You are describing a most unusual situation. On one hand you describe a part of your life in which you are able to function well. You are able to maintain work and your social life as usual. You say that other than being tired you basically have a healthy and normal family life. On the other hand you report experiencing very serious psychological symptoms which include suicidal ideation, voices telling you to harm yourself and dissociation. You also have instances in which you are driven to purposely injure yourself as a way to cope (although you did not say what self injury specifically helps you cope with). What is unusual about your situation is that typically when an individual is experiencing the type of psychological disturbances you’ve described (i.e. self-injury, suicidal ideation, etc) these symptoms tend to permeate all aspects of their life, not just compartmentalized parts. You described being able to “fairly easily” ignore the symptoms and even wondered whether they are worth addressing. It’s almost as though you are experiencing two distinctly different realities.
If I were able to meet with you in person I’d have many questions about your experiences. I would be trying to ascertain the frequency and severity of your symptoms as well as explore more thoroughly the voices, self-injury and dissociation. Without having access to much more information about your situation it is difficult to know what exactly you are experiencing. The fact that you are able to ignore these symptoms indicates possibly one of several things: (1) the symptoms are infrequent and not severe; (2) you are not reacting appropriately to your symptoms and thus have misjudged the seriousness of your situation; or (3) you’re experiencing a high level of dissociation. Please know that this assessment is based on very little information and therefore may be incorrect. Also, there may be other possibilities to explain your symptoms that I have not mentioned here.
Generally speaking you should never disregard self-injurious behavior, suicidal ideation, voices or dissociation. It may be easy to ignore these symptoms but I would never advise anyone to do so. You should be evaluated by a mental health professional. An evaluation is necessary to determine what if any treatment you should receive. What is good about your situation is that even though you seem to be experiencing serious psychological symptoms they have not affected your work, social or family life. This is very encouraging. To ensure that these aspects of your life remain uninterrupted please consider being evaluated by a mental health professional. Thanks for writing.