Sunday, May 07, 2017

If they died from suicide

I've suffered from depression for most of my life and have had a couple of major episodes. There have been times when I decided dying would be better than living and while I'm not proud of that, I'm also not ashamed of it. My illness has caused lots of irrational thinking, but so far, I'm still here.

Chronic depression is a mental illness - emphasis on the word illness. You can't snap out of it or overcome it with activity, will power or positive thinking. Depression is an emotional disorder caused by the brain's inability to maintain the chemical balance required for normal functioning. It's a physical disease just as much as hypertension and diabetes are physical diseases. And that's why, when someone dies from suicide, no one should beat themselves up for failing to stop it. Suicidal depression can be extremely hard to identify and, like high blood pressure and diabetes, when it ends in death, no one is to blame.

When they hear that someone took their life, people who don't understand suicidal depression invariably react with things like,
How could she do that?
Why did he do that when he had everything to live for?
She took the coward's way out.
How selfish of him.

They act as if suicide was a lucid action taken by someone who clearly looked at all the options, added up the numbers and made a reasoned decision. Bizarrely, people who react that way are often the first to judge someone's actions with she must be crazy. For some reason, when someone really does act out of insanity, these judgmental people switch to seeing the person as selfish or cowardly instead of ill. 

What was really going on was that someone whose suicidal depression reached the point of death was in a state of serious illness. When someone reaches that point, there's nothing that can help them except for professional help such as hospitalization, medication and therapy. 

But sometimes even the best professional treatment isn't enough and that's why people who find out that someone they know killed herself/himself should not feel responsible. I say this to anyone suffering the emotional aftermath of a suicide. Because suicidal depression is an illness, it's not influenced by things that would cheer someone up if they were just going through "the blues." When someone's having a bad day, you might be able to pull them out of it through conversation, humor or activity. But suicidal depression is not an emotion. It's a set of symptoms caused by a malfunctioning brain. It's a physical disease with behavioral symptoms. Your actions and words will rarely have any effect at all on a disease like this when it's at its worst.

Because people misunderstand suicidal depression as being in a bad mood, they think their actions could have made a difference, but they couldn't have. If, instead of suicide, the person had passed away after years of managing high blood pressure or Alzheimer's or a lower respiratory disease, would you believe they would have lived if only you had done more? Would you be plagued by the guilt of "If only I'd made more time for her, she'd still be here today?" No, you wouldn't. If someone died from Alzheimer's or a lower respiratory disease or a heart attack, you might feel guilty for not having given her more attention while she was alive, but you wouldn't feel responsible for her death. Likewise, with someone who has killed herself, more visits, texts or I-love-you's would not have made the difference. Once someone begins planning her death, her brain has tipped so far out of chemical balance that it's producing little else but irrational thinking. She needs professional help.

Maybe you think that because it's the person's own hand that caused his death, there must have been a way to stop it. Well, I suppose if you lock up such a person on suicide watch permanently you might physically keep him alive, but you can only do that once you've realized how dangerous he is to himself. Unfortunately, suicidal depression is often too tricky for even family members to identify. People in the worst of a major depression might give hints about wanting to kill themselves, but those who are most determined to do it usually give the fewest clues. This makes sense to me. If someone is absolutely convinced that ending his life will be best for all concerned, why would he give anyone a chance to stop him? He won't. He'll just do it. Because suicidal depression can be that hidden and wily, no one should feel bad that they didn't see it.

People who kill themselves sometimes leave notes apologizing for the pain their death will cause (many kill themselves in the symptomatic delusion that no one will care, so they don't leave notes). As someone who's been on the inside of suicidal depression, I know that remorse is real: they know there will be pain, but they've weighed the pain of their death against the pain of their life and have decided that dying is the better option. But as much as their disease has twisted their thinking, the lucid part of them makes this final attempt to connect. With such a note, the person about to take her life tries to relieve her family and friends of feelings of responsibility and guilt, as someone dying of cancer would try to alleviate her family's pain.

Both the person who dies of suicide and the one who dies of cancer knows there's no one to blame and no one who could have done anything more for them. Please take that to heart. While you grieve your loss, feel your sadness and wonder why this happened to your family member or friend, please don't add to your pain by thinking there was anything you could have done to change this outcome. There really wasn't.


livelearn said...

Thank you for this!

Unknown said...

