of emotions that, at times, have pulled me into dangerous depths. It’s taken almost a lifetime to learn how to manage these feelings, how to discern the critical moment when mere thoughts of death become a harrowing desire to rush headlong toward it. In my twenties and thirties, I was often blindsided, unprepared for when a passive wish for nonexistence transformed into a reckless urge. The darkness that accompanies suicidal thoughts is thick and consuming, eclipsing the love for family and life itself, clouding judgment, and obscuring any possibility of rational thought. Within this blinding pain, where hope seems to have vanished, there exists a stark choice: surrender to the pain with its alluring promise of relief or reach out to the world beyond for help. This decision point, elusive and swift, requires unthinkable bravery, yet it holds the potential for lifesaving change. I am here to offer hope for life at the brink when no hope exists.

Disclosure: I am not a psychiatrist or psychologist, and much of what I am describing here, and will describe below, comes from my experiences as a human and as a patient. I have been in treatment for depression and suicidal thinking since 1994. I have had thoughts of suicide that date back to second grade. Thanks to a molecular biology degree from undergrad, I have some understanding of how the disease process works on a molecular level. I have some understanding of psychology from incessant research and reading of top psychology thinkers and researchers. This doesn’t give me a master’s degree or an MD, but it gives me knowledge and perspective. It keeps me learning for the sake of growing, and it helps me heal for the sake of keeping myself and my family safe. What I share, I am sharing as a patient and as a human; it is not intended to be substituted for medical advice.

I am known for evoking emotion in my writing, but in this instance, I am purposefully attempting to remove emotion. If I didn’t, we’d all stop reading halfway because the pain I am talking about would be too great to bear. This piece is designed to be read.

AN ARMY OF SOLDIERS, UNCALLED

I am eternally lucky to have people in my life who endlessly offer their hand or ear when I am faced, once again, with dancing around life-altering decisions. And I generously accept their offer, knowing I may never call. This last time, a long-time patient—a man I respect dearly—offered to be “in the army” of people who support me through the darkness. I responded with a thank you, which I wholeheartedly meant. I am grateful for the sentiment, for the offer, for an incredibly generous gesture—but one I simply know I may never call on. In possibly declining that offer internally, I also want to explain why, from my personal experience, when considering suicide in the depths of absolute darkness, a call from me was never made.

NO ONE TO CALL

I think it’s important to mention that, though this isn’t my particular experience currently, many people who do consider suicide suffer in silence. They might not have a support network. They may live in shame. They might believe that depression or mental illness makes them weak, and thus, they have no one to tell. They may also live within a network of people who are not familiar with mental illness or are unaccepting of it. They do not make the call because they have no one to call. Thankfully, we now have a solution with the rise of awareness of such issues. A call can be made anonymously to get help, and it’s free. For those with no one to turn to, call 988 for help.

FAST. FURIOUS. DANGEROUS.

When in the throes of that deepest darkness—the one that is most dangerous—it’s important to understand that the energy guiding those moments, at least for me, is very erratic. When it gets erratic, I know it gets very dangerous. I can go from melancholic and depressed to fearing I might crash my car into a light pole. It might build over days or hours, and then it’s hard to manage the feelings minute to minute.

I have been dealing with these feelings for 30 years—long enough to recognize when it gets dangerous. I know how to manage it. Now I do—30 years later, I do. When I was 20, I didn’t. When I was 30, I didn’t. I didn’t know when the feelings within me would go from just wishing for death to happen to me, which I call passive suicidality, to considering speeding to 100 miles an hour into a light pole.

When the thoughts of taking one’s life come about, they become so dark, so unpredictable, and so painful that one cannot fathom going on. This is the part I want to focus on. The pain in that very moment is so blinding that the love you feel for your family or anything earthly no longer tips the scales toward making rational decisions.

The moment I am talking about is devoid of all hope. The only place where there is hope is in the place where there is no pain—on the other side of life. And in this very moment comes a choice: to give in to the pain with a promise of peace (from the pain) or … to reach out for help. All of this happens faster than I can even explain.

