It’s Going To Get BetterJune 13th, 2018
So I wanted to take a break from our regularly scheduled programming of princesses and super heroines to talk about depression and suicide.
I know these aren’t the most pleasant topics to discuss, but I feel like there’s been a lot of judginess and disinformation floating around out there, and I want to see if I can to change that a little.
This is the only trigger warning you’re going to get on this post. Discussing suicide in a thoughtful way doesn’t trigger it, but if the subject is an especially sensitive one to you, or makes you uncomfortable, you might want to skip this blog entry. I promise you that I am NOT writing a book on this subject, only discussing it here.
I’m not a professional therapist, of course, but I’ve had experience with both depression and suicide, not only personally but also because I worked for ten years as an assistant director in a residence hall at New York University. Suicide is one of the leading causes of death for young people aged 15-24 (CDC), so it isn’t unusual that in a college population I encountered it.
I’m actually deeply sympathetic to those in chronic pain—both physically and emotionally—and to those who wish to end their own suffering. I don’t consider suicide a “selfish” act. I understand that those who are considering killing themselves truly feel (in that moment) that the world will be better off without them, even if I don’t necessarily agree that this is the case.
But I’m also deeply sympathetic to the families and friends of those who take their own lives, as well as to First Responders and others who are called to the scenes of non-physician assisted suicides—especially since, when I worked in the dorm, I became one of those people.
I know that those who are choosing to end their lives aren’t thinking about what happens after they die, but what happens after they die is that someone is going to find them and call 911.
And I can tell you from experience that the people who arrive immediately after that are going to be very frustrated and upset (likely for days afterward) that they got to the scene too late to do what they get paid to do: SAVE A LIFE. It’s their job. They hate seeing a life wasted.
But like I said, I get it: I sympathize with both sides.
That’s because I know personally that someone who can seem to have a great life on the outside can be struggling on the inside with some heavy duty personal demons.
I know I’ve mentioned before on this blog (or interviews) that while I’ve never suffered from chronic depression, I’ve certainly experienced occasional situational depression.
Situational depression, more commonly known as adjustment disorder, can have a number of symptoms, but the primary one is that you find yourself engulfed in sadness and anxiety from which you feel you’ll never escape, because of one or more super sh*tty situations going on in your life.
I wrote about this kind of depression in the ninth book of The Princess Diaries, Princess Mia, which many readers have told me is their favorite book in the series. This book seems to have helped a number of readers through their own difficult periods, often with depression, anxiety, or other mental illness.
The reason it reads so realistically is because it was modeled on a bout of depression I went through my senior year in high school, a time when I did, in fact, feel so depressed I would not have minded dying (though I did not take active steps to hurry along my own death. The truth was, I was so depressed, that would have taken way too much effort).
I was very lucky back then that I eventually recognized what was happening, and asked my parents for help. I was also fortunate enough to receive it in a timely fashion (like Mia does in the book) in the form of a cognitive behavioral therapist. There were no anti-depressants in those days (or at least none any doctor in Indiana was going to prescribe to a seventeen year old girl). The only therapy available to me was talk therapy.
But by venting to the doctor and taking his advice, slowly (very slowly) my depression lifted, and things got better . . . and have (comparatively) stayed that way ever since!
I still see a therapist for talk therapy from time to time for “tune ups” when I feel myself slipping into the “dark place,” and always feel better for it.
But this is why I can place myself so perfectly in the shoes of both suicide victim (well, almost!) and first responder—because I’ve been both!
I know most people think that those who take their own lives must be suffering from long-term depression, but that isn’t always the case. Most people with depression never attempt suicide, and some people who attempt suicide aren’t depressed. They’re upset, certainly, but it can be because of a specific event or sudden crisis in their lives.
When I first began working at NYU, I was surprised by the number of students (primarily male, because while more females than males attempt suicide, more males than females succeed) who took their own lives after receiving what they considered to be a bad grade. These were students who (unlike me!) had never received any grade lower than an A before. The accumulated pressure of moving away from home, beginning a new life in a non-familiar environment, and then receiving a less than perfect grade simply became too much for them.
Because of course there is never any one reason someone takes their own life. According to the World Health Organization, suicide is always caused by a combination of factors.
But since the primary contributor to suicide is a feeling of overall hopelessness, victims may not be able to see that there are many other alternatives to their problems than ending their life (it certainly never occurred to me when I was at my most hopeless that I could simply drop the class that was causing me so much anxiety . . . my doctor had to suggest it, and even then in my depressed state I couldn’t get it through my head for the longest time that this was something that was perfectly acceptable to do).
According to the CDC, suicide is actually almost always an impulsive act. Yes, there are people who intricately plan out their own death, but for the most part, based on interviews with survivors, most suicides are impulsive acts based on a fleeting desire to escape pain felt in the moment, often precipitated by a crisis of some kind (and often done while intoxicated or on drugs, either prescribed or recreational).
47% of suicide survivors, when asked how much time passed between when they decided to take their own life and when they completed the act, say an hour or less. 27% say within 5 minutes.
