Again a piece of news makes us stop and consider mental health. It resurfaces briefly but regularly, when the unafflicted become the damaged collateral because someone they know or admire has actively chosen to stop enduring the pain of existence.
Suicide happens indiscriminately. Kurt Cobain, Ernest Hemingway, my fifth-grade teacher, Meriwether Lewis, Dr. Seuss’ first wife… There is a long list of notable suicides on Wikipedia and I am intrigued by the diversity of suicide victims I found there, not just the artists, poets, musicians, and authors we expect to find when suffering and creativity are so intertwined. Some deaths are rather ironic: the cardiac surgeon who created the technique for bypass surgery shot himself in the heart; fashion designer Alexander McQueen hanged himself in his wardrobe. I am surprised to see athletes: Olympic gymnast, race car driver, professional rugby, hockey, soccer, and football players. And in the last ten years a new category of otherwise non-notables have become famous for their suicides: bullied teens.
I’m going to insert a caveat here. This is an opinion piece, but it is based on not just my 40 years of experience accepting then battling depression, but also my observations as part of multiple depression and dysthymia support groups online and my filter of cognitive empathy while listening to friends who suffer from mental illness.
As I see it, avoidance of suffering is the reason why most people end their own lives. That actual or anticipated suffering may be the result of terminal disease, shattered pride (/shame), an impulsive reaction to change, or the invisible illness known as depression. Because the avoidance of suffering seems like a cowardly choice to some, suicide is viewed by a minority as “selfish,” especially when mourners are left behind to be sad. I very intentionally relegate the response to just “be sad” and not “suffer,” because the loss of a loved one causes pain that is eventually incorporated into the survivors’ otherwise functional lives, except maybe in the case of a parent losing a child, which can cripple that parent forever. But suffering is a different state of mind than pain. Suffering covers past, present and future in a kind of cloak that absorbs light, multiplies gravity, and constructs a preternatural friction.
Clinical depression is a diagnosis defined by persistent and prolonged low mood accompanied by loss of interest or pleasure. It is not a) being bummed out because you lost the state championship; b) being sad for a while because your dog died; c) being cynical, jaded or plain pissy because you are living with your parents again at 40. Depression exists independent of, and sometimes in spite of, external situations in one’s life. I will agree that attitude contributes to depression, but at its base, there is a neuro-chemical fail that I like to compare to diabetes. This is not to say that biology is the only factor. I believe, and science has recently begun to prove, that environment and our own cognitive habits can alter our brain biology. Still, to say “you’re as happy as you want to be!” is banal and mostly incorrect for people with depression (and makes me want to punch you in the throat).
If you’ve never experienced depression, dysthymia, chronic fatigue syndrome, or the aftermath of Vulcan death grip, I want to help you understand how it feels by tapping into experiences you probably have chronicled in your memory and can pull up for this exercise.
That not-quite-ache in your gut when you learn your dog has cancer. Or your husband is cheating on you. Or there was a school shooting and your daughter isn’t answering her phone. Or you learn that fat lady actually heard you whispering about her. That is the heavy wad near your solar plexus most of the time that you are awake. And some of the time in your dreams.
That ache is always there. And what’s worse, it’s there when you should be happy and carefree because you’ve got everything going for you: love, money, career, health, talent…
Now imagine 2 hours of lifting heavy boxes and furniture in July to help your friend move to that third floor apartment. You are worn out, but there is an 80-pound box that needs to go up the stairs and you are the only one left to carry it. The dread and exhaustion of approaching and lifting that last box is what you feel some days just to accomplish the following simple task: identify the tag in a t-shirt before you put it on, so you know back from front.
In the not-too-distant past, I considered suicide. I knew I wouldn’t be doing it immediately because I didn’t want to cause trauma to my mom and leave my dog an orphan. But I decided a very feasible way I could pull it off in the future when my obligations to those two who depended on me were no longer an issue. I had been in therapy, both cognitive and pharmaceutical, for 20 years. I had turned my attitude around and was an optimistic, high-functioning, professionally successful person. I owned a home and had a good man in love with me. I was physically healthy and even completely quit alcohol for the prior 6 months. Friends and family loved me. I was confident that several people even considered me among their top 5 favorite humans. But I was weary of the daily battle against depression. It wore me down in a way I can’t describe in physical terms. It’s like a psyche depletion. I would make some progress every time I made a big change in my life such as a new city, new job, new man… but it would always come back.
Currently I’m on the best peak of recovery I’ve ever known since I left everyone in my orbit behind and moved to a new town on the sunny side of the state. My job changed a little and for the better. I am dating and volunteering and making friends. But I can’t expect this time to be so different from all the other times I’ve achieved a stretch of normalcy after a big change. I may fall again. Even now, as I’m not feeling down and mentally exhausted, I still deal with dysthymia: I fight myself to get out of bed and take uppers to stay awake all day. I would still rather sleep than anything else. But much of the time, I have the discipline to not let myself do that, and so I push myself to participate in life while I’m feeling relatively good. Mostly because I want to be a contributing member of society and not waste all the resources that have been poured into me.
Finally, my point: The case for suicide. I would argue that no young person should consider suicide because I don’t believe they have exhausted their options for finding a cure for their depression, angst, or attitude. But what about those of us who have tried all the medications, who have passed the cognitive education and implementation at a PhD level, who have suffered for decades and only still exist because of our obligation to sacrifice for others? Would you sentence us to another 10 to 40 years of suffering so you don’t have to be sad? Many people condone or support assisted suicide for the terminally ill, not because the victim is going to die, but because the victim is going to suffer before he dies. So put long-term treatment-resistant depression in that category. It can be a mercy to rest in peace.
The most common reaction I see to suicide is the encouragement to unidentified masses (potentially suicidal people) to reach out, to get help, to know they are loved. To those who have not exhausted their resources already, that is a good message. For those of us have already done all of that, please consider that sometimes suicide IS an option. Bemoaning the senselessness or selfishness of the act doesn’t help anyone.
I do encourage support for research to cure mental illness, I urge education on depression as a legitimate disease, and I hope we can de-stigmatize the issue so that those who still have hope for a cure may access help without barriers.