For those expecting game design content, this is very much not that. This is me talking about my mental health and how back in 2010, I nearly killed myself. I'm posting it because I'm tired of being quiet while others I know and meet believe they suffer in solitude.

(Edit to add: free free to share this post. I did it not to focus on myself, but because I know there are folks who could hear others talk about this.)

Hi, I’m Ryan, and I take medication to control anxiety.

I want to talk about what preconceived notions you might have upon reading that sentence. I don’t know who all is reading that—nature of posting it online—but I’m sure some of you out there think “oh, anxiety, everyone deals with that. get over it.” I know this because that’s what I thought once.

Turns out what anxiety means to people who don’t deal with it chronically and what it means to those for whom it’s a medical condition are Two Totally Different Things, and they happen to manifest with similar outcomes. (In other news: the English language is imprecise on many other fronts!) So I’m going to take a stab at what it means for me to say “I suffer from this mental illness.”

I want you to go out and get drunk. I mean, ripped up, near blackout drunk. Commune with vodka. Become one with tequila. Whatever it takes. And when you do, don’t drink water or anything to mitigate the hangover.

Now I want you to crash, wake up, and feel like utter shit. Specifically, I want you to feel that odd state where everything is too loud and bright, where your mind is in a fog, where thinking hurts. And I want you to take a Mensa test in that state.

When your brain shuts down because it cannot handle the input, when the ache in your head becomes too much to bear, then you’ll know what it was like for me for 2010 and much of 2009.

Oh, and when that happens, you can take a drink to make your head feel better. And you’ll know why I have the reputation I do for being a lush.

Anxiety isn’t, for me, about being scared of shit. It’s about having a head that is in a continual, painful fog, made worse my inputs and points of decision. Things I can autopilot—going to the same restaurant and ordering the same thing, hanging with the same people, etc.—were things I did because they took, like, no effort. They did not hurt to think about.

Hang on, I’ll back up. There is a fear involved, but it’s not a fear of whatever I’m doing. It’s a fear of suddenly being in more head pain because I put myself in a situation where I have to take in more inputs that I can handle. If you’re familiar with Spoon Theory, this is pretty similar (and if you’re not, and you know people in your life who deal with chronic illness, you should get to know it: Dealing with something that causes high contact—a lot of inputs or decisions—costs me a spoon.

So here I am, constantly in pain when I have to use my head, which is all the time. For a couple years, as this problem began—something I only now see in hindsight—I was able to solve it be drinking. I edited a number of things a little buzzed, because that’s when my head didn’t hurt. Unfortunately, in my day job, I couldn’t just be drunk all the time, so I started to suffer there. I thought it was stress—the economy was tanking, and the idea of being one of thousands of state workers potentially laid off in a government town, all competing for the same scarce jobs, was a hell of a thing to be stressed about. And while I certainly was stressed, that wasn’t the problem.

I tried changing my situation, but it didn’t help. I understand why today—it’s not like I can escape the problem when the problem is my head and not my situation—but back then I was demoralized. I felt lazy, because I couldn’t muster the energy to do as much as I needed to, as much as my colleagues did. I constantly felt like a failure, which only served to downward spiral me. And so, with the constant chronic pain in my head (and elsewhere physically) and the defeatism that it fostered, I made a decision: I was going to commit suicide.

This was in April of 2010. I made a plan, which involved sucking it up and pushing some books I cared about out into the world, and being “done” around mid-2012. This was a cold, seemingly rational decision on my part. I was in pain. The pain wasn’t leaving. I didn’t want to live like this anymore.

(Since then I’ve read up on suicide psychology. It’s interesting how textbook my thought process was. I’ll leave it to you, the reader, to google more about that.)

Every day, I would wake up. I would be in pain, from the anxiety, from the gout, from a dozen other things. I would think “it’ll all be over soon.” And I’d to go bed, thinking “it’s okay, I have an end date.” You know what? That was actually a fucking comforting thought. Now, today it wouldn’t be. But then? Man, it helped me get through each day.

If you saw me at a summer con in 2010 (the year we released Dresden Files, by the way), you probably saw a happy, excited, celebratory Ryan. I was happy. I was excited. I was celebrating. And all the while, none of that changed the plan. The pain was there (except when I was drinking) and I knew this elation was transitory. I was even thinking during Origins that year “Yeah, I’m glad this happened before I punched my ticket.”

As the months went on, I kept revising down my “end date.” The pain was getting worse. My ability to cope was shrinking. By November, I wasn’t sure I was going to make it a couple more months. The pain was getting worse, and my economic situation suffered greatly from it. That’s when people finally talked me into getting psychiatric help. I remember walking on a bridge over a busy freeway—around 2pm, so the traffic was fast—and looking for a way to get past the fence. I could see one, and I stopped, pondering just letting go.

