Discussion My Pros/Cons of CTBing

[SomewhatLoved]

I'm probably the second closest I have ever been to suicide. I'm actively considering it, have practiced my method, but still unsure. Only other time I was this close, I decided I was going to hang myself but I ended up adopting a cat. I thought maybe it would save me, give me purpose, or keep me going. It hasn't. My brother and dad have both shown interest in getting a cat - I know one of them would be happy to take care of him. I intend to start my note with "Most important is that someone takes care of Tucker" (my cat), and then describe how much to feed him, what toys he likes, how to make a space for him, etc...

Considering that, I'm trying to figure out if I should CTB. I'm unhappy all the time, but I still feel a little bit conflicted for some reason. Others have said this on the forum how some people will always want "just a little bit longer"/might cling to hope, and I think that might be me. So here are my pros and cons. I find usually putting things out into the world makes me feel more resolute because then it's not all tangled up in my head, so that's the main reason I'm doing this. I would greatly appreciate any feedback, though.

Pros of CTBing
- This past year my mental state has gotten significantly worse. Depression has turned into delusions/hallucinations. For example, while trying to be good and go on a "mental health walk" last fall I had a hallucination that the canopy of trees was bending over and encapsulating me on the trail I was walking on, trapping me in. The whole walk I felt like I was lost even though I knew where I was and like I was walking through nothing. I sat down and cried for probably an hour. Also on another occasion when I got home from work I had a hallucination that every app on my phone had hundreds of notifications and I felt completely freaked out by it (like, irrationally freaked out as if the world was ending or something). Also cried on that ocassion.
- I'm unable to maintain friendships, currently have no friends despite trying multiple times over the past few years to find community. I made a good friend this fall, but at some point something changed and they all of a sudden never seemed to be able to make plans and eventually just stopped initiating texting at all. Eventually I found out they were lying about being too busy to hang out. I tried to ask her if I said something that upset her or anything wrong, and she said no. She said I was a great friend but still seemed to push me away. This is a pattern in my relationships - I've never been able to figure out why people leave. I made a point to make sure I didn't seem too sad or depressed either, and she specifically told me she had a lot of fun when we hung out together so I am lost for why she just decided to stop being my friend without telling me why.
- Only relationship I've ever had ended really badly. I put my whole self into it and I wasn't enough, it's left me feeling empty. I now have no desire to be in relationships again despite feeling lonely.
- I have a complicated relationship with sex/intimacy what has impacted my self worth and ability to connect with my partner when I was in a relationship.
- Passion for my job, which used to be a major reason I kept going, is all gone now. I could care less about my work, and in fact most days I feel exhausted, frustrated, or grouchy while at work.
- I have no real hobbies or things I do recreationally - I feel like I have anhedonia. When I was younger I liked video games, going out with friends, going to concerts, weightlifting. I've been forcing myself to do these things but they don't make me feel better. Last time I made myself go to a concert I just felt insanely uncomfortable and out of place.
- Multiple people have told me they suspect I might have BPD, BD, MDD, PTSD, or other similar conditions. All of which are treatable but not curable. Working in healthcare alongside in a role where I interact frequently with social workers, I've often heard them talk about how there are no "cures" per se, and treatment focuses on coping mechanisms and controlling your thoughts. I feel pessimistic and this reality of just having to deal with myself forever feels very depressing. Essentially, the possibility of "getting better" doesn't even feel inspiring to me.
- I have been in therapy as well as family therapy. Neither made me feel better, and in fact I was often frustrated by my therapists. Family therapy also didn't solve any issues. We would set boundaries and they would be immediately broken (in one case, literally the next morning).
- I feel "spiritually dead". I'm not really sure how else to say it, but any meaning I found in life doesn't feel there anymore. Every member of my immediate family suffers from mental illness and/or addiction. For a long time I found meaning in the idea of staying sober/being straight-edge and trying to end the cycle but I honestly stopped seeing any purpose in that a while ago.
- Currently suffering from two or three addictions myself which leave me feeling drained. I have tried to overcome them multiple times but failed.
- Even when I have "good days", I'm not really happy in a rich, fulfilling sense. Moreso I just have something that momentarily excites me. For example, Yesterday me and some coworkers were having fun joking around during downtime at the end of shift, but as soon as I clocked out and started driving home I just felt depressed.
- I've been trying to work to build a good life and people tell me I'm so hardworking and such a good guy, but things feel like they just keep getting worse. I have a full time job with decent pay, benefits, vacation time, stability, and I have savings which I could potentially eventually put towards buying a house, vacationing, or retiring, but I'm still not happy. Nor do I really think buying a house or vacationing or anything would make me happy. I briefly lived on my own and I wasn't happy, vacations in the past haven't made me feel better either.