I totally agree with you on this Regina. And I totally support the self right to suicide for every human being. However, I would recommend a very intense self evaluation of life before taking this decition. And, after running a very meticulous introspection, and leaving everything ready (such as funeral and other expenses and matters solved) I consider the person should be respected if taken such an important decition.

Anonymous said...

Part One. I don't know from 'right to suicide' or inevitability of depression as a disease indistinguishable from hypertension. I have hypertension. My mother died of cancer. Even those 'emotionally neutral' illnesses have at some level an element of need for reinforcement from loved ones. My mother died years before she should have because she refused to go through rehab, chemo, and radiation after a surgeray had eradicated the cancer; the cells were still there and they eventually reappeared and metastasized. We all wonder if we should have pressured her more, or if the decision we made to respect her wishes might have been the wrong decision. I think it is proper that we feel this ambivalence; it is the cost of love.

I think, from having lived with people I loved who were chronically depressed, and having had friends who were suicidal and one friend who actually committed suicide, that depression is a spectrum, not an orthodoxy. It ranges I think from psychologically rooted causes (some of which can be impacted profoundly by therapy--the 'talking cure') to purely or partially physiological causes (body chemistry, which can sometimes by impacted by mood altering and physiology-altering drugs) and from that to partial physiology and partial brain chemistry, or wholly brain centered causes, some of which can be impacted chemically and apparently some of which cannot (thus, my friend killed himself).

Rayfield Waller said...

PART TWO. Then there is the mystery of the area doctors and psychologists have yet to understand and so cannot treat diagnostically or prognostically, which some researchers are saying may be genetic. We still don't really know what genes are! We pretend to have made breakthroughs by 'decoding' the human genome, but I suspect that's a lot of high end crap--genotype and phenotype and the action of alleles and of messenger RNA take place in three dimensionality and researches believe the human gene exists actually in four or more dimensions, one of which is out of our reach or understanding. Besides, we really don't know much of anything in the 21st century, we mostly are able, like the ancient Greeks and Sumerians, to describe and manipulate physical reality and the body and mind. Neither description nor manipulation equals understanding, as Werner Heisenberg warned.

You know your SELF of course, and so I totally believe everything you are saying and have said about your struggle with depression and what you think it arises out of. Because you say so, I will not obsess over 'fixing you' or 'making you feel better', but will just appreciate having you in my life. I don't believe I will thank you for your assurances that my friend died as a result of something I could not have impacted, because in fact, I feel the opposite--that I should have seen what was coming (for HIM, I mean) and helped him more. I will feel that way for the rest of my life. Some people I've known I think fall right into the definition you are presenting, but I don't believe he did--I believe his childhood traumas wounded him so deeply that he needed to have a lot of people in his presence constantly to reassure him he was loved, and that we, his friends, failed him just briefly, but briefly enough for him to leave us; I think his problem was not chemical, physiological, or genetic, but was emotional and psychological, and that because he was paranoid, he refused to resolve his trauma with consistent and thorough enough psychotherapy. Alcohol addiction prevented him from doing that, despite my staying by his side as he began therapy--he quit, started again, quit again, and never completely dedicated himself to making himself well.

Rayfield Waller said...

PART THREE. One thing I want to say is that I find it amazingly courageous of you to post this, and that it does help me to understand you and perhaps to understand, somewhat, what YOU need from ME as a friend who loves you. I also think so many people actually do fall into the definition you are presenting that you probably are helping a lot of people who genuinely need to understand that some people they have lost or whom they fear will commit suicide are not a reason for them to feel guilty, as you say. That is very generous and courageous of you--the honesty of this post is inspiring. I plan to ask you periodically for the rest of our lives how I can be a friend to you through this struggle, Regina. I love you with all my heart--for 27 or 28 years and counting.

Rayfield Waller said...

That 'part one' comment, labeled "anonymous' was mistakenly labeled that way, it was by me, as probably is obvious. I couldn't figure out how to edit it once I'd posted it.

Regina Rodríguez-Martin said...

Thank you very much for your views, Ray. I think your belief that you did fail your suicidal friend indicates how strongly people hold on to a sense of responsibility in the aftermath of suicide. Hence, my post.

I definitely feel your support and friendship. We've been friends for almost 29 years. Damn.

Andria Anderson said...

Exceptionally clear writing on a subject that needs it. I'm saving this article to give to friends who are survived-by's in the future.