How do you talk about trying to die?

Killing yourself is tougher than you’d think.

That’s what Anna Mehler Paperny wants you to know. She has tried many times: Overdosing on windshield-washer fluid, sleeping pills, antidepressants, Aspirin, paint thinner and more.

She survived these many suicide attempts thanks to a “freakish tolerance for toxins” more than a will to live.

Survival didn’t help alleviate the guilt that comes from having caused loved ones so much pain. And the feelings that led to the suicide attempts in the first place – “subsuming despondence, inescapable hopelessness and worthlessness” – didn’t magically disappear either.

“No one tells you that after trying to kill yourself and failing miserably, you don’t necessarily wake up in the ICU feeling awesome,” she says.

Ms. Mehler Paperny’s new book Hello I Want to Die Please Fix Me is raw, frank and dark-humoured.

It’s not a story of redemption or triumph. It’s not a Hallmark movie. Rather it’s an “uncomfortably personal exploration of a sickeningly common condition” – depression.

But, in its unpretentiousness, the book is a must-read for those who want to understand what goes on in the heads of those who take their own lives each year (800,000 annually worldwide), and the multiples more who, like the author, come perilously close.

Ms. Mehler Paperny does a masterful job of delving into the complexities of living with depression, the challenges of getting the help you need and why it’s so difficult to prevent suicide.

“How do you talk about trying to die?” she asks in the first line of the book.

In the chapters that follow, she answers: haltingly, urgently, abashedly, gingerly, quietly, desperately, trepidatiously, searchingly and loudly.

When she first tried to kill herself, Ms. Mehler Paperny was 24 and working at her dream job, as a reporter for The Globe and Mail.

Like many people with depression, she put on a stoic public face, excelling at work while otherwise consumed by despair.

But there were hints that all was not well and, luckily for Ms. Mehler Paperny, when she didn’t answer calls, editors went to her apartment and found her, self-poisoned and dying.

That was the “entry point into a labyrinthine psychiatric care system via the trap door of botched self-obliteration.”

The most stinging parts of Hello I Want to Die Please Fix Me are those that look at that system through a patient’s eyes.

Today’s psychiatric hospitals are not the stuff of One Flew Over the Cuckoo’s Nest, but they are a place where patients have no agency, and little dignity. Increasingly, patients are committed involuntarily.

The psychiatric ward, Ms. Mehler Paperny says, “felt like a holding pen – drunk tank for crazy.” When deemed to no longer be a danger to herself, she was discharged – with a list of phone numbers for therapists and a pat on the head.

Ms. Mehler Paperny reminds us repeatedly that she is blessed with a supportive family, a job with insurance that pays for some therapy and meds and a reporter’s pigheadedness, all of which allowed her to get care.

But many people fall through the cracks in the transition from in-patient to outpatient care, especially since most psychological services are not covered by medicare.

“If your illness is in the brain, universality is a lie,” she writes.

Ms. Mehler Paperny writes unblinkingly about her bumpy ride on the “psychopharmacological merry-go-round” – trying 14 drugs over seven years, in dozens of combinations, and still not finding one that works, with near-fatal consequences.

She also tried cognitive-behavioural therapy (CBT), an “endless sadomasochistic Socratic logic exercise,” and rTMS (repetitive transcranial magnetic stimulation), and considered ETC (electroconvulsive therapy).

Some of the most insightful parts of the book are reflections on the stigma of mental illness. How do you return to work after your bosses have found you overdosed on antifreeze and in a puddle of vomit? How do you tell them, “I missed work because I was flattened by self-loathing"?

Who do you trust to share your diagnosis? Will your friends abandon you? Who, if anyone, can you trust in the health system? Who do you call when you’re suicidal? What will happen when you disclose widely – say, by writing a book?

“We talk a big game about talking,” Ms. Mehler Paperny writes. But disclosure can be costly – professionally, financially, emotionally.

Hopefully, in this instance, it will pay off. Because, as Ms. Mehler Paperny says of the book: “I write this because I need both life vest and anchor, because I need both to scream and to arm myself in the dark.

“Maybe you need to scream, to arm yourself, too.”

If you are having thoughts of suicide, call Kids Help Phone at 1-800-668-6868 or Crisis Service Canada at 1-833-456-4566, or visit http://www.kidshelpphone.ca