Cons of CTBing
- I could still potentially try antidepressants, anxiolytics, mood stabilizers, antipsychotics, etc. Most people I know have had bad experiences with these though, saying it doesn't make them feel better. Just "numb" - like the thoughts were still there but just sort of off to the side.
- I could also try transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) or other non-traditional treatments, but again I'm unsure of the benefit or if I would even be "prescribed" them if I asked. Nor do I really even see any point in recovery, as stated in the pros section.
- I would feel guilty or ungrateful because I know my parents tried to create a good life for me, and I know they love me and would miss me or be hurt by me dying.
- I worry about my cat.
- Part of me feels like I don't want to die, but these thoughts usually follow me thinking about how CTBing could be uncomfortable.
- My family might be financially worse off because of my death.
- I was thinking I might get a motorcycle this spring, but I really doubt that would make me happy in any meaningful way. Riding a hunk of metal might be fun or exciting in the moment, but it wouldn't matter in the big picture.

 

[saucerfulofsecrets]

Hey, I don't have much feedback to provide overall, but here's my two cents on a couple of things you've said.

If you are open to it, try medication. They will provide you with non-traditional treatments once you prove that any disorders you may have are treatment-resistant. This could be a journey that takes multiple trials of multiple different medications, but it'll keep you here while you try. You'd have the time to care for your cat, and potentially get a motorcycle. It doesn't have to "matter in the big picture" in my opinion, unless it will overall financially hurt you. We make our own purpose, and if that's part of it, you should get it.

I was diagnosed with BPD two years ago after getting the cops called on me and a pretty gnarly hospital visit. I initially thought I was Bipolar, but the BPD diagnosis made much more sense in the grand scheme of things, so I wasn't completely caught off guard. It's really intimidating clearly, it's a disorder that I would never wish upon those who've wronged me the worst, and you will have to live something like that for the rest of your life. But, that's not to say it will always have control of you.

I've been through many different medications since my first-ever clinical diagnosis of depression, and I am currently on an antipsychotic and antidepressant. I take more of the latter than the former. The antipsychotics (Seroquel) have exponentially helped my mood swings. I am not numb, as I still feel intense emotions (as I always will, due to BPD), but they are so much easier to regulate. I find, however, that they do not help with depression by themselves.

While you should take into account your peer's experiences with different medications, remember that medications react differently with everyone. That's why I'm hammering it in to, if you can manage to stick around, try it and see what works for you.



Best of luck, and I hope that whichever option you choose brings you bliss and comfort.

 

[Fall_Apart]

In my opinion, the fact that you are considering pros and cons means that it is not the time to consider CTB. You also talk about medications that you could try to recover from your depression, and this is once again a sign that there is a part of you that still considers recovery as a possible path. Don't get me wrong, this should not sound like a pro-life message, because I am always in favor of choice, whatever the reason. In any case, there is always time to do CTB, but I think that in your case you should at least consider an attempt at recovery without rushing. Then you can make your choices with serenity.

 

[roommate]

Like mentioned above; You have so many things to try still, please give it a chance :)

 

[Freebandzgang]

The fact that there are cons should make you reconsider, i understand you are close to ctb but you have 7 more cons then i do. You have 7 reasons to live, you have 7 chances to restart your life. I respect whatever decision you make.

