God Help Me, I Don't Want To Live Any More

This article was originally posted on my old site in December 2004. However, in light of the recent death of Hunter Thompson, and the increasing interest that his suicide caused, I thought it appropriate to re post it. So, here it is in its entirety.

Earlier this month (December 10th), Gary Webb committed suicide. Mr. Webb was the author of Dark Alliance a book about the connection between the Contra's and Drugs and the CIA. My friend Marc Cooper wrote extensively about Mr. Webb here, & here.

Suicide - the killing of one's self is a mental health issue stretching back through the millennia. Whether it be from Alexander falling on his sword, Socrates drinking hemlock or Mr. Webb, suicide hurts everyone it touches, from the victim to the victims loved ones.

The Center for Disease Control reports:

* Suicide took the lives of 30,622 people in 2001 (CDC 2004).
* Suicide rates are generally higher than the national average in the western states and lower in the eastern and midwestern states (CDC 1997).
* In 2002, 132,353 individuals were hospitalized following suicide attempts; 116,639 were treated in emergency departments and released (CDC 2004).
* In 2001, 55% of suicides were committed with a firearm (Anderson and Smith 2003).

The CDC goes on to say that women attempt suicide three times the rate of men and men complete suicide four times the rate of women. It is a grisly set of statistics, especially at this time of year when one would think that being with family, the giving and getting of expressions of love, sharing with others etc., would be a happy time for all.

And yet, and yet, this is not the case. No, is there trouble in the world, with war, famine, disease and sorrow. And for far too many, despondency.

Risk factors for suicide include the following:

• Previous suicide attempt(s)History of mental disorders, particularly depression
• History of alcohol and substance abuse
• Family history of suicide
• Family history of child maltreatment
• Feelings of hopelessness
• Impulsive or aggressive tendencies
• Barriers to accessing mental health treatment
• Loss (relational, social, work, or financial)
• Physical illness
• Easy access to lethal methods
• Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or suicidal thoughts
• Cultural and religious beliefsÂâ€â€�for instance, the belief that suicide is a noble resolution of a personal dilemma
• Local epidemics of suicide
• Isolation, a feeling of being cut off from other people

I know the feeling of despondency, of being cut off from others, of severe loss; and I know them far too intimately! In July, 1996 my first wife passed away from the complications of asthma. We were 15 days away from our 27th anniversary! As the family gathered around my daughter and me, I still felt isolated. When my wife's mother, brother and I went to our chuch to talk with the pastor about the memorial service my brother-in-law noted that my wife was no longer in pain, that we would soon enough be with her but we didn't want that now. I looked up at him with tears in my eyes and my heart breaking and said "I do." I meant that then, at that time in my life. I, to this day, don't know if I would have actually attempted suicide (obviously I didn't commit it); but I do know that if I had been crossing the street I wouldn't have hurried out of the way of a car speeding towards me, so great was my despondency. I survived that time, with the support and love of my friends and family, especially the love of my daughter Jennifer. I fell in love again (though I never thought I would) and re-married and am delightfully happy once again.

Suicide has been called the Savage God by A. Alvarez in his classic book, and part of my title comes from remembering reading that tome when I was in graduate school. In my 35 plus years of mental health work, I have dealt with the family survivors of suicide time and time again and it's never easy; on the therapist or on the family. The grief, the doubt and the pain go on and on in unremitting waves. Suicide is far too often not a well thought out action, but an action of desparation, of despondency of a belief that nothing will again be better. Gary Webb doubtlessly felt this way before shooting himself.

Suicide grows out of an irrational belief that nothing will improve - and no, I'm not talking about people with an incurable disease, with an immediate future of unremitting pain and ultimate death. I'm talking about people who in the depths of depression believe that nothing will improve. Nothing could be farther from the truth! While there is life, there is hope. Suicide dashes that hope for the victim and the surviving loved ones.

It is said that depression, like any mood is cyclical, that is that our moods go up and down in a normal fashion with a fairly predictable regularity. Clinical depression on the other hand is a gross exaggeration of this cycle. A psychiatrist friend of mine explained it once as waking up in the morning feeling lousy and down. Going to work someone notices and says "What's wrong?" to which you sigh and reply "I'm depressed!" The other person says "It's OK, things will get better" and sure enough, after a few days or a week or so it does. But depression, real depression is much more complex and much greater than just the "blues."

Depression is often mistakenly thought to be caused by one or more of the following:

• Depression is the result of a medical condition involving an imbalance of hormones or neurotransmitters in the brain.
• Depression is the result of "bad" thinking processes.
• Depression is a result of significant psychological/physical trauma and it's aftermath.

The Depression Learning Path here has a terrific bit of information regarding depression. Read it all.

Depression is not the "cause" of suicide though, even if it is often directly and unavoidably linked to depression. I once had a patient who had lost her husband and two children in separate accidents a couple of years apart, lost her business and managed to cope with it all. She became depressed and had persistent thoughts of death and dying when her pet dog died. So, how did she cope with true tragedy but "fall apart" when a pet died? Perhaps it was the proverbial straw that broke the camels back. Perhaps it was the time of year, perhaps her pet's death occurred as she was starting to realize the extent of her previous losses. I don't know. I do know that with the help of a psychiatrist and counseling she was able to recover and become a fully functioning happy person again.

The loss of belief in a future, despondency too often leads to suicide. For the family of the suicide, the resulting guilt and belief that they could have prevented it is wide spread, almost universal. There are warning signs, but they are not always present, and often the person contemplating suicide goes to great lengths to keep anyone from realizing what is about to happen. SAVE (Suicide Awareness Voices of Education) has a great Question & Answer section on suicide, causes, prevention etc. I strongly, strongly, suggest a full reading.

Educate yourself about depression and suicide; the cost in lives ended, lives of survivers shattered and the cost in human suffering demands it. You may know someone who is contemplating suicide. If so, act, now, go to the internet and learn as much as you can and do something. Take a risk! Be proactive! Save someone you love, even if they get furious with you. You may not be ultimately successful, but you won't feel guilty if they eventually do take their lives.

UPDATE: From SAVE a bit of good news. President Bush signed the GarrettLeeSmith Bill.

President Bush signed into law a bill authorizing $82 million in grants aimed at preventing suicide among young people. The Garrett Lee Smith Memorial Act is named for the son of Oregon Republican Sen. Gordon Smith, who championed the legislation as a tribute to his 21-year-old son, who committed suicide last year. The senator, his wife Sharon, daughter Brittany and son Morgan attended the signing ceremony at the White House.The law authorizes $82 million over three years to provide grants to states, Indian tribes, colleges and universities to develop youth suicide prevention and intervention programs. It emphasizes screening programs that identify mental illness in children as young as sixth-graders, and provides referrals for community-based treatment and training for child care professionals.

Suicide can often be prevented if we all make a significant effort.