The reason I didn’t is because I didn’t want my final moments to be of that selfish asshole that ruins a day and traumatizes people.

It took a couple weeks to finally get my my insurance to give me an appointment. And you know what’s really fucking...I can’t tell what the right word is. Demoralizing, maybe. Frightening. Eye-opening. Anyway, here’s what it’s like to be on the phone with a screener:

Do you think about hurting yourself? Yes.
Do you have a plan? Yes.
Tell me about your plan. I tell. (And that's something I'm not willing to share.)
Do you have a gun? etc. etc. (The answer was no, but if I had, I would have already used it. Which is why I won’t own a gun.)

There’s nothing quite like hearing yourself be truthful about it aloud. You’re asked about it again, on the form you fill out before your first appointment. And then again, by the shrink. You get to face the fact that you came to this very strange decision, and why you did.

I got prescribed some pills. I got lucky; the first thing I was prescribed worked like a charm. I deal with some mild side effects, but they’re manageable, and I don’t feel like checking out of life now.

A couple weeks after I started taking them, I realized something. I felt like the goods parts of being drunk—being able to think without pain—without the downsides of, well, being drunk. Then one day, a month in, I missed a day. I cannot begin to adequately describe the pain, except to say that it was a hangover so immense that I couldn’t before...fuck it, it was damned painful. I couldn’t think, and I had to pretend to. Nothing I could do fixed my head, and I remembered in those painful hours before I was able to get more meds all the reasons why I originally chose to end it all.

I can still, on an intellectual level, remember the pain. I fear it. I fear nothing like I fear running out of my medication. I don’t want to lose the ability to function again. It is the same thing as death to me, and that isn’t hyperbole.

But, like, dude. I can function! Those of you who don’t suffer from problems like this don’t really understand what it’s like to say that. I can wake up and think. I can walk into a new store and not become paralyzed. I can make decisions about my life that require a fuckton of inputs, without needing to be drunk to do so.

I can function, because I started taking medication to correct an imbalance.

I will continue living, because I started taking medication to correct an imbalance.

I can be me, because I started taking medication to correct an imbalance.

Chronic anxiety isn’t about just being scared of little shit. It’s about your biochemical responses being all out of whack, crippling your ability to take in inputs or make decisions. Painful biochemical responses. I cannot stress enough how much goddamned pain I’ve endured because of this.

I remember in the beginning of December, I was walking back from a failed attempt at getting an appointment through my insurance. I walked along a bridge over a freeway. And I stopped, seriously thinking about throwing myself over.

I cannot strongly enough in text convey the pain, and I don’t know if I ever will be able to. I’m reading this all back, and they feel hollow. It’s the sort of pain that makes me want to take a brick and bash my head in, because certainly that would feel better. No, really, I used to fantasize about that as I went to sleep at night. And for that to be something I wished for, something that helped me sleep, well shit man, that was living in hell.

I stopped at the bridge, and the funniest thought kept me from doing it. “I don’t want to be one of those selfish fucks that ruins traffic.”

Seriously, I hate it when people do that.

That’s what all this is for me. It’s not the worthlessness of depression (which I also deal with). It’s not the irrational highs of mania (which I also deal with). It isn’t being scared of “silly shit” or whatever people say about this problem they don’t understand.

It’s what happens when pain and thought are inseparable.

But it can get better. I no longer plan on killing myself. I can walk over bridges. I can plan for my future, a real future. I deal with a ridiculous medical expense every three months, but it’s worth it. I can’t tell you how amazing it feels to be a functional person.

There are not words enough to tell you what a joy it is to be able to think without pain.

I’ll leave you with a moment that I had last year: I was sitting outside, reading Jim Butcher’s Ghost Story, the most recent Dresden Files novel. I was enjoying the “love letter to Harry Dresden fans” that it was, as it went into some of his backstory that we’ve been wanting for years.

I started to cry. It hit me: I wouldn’t be reading this right now, if I had killed myself.

That still happens from time to time, that sense of reaffirming life. It goes beyond “I’m glad to be alive” and into something...hard to explain.

But damn if I’m not glad to be alive.

- Ryan

P.S. I’ve been sitting on this letter for around a year, afraid to throw it out there. A few people have read it, but every time I hear about someone suffering and feeling alone, or when I hear about someone committing suicide, I’m ashamed. I’m being quiet to protect myself—from shitbirds on the Internet that take pleasure in making others feel crappy, from potential employers looking for any reason to decline a candidate, from those who would judge because they personally have toxic notions about mental illness.

I’m done being quiet. I’m so fucking done.

Help is out there. It can be hard—Kaiser made it really hard for me—but I get to be myself again. The guy in 2007 who was bursting with passion about making games.
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