by Anonymous

Trigger warning: This piece contains frank discussions of suicide, self-harm, suicidal ideation, and recovery.

I want to talk about suicidality.

Sometimes it feels like the ultimate elephant in the room when it comes to mental health, but especially when it comes to adoption. At the end of the day, we know it’s more common in adopted populations. It’s a statistic frequently quoted when we talk about adoptees and mental health, and in discussions about the ongoing therapeutic support we deserve:

“Adoptees are four times more likely to attempt to end their lives than the average population.”

Because I work in mental health and studied in this area, I’ve read that study. I understand it, and I can weigh up its validity and reliability. Of course, it’s a little old now, having been published back in 2013, but its strengths lie in the large participant numbers, national registry data, and direct comparison to a control group. More recently, another study reported figures as high as 35 times more likely to attempt suicide. While those findings are striking, they come from a self-selected survey sample and should be interpreted more cautiously. Even so, they reinforce the same troubling picture: adoptees appear to be at a substantially elevated risk of attempting suicide.

A major challenge in adoption research is that once people are legally adopted, they effectively disappear as a distinct population. Adoption status is rarely collected as demographic information in healthcare, education, or research. Throughout my life, I have filled in countless forms asking about family medical history, writing “Adopted – unknown.” Yet there has never been an “Adopted – unknown” box to tick. Without one, researchers cannot systematically identify adoptees as a population, meaning our outcomes whether they involve physical health, mental health, suicide, or countless other areas are rarely collected, compared, or even recognised.

The same is true for suicidality in adoption. Unless adoption status is deliberately recorded alongside mental health outcomes, we have no systematic way of knowing how many adoptees struggle with suicidal ideation, attempt suicide, or die by suicide outside of the few studies that exist.

But I think we all know it exists, far outside of the rare times it is officially studied. As someone who has been in the adoption community for a few years now, mostly online, it feels like I see a new eulogy every single year. I know adoptee leaders see this frequently too. Sometimes the cause of death isn’t included. We’re left to wonder how someone seemingly healthy and young is suddenly no longer with us.

Ultimately, we’ll never fully know why someone decides to end their life. There are always many contributing factors, and we can’t know exactly how much adoption had to do with it. But statistically, we do know that adoptees are at a vastly elevated risk.

In many ways, that statistical wall is where the conversation stops. I mean, it often branches into discussions about our ongoing advocacy for continued, lifelong mental health support. But suicide is so profoundly sad, so deeply personal and wounding, that even imagining the suffering leading up to it can feel unbearable. It is often easier not to look too closely.

That makes sense. As people, we struggle to cope with death and grief, never quite finding the right words to comfort someone who has lost a loved one.

Sorry for your loss.

In much the same way, it’s difficult for those outside the experience to imagine the emotional forces that can drive someone towards ending their own life. The grief left behind by suicide is equally complicated for those still standing, grieving someone they loved, wondering if there was something they missed, something they could have said, or something they could have done.

What do you say to that?

Well… this is what I can tell you.

On my sixteenth birthday, I tried to kill myself.

I don’t want to describe the event, or even what led me to my actions. All I will say is that despite my young age, it was real. I was ready to, and attempted to, end my life.

In terms of adoption, it really wasn’t actively on my mind in that moment. But looking back, I do wonder whether the first exit of my biological family—an exit presumed permanent—taught me that my own life could be exited just as easily.

When your very existence begins with a profound disappearance, maybe leaving becomes a familiar language.

I struggled with suicidal ideation for years before that day, and for years afterwards. It is only in more recent years that I have begun living life less with the mentality of, “Well, I am alive, so I’ll just deal with it,” and more with the realisation that, “Oh… I actually want to wake up tomorrow. And the day after that. And so on.”

I have always carried guilt about that.

I hated being in the position where the people who loved me didn’t know if one day I might choose to leave them. I hated that they might wonder if they hadn’t said enough, done enough, or loved me enough. I hated that I couldn’t will myself to not have those thoughts and feelings. I have also stood on the other side of that grief, staring at the empty chair where my friend should have been sitting, wondering if I could have done more.

