I've not been OK

Content Warning - Discussion of suicidal thoughts, depression, suicide methods, general whinging and belly aching.

*If you're worrying about my current health at any point reading this... read the penultimate paragraph first.

"Do you have a plan?" she asked.
Oh, I have plans. I have a head full of plans and little else, unfortunately. I'm in trouble because my brain won't engage with anything but plans for hours, days at a time.
The plans range from juvenile and ridiculous (stepping in front of a gun in an armed siege/robbery gone wrong and going out as a hero) to horrendously detailed and scarily practical. It was the latter that I described to her.
I was sat talking to a young locum GP at the suggestion of someone at the Samaritans. (Did they suggest it, or did they just let me talk until I convinced myself that was the best next move? I'm not sure I remember.) The expression on her face as I laid out the plan, like she'd asked me to, suggested to me that she'd not had to have this conversation with a patient before.

I've suffered from depression on and off for 30 years. My recollection is that I first noticed it after my first wife died when I was 21, but it's possible I suffered before that, just not as deeply. For most of that time it would come and go, so I didn't take medication for it. I knew I could ride it out. Then, during the second COVID lockdown, it came but it didn't go; it just got steadily worse.
I started to struggle at work; initially, I thought, due to the depression. Anti-depressants would help for a while, but then things would pile up, I'd get more anxious and stressed and, inevitably, more depressed.
It's taken me several years to realise that what was happening was down to Long-COVID and, at that time, undiagnosed ADHD / ASC1^[1]. The cognitive impairment and the constant fatigue had destroyed the coping mechanisms that had kept ADHD hidden even from me. Deadlines that used to fire me up to my most effective—that used to drive me to pull all-nighters where my best work would out—were now flying by with tasks uncompleted. Work tasks, domestic tasks, life admin, and even my hobbies and fun stuff were not getting done, and I was in trouble. The combination led me to several crises, and the worst of those brought about something I'd never imagined could happen to me: the tearful phone call to The Samaritans because I was at the end of my tether.

I wouldn't describe myself as "suicidal" as such. I had a growing feeling that I didn't want to live anymore. If there were a "no consequences" off-switch—if I could opt out of life without hurting those around me—then I'd take it. But, in practice, I couldn't take my own life because I couldn't do that to my family. 
So, instead of actually committing suicide, my mind started obsessing over it. Every minute I wasn't focused on something, I'd be making plans, refining plans, or replaying plans. I had plans for every situation for every environment. I had the most ridiculous, stupid plans. I had a number of scarily plausible plans.
I didn't know that this isn't uncommon. There's a name for it—Suicidal Ideation—obsessive, intrusive thoughts about suicide. I guess, in hindsight, this has been a part of my life for as long as depression has. Low level, occasional, just when I'm at my lowest and never too intrusive. But this year it broke me. When I finally caved, I'd been able to think of little else for days on end. I'd done no work, I'd struggled to socialise or interact, I wasn't functioning.
I sat at my desk in floods of tears, not a common occurrence, and rocked backwards and forwards between ringing The Samaritans, and feeling like the biggest idiot for not being able to talk to someone/anyone. I called them, eventually, because I didn't know what else to do. The lady on the phone was the person who introduced me to the concept of Suicidal Ideation. She reassured me that I wasn't unique and then she seemed to simply let me talk myself into making a plan—a sensible plan—to tell MrsVark and to seek help from my GP.

The 6 months since I found myself scaring a new GP have been difficult. The NHS was quick to respond to the crisis. I've had lots of people asking if I'm "a danger to myself" and reminding me of the emergency contact details for The Samaritans and similar. But it's been relatively slow to get to any treatment, despite the hard work and fantastic help of my regular GP. My employer has been incredible and understanding, but I'm still working reduced hours while awaiting more substantive treatment. Sharon has come to understand me a little better, but I've realised I still have to be a touch circumspect when discussing the darker parts of what's in my head. I've been quite open about what's happened with friends and anyone else that has asked. And this has helped a lot. Talking and being unashamed, as I've always been about my mental health, has a way of relieving the pressure a little. Although I've been less forward with this, because of the impact it can have on someone who is not ready to hear it.

As at December '24 - I'm still not OK, but I'm coping. I described myself as "stable" to my GP this week; things have stopped getting worse. When I'm busy, I can almost forget that I'm depressed (a "silver lining" of the lack of object permanence that comes with ADHD—if I'm distracted it almost ceases to exist). The ideation is much less intrusive, but it's still there when I'm alone with my thoughts. I'm finding new coping mechanisms, with the help of other people, to deal with the ADHD, but I'm hoping to get better treatment next year. I've been referred to an NHS psychiatrist, which hopefully bypassed the 3 to 8-year waiting list for ADHD clinics.

If you're going through any of this yourself, I encourage you to talk to someone. In the UK: talk to your GP or The Samaritans if you can't face talking to family or friends. Or the new NHS mental health service via 111. International: check this list of helplines.

And feel free to talk to me.

^[1](*Autism Spectrum Condition Level 1, or what used to be known as Asperger's.)