 

[gothbird]

Hey—first off, thank you for writing all of this out. That probably took more out of you than most people will ever realise. I don't think people understand how hard it is to be this articulate while carrying this much pain. So, for what it's worth: I see it. And I believe every word of it.

The first thing I want to say is this: just because you're conflicted doesn't mean you're not serious. It doesn't make your pain less real, or your thoughts any less heavy. That "pull" toward wanting just a little more time—toward some kind of imagined maybe—isn't weakness. It's instinct. It's human. And it doesn't invalidate the twelve other reasons you gave for wanting to go. It just complicates them, which is what being alive does. You're allowed to hold both things at once.

You don't need to be sure. You don't need to feel peaceful. You don't need your pain to have a perfect cause. You just need to be honest—and you already are.

What really stood out to me is that everything you've tried has been intentional. You've fought like hell. You didn't just sit in your sadness. You adopted a cat. You reached for connection. You went on walks, tried hobbies, tried therapy, tried to give meaning to your pain. You even tried to build a life other people would want, thinking maybe it would make you want it, too.

That's not laziness. That's not failure. That's someone who's been trying to outrun despair in every socially acceptable way possible. And now you're just tired.

I also want to point out something that might not be obvious to you: the way you've cared for your cat says so much about who you are. A lot of people leave without thinking of the animals they loved. But you? You're planning your note around making sure Tucker is safe and loved. That matters. You've already made sure love didn't die in you—even if everything else did. That kind of care is rare, and it says a lot about how much you've given—even when you had nothing left.

Now, onto the guilt. You're allowed to feel it. And it is valid to think about what your family will feel. But here's the thing: guilt doesn't mean you're wrong. It just means you still carry compassion. You said it yourself—your family tried, and they love you. But that doesn't automatically undo twelve years of quiet internal collapse. Love doesn't cancel out despair. And having a decent job, savings, or a life that "looks fine on paper" doesn't mean you're not allowed to want out.

People look at pain like it's a math equation: if you have XYZ, you shouldn't feel ABC. But emotions don't care about logic. You've outlived passion. Outlived meaning. Outlived the feeling that life was something you wanted to participate in. That isn't selfish. It's just true.

If you want to know my honest opinion?

You sound like someone who's already died emotionally and just hasn't stopped breathing yet. And I don't say that to dramatise it—I say it because I know what it feels like. When nothing lands. When joy is theoretical. When you could win the lottery and still feel nothing but the echo of "okay, now what?" It's not about lacking potential. It's about lacking the capacity to care anymore.

That doesn't mean you should go. But it does mean no one gets to shame you for thinking about it.

If you do stay—don't do it out of guilt. Do it because some part of you still wants to see what a future version of you might feel. Maybe that part is small. Maybe it only speaks up when you're tired, or scared, or feeding the cat. But it's still part of you.

And if you don't stay—then I hope you go as gently as possible, with the same care you're already trying to extend to the people and creatures around you. That alone says everything about your character.

Whatever happens, you've already done more than most people ever will:
You were honest.
You were kind.
You saw yourself clearly.

I'm here if you need.

 

[WatchmeBurn]

I could still potentially try antidepressants, anxiolytics, mood stabilizers, antipsychotics, etc. Most people I know have had bad experiences with these though, saying it doesn't make them feel better. Just "numb" - like the thoughts were still there but just sort of off to the side.

There may be a selection bias here, you're better off reading academic studies on them rather than just relying on anecdotal evidence. The total body of evidence suggests that antidepressants (and other mental health medications) do work for a significant percentage of people. Their efficacy is significantly better than placebo. As for the side effects-they are real, but for most people they are mild. They wont make you 'not you', and they certainly wont remove your agency such that you couldn't go off of them if you wanted to anyway. Just remember that it takes 8 weeks or so for them to have an effect, so don't give up right away.

