Since my dad died by suicide four years ago, I’ve continued to debate how much of a “choice” he really had at the time. On the surface, it seems simple. He chose to take his life and stop struggling with depression and anxiety. He chose not to stay and spend more time with his family and work. He chose the time, place and method to end his life. However, the more I learn about suicide and the crippling effects of mental illness on a person, the less clear I feel about his choice being so black and white.
A while back, I wrote about the difference between depression and a “slump.” Never thinking suicide would cross my dad’s mind, I attributed his change in demeanor to a temporary slump he would eventually shake. As I dug deeper, I learned depression can feel mentally and physically paralyzing – like the world is caving in and there is no longer a light at the end of the tunnel. The thought of death, as finite, terrible (and irrational) as it sounds, is more appealing than continuing to live through this nightmare of a cave. I couldn’t imagine having to make such a “choice,” and I am confident it was the most difficult one my dad had to make. Do I think he really wanted to have to do so? Absolutely not.
Similar to how the body may eventually shut down when fighting a life-threatening disease, those battling the despair of mental illness can also stop functioning. In one case, people die naturally after a fight and, in ours, a loved one died by their own hand. Thus, it is perceived they had a choice and chose to stop fighting. Sometimes people who are fighting a lengthy illness without the promise of full recovery do seek medical intervention to stop their pain, perhaps by ceasing life support. Yet, those deaths don’t seem (to me) to carry the same stigma around choice. In extreme cases, maybe there’s no guarantee a loved one could be forever cured of their mental illness. Many readers can attest to this based on numerous suicide attempts by a loved one and even pleas for their pain to end. Why don’t they have the same option to end “life support” (medications, therapy, hospitalization, etc.) without shame? As my therapist recently reminded me, my dad also didn’t choose to have anxiety or depression.
I think it’s easy for society to look at someone battling depression and expect him or her to
simply look through life with a different lens. A cartoon suggesting just that inspired the idea for this post. Considering what I shared above, I don’t think that’s fair to ask of anyone. We are very quick to assume someone has fallen into a “slump” and has the ability to put on rose-colored glasses and feel better. This does not pay respect to the weight of mental illness or the dark cave a person may be living in. As a survivor of suicide, a cartoon like this also makes me want to yell, “it’s not that easy!” If it was, I’m sure my dad would still be here.
I have raised this topic with my grief therapist many times, particularly when I come up with a supposed reason for why my dad killed himself. “Oh, it’s because he was worried about money, or work…” She always refutes me by saying, “but there are many, many more people who have money and work problems and do not take their life.”
So, how much choice is there in suicide? While society may say 100%, I don’t believe I will ever have a hard and fast answer on the role it played in my dad’s suicide. It’s so much more complicated than that. I don’t feel comfortable saying he chose to die and leaving it there without adding all of these accompanying questions and thoughts.
I don’t think there is much of a rational choice involved in suicide. Depression is unfortunately one of those insidious disorders which eventually leads to cognitive distortion. I think this article explains it pretty well what is happening:
http://academicdepartments.musc.edu/pr/newscenter/2014/suicide.html#.Vr3er-Y2WrJ
I lost my 17 year old 6 months ago. He fought epilepsy all his life. Medication didn’t fully control it. As you read the above mentioned article you learn about DBS and TMS. Our psychiatrist explained it this way: Many patients with epilepsy have undiagnosed psychiatric disorders like depression and anxiety or both, those are masked by the epilepsy, present atypical and the symptoms you do see, are also often side effects of AEDs. At some point in treatment however, a patient may become seizure free (meaning no clinical seizure activity, brain waves on EEG normalize). This used to be called “forced normalization”, what the patient then may experience instead is their underlying psychiatric disorder – an “alternate psychosis” due to imbalanced neurotransmitters and other biochemical disturbances.
It’s really not much different in patients with depression, especially if not treated or under-treated or as often happens, wrongly treated.
Here a PET Scan of depression showing decreased brain activity..it’s quite shocking and unfortunately this kind of stuff causes suicidal thinking, ideation, and at some point the worst…an impulse you cannot control. It’s like having to sneeze.
http://www.mayoclinic.org/tests-procedures/pet-scan/multimedia/-pet-scan-of-the-brain-for-depression/img-20007400
So no, it’s not a choice at all. Our mind is a weird thing and quite fragile. Pair this with life stressors, perhaps a lesion which is not discovered, a chemical imbalance, genetic predispositions etc. and it becomes a very, very complex disorder.
I think it’s very important to get the word out that it’s not a choice. I think for the survivors this “choice talk” does more harm than good.
Dear Becky and Diana,
Thank you for raising awareness about depression. It is hard for those of us with healthy brain function to understand why someone we love would resort to suicide because yes, everyone worries about money, their jobs, their relationships, etc. but not everyone feels they are trapped and that death is the only solution. Sadly, it is often those who struggle cognitively who are unable to reach out for help and handle their pain in a clean-cut, linear way that leads to a coping and healing strategy. My boyfriend took his own life this year and I’ve asked “why” a thousand times, have cried incessantly and blamed myself for not being able to get through to him or cheer him up. Seeing it the way it is described in your article Becky and understanding it was not a rational choice as Diana has posted gives me some respite.
