Sunday, May 17, 2015

Depression can be deadly...

The other day, I got a comment on this blog from true crime author Kathryn Casey.  She had read my positive review of her latest book and asked me to "friend" her on Facebook.  I was happy to oblige, only she has reached the limit of friends allowable on Facebook.  So I "follow" her instead.  ETA: I guess she's cleared out her friends list, because today I was allowed to send a request.

This morning, Kathryn Casey posted about the sad case of the woman who was flying on Southwest Airlines and got a text from her husband indicating that he intended to kill himself.  She wanted to call for help, but a flight attendant told her she had to put away her cell phone and supposedly refused to ask the captain to call the police.  There she sat on the plane, helpless to try to save her husband's life.  By the time police got to him, he was dead.

I read some of the comments people had about this case.  One woman wrote about how she is unsympathetic to suicidal people and thinks it's a selfish act.  I know many people have this viewpoint.  On the surface, I can understand why many people think suicide is selfish.  However, as someone who has been suicidal before and has suffered from clinical depression, I usually have to add a rebuttal.

I suffered a rather significant bout of clinical depression in the late 1990s.  It took time and effort to work up the courage to see a doctor.  I was fortunate in that a friend recommended a good therapist for me.  I made an appointment with my therapist and took steps toward finally getting over the depression that had plagued me for years and gotten to a fever pitch.  Had he not done that, I might not have been as successful as I was in getting my depression treated.  Therapists can be excellent and competent, or they can be quacks.  When you are depressed, you may not have the will to look for a therapist.  You may not have the energy to get to the doctor's office.  Your thinking may be so warped that you don't think you're worth the effort of trying to get well.

People who are suicidal usually suffer from clinical depression.  Part of the clinical depression experience is feeling worthless, tired, apathetic, and sad.  But it also screws up your thinking.  You can end up in a spiral where you feel paranoid.  You may resort to self-medicating with alcohol, illegal drugs, or food.  These substances can also alter your thinking and skew your thoughts to the point at which you might think you'd be better off dead.  You might think your loved ones would prefer you to be dead.  You might feel like a burden to them.

Clinical depression can be merely debilitating or it can be downright deadly.  It's an illness often caused by biochemical issues in the body.  That's why antidepressant and anti anxiety medications usually work to make people with depression feel better.  Medications prescribed for depression aren't "happy pills"; they don't make a person feel happy or high.  All they are intended to do is make a person feel more normal and even keeled.

But antidepressants can be expensive.  They require a prescription, which requires a trip to see a doctor.  Depression can sap a person's energy to the point at which they don't have the will to get to a doctor.  They may not have the money for the visit or the medications.  Sometimes, it takes awhile to find the right one at the right dosage.  Doctors who treat the illness competently will need to monitor the patient closely, which requires more trips to the doctor, more money, extra time to see the doctor and wait in the pharmacy for the drug(s), and access to transportation.  This may not seem like a big deal to a person who isn't depressed.  I can tell you from personal experience that depression can make all of these needs seem insurmountable.  It messes up your thinking and steals your energy.  It saps your will to keep going and sense of self-worth.  Just picking up the phone to call for my first appointment was very difficult.  Going to see the therapist and then the psychiatrist, talking about the issues that had led to my depression, taking Prozac and suffering the side effects, then finally reaching suicidal tendencies when the drug didn't work for me...  that was all very difficult and caused significant anxiety and stress.  I can see why so many people who are depressed never get treated.  Treatment is tough.

Now, having written all of this, I want to make it clear that I have empathy for those left behind after someone commits suicide.  I can understand the anger and sadness that comes from the grief resulting from a person who decides to end it all.  Suicide can seem like a selfish, manipulative, self-centered act.  The person or people left behind after a suicide are often left feeling guilty, asking why, and wondering if there is something they could have said or done to prevent the suicide.  I just want to tell these folks that the suicide is not about them.  Depression is a legitimate illness and sometimes it kills, just as surely as cancer, diabetes, and heart disease can kill.  When a person dies of a heart attack or a stroke, there is often sadness, shock, and grief, but most of the time, people don't get really pissed off about it the way they do when someone commits suicide.  Sure, they might be angry that the person didn't adhere to a healthy diet or take steps to control their blood pressure.  But you usually don't hear people who died of what is considered an organic physical illness being accused of "selfishness".

Here's another thought I'd like to toss out there for those who think suicide is "selfish".  Okay, maybe it really is a selfish thing to do.  But before you lambast the person who killed themselves, ask yourself if you did anything to help them.  Did you offer to help them find and get to a doctor?  Did you listen to them if and when they wanted or needed to talk?  Did you reach out to them in support and express concern for their welfare?  If you didn't do any of those things, then in my mind, you were probably part of the problem.  Moreover, you can't know what that person was dealing with.  You don't know the pain they were living with.  And if you didn't offer them support or try to help them get well, you really have no right to call them selfish.  I would submit that expecting someone who is living with depression to keep living so you won't feel guilty is also pretty selfish.  You wouldn't tell someone with a broken arm to buck up and get over it, would you?  People with clinical depression often need competent medical help and compassion, not judgment and ridicule.

When I hear of someone committing suicide and I know it's because they were clinically depressed, I try to remember the days when I felt overwhelmed by life.  I recall how hopeless and helpless I felt.  I remember how hard it was to get help and how long it took to feel better.  Then, I have empathy for the person who died.  I realize that what they did was not about selfishness.  It was about losing the fight against depression.  And instead of feeling angry, guilty, and cheated toward the suicide victim, I feel compassion for them.  Unfortunately, sometimes depression wins.

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