Here Comes the Sun (Dealing With Depression)
Romance and the Reality
Many have commented
on the tendency to romanticize suicidal
depression. In the wake of Goethe's eighteenth century novel, The Sorrows
of Young Werther, Europe was swept with a wave of suicides by
passionately melancholy young men, thwarted in love and, in the words of Keats,
"half in love with easeful death."
writers like Sylvia Plath have glorified suicide. Her novel, The Bell Jar,
featured a heroine whose own instability made suicide seem a romantic and
courageous solution to spiritual distress. The Japanese, wrote Plath,
"understood things of the spirit."
a much-quoted poem ("Lady Lazarus"), Sylvia Plath continued her autobiographical flirtation with suicide:
True to her art, Plath finally committed suicide successfully, after
several previous attempts.
The Grisly Secret of
has been much speculation about reasons for suicide--many theories, many
explanations. Suicide can be viewed as a cry for help, as a romantic gesture of
self-renunciation, or as a spiteful act of supreme vengeance -- in a sense, a
willful triumph over real or imagined enemies, and a spit in the eye of God. But
all too often the grisly reality of suicidal behavior remains a much-guarded
reality is this: Suicide is not a tidy solution. The suicide inevitably leaves an ugly mess behind -- in
physical terms -- for someone else to clean up. In the words of sociologist
Lionel Tiger, the aftermath of suicide is a "legacy of pain."
Tiger remarks that suicide is "vicious, distorted, unbearably painful to family and friends, and a gross violation of the tentative truce with mortality which all humans must make." Tiger goes on to say, "Suicides . . . make a major statement about the value of life and thus call into question the very source of optimistic gregariousness which sustains us all."
on suicide in the CoEvolution Quarterly, Art Kleiner comments:
author of Optimism: The Biology of Hope, had a close friend and
colleague who killed himself. Tiger was the last person to see the man alive,
and recalls, "I cannot begin to describe the profoundly demoralizing effect
his suicide had on those of us around him." The impact was all the more
demoralizing because the suicide victim was "an extraordinarily talented, charming, seductive and psychologically
later the chairman of Tiger's department disclosed he had recommended that Tiger
be given a year's leave of absence
because the chairman believed Tiger was gravely depressed and needed to escape
the blight of what had happened. "Was his diagnosis correct?" asks
Tiger. "I think so, although I wasn't aware of the degree of my despondency
Such deep and soul-searching despondency is common in the people the suicide leaves behind. "When suicides occur;" Tiger reflects, "we all claim responsibility or feel we share in the failure of the social fabric to support the person in need."
Was there something we could have done or said to prevent the person from taking that last final step into oblivion? Did we ignore the obvious signs, did we bother to find out how depressed the person was? Did we fail to take the depression seriously and think it was "just a phase"? These questions and more run through the minds of the friends and loved ones left behind.
But there's another aspect of suicide that undermines the foundations of our own
lives. The suicide attempt devastates and fascinates us because it reminds us
how fragile our hold on life really is. We struggle along with our problems, and
the suicide just seems to put it all aside, saying, "It isn't worth the
struggle. Good-bye, cruel world." It's a shocking repudiation of the high
value most of us place on life. The suicide tosses life aside like so much
trash. As Tiger puts it, "Suicide is a violent challenge to our general
complacency about the extraordinary value of life. To be sure, suicide is
not only violent
against the community but also against the survivors”
might be called the psychological legacy of pain. But there's
another legacy of pain that most suicides never take into consideration -- the
legacy of a broken, battered, blood-and excrement-soaked body drowning in vomit,
clinging to life in spite of all the good intentions about a sanitized and
as alcohol and other drug abuse have been glamorized in the past by showing the
use of drugs without real-life consequences, so suicide has
frequently been depicted as a swift, painless, and uncomplicated solution to
life's problems. An extreme solution, to be sure, but an awesome and
perhaps courageous step into the void.
What more people need to know is that suicide is most often the pathetic
act of a confused and desperate person. If we look at the real-life consequences of suicide and
suicide attempts, we find that the seemingly antiseptic solution turns out to be
messy and unpredictable.
the words of an advocate of rational self-deliverance, more people need to know
"how not to commit suicide."
