The Invisible Burden: Living with Suicidality Behind a Well Face

By an Anonymous member of the Harmless team

For decades, academia and frontline services have poured immense resource into a single, haunting question: How do we predict and understand suicide? At Harmless, this question sits at the very core of our existence. We frequently look to established psychological frameworks, such as Rory O’Connor’s Integrated Motivational-Volitional (IMV) model, to map the dark geography of human despair. The model beautifully illustrates that there is a vast, distinct separation between thinking about suicide, contemplating it, and moving toward suicidal action.

There is a real, measurable distinction in how a person transitions from one phase to another.

Understanding these mechanisms has massive implications for how we work with people, how we foresee danger, and how we attempt to mitigate risk. But frameworks have their limits.

We try to put structured frameworks around people because structures make the overwhelming tangible. Yet, the reality remains that humans are deeply, stubbornly complex. While there may be shared patterns that enable our general comprehension of psychological pain, that understanding is, and perhaps always will be, inadequate.

Living with suicidality is a heavy, ruminative and haunting experience. It is not something to be easily quantified or dismissed. And for those who live it, explaining it to the outside world is an entirely different conundrum.
If I had to describe it, I would say this: it is a little bit like being in a crowded room full of people, yet feeling completely, entirely alone.

Everything on the outside can look perfectly okay. Objectively, I can describe my life as okay. I can experience real joy. I am not clinically depressed. I deeply value the people in my world, and to some extent, I can even see a future. And yet, alongside all of that, I can feel acutely, desperately suicidal at times. There is this burning ache in my chest that quietly tells me I shouldn’t be here.

It is a deeply shameful, confusing space to occupy. How do you seek support for an experience that doesn’t fit the clinical criteria of an acute depressive episode? As with any chronic health condition, specialised understanding is rare, and appropriate services are incredibly hard to come by.

You find yourself trapped in a silent negotiation. You don’t want to worry your loved ones, nor do you want to bore them. You don’t want to be labelled as ‘dramatic’, yet you don’t want to invalidate the very real risk that this ache carries. You don’t want to undermine the faith that people have placed in you, nor can you fully fathom the feeling yourself.

But if I am being completely honest, I have lived much of my life assured of the fact that I will die by suicide. It has felt less like a choice and more like an underlying script – as if, somehow, it’s a default setting. But acknowledging it means I can actively choose to write a different ending, even on the days the journey feels deeply lonely.

You can feel so acutely, desperately low, and yet still get up for work or socialise in the evening. It isn’t a performance, but it isn’t entirely honest either. It is simply a parallel reality.

I write these words wondering how many others are walking around carrying this exact same split existence, needing to hear that they are not alone in it. This is the profoundly difficult reality of suicidality that completely defies the standard public narrative. The world expects a suicidal person to look visibly distressed, to look like the face of an emergency.

But every single day, we hear the same heart-breaking refrains from families who have lost someone:
‘They were the life and soul of the party…’
‘We never saw it coming…’
‘They actually seemed like they had recovered from everything they were going through…’
‘They were completely fine when I saw them yesterday…’

So, I write this to pose a vital, tender wonder: Is this exactly how those individuals felt? Were they walking through this mortal place, looking ‘ok’ to the world, while carrying a deeply personal, fiercely protected experience of confused and conflicting anguish?

If we are to truly save lives, we have to stretch our understanding beyond the framework. We have to learn to listen to the people who are doing well, who are experiencing joy, but who are still carrying a burning ache that tells them to leave. Frameworks give us a baseline, but empathy is what allows us to see into the quietest, loneliest rooms.


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