Christina, I am so very sorry for your loss. The year is still young, so your loss was very recent – I know it hurts really bad, Please know I am with you in thoughts and you are not alone.
You know, the past 8 months I’ve done a lot of research. I too wondered why the suicide rate among men is so high. Women attempt more, but men pick the most lethal method more often…..why?
I found a little gem in a book can’t even remember the name of the book (and I have read quite a few); a man described his experience with depression. He said, he didn’t even know what was happening to him, he seriously thought he was physically ill, so he went to his general practitioner for relief of back pain, upset stomachs, insomnia, headaches etc. Even when treatment didn’t work, it didn’t occur to anyone, not even his doctor, that he might be depressed.
There is a problem with that! Men don’t even recognize their own feeling of depression, it’s very often felt on a physical level, not an emotional level. Of course they then get frustrated, angry and with it unfortunately agitated. In the right moment, they might go, without a warning (weird car accidents for example) as they can’t take this anymore (meaning, now mostly confused). It kind of produces a trance like state in some, it’s pure anger in others (impulsive), not even recognizing what is happening. Some plan, they are aware of their depressed mood, but don’t want to be “stamped” so they don’t seek help. They are convinced, this is the right thing to do. (at some point, usually after years of alcohol and drug abuse to numb it all).
You know, a lot of psychology and psychiatry is based on the needs of women. Women throughout history been viewed as the “weaker”, “hysterical” , “emotionally labile” , and “feeble minded” of the genders. It was totally unmanly to be anything but stoic.
So…to this day, many men believe it’s unnatural for a man to suffer from depression or other mental health issues. Help for men has to look different, it has to be more manly. No wonder I didn’t recognize certain symptoms in my son. He didn’t seem depressed in the sense of how I feel depressed, he did have some physical complaints thought for which we’ve been to the doctor just 2 weeks prior to his suicide. In yet another of my many books I read: Lots of general practitioners don’t have enough training in spotting depression. Imagine that!
Again, my greatest sympathies to you.
Dear Diana,
The article you listed by Dr. George was very insightful and helped so much. I have already shared it with some family members as an excellent reference because it explains why the impulse to take one’s life can be so strong that it rules out rational thinking…and all it takes is one moment of that to end their lives.
I am so sorry about the loss of your son which was also quite recent and it’s true that men (young and old) are not often able to articulate their feelings the way women do because they are conditioned by society not to. They often turn to drugs and alcohol to self-medicate and sadly, those substances only exacerbate their condition and struggle.
What you say is 100% true: “Help for men has to look different, it has to be more manly.” The mental illness field of study does cater more to women and women are more adept at opening up about emotions in a counseling setting whereas men might go play some basketball or work out at the gym when frustrated. I think therapy for men may have to combine personal training to be effective.
I have found many GP’s have a broad knowledge of many things but not an in-depth knowledge with regards to depression–and especially in recognizing symptoms in men. Often, physical symptoms in males are written off as common and brushed aside. I am sure you are frustrated with the medical system for not delving deeper with your son’s complaints. My heart goes out to you and you will be in my thoughts as well. Your posts inspire me to raise awareness and effect productive change within the medical field.
Hello again Christina (and all other readers),
“Your posts inspire me to raise awareness and effect productive change within the medical field.”
I am so glad to hear that. I have been struggling with myself as I speak another language and thought my home country is really lacking blogs of this kind. I have yet to get myself to actually put one word on a sheet of paper. Every time I try – I am surprisingly mute. I hope you will be more successful. (but you never know, my pain still stings badly)
I see you are very interested try:
A History of Male Psychological Disorders in Britain 1945 – 1980 (I got a free copy on Amazon Kindle). It’s a mouthful!
Much love to you
Dear Diana,
I will get a copy of that title you recommend. I am not sure where you hail from but this blog, though USA-based, is very universal. I am based in Colorado where drug and alcohol abuse is a big problem in addition to isolation and depression (or “cabin fever” as they call it). In resort areas here, mental health services are severely lacking and frankly, takes substance abuse or mental health disorders seriously–even after a tragedy occurs. They just sweep everything under the rug. Because of the prevailing attitude out here, I have been unable to bond with my boyfriend’s family or his friends over his death so this website has been a great help. You have done a great job expressing your thoughts and feelings and your words have been such a comfort to me today. Thank you.
Dear Diana,
I wanted to post to you and others that there is an educational documentary called The Mask You Live In about the raising of healthy boys in society. It is available to stream on Netflix, and perhaps elsewhere. It deals with many issues that my boyfriend faced and that led to his suicide. Things need to change so men are not chastised by others for expressing their fears, pain, sorrow, etc. Men of all ages should not suffer in silence.