Little Known Hazards of Suicide
theme song from the movie M-A-S-H is titled "Suicide," and the lyrics go: "Suicide is painless,
It brings on many changes. . . . ."
suicide does not always bring on swift,
painless, sweet oblivion. The attempt sometimes gets all botched up and
the would-be suicide suffers a good deal of pain and disfigurement.
suicides and suicide attempts take the form of drug overdoses. Art Kleiner
describes what happens:
brain damage occurs when the brain is deprived of oxygen for three to five
minutes. Higher brain functions are the first to go -- memory is destroyed,
verbal skills are impaired -- and the longer the oxygen starvation goes on, the
more severe the retardation.
is one of the most common drugs used in botched suicide attempts, probably
because of its wide availability and
our ignorance about the terminal effectiveness of an overdose. One pharmacologist calls
aspirin "one of the messiest, most complicated overdoses you ever hope to
see." Aspirin can burn the gastrointestinal tract and can damage the
kidneys, lungs, and liver. Aspirin in sufficient quantity can produce a
fever and seizures. People who survive aspirin overdoses can suffer permanent
liver damage and sometimes suffer deafness or tinnitus (ringing in the ears).
(or acetaminophen) poisoning also destroys the liver This can result in an
especially painful death because patients often sleep off the initial sickness,
recover enough to realize they didn't really want to die, then slowly slip off
into a coma after five days because the liver has been destroyed.
and alcohol are a common and dangerous combination in
suicide attempts. When taken together, alcohol and Valium, Seconal, or other
sedatives and mild tranquilizers produce nausea and vomiting. Instead of
drifting off into death, the suicidal person sucks vomit into the lungs. If the
person doesn't drown in vomit, they can become infected and develop
pneumonia and irreversible lung damage.
most painful form of a suicide attempt is swallowing lye, Drano, oven cleaner,
or some other form of household caustic agent. Very few people die from
swallowing lye or other caustics. "If they do die," says one
physician, "it's days, weeks, or even months later; of infection."
Caustics like lye burn the mouth, tongue, and may burn holes through the
esophagus and into the chest cavity. The resulting scar tissue can obstruct the
gastrointestinal tract, and patients may have to undergo years of painful
death is so often portrayed as sudden and painless,"
Kleiner reports, "but the human body is harder to kill than it
seems." Slitting the wrists, for example, rarely results in death.
More often, tendons and nerves are damaged, and the would-he suicide ends up
with a weak or deformed hand.
who cut their throats rarely die. They cut the nerve that controls their voice
box and larynx and end up voiceless. Gunshot wounds can kill outright, but,
remarkably enough, people frequently miss the brain and blow out an eye or part
of a jaw. People can live for hours with a hole in the head the size of a
half-dollar. Says one physician, "One man I treated is completely paralyzed
on his left side, and can't speak, walk, or feed himself. It's as if he had a
major stroke. He hit the area of the brain which controls motor function."
brain death comes fairly rapidly with oxygen deprivation, the brain can survive bizarre assaults. One man
tried to kill himself by hammering eleven nails into the top of his head.
Finding himself still alive, he walked to the hospital and presented himself to
the emergency ward.
seems to offer a fairly rapid demise, but those who try to hang themselves may
dangle and slowly choke. They don't always die but, like other failed suicides,
end up with irreversible brain damage.
Jumping from a high place can cause a nonfatal, but painful and permanent injury. In 1986, a world-class runner dropped out of the middle of a race and jumped off a bridge. She did not kill herself, but her jump caused irreversible injuries --she became quadriplegic. According to those who have studied suicide attempts, people can fall over a hundred feet --and sometimes more -- without killing themselves. Jumpers who survive suffer multiple fractures -- crushed and shattered bones -- and ruptured internal organs. Because of the fragility of the spine and brain, jumpers may be left totally paralyzed.
suicides happen so frequently and have such unexpected
and unseemly consequences that Dr George B. Mair, a British advocate of rational
self-deliverance, wrote a book on suicidal etiquette called How to Die
With Dignity. Dr Mair cautions:
is exceptionally unwise to attempt to jump in front of trains, motor buses, or
other vehicles. Results are unpredictable.
into the sea from the ferry or other deep sea vessel is highly inconvenient for
the ship's crew and passengers.