IT DIDN’T HAPPEN JUST ONCE

My first attempt was in college, which put me on a leave of absence and led to a three-day hold in a psychiatric facility, followed by several months in an outpatient program. My last attempt, in 2016, was interrupted by my husband. This final plan was made in haste, and its execution began under the cover of night. I found a long enough, large enough hose, duct tape, and cardboard in the garage. I connected the hose to the car’s exhaust and ran it to the window. I was measuring the cardboard with the duct tape while sitting in the driver’s seat when I heard a commotion. I paused and saw my husband walk in.

I will never forget the shock, pain, and disbelief in his eyes. We sat on the stoop that divides the garage from the rest of the house for the rest of the night. We cried and held one another. I convinced him not to call an ambulance. In fact, I went to work that morning as if nothing had happened. For many years, no one but my doctor and my husband knew. But that moment changed my husband forever.

For weeks, he couldn’t sleep. For months, he followed me every time I went into the garage. To this day, if he knows I’m struggling with suicidal ideation, he won’t let me out of his sight. And we don’t own any hoses that might fit around an exhaust. To remove any lingering temptation, my husband drives an electric car, and I drive a hybrid vehicle.

I carry the weight of the trauma I’ve imposed on him—the fear he will live with for the rest of his life. And it’s not a lightweight burden. Yet, despite that, despite every possible treatment and prayer, despite my best efforts and compliance with therapy, despite begging and bargaining with my higher power, my disease and dance with suicidality continue.

I WON’T ASK FOR HELP

Refusal to ask for help is complicated. One reason, as I mentioned earlier, is shame and fear of burdening others. Another reason, for me, is the illusion of control. I tell myself I’ve got it under control, that I’m okay, that I can manage the thoughts. I think, “It’s not that bad.”

But, as I said, these thoughts are unpredictable and erratic. Very often, I have less control than I believe, and the impulse to act might come earlier than I could have predicted. My biggest hesitation about reaching out for help is not wanting to upset the lives of others.

• I never told my parents because I didn’t want to break them. I didn’t want to hurt or shame them. As a parent myself, I understand how heartbreaking it would be to know my child was considering suicide—but I wouldn’t be broken. As a parent, I was made to save my child. So, TELL YOUR PARENTS ANYWAY. They want to know. They want to help. It is their purpose to support, love, and carry you.
• I never told my friends, even my closest ones. Everyone leads stressful lives, and I didn’t want to add to their burdens. CALL YOUR FRIENDS ANYWAY. If the first friend doesn’t pick up, call another. Keep calling. If no one answers, text them “911.” Your life is worth fighting for. FIGHT! They will be honored to help, to have been chosen as your safe space. Imagine if the roles were reversed—wouldn’t you want to be there for them? Wouldn’t you drop everything?
• I don’t want to retraumatize my spouse. That’s a big one for me. I remember the pain in his eyes in 2016. What would his life have been like if I had succeeded? What about my daughter’s life? GO TO YOUR SPOUSE OR PARTNER. Wake them up. When I go to my husband, I often don’t say a word. He just knows. He holds me, and we figure out the rest as time comes.
• I don’t want to page my healthcare team—they have lives too. But this is the job they signed up for. PAGE YOUR CARE TEAM. I’ve done this on occasion, and each time, I feel an incredible sense of relief, even if I don’t get a call back right away. Just putting my feelings and plans out in the open makes me feel safer.
• CALL 911 or 988. I’ve been fortunate not to need this, but there have been times when I was driving with unsafe thoughts. If my husband hadn’t answered the phone, I would have driven myself to the emergency room. The fallout from going to the ER is far less than the fallout of suicide.

SO, I LIED. HERE’S THE EMOTION.

