Suicide.

Until tonight I was content reading all the posts about Robin Williams and remaining quiet, but there have been a few things I read that make me feel like I need to respond for my own sanity and safety.

To begin with, this is a topic I feel strongly about, I have personal experience, done a great deal of research and have had a great deal of exposure to the world of mental illness. I have schizo-affective disorder. I like to call this full-on crazy. No other explanation has felt appropriate to me, and I understand that it can be offensive. I have manic-depressive swings, I have contemplated suicide, I have made the choice to call 9-1-1 instead of taking the pills I so dramatically liberated from my husband’s safe (without the key, without the combination, without breaking the safe), I experience full hallucinations (auditory, visual, tactile, ol’ factory…all in one episode at one time. I once had a doctor suggest that I might be a spiritual medium, that was entertaining for the scientist in me.)  I am smart, I hold a bachelor’s in French language and biochemistry, and an Associate’s of Applied Science in Biotechnology. I was accepted and (arguably) completed one year of graduate school in chemistry before I decided it wasn’t for me. I hold jobs in my field, I’ve been married for 5 years and I have a 16 month old son that is amazing. I was fortunate enough to not deal with any postpartum depression or psychosis beyond what I feel I would have experienced anyway. I have been in-patient 6 times, have a (fabricated by the ER) suicide attempt on my record, and for the past year I have been in treatment funded by the county I live in, exposing me to a lot of people on many levels of functional. I give this background, which I’m sure is readily available by reading my posts, because I don’t update regularly and I have no idea what I’ve written previously.

A friend posted this response to this post by Matt Walsh. I will preface this by saying I don’t read the bottom half of the internet unless it is in response to me, and I don’t have any previous knowledge of Matt Walsh. The article from Matt Walsh made her so angry that she felt it inappropriate to link to it, clearly that wasn’t the case for me and I feel like I want to address some of his points based on my own experience.

“The death of Robin Williams is significant not because he was famous, but because he was human, and not just because he left this world, but particularly because he apparently chose to leave it.

Based on Matt Walsh’s own rebuttal to his post he feels like this statement was under fire when he was called cruel and told he lacked compassion. The whole premise of the article is about the choice of suicide, how it affects others, how it affects the world. I feel very strongly about the word “chose”, and having experienced mental illness the way I have I believe in choices for the mentally ill community. Every day I battle thoughts that I have to physically choose to keep or reject. Every day I make choices to get up and live my life or stay in the shadows and let life happen to me. These choices are universal, everyone makes these choices. It starts little, I’ve been seeing it in my son. Does he want the blue shirt or the red shirt? Does he have a meltdown about uncut watermelon, or does he ask for it to be cut? I guide him in his choices, help him choose options that will serve him well later in life, while I grapple with my own. Do I get out of bed and go to work or stay home and get fired? Do I take on that extra project or elect for more time for personal reflection and growth? They seem so different, and the choice of do I call for help or choose to leave for good seems to be somewhere off the charts. I guarantee that they are not that different. For my son it can be catastrophic for that watermelon to be uncut. He cannot see beyond that rind to understand that cutting the watermelon is a simple solution to a desired result. I am now capable of choosing to go to work every day because I love what I do, and the people I work with make that an easy choice, but I need help and guidance to choose time for personal reflection and growth. I am really fortunate that my husband is as kind as he is when helping with that choice, and even more fortunate that I have coworkers that also understand when I cannot see the simple solution in front of me. The solution to live rather than die is also a simple one, but like my son and myself, people need help and guidance to see that solution. The tragedy happens when people feel they are so different from others that they can’t get help, they don’t deserve help, they aren’t worth help. They then don’t open up about the horrific world in their own heads, they don’t let the danger escape, they don’t feel worthy of themselves, the result of this is an inability to see the simple solution of asking for help and the choice to leave life seems like the simple solution. Yes, I feel that suicide is a choice, it is one that is made by not understanding the severity of our own situation and not wanting to bother others with our “trivial” troubles and pain. Is it an easy choice? Of course not, it’s one that is fraught with months or years of pain that isn’t visible to the outside world, often not even those that love us most. It takes a great deal of candor on the part of someone with mental illness for someone who loves us  to pick up on the dire need for help. There is no one to blame for the act, the person who needed the help couldn’t articulate their pain, and the person who loved them had no way of knowing, but in the end it is a choice. We can learn a lot as a community about Robin Williams’ choice. First, this is not something that only affects the weird person on the bus talking to people who aren’t there, we are all susceptible no matter our economic standing, our “popularity”, our race, our family status. Second, just because someone has the financial ability to have the best care in the world does not mean they understand how to ask for it, or have anyone around that can see the need. It is very easy to get wrapped up in the act of life, and that is what Robin Williams did for a living. Last, as a country we have a long way to go in understanding and discussing mental illness. This prevents a lot of people from asking for help and receiving treatment. My mother told me a few weeks ago that she is continually grateful that I can have, and don’t fear, that conversation. It can destroy a person’s whole career to admit to a mental illness the way I do, that’s completely unacceptable to me. I don’t hide behind an ideal of normal because that is not who I am, I am also not my illness. It took a long time to come to that conclusion because a lot of people would prefer I hide my illness to make themselves more comfortable or they feared other’s wouldn’t understand. Fuck them. I am me, and a lot of that is due to my illness. I talk about it and as a result I am not afraid to admit when I need help. I know who to ask, and what avenues I need to travel. I am lucky, but refusing to hide behind normal was also a choice.