· An attempt to crash a car
even moving at a very high speed is extremely uncertain and should be avoided.
onto the live rail of an electric rail system is not in any way dignified and is
a great offense to witnesses.
her poem "Resume," Dorothy Parker made some wry observations about
various drawbacks of suicide techniques:
students of depression and suicidal behavior have commented on the
"rational suicide." Given the fact that most suicides leave a legacy
of pain, there is another aspect to be considered: Some suicides appear to be
well thought-out solutions to intolerable problems. From an outsider's point of
view, the solution of suicide may not necessarily seem to be the best solution,
but it is perhaps better; in the suicide's eye, than the perceived alternatives.
Many students of depression and suicidal behavior have remarked on the
Beck, a psychologist who has written extensively on depression, observes
that depression stems from the cognitive
stance the depressed person takes toward the world. The depressed person's
expectations are permeated with negativity,
and he or she sees only continued unhappiness and hopelessness on into the
future. Rather than fact such a future, the suicide opts to turn away from a
painfully futile existence.
cannot visualize any way of improving things;' says Beck. "He does not
believe it is possible to get better. Suicide under these conditions seems to
the patient to be a rational solution."
Thanatos Society and similar groups give individuals support for the choice of
suicide under intolerable conditions such as terminal illness.
Of course, what one person considers to be intolerable, another person might readily tolerate. In E. A. Robinson's well-known poem, Richard Cory had it made:
He "fluttered pulses when he said, Good morning, and he glittered when he walked." (What a guy!)
But Robinson's poem
comes to an ironic conclusion:
Nebraska farmer committed suicide, a friend reflected,
"That last day seemed like all the others. I never knew how bad it was for
him Pete never let on. He was cheerful, he ate turkey sandwiches with me, and
then he killed himself."
Pete's wife, bad no idea he had been plotting his suicide for six months or
more. "I lived with a man who was planning to kill himself and I didn't
notice any signals. I look back now, and I still don't see any signs. I worried
about heart attacks and car wrecks. I didn't think about interest rates,
foreclosures or bankruptcy. But that's what killed Pete.'"
Pete was not immobilized by depression. Quite the opposite.
He left a set of instructions about how to organize the funeral (along with a
detailed script for his own funeral, including
friends to notify and pallbearers). He also left elaborate suggestions about how to deal with bankers, bill
collectors and other creditors, as well as insurance agents. He entered his
wife's name in the new telephone book as president of
their corporate ranch. He prepaid her dues at the country club for the next two
years -- again without her knowledge. He filled in chores to be done on the pages
of the next year's calendar. And he bought Christmas gifts for his wife and
kids, to be delivered by friends.
No doubt Pete
thought his elaborate preparations would make his death less traumatic. But his
death shocked and devastated those closest to him. Would prepaid dues at the
country club compensate for the loss of a husband? Would Christmas presents
delivered by a third party really be any consolation for the loss of a father?
What made him think it would be easier for his wife to deal with creditors than
it was for him?
For all of his
apparent concern for the future of his family, Pete was capable of enormous
deception and irrational self-justification
-- a sure sign of the distorted logic of the suicide. His "solution"
solved nothing; it only created unspeakable
pain for his survivors.
Another example of the twisted covert thinking of the suicide
can be seen in a beleaguered Wyoming farmer who also killed himself without any
warning. His wife said his decision must have been a long time in the making.
"In all our years together I never had to pick up a sock. He was very
orderly and methodical. That day, for the first time in weeks, he didn't seem
worried. He was in control. As he left the house, he turned around in the yard
and came back three times to kiss me.''
His wife asked if he was okay, and he said, "I love you very
much." That was the last time she saw him alive. She had a long time to
reflect on the kind of love that leaves behind immeasurable grief and confusion.