As I got older, those dark thoughts never fully disappeared, despite expecting they would as I healed and processed what had happened. It was challenging, particularly while training to work in mental health. I often felt like I wasn’t allowed to study what I was studying; that some special mental health SWAT team would burst into my university accommodation and expose me as an imposter. Too broken to help anyone else.

I’m thirty-two now. I’ve lived twice as long as the sixteen-year-old who tried to end her life. I often stop and think about that – I’ve now spent more years living after that day than I ever lived before it. I never really expected to.

It’s interesting.

Sometimes I wonder whether we should think about suicidality in the same way we think about eating disorders or addiction. We understand that someone recovering from an eating disorder may continue to notice calories, or that someone recovering from addiction may always carry the urge to drink when life becomes overwhelming. We recognise these as deeply established pathways that require ongoing awareness rather than a magical cure.

Yet suicidality is frequently treated differently. We often seem to expect suicidal thoughts to disappear entirely, as though their continued existence represents failure rather than an ongoing vulnerability that can be recognised, understood, and empathised with

The truth is that, for me, suicidality may always be a quiet passenger. During moments of profound grief, crisis, or overwhelming stress, that old familiar voice may still whisper. I don’t always know where the cause and causality begin and end for me. Perhaps it’s the blueprint left by my adoption.  Perhaps it’s my temperament, my history, my genetics, or some combination of them all.

I may always live with passive suicidal ideation.

I’m no longer frightened of that reality. I don’t believe it makes me incapable of the work I do. If anything, it has helped me understand people who feel similarly. I still feel guilty for the burden it places on those who care about me. Sharing those thoughts means sharing some of the darkest places in my mind, places that are frightening both for me and for them. But I have been in and out of therapy long enough now to know that I can survive, even if, from time to time, I still notice a brightly lit exit sign where other people don’t.

I live with suicidality much like I live with my black hair, my accent, the way I smile, and how I enjoy the sun peeking through the leaves high above me.

It feels like a strange truth to live with.

In some ways, perhaps it isn’t so different from adoption itself.

There are now millions of adopted people around the world, and many more growing up in foster care, kinship care, or guardianship. Yet one of the earliest things I learned, almost alongside learning my place in my adoptive family, was that I was originally meant to be somewhere else, with other people. Almost everyone I would ever meet had two parents who had conceived them and kept them.

The questions I first grappled with as a young child still remain:

What if they knew something was wrong with me?

Like, fundamentally wrong with me?

What if someone had told them, while I was still in utero, that I would grow into someone who would cause enough pain to make letting me go worthwhile?

Of course, I know now that those beliefs are not rational. They were the emotional conclusions of a child trying to make sense of being left. But sometimes, the echoes persist.

So no, I don’t think adoption caused me to attempt to end my life.

But abandonment. The Primal Wound, as they say, may have played a role. Affecting how my identity formed. The way I learned to see myself. My self-concept.

I do think adoption shaped those things for me. I know many adoptees who struggle with attachment, identity, belonging, or other emotional and psychological challenges. Others find adoption affects them in entirely different ways. None of us process adoption in exactly the same way. Our stories are not a monolith. We are all different.

But I suppose this became one of the ways I learned to cope. Much like self-harm, suicidal ideation can sound frightening to those looking in from the outside. Yet for some people, the thoughts themselves become a coping mechanism rather than an intention. Paradoxically, living with that exit sign can sometimes be the very thing that keeps a person alive long enough to find another way forward.

For me, the exit sign hasn’t ever fully disappeared. Maybe it never will. But these days it is simply part of the landscape, not the direction I’m walking. I know it’s there. I know I’ve survived every time I’ve noticed it before. And despite everything adoption taught me about leaving, I find that, honestly, these days, I want to stay.

Life now stretches out in a way I never imagined.

Author’s note

This essay is a personal reflection rather than clinical guidance, and every person’s experience and support needs will be different.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC3784288

https://www.mdpi.com/2076-0760/15/3/167

Verrier, N. N. (1993). The primal wound: Understanding the adopted child. Gateway Press.

Resources

ICAV Memorials including a number of resources on adoptee suicidality