“It is not freeing. In suicide you obliterate yourself and shackle your loved ones with guilt and grief. There is no freedom in it. There is no peace. How can I free myself by attempting to annihilate myself? How can I free something by destroying it? Chesterton said, “The man who kills a man, kills a man. The man who kills himself, kills all men; as far as he is concerned he wipes out the world.” Where is the freedom in that?”

This is a hard truth about suicide. It’s something that suicide survivors know on a level that others just can’t. I have not myself been a survivor (my suicide attempt was fabricated, I never intended on suicide, therefore I cannot be considered a survivor), but there are lots of different types of survivors. Someone who tried and failed is clearly a survivor, the loved ones in Matt Walsh’s dialogue are survivors, people that are affected deeply that have no real connection to the suicide are survivors. I don’t deny that making that choice can seem freeing. Most of the commentary I read about this part said people don’t need to be reminded of how their actions can affect others when they are already teetering on the edge of suicide. There was an implication that people might choose suicide by thinking of the pain their loved ones would experience, another implication that people shouldn’t be forced to choose between their pain and the pain of their loved ones. This approach is clearly not for everyone, but there is a large subset of mentally ill people for which this approach works. I have been hospitalized 6 times, the most recent in January of 2013, and this is something that every hospital works on with patients. Who will you leave behind if you do what you are talking about? How will they feel? Will they experience financial issues? How do you feel about causing them pain? The answers vary wildly, as expected. Some don’t care, some deny they need help entirely, some are so wracked with grief the hospital has to choose another treatment approach, others, like me, use this approach to save our lives and make the choice to reach out for help. When I approach the breaking point I don’t care about me, suicide wouldn’t be freeing for me. It would be a means for freeing my loved ones of burden. They would no longer need to worry about me, pretend they love me, pay for me to have a roof over my head, the list goes on and on. Then my brain gets rational. Will my husband be able to pay the bills? Where will my cats live? How will my snakes get fed? Will my son have what he needs? This approach is effective and appeals to the little bit of rational thought that sits in all of our brains. Those every day actions of feeding an animal, watering a plant, fixing a car…those are powerful motivators to bring a brain back to reality when it’s spiraling out of control. That is the message I saw in this section of Matt’s post, an having been in treatment both in and out patient for nearly a decade and a half I have seen this method work, and have used this method on both myself and others around me.

“Only we shouldn’t turn the subject into a purely cold, clinical matter. “Chemical imbalances,” people say. “A man is depressed because of his brain chemicals, and for no other reason.” No, we are more than our brains and bigger than our bodies. Depression is a mental affliction, yes, but also spiritual. That isn’t to say that a depressed person is evil or weak, just that his depression is deeper and more profound than a simple matter of disproportioned brain chemicals.”