It's not uncommon for the first one not to work. Apparently around 40% are helped by the first one, but then most of the remaining 60% are helped by the 2nd or 3rd. Let's say you try 3 medications-that's 6 months. Not a lot in the grand scheme of your life. Ofc I am not even going to advocate giving up after 3. I've tried 15! If you've not even tried any medications then, to be honest, I think it'd be a grave mistake to kill yourself before giving them a proper go. You could still be happy and live a good life. That, to me, is worth giving a go, for surely living happily is better than dying if possible?

Suicide is only really the obvious choice for unbearable and **incurable** disorders. You cannot say what you have is incurable/untreatable in any way.

- I could also try transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) or other non-traditional treatments, but again I'm unsure of the benefit or if I would even be "prescribed" them if I asked. Nor do I really even see any point in recovery, as stated in the pros section.

rTMS and ECT both have pretty strong efficacies. I think rTMS has 60% and ECT about 70%, off the top of my head? But ECT has worse side effects whereas rTMS almost exclusively has very minor ones. That said, unless you can afford to go private (IDK anything about where you live or what your financial situation is) you will not be prescribed either before you try antidepressants and/or other mental health medication. They're pretty much only given to people w/ treatment-resistant mental health issues because they're both much more expensive to administer and, in the case of ECT, it can have significant side effects.

I think it's worth trying rtMS after medication if it's available to you. ECT is a tougher decision and you'll have to decide the risk/reward of that for yourself.

- I have been in therapy as well as family therapy. Neither made me feel better, and in fact I was often frustrated by my therapists. Family therapy also didn't solve any issues. We would set boundaries and they would be immediately broken (in one case, literally the next morning).

I wonder what specific types of therapy you've tried-what therapeutic approaches? E.g., CBT, DBT, EMDR, and so on and so forth. Different mental health issues (and conditions) respond better to different treatments, and different people will naturally resonate with some more than others regardless. For instance, if you do have BPD/EUPD, then DBT is the most effective treatment by far. Other therapies are not as efficacious.

As for the family therapy-it sucks that your family isn't cooperative and, yeah, that's probably going to make it not work. Do you still live with your family in that case? Are you going to be in a position to move out at any point in the near future? This could help you a lot if some of the issues are caused by cohabitation w/ family. I don't know, of course.

- This past year my mental state has gotten significantly worse. Depression has turned into delusions/hallucinations. For example, while trying to be good and go on a "mental health walk" last fall I had a hallucination that the canopy of trees was bending over and encapsulating me on the trail I was walking on, trapping me in. The whole walk I felt like I was lost even though I knew where I was and like I was walking through nothing. I sat down and cried for probably an hour. Also on another occasion when I got home from work I had a hallucination that every app on my phone had hundreds of notifications and I felt completely freaked out by it (like, irrationally freaked out as if the world was ending or something). Also cried on that ocassion.

If you're suffering from psychosis then I think it's even more pertinent that you seek out medication. Treating psychoses and delusions = higher efficacy than just treating depression in itself. I'm not a medical professional and I'm not going to armchair diagnose you or whatever, but if you say this to a trusted medical professional then they'd hopefully put you on a more intensive and specialised treatment pathway than if you 'just' had depression. Again, this makes it clear to me that it would be wrong to try and commit suicide when you've not tried any medications.

Mental health issues-but particularly psychoses/delusions-are not just 'in your mind' so to speak, they have a specific physical pathophysiology, and thus treatment can help even if you'd rather kill yourself at this exact moment.

- Multiple people have told me they suspect I might have BPD, BD, MDD, PTSD, or other similar conditions. All of which are treatable but not curable. Working in healthcare alongside in a role where I interact frequently with social workers, I've often heard them talk about how there are no "cures" per se, and treatment focuses on coping mechanisms and controlling your thoughts. I feel pessimistic and this reality of just having to deal with myself forever feels very depressing. Essentially, the possibility of "getting better" doesn't even feel inspiring to me.

Well I wont presume until you secured a formal diagnosis. All of these are very different conditions w/ different treatment pathways and even prognoses.