Psychiatrist William Glasser reports on one seventeen-year-old boy who committed suicide:
a typical case, the parents of a seventeen-year-old boy thought in retrospect,
he spent more time by himself than seemed normal. In school, where his work was
satisfactory, what was noticeable was that he was not noticed; he tended to
blend into the background. He did have a few close friends, and he did not
complain that anything major was wrong. Obviously, he must have been suffering
from a huge and growing perceptual error;
the life he wanted was not at all working out. Even though he appeared outwardly
calm, we believe that disturbing ideas that had never been there before were
racing through his mind. More and more the idea that life was overwhelmingly
painful crowded out other thoughts. To relieve the pain, he threw a rope over
the garage rafter; fixed it around his neck, and stepped off the chair
the boy did not understand that suicide
is forever; not just for the victim, but for those around the victim -- the
friends, children, and parents. For they are the ones left with the
suicide's legacy of pain.
How can one tell whether a person is suicidal or not? There is no way to
predict with absolute certainty that an individual is a suicide risk. But there
are a number of indicators that show up fairly often in high-risk individuals.
Consider these questions when trying to assess the risk for suicide:
"yes" answer to two or more of the above questions indicates a high
risk of suicide.
How about suicide
prevention? Most suicide prevention workers feel that suicidal people haven't
examined all the alternatives to suicide. Those who work on telephone crisis hot
lines try to get the caller to consider alternatives.
One worker speaks
about the "tunnel vision" of suicidal callers. "Usually it hasn't
dawned on them who it will affect or what the long-range effects of their act
will be. Once they realize it, they often don't want the suicide to happen. They
don't want to die; they want the pain to stop."
When dealing with the depressed person, most of us tend to tippy-toe
around the topic of suicide. There's a hidden agenda that goes, "Let's
don't talk about it." Or: "I won't bring it up if you won't." We
are often afraid to ask depressed people if they are considering suicide,
because we think that somehow it might give them ideas, it might trigger a
suicidal gesture. We are trapped by the myths about suicide.
People who talk
about suicide do not commit suicide.
are often doers. Threats should be taken seriously.
talk about hopelessness and the suicidal solution.
They make threats - some veiled, some overt. They may talk about death fantasies
or express the feeling, "They'll be sorry when I die." In general,
the more specific the threat (as to method of suicide, time, place, etc.) the
greater the probability of a real, serious attempt.
are fully intent on dying.
Fact: The man
who jumped into the cactus patch said, "It seemed like a good idea at the
time." So it is with suicides. Suicide may seem like a good idea at the time, but
many suicidal people appreciate the opportunity to reconsider.
A man who survived a suicidal jump from the Golden Gate Bridge says he
realized he was making a horrible mistake when his hands slipped from the
railing and he plunged 249 feet into the Bay. A year later, he told a reporter
be was "thrilled to be alive," and he urged others thinking about
suicide to give life another chance.
Once a person
is suicidal, he or she is suicidal forever
who feel suicidal or who actually attempt suicide may find ways to strengthen
their resolve to live and may put all thoughts of suicide entirely behind them,
going on to live happy and productive lives.
following a suicidal crisis means the suicidal risk is over.
The mood change from suicidal depression to apparent tranquility may in fact
reflect that a person has reached a decision to commit suicide. Having
reached a decision, the burden of living is lifted, leaving room for a serenity
that may mislead others into thinking the crisis has passed.
more often among the rich, or almost exclusively among the poor.
Fact: The will
to live appears to be distributed equally among all economic levels of the
journalist Karen Lindsey became suicidal, friends rallied to bolster her
flagging motivation to continue living.
appreciated this straightforward, reality-based focus on suicide. Her friend
Byrna spoke about the unspeakable, bringing up all the unpleasant details,
grisly secrets, and uncontemplated hazards of suicide. It may sound heartless,
but Karen found the discussion to be helpful.
What about suicide prevention services? Do they help?
The data is
sketchy. Studies show that these services in the United States have failed to
produce the hoped for reduction in suicide rates in the locales where they have been
developed. The harsh fact remains: "People who are sure about killing themselves rarely call the suicide hot line." These are
what some researchers have called "the true suicide constituency."
the book Suicide: Theory and Clinical Aspects, L. D. Hankoff and Bernice
In the end, we must candidly admit that suicide prevention is in its
infancy. We can list endless reasonable arguments against suicide, but as writer
Cesare Pavese, a member of the "true suicide constituency" (he
committed suicide) once observed: "No one ever lacks a good reason for
But if given the opportunity, depressed people who think they have found a way to relieve their misery through suicide, might find that there are better means of relieving the misery. . . by changing their lives instead of abandoning them.