Now about the stunned amazement I’ve been hearing over the method certain celebrities have used to end their lives:
According to the CDC, the methods people use to kill themselves tend to be whatever is most easily available. In the US, because guns are so prevalent, it is guns. But the means used to end one’s life vary widely from community to community. For many years in San Francisco, the favored way to kill oneself was a leap from the Golden Gate Bridge…until bridge barriers were constructed.
When I first began working at NYU, students chose defenestration (jumping from windows) until we installed blocks on all the windows to prevent them from being opened more than two inches. After that, not only did suicides decrease dramatically, complaints to my office that students were mischievously dropping things onto the heads of pedestrians on sidewalks below also ceased. I considered that a double win!
Death by hanging was a common method of suicide in the dorm—but it was often difficult for us as first responders to tell if the student meant to harm themselves or was participating in the popular “hanging game” (my brother, a police sergeant, tells me that he and his fellow officers have the same problem). Since only about 25-30% of suicides leave a note, in a suicide by hanging it is sometimes impossible to tell if the death is accidental or on purpose.
So why am I telling you all this, including stuff you probably don’t want to know?
Because despite what you might have heard, there absolutely are things that can be done to help prevent suicide (note our success at NYU with the window blocks, and the same success of communities who’ve employed stricter gun laws and bridge guards).
I know some people insist: “But those intent on killing themselves will just some find some other way!”
Studies have shown this not to be true, since suicide is an impulsive act. Making the means of death less convenient often stops the act entirely.
No one, of course, can keep anyone from destroying their own life, be it from drugs and alcohol, other reckless behavior, or suicide.
What we can do, however, is be there for anyone we suspect might be going through a bad time (at least to whatever degree we can be without causing emotional or physical harm to ourselves. Remember there’s a reason the airlines tell you to put on your own oxygen mask first! You can’t help others put on theirs if you’re dead).
Of course it’s tricky because most people suffering from depression are doing their very best NOT to let you know there’s anything wrong. I know that when I was suffering from it, I did everything I could to act as “normally” as possible.
So a good solution is just to treat EVERYONE kindly, and assume EVERYONE is going through something.
Keep this in mind for friends who constantly turn down your invitations to lunch or the movies (and DO be the kind of person who makes a lot of these sort of invitations, despite how busy I know you are).
DO send texts or cards or funny emails to those you think might need them (individually. DON’T mass cc. People tend to ignore those) . . .
But DON’T take it personally if your sad friend doesn’t write back right away, or at all. Even healthy people don’t write back right away!
DO know that even tiny gestures help. I have a friend who, when I’m on a deadline and she hasn’t seen me for a while, leaves me a treat (a piece of fruit or other healthy snack) in a brown paper bag on my doorstep with an encouraging message scrawled on it. This small gesture makes me feel great!
DO know how much something as simple as an offer of a movie or game night at your house (or theirs, but YOU bring the popcorn) or even a home-cooked favorite meal (or delivery from their favorite place) can mean. Even going with them to one of their favorite places (it doesn’t have to be a meal. Coffee or a walk) could make a huge difference.
But DO be prepared for the depressed person to turn your offer down, once or multiple times, or even to have some unkind words to say to you now and then. Depressed people can often be uncharacteristically mean. It’s up to you how long you’re willing put up with that kind of behavior. When I was depressed, I picked a fight with every single one of the few friends I had left (most had graduated or were spending the semester abroad). Good job, brain!
But studies show that socializing is an effective way of helping to alleviate depression–even though of course I can tell you from experience that depressed people hate socializing . . . and pretty much everything (except watching TV, or as I like to call it, Vitamin TV)!
That’s why I’m advising you:
- DON’T try to “cheer them up” (that’s just awkward for everyone).
- DON’T remind them of all the “great” things they have going for them (this one is worst of all. Depressed people already know they have great things going for them. Don’t rub it in).
- DON’T offer them advice on how to alleviate or solve their problems. Leave this to the professionals.
- DO tell them you think they’re doing great, even if you don’t think they are. The fact that they’re even getting up in the morning means they ARE doing great.
- DO try to engage them about the things they ARE expressing enthusiasm for. If this means every episode ever made of Forensic Files, so be it. Forensic Files is a great show.
- DO be there for them and lend a non-judgmental ear.
I swear to you, your offering just to hang out in a non-stressful way could mean the difference between life and death. (One of the reasons my depression got so bad my senior year in high school was that I had no friends–or I felt that I didn’t–with whom I could vent about my problems).
And most importantly of all: DO know that it’s completely okay to ask a depressed person if they’re considering suicide. Doing so WON’T “put the idea” in their head.
But DON’T freak out. Lot’s of people think about suicide but never take their own lives. Encourage your friend to take it one day at a time. Once they’ve made an appointment with a therapist, keep in mind that–depending on where you live–there might be a bit of wait, which can be frustrating.
But trust me, it’s worth it!
And if you’re reading this and have realized YOU are the depressed person, DON’T SAY NO WHEN PEOPLE ASK IF THEY CAN HELP YOU.
I know you don’t feel like talking, or like doing anything, really. I get it.
But you’ll never get better if you don’t make a TINY bit of effort.
I know it’s exhausting, and also that you hate everything.
But I swear to you–and though I lie for a living, I’m not even making this up when I say it–things are going to get better. You may not believe it, but I’m living proof of this. They really, really will.
Thanks for reading.