Technically you can go into remission for all of them, though it's obviously a long-term thing. If you don't meet the diagnostic criteria for a long period of time then you are considered 'cured' of it. In time, treatment can alter the physiology in your brain to the point where whatever causes the symptoms of mental ill-health is just not happening anymore. People can live happy and fulfilling lives with this stuff, and when you've not even tried any treatments you cannot know if you are one of them or not.

No, not everyone will go into remission, and not everyone will even be able to manage it (there are some people for whom their mental health issues are incurable, and it is they who I'd say have impetus to a peaceful and dignified death above all else. This is, however, a minority of people. Most people with mental health issues will never kill themselves or even attempt suicide, for example. You could be in the majority and it'd be a grave mistake to call it quits before you've even figured it out!

 

[SomewhatLoved]

Thank you everyone for your thoughtful replies. I will consider trying further interventions like going to a different therapist, possibly trying psychiatric medications, or other things. However, part of me feels that recovery would not be worth it. Even if I continue living there are problems that will likely never go away and will continue to burden me in some form for the rest of my life. My life does not feel that special, and a lot of my goals in the past that I believed could make me feel special are now unrealistic for me to achieve. People tell me that I don't have to be "big picture" happy, and even just small moments of joy are ok and should be enough. But I feel unsatisfied with that and I always have.

I wonder what specific types of therapy you've tried-what therapeutic approaches? E.g., CBT, DBT, EMDR, and so on and so forth. Different mental health issues (and conditions) respond better to different treatments, and different people will naturally resonate with some more than others regardless. For instance, if you do have BPD/EUPD, then DBT is the most effective treatment by far. Other therapies are not as efficacious.

From my recollection it was DBT for both my individual and family therapy. We mainly focused on things like coping mechanisms and how to deal with certain emotions, and in family therapy it was mostly about how to communicate with each other and setting boundaries.

If you're suffering from psychosis then I think it's even more pertinent that you seek out medication. Treating psychoses and delusions = higher efficacy than just treating depression in itself. I'm not a medical professional and I'm not going to armchair diagnose you or whatever, but if you say this to a trusted medical professional then they'd hopefully put you on a more intensive and specialised treatment pathway than if you 'just' had depression. Again, this makes it clear to me that it would be wrong to try and commit suicide when you've not tried any medications.

I'm worried that if I opened up about my psychosis (if that's what it is) I would lose my livelihood.

The total body of evidence suggests that antidepressants (and other mental health medications) do work for a significant percentage of people. Their efficacy is significantly better than placebo.

I think I have an aversion to anything psychoactive (even prescribed drugs) as a result of growing up in a home where substance misuse was a common issue. I was assaulted by my own brother who was abusing prescribed Ativan as well as alcohol alcohol when he abruptly stopped taking all of his meds for his BPD, depression, and other conditions. I know it's possible they could help but I honestly feel unwilling to try because I think I am traumatized by these things.

The fact that there are cons should make you reconsider, i understand you are close to ctb but you have 7 more cons then i do. You have 7 reasons to live, you have 7 chances to restart your life. I respect whatever decision you make.

I feel 6 of them are not so much reasons to live, but more so just possible ways I could be treated medically or external reasons that I feel compelled to drag myself forward for the sake of others. I don't really see taking antidepressants is a reason to live. I only have one real thing I look forward to, and as I said I think I even sort of know that getting a motorcycle wouldn't really make me feel different in any meaningful way. The desire to even get a motorcycle arose around the same time my mental state started decreasing. When I was in school I had an instructor tell me about a family member they had who suffered from schizophrenia and bipolar disorder who bought a motorcycle during a manic phase and would go way over the speed limit. Of course this is just anecdotal, but I'm not even sure it's a genuine aspiration so much as a high-risk behavior that has risen as a result of my mental state. Similarly at work I feel like I've developed a disregard for my own safety. There have been times I was going to put myself in a position of danger for the sake of providing patient care and a coworker stepped in to remind me I shouldn't do that.

