Monday, September 1, 2014

Can We Talk About Depression and Suicide?

The entertainment world along with his countless fans were stunned and saddened upon hearing of the death of Robin Williams at the age of 63.  And while any premature death is a source of deep sorrow, the apparent fact that he took his own life makes it all especially unfathomable.  How can somebody who was so great at making us laugh be depressed enough to do this?  Of course, we cannot go through his thoughts prior to the act, but it stands to reason that he must have known how much pain his death would cause to his wife and children along with his friends.  It would then stand to reason that he must have been suffering tremendously to do what he did.
Williams had been battling severe depression and in addition, was fighting alcoholism.  His widow in a statement said that he was sober when he took his own life.  But although severe depression alone can be bad enough to contribute to suicide, it is well established that alcohol abuse can make an already bad situation with depression critical enough to push a person over the edge. 
The sad fact is that it too often takes a celebrity tragedy to put something like depression on the public’s radar despite the fact that suicide is the tenth leading cause of death worldwide. Since this tragedy, there have been a number of writers, mostly among the mental health community who have written on depression. For example, this outstanding op-ed on suicide was written by a psychiatry professor who once battled suicidal depression.

Of course, their input is vital for us to understand about depression and how it can sometimes lead to suicide.  But especially for laypeople, it is difficult to truly understand this disease unless one has either experienced it first hand or through a friend or loved one. 
As someone who has battled severe depression over a number of years (but was never suicidal), I believe I have something to contribute to the discussion.
Back in 2008, I did a previous posting Can We Talk About Depression? that was in response to losing a member of a singles group I am part of to suicide.  I truly hope the reader will read this posting which among other things points out the extreme stigma surrounding this disease.  While most of us would not be uncomfortable talking about physical ailments, many of us would never admit to others (even loved ones sometimes) that we are suffering from a mental illness.  For some, that means not wanting to get professional help.  How many people would want to admit that they need to see a ‘shrink’ or disclose to others that they see one? 
All too often, this stigma associated with depression drives the suffering underground where the victim suffers in private – sometimes even with friends and family in his or her life.  This suffering in private whether from being alone or not makes things worse since all too often, the person afflicted can’t help but think over and over about how hopeless things appear to be along with possibly increasing feelings or worthlessness – a part of depressive symptoms for many.
But to confuse things, we hear of people who commit suicide who seemingly have it all – loving friends and family, meaningful work, and adequate financial resources – just  like Robin Williams and wonder how this could possibly happen.  Perhaps the answer can be found in the trite phrase: perception is reality.  It is not what we on the outside feel that matters, it is all about the person suffering those feelings.
One of the things we lose as we fall deeper into depression is a sense of perspective.  We all have disappointments and setbacks – that is simply a part of life.  But the normal person can deal with these and soon move on.  But to the person with severe depression, events like these can be devastating.  If I lose my love (or my job or my money etc.), will life go on?  Here, we have another unfortunate trite phrase: suicide is a permanent solution for temporary problems.  This is easy for those of us on the outside to say, but for the person suffering from severe depression, it is all too easy to endlessly think and rethink tormenting thoughts (known in psychobabble as ruminating) until his or her emotions and reasoning spin out of control.
Allowing a person to gain that vital sense of perspective is how we can best help the person suffering from severe depression and help to avoid the horror of suicide.  While severe depression often requires the help that medication offers, simply having somebody to talk to in the form of a therapist, or at the very least a caring friend or loved one can make all the difference in the world.  In can lead to some straight thinking that those problems a person is wrestling with are indeed temporary and are not the ‘end of the world’ – still another trite phrase.
But sad to say, we will never know for sure why some people ultimately decided to end it all unless they were unsuccessful in their attempt(s).  One of my favorite entertainers is another funnyman, Craig Ferguson who hosts a late night comedy/talk show on CBS (until the end of this year).  His show is usually non-stop silliness, but one night after feeling bad about all of the laughter and ridicule around the news of Britney Spears going into rehab, he surprised me and his audience with some serious reflections on his battles against drugs and alcohol to the point where he actually planned to take his own life.  The poignant 13-minute video can be seen in this link: Craig Ferguson Speaks From The Heart.   In addition, for those who are interested, he tells his story in more detail in his well-written autobiography, American on Purpose.   Although Ferguson and I have never met, I believe I feel a closeness with him ever since seeing him tell this story about himself.
As it turned out, he got distracted from ending his life as planned and then decided to immediately go into rehab.  Since then, he has had a wonderfully productive life as a writer, actor, and comedian.  It was John Mellencamp who sang, life goes on – long after the thrill of living is gone.  With the proper help and support, those with depression can someday indeed get a thrill out of living again!

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