Friday, March 05, 2010

Depression and Suicide

Michael Gerson took on the difficult topic of depression, sharing a sensitive perspective. The problem with trying to understand serious depression is that, unless you've been there or had a front row seat while a loved one battled through it, it's not easy to understand. Gerson highlights two examples of celebrity suicide:
Andrew Koenig, 41-year-old son of actor Walter Koenig, hanged himself in a Vancouver park after leaving a despondent note. Days later, Michael Blosil, the 18-year-old son of singer Marie Osmond, jumped from his eighth-floor apartment after writing that his depression had left him feeling friendless.
If I were to simply go by age, the statistics would suggest that Koenig was experiencing career setbacks, with associated financial stress, and at the same time suffered a breakdown of his primary relationship. Because when you're looking at a middle age man whose career and family both crumble at the same time, you're talking about a high risk group for suicide. If you define yourself by your career and family, as is pretty common in our culture, losing both at a time when you feel like you're "too old to start over" is devastating.

Teenagers are harder to figure out. There could be issues of long-term depression, but the depression could be situational - such as the break-up of a relationship or a situation at home that seems inescapable. Gay teenagers attempt suicide at a rate significantly higher than their straight peers. As Gerson notes, "Females attempt suicide more often than males. Males complete it more often than females." An attempt is often a cry for attention. A person who is seriously suicidal isn't likely to survive the first attempt, let alone a second. But if it needs to be said, a suicide attempt as a cry for attention or help is a dangerous act that, whatever the intent, may result in serious injury or death.

Gerson suggests that hopelessness is an important element; I think he's understating his case. When Gerson speaks of treating the underlying depression, without diminishing the fact that depression and hopelessness go hand-in-hand, most depressed people don't commit suicide. I suspect it's the extreme end of hopelessness, lasting long enough that the person thinks he's never going to get back to normal, that leads most people to suicide. In cases of chronic clinical depression, the knowledge that you'll eventually get back to normal may not be much of an incentive, because normal's just not that good.

Gerson mentions "pervasive loneliness" and isolation in our society as contributing to depression, and I suspect that's true. Although clinically depressed people tend to find ways to isolate themselves. In the depth of depression, it's possible to be alone in a room full of people. Depression is, in that sense, narcissistic - you, and your own misery, become the center of your existence. You're drawn to depressing music, sad stories on the news... you can't motivate yourself to go out with your friends because you know, in advance (and despite your past experiences) that you'll be miserable the whole time. You're certainly not meeting new people. Your suffering is terrible in ways others won't understand or might judge, so seeking help seems out of the question. And you probably have a loop of negative thoughts repeating in your head about how bad your life is.

If your life was pretty good before an incident that led to depression, odds are you're going to rebound to that level once you adjust to the trauma that triggered your depression. We as a society understand grief as an acceptable response to certain types of loss, and that you do recover from grief - situational depression works in pretty much the same way. If you are dealing with chronic depression or dysthymia, the same applies - but you have to work to raise your baseline. It's tough. The opposite of "depressed" isn't "happy" - it's "not depressed". Get outside of yourself. Go out even when you know you're not going to have fun because eventually (and perhaps even the first time) you will. Find ways to meet other depressed people, even (gasp) group therapy,1 because whoah - you're not alone, you're not the most miserable person in the world, and there is hope.
1. If you have substance abuse problems, you can get anonymous peer support through 12 step groups.

1 comment:

  1. This is a very important and timely post. Depression must be taken seriously. I'm glad you suggested 12 Step Programs, they are wonderful. I am an active member of Al-Anon for over 10 years.