Hey—first off, thank you for writing all of this out. That probably took more out of you than most people will ever realise. I don't think people understand how hard it is to be this articulate while carrying this much pain. So, for what it's worth: I see it. And I believe every word of it.

The first thing I want to say is this: just because you're conflicted doesn't mean you're not serious. It doesn't make your pain less real, or your thoughts any less heavy. That "pull" toward wanting just a little more time—toward some kind of imagined maybe—isn't weakness. It's instinct. It's human. And it doesn't invalidate the twelve other reasons you gave for wanting to go. It just complicates them, which is what being alive does. You're allowed to hold both things at once.

You don't need to be sure. You don't need to feel peaceful. You don't need your pain to have a perfect cause. You just need to be honest—and you already are.

What really stood out to me is that everything you've tried has been intentional. You've fought like hell. You didn't just sit in your sadness. You adopted a cat. You reached for connection. You went on walks, tried hobbies, tried therapy, tried to give meaning to your pain. You even tried to build a life other people would want, thinking maybe it would make you want it, too.

That's not laziness. That's not failure. That's someone who's been trying to outrun despair in every socially acceptable way possible. And now you're just tired.

I also want to point out something that might not be obvious to you: the way you've cared for your cat says so much about who you are. A lot of people leave without thinking of the animals they loved. But you? You're planning your note around making sure Tucker is safe and loved. That matters. You've already made sure love didn't die in you—even if everything else did. That kind of care is rare, and it says a lot about how much you've given—even when you had nothing left.

Now, onto the guilt. You're allowed to feel it. And it is valid to think about what your family will feel. But here's the thing: guilt doesn't mean you're wrong. It just means you still carry compassion. You said it yourself—your family tried, and they love you. But that doesn't automatically undo twelve years of quiet internal collapse. Love doesn't cancel out despair. And having a decent job, savings, or a life that "looks fine on paper" doesn't mean you're not allowed to want out.

People look at pain like it's a math equation: if you have XYZ, you shouldn't feel ABC. But emotions don't care about logic. You've outlived passion. Outlived meaning. Outlived the feeling that life was something you wanted to participate in. That isn't selfish. It's just true.

If you want to know my honest opinion?

You sound like someone who's already died emotionally and just hasn't stopped breathing yet. And I don't say that to dramatise it—I say it because I know what it feels like. When nothing lands. When joy is theoretical. When you could win the lottery and still feel nothing but the echo of "okay, now what?" It's not about lacking potential. It's about lacking the capacity to care anymore.

That doesn't mean you should go. But it does mean no one gets to shame you for thinking about it.

If you do stay—don't do it out of guilt. Do it because some part of you still wants to see what a future version of you might feel. Maybe that part is small. Maybe it only speaks up when you're tired, or scared, or feeding the cat. But it's still part of you.

And if you don't stay—then I hope you go as gently as possible, with the same care you're already trying to extend to the people and creatures around you. That alone says everything about your character.

Whatever happens, you've already done more than most people ever will:
You were honest.
You were kind.
You saw yourself clearly.

I'm here if you need.

Thank you for this message, you've made me feel heard and listened to in a way I haven't in a while. I resonate with what you said about how it seems like emotionally I have already died in some way. A lot of the time when I look at the world it feels like there's no colour in it. Everything feels sort of gray and muddy. All my aspirations pretty much feel impossible now because my mental state has worsened.

I'm not sure what I'm going to do. As I said, I know I maybe have some options but in a lot of ways I'm tired of putting up with life. You cannot negotiate, you are subject to the terms and you either have to accept them or fall behind. If you don't want to play your only option is dying. I'm not reall sure I want to keep playing.

I think next week once I've tied up some loose ends I'm going to go to the forest where I planned to kill myself the first time (also where I had my hallucinations). I'll tie a rope with a noose to a tree and stand there and see how I feel. I think being in that moment and having the opportunity in front of me will help decide what I want and if it would be worth it to keep going.