Farmers are committing suicide as you read this article. In countries like India, the rate of farmer suicides has become a national crisis. The World Health Organization (WHO) is particularly concerned with farmer suicides because of the impact it is having on families. WHO estimates that one person commits suicide every 13.3 minutes.
The death of comedian Robin Williams last month sparked a worldwide discussion about suicide, its underlying causes and how it might be prevented. And, with World Suicide Prevention Day taking place Sept. 10, the subject is certain to generate more debate as people seek to understand this important health issue. Having spent 10 years researching the subject while working as a professor of psychiatry, I believe there are things we can do as a community to tackle this problem. With that in mind, I thought it might be helpful to reflect on what researchers have learned over the years about strategies for preventing suicide.
Depression should no longer be hidden behind closed doors and under bed covers. Rather, society should become as sympathetic to the disorder, as they were eager to pour ice water on their heads. We might even be able to lessen the very obvious divide between those who suffer from mental illness and those who do not. So this is why I love the idea of mounting a campaign in which children and adults band together to acknowledge the severity and the legitimacy of this epidemic.
I read Zelda Williams's tribute to her dad. I could barely focus on the accolades because my mind zeroed in on the few words "While I'll never, ever understand how he could be loved so deeply and not find it in his heart to stay..." Because that's the bottom line. His children loved him deeply, and he loved them, and yet, all that love was insufficient to keep him here...Or rather, the pain was just too much. That scares me.
I understand why people kill themselves. I think about it every day. That's not an exaggeration. It varies how much I think about it each day, but there hasn't been a day in the last six months that I haven't thought about it, and it's been this way since I was about 10. Very very occasionally I get a day where I'm struggling really bad, but I don't want to be dead. But it's not often.
I cried a lot, and slept when I could, and felt like shit. I can't even tell you how shitty I felt because there's actually no way to articulate it. I didn't want to die, but I felt like I was completely out of control, because I was, and that shit is scary. And of course, no one knew. I told no one. I acted fine, just like I still do, because I don't really like to talk about this kind of shit. Those emotions have been catalogued and put away.
Go ahead and post that suicide hotline number. I've used it and I'll continue to use it. But even better, recognize that this darkness is a monster that -- even with all the help and resources and puppy cuddles -- is lonely and demoralizing and confusing and exhausting to fight. And please recognize all of the work we do to stay alive.
Depression forms its own secret society. We're afraid of the consequences of our bosses, co-workers, family and friends finding out about our depression on Facebook. What is the worse consequence? People finding out you are depressed or you committing suicide? All it takes is one soul among friends to speak out.
I will tell you that I know you've tried what feels like everything to create a tolerable existence, but it hasn't worked thus far. I also know that you have hoarded your past expired medications in your toy hamper waiting for this day when you finally get "the nerve" to go through with ending it all. Please don't let today be your last, I want you to experience what it's like to smile for real again and you'll be taking that opportunity away.
Mental health isn't just about feeling good. As someone who has suffered with generalized anxiety disorder and subsequent depressive episodes, the last thing I want to read is feel-good drivel. What the media needs to focus on is honesty -- like the countless numbers of medications I've tried just not to have a panic attack on a subway car, the days I skipped work to lie in bed and cry (and how I always told my friends, family and employers I was sick), the pounds I shed not being able to eat in my depressive state, the long hours I spent in a therapist's office because I didn't know how to "fix my head."
Funny people aren't supposed to take their own lives. But then again, neither are fathers or mothers or first responders or any of the other host of people we outwardly see as having too much to live for. The way things appear to others is never the whole picture. Those who struggle with depression are not so easily defined by only the characteristics everyone else sees.
Rare are the moments where reading of an actor's passing does much more to me other than illicit a half-shrug before I carry on with my day, but in the case of Robin Williams it stopped me straight in my tracks. Williams depression wasn't new. He was an alcoholic with a long history of substance abuse. He dodged consistent allegations of stealing jokes throughout his years as a stand-up comic. He suffered. Despite and through the laughs, he suffered.
The moment a celebrity or somebody takes his or her life we, as a society, are all over it. It makes me think if we talked about suicide this much when it wasn't in the news due to something like Williams' death we would be better off. In addition to talking about Williams let's also talk about the thousands of other "normal" people who also died of suicide today.
Suicide isn't "giving up" or "giving in." Suicide is a terrible decision made by someone whose pain is so great that they can no longer hold it, and feel they have no other option in life but to end it. It's a decision you can't take back, and a decision that will affect your friend and family forever. It is not taken lightly. For someone looking in, it does seem like a waste -- especially in the case of Robin Williams, who was a brilliantly funny man and a talented actor. But imagine, if you will, feeling so desperate, so desolate, so incredibly sad and hurt that you honestly cannot see a way out. Williams did things in his life that touched people to their core. It is a sad, sad loss, but it is not a waste.
How should psychiatrists' roles be defined in order to provide as much specialist care to as many high-needs individuals as possible in the most cost-effective way? Because psychiatrists appear to be organized in a far less than systematic fashion within Ontario's mental health system, there is a fairly steady level of unmet need no matter how many psychiatrists practice in a region.
Generally speaking, taking medications against depression or anxiety should not always be the first measure to find relief. A health-promoting lifestyle that includes eating a balanced diet, regular exercise, and enough sleep can be very helpful in dealing with many disturbances, both of body and mind.