In his rebuttal Matt mentioned that he was said to have been dismissive of depression. In fact, in this post the author writes “Depression is a mental affliction, yes, but also spiritual,” he says. But no. No, it’s not. Let’s be very clear on this point. CLINICAL DEPRESSION IS A MEDICAL DIAGNOSIS. (Emphasis belongs to the original author.) I disagree that he was being dismissive. I share his belief that mental illness encompasses more than “just” chemical imbalances in the brain. I have read a lot of academic papers that struggle with the idea of nature (chemical imbalances) and nurture (the surrounding environment) and how much they affect mental illness. In one life I could have easily been the lady my mom saw on the bus recently, talking to someone that didn’t exist outside of her mind. In another I could have become a drug addict. In yet another I could have ended up broke, unable to hold a job, full of empty relationships and a family who hates me. All of those scenarios are things I have seen in various therapy groups and in-patient stays, all of them people with my exact diagnosis. What makes me different from them? We have no way to determine if my brain chemistry is different from theirs, science is not there yet. What I do know is their environment was significantly different from mine. The friends they chose made bad choices, they were from homes less supportive than mine, they were not pushed the way I was pushed to graduate, their role models were significantly different than mine. The same friend that has prompted this post sends me information that I have used in my treatment and maintenance programs. She sent me literature on B12 and hallucinations when we learned that my B12 was dangerously low. She shares reguarly literature on healthy relationships and communication. She has been a sounding board when I’ve been ridiculously low and (literally) talked me off of ledges. I strive to succeed like Kay Redfield Jamison, and others I can’t think of right now. My friends and family help me remember that I am capable, and I can live a successful life. Brain chemistry is a huge part of it but there is research now that suggests changing thought patterns can change brain chemistry. There is a reason that cognitive behavioral therapy and dialectical behavioral therapy are so successful. In mental illness you have to treat the whole being, not just the imbalance. There is a huge push in the medical field to do the same with cancer and other serious illness. Commercials for hospitals that specialize in cancer treatments regularly show patients that are grateful the doctors treated them and not the disease, some even mention how they treated the family and not just the disease. I understand that depression cannot be “fixed” with religion or spirituality, but suggesting that was the intention in the above passage comes from a trigger within the person feeling that way, not from Matt’s written words. What we need to take from the above words is mental illness is bigger than the brain chemistry, it’s bigger than the person experiencing it or their family and immediate support system, right now we need to be waging a community battle for the mentally ill. We need to de-stigmatize, we need to learn acceptance, we need to step beyond our cultural comfort zone and reach out, provide information, remind people that the simple solution is help and hard work, not annihilation and destruction. Great advocates of de-stigmatization are Glenn Close and her sister Jessie.

“We tend to look for the easiest answers. It makes us feel better to say that depression is only a disease and that there is no will and choice in suicide, as if a person who kills themselves is as much a victim as someone who succumbs to leukemia”

While I understand the sentiment here I must respectfully disagree. I do believe suicide is a choice, but it is a choice made by a lack of options. Most who make this choice do not choose lightly, and the disease eats them from the inside out for a long time. That would make this very similar to leukemia. I do consider them a victim, this thought is too complicated for me to put into words effectively, but it boils down to what I said above about the tragedy of suicide and how it robs the person of their ability to rationally choose the alternative of life.

“…in the end, joy is the only thing that defeats depression. No depressed person in the history of the world has ever been in the depths of despair and at the heights of joy at the same time. The two cannot coexist.”

I don’t agree with this. I have experienced exuberance and depression at the same time. In the middle of that it feels like joy and anger and sadness all rolled up into a tiny ball in your heart that you can’t escape or express because no one understands. In the Bipolar world they call it a mixed episode and it is terrifying. I understand that isn’t what he is getting at, but man do those words hit close to home. I don’t think we are all “destined for joy” the way Matt says earlier in his post. That is not the purpose of life. My husband says the purpose of life is passing on genetic data from generation to generation, but that is too scientific for me. I feel life is about making an impact on our surroundings. Sometimes it’s positive, sometimes it’s negative, but we are there to make that impact. We are there to learn and to grow from our actions and others. I think happiness is a ridiculous goal that is not reasonably reached. Humans are constantly striving for that next thing, we will be happy when we have more money, meet the right person, find the right job, win the lottery…the list goes on forever. I strive for being content with what I have. I love my husband and my son, my coworkers are wonderful, my job challenges me and excites me, I want to learn more because of it. This Cracked article talks about comedians and how unhappy they are as a group, with some very specific examples. I honestly believe that while there are happy moments, happiness is like love. Unsustainable for the long term and only truly enjoyed in those short moments. Some people are not destined for happiness, they are destined to make others happy and that is ok. More than ok, it is amazing and wonderful that they can make others happy and that should be celebrated.

Everyone deserves the help they need to find their content life. We absolutely need to wage a community war against stigma that prevents people from reaching out, providing them tools to learn when, how, and who to reach out towards. This is necessary because losing lives like Robin Williams, and my friend’s dad, and my husband’s friend, and my own is a disaster. It is an epidemic, and it needs to stop. This post is mostly for me, and if it’s found in the bowels of the internet where I post I fully expect no support for my opinions, but I needed to write this down, get it out of my head, and allow myself space to prepare for tomorrow’s job interview.