At Hobson’s choice, I made a desperate attempt to end my life without reaching out for help. The first time, I lay in the emergency room, having gained some semblance of consciousness. I saw my dad kneeling by my bed, crying. I remember his head bowed and the dark coat he was wearing. He didn’t know I was awake. He held my hand just inches away from my bandaged wrists. The pain I witnessed in this man was unimaginable, unbearable, and often too difficult for me to fully recall.

Yet within the agony that shattered his soul, there must have been an incredible sense of relief, for which he and my mom remain grateful to this day. I blocked out my mom’s reaction because I still cannot bear to remember the torment I caused her. For nearly a decade, she couldn’t bring herself to tell our extended family about my actions. At the time, I thought it was because she was ashamed of me. Today, I understand that her pain had paralyzed her voice, preventing her from uttering a word.

My second attempt, as described earlier, once again forced me to confront the aftermath of my actions. I glimpsed the unfair burden of self-imposed guilt that survivors endure and the destruction that suicide wreaks on those left behind. Their pain is as unimaginable as the pain that leads to the act itself. My own suffering would have ended, but theirs would have lasted a lifetime.

Through many thousands of hours in therapy, I learned that children of suicide never truly recover. That knowledge has always kept me fighting just a little harder. The pain that drove me to those actions was no greater or lesser than the pain I would have inflicted on my family had I succeeded. But because so many more people would have suffered, my utilitarian philosophy tells me that seeking help was the greater good.

I know it’s not that simple. I have lived through the complexity of that struggle. But… it is that simple. Since 2016, I have never stopped asking for help. I always make the call. Maybe not to a friend, but to my husband or my care team.

I will not give up. Even when the devil tempts me to dance in the moonlight and promises freedom from pain on the other side, I will not give up. Suicide will not take my life.

YOU’RE WORTH IT

The best advice I can offer to someone suffering—someone whose mind is toying with the fantasy of suicide—is that this fantasy can accelerate faster than you might imagine. Especially if this is your first or second encounter with it. That has been my experience.

In 2016, suicide, for me, happened without a plan, on a whim. It occurred at a time when I thought I had control over my life, my emotions, my family, and every outcome. But there is a very real danger in believing you have that control.

If you are in a place where you’re having thoughts or fantasies of suicide, I beg you to ask for help. You might downplay your need for help, as I did. You might convince yourself that you have more control than you do. You may even come up with reasons why your friends’ mundane tasks are more important than saving your life.

STOP.

Even if you think you’re right, even if you believe you’re not that far gone, it’s NOT worth the risk. No pain lasts forever—I promise you that. I’ve been in a place where I believed it would never end, and I was wrong. I put my life on the line because I believed it wouldn’t end, and I was wrong.

Let the tears flow. Sit still in the moment with your pain. Let it envelop you. I know you’re tired. I know you need rest. As someone who has lived with this pain nearly her entire life, I assure you: it will end—with help.

Your life is worth saving. You, as a human being, as someone’s child, parent, spouse, or friend, are worth staying alive. Remember, you may be the whole world to someone. Your spouse, your child, your friend—they need you. They want you. Their lives won’t be as full or as happy without you in them.

We don’t just need you. We want you.

Get help. I beg you. Get help.

REFERENCE

1. https://www.cdc.gov/mmwr/volumes/69/wr/mm6903a1.html

ABOUT THE AUTHOR

Dr. Maggie Augustyn, FAAIP, FICOI, is a Dawson-trained practicing general dentist, owner of Happy Tooth, author, and inspirational keynote speaker. Featured on 4 dental magazine covers and recognized by Dentistry Today as one of the top 250 leaders, she inspires others through her writing, helping them find healing and connection. Dr. Augustyn serves as the national spokesperson for the Academy of General Dentistry and as a faculty member for the Productive Dentist Academy. She contributes monthly to her “Mindful Moments” column for Dentistry Today and AGD Impact and writes for other publications as well. With unwavering compassion and a dedication to excellence, Dr. Augustyn addresses audiences ranging from a few dozen to thousands, guiding them toward fulfillment and meaningful impact. To contact her, email drmaggie@myhappytooth.com.