Thursday, December 10, 2009

Out of the shadows

It's no secret that I read the obituaries. After we moved to London, I'd read the obits from Montreal as a means of remaining connected with my hometown. Since we've been in our adopted home for a few years now, I've begun reading the listings here, as well.

You learn things when you read them. Sometimes heartwarming, sometimes jarring. I was jarred one morning last week:
"[Name of deceased] spent more than a decade struggling with increasingly severe depression but the worsening of his illness coupled with lack of proper medical care led him to take his own life."
It's not often that families choose to be so overt when cause of death is suicide. For as long as I can remember, members of my own family have barely been able to utter the word in conversation. Otherwise well meaning people often shunt - sometimes subtly, sometimes less so - those who suffer from diseases of the mind to the margins. They won't say it, of course, but their quiet message is that it is a weakness more than a true affliction. Even seeking help is often looked down upon - indeed, I remember the tone used in otherwise friendly discussions at get-togethers to describe those who had "gone to see their shrink." I shuddered then, and I shudder now.

So when I saw this announcement, I couldn't get this poor soul's family out of my mind. By choosing to lift the veil of secrecy, they showed such courage in the face of such unimaginable loss. At that moment, I wanted to reach through my screen and let them know just how much I felt for them, and how much I appreciated their decision.

Mental illness lives in the neglected shadows where few of us would choose to look. It forces sufferers to endure its ravages in silence. It condemns the families of its ultimate victims to live not only with the loss of a loved one, but the stigma of the fact that it was by one's own hand.

I can't help but wonder if things would be different if that stigma didn't exist, and if we spoke about it in the same terms as, say, cancer or heart disease. Either way, please consider this entry my effort to start raising the volume.

Your turn: Please share a perspective on mental illness, if you've got one.


lissa said...

All too often, this is the unspoken taboo. Suicide. Depression. Mental illness. As though there is shame associated with it. (there isn't) Having lost a friend to suicide at age 18, I studied the concept at length to try and understand. There are no answers.

But when it is associated with depression/mental illness, it is something that can be avoided - at least, I believe so. But all too often, those involved don't acknowledge the existence of the unseen pain that plagues their loved one, and only too late do they get that understanding.

Thanks for bringing it out in the open, Carmi - if more people did validate the existence of depression as an illness, not a mild "sadness", it might someday be eradicated...or avoidable.

PS - I have been reading obits since I was little; my mom and grandmother had that habit, and I picked it up from them.

CynAnn said...

God Bless you Carmi for having the courage to discuss this. I have been trying to survive depression for most of my life. I've learned alot about it, take my rx faithfully, but still the dark clouds can come. No one but those who have this existence can understand. It's a lot more difficult to overcome than just smiling and picking yourself up by your bootstraps. Sometimes we don't have bootstraps to pull ourselves up with. Even with all the knowledge I have, it is genetic with me, and the result of a childhood that would make people shudder. Bless you again

Mark said...

My wife suffers severe depression and has been on just about every prescription drug out there. It's almost frightening how a psychiatrist in only one visit will decide what very powerful drug (or more) to prescribe. I've watched helplessly for 17 years as she fights it. It's heart-wrenching to watch a loved one go through it and have no power to change it.

Anonymous said...

It is hard to quantify my thoughts here, Carmi, but I will. I appreciate your candor and compassion on this issue. I've never struggled with the "unspoken shame" of suicide. My mother's only sister shot herself in the heart when I was five, and then my sister-in-law's father killed himself when I was 17 years old. It's never been a secret to me. However, as a close family member in both instances, what I saw was not the depression or the cries for help. What I saw was the family's pain. From this, I learned early on (when thinking compassionately wasn't a lesson I'd learned yet) to view suicide as selfish. Even now, years later, when I hear of someone who has taken their life, my thoughts turn to the family member who had to find the body, the spouse who has to explain it to the children, the life insurance policy that won't be paid, etc., etc. When I was in my early twenties, my life crescendoed to such a level of pain that I seriously considered ending my life; but didn't follow through because I couldn't inflict that much pain on those who love me. I muscled past the pain out of sheer grit and determination and made it through to a place where I love life.

To be honest, yours is the first discourse to take me down the road of examining compassion or considering mental illness and it's role in suicide. I've known plenty of people who suffer from mental illness, but as they didn't kill themselves, I haven't connected the two. Now I will.

I've always considered suicide as selfish. You have now made me consider that perhaps my attitude is selfish, as well. Not a nice mirror, but I will spend more time thinking about this. Thanks, Carmi

Mojo said...

How spooky is this. I was just today thinking of a blogger friend of mine Suzanne Horne who ended her life nearly a year ago. The ripples that emanated from that event are still being felt throughout the blogosphere, even by people who never actually met Suzanne in the three-dimensional world.

Her friends in "Blogaritaville" (her name for it that I co-opted) are still struggling to make sense of it all. I hope that her family -- especially her children -- have made their peace with it at last.

Very few people would have suspected that this woman who was outwardly bright, vivacious, and loving toward everyone was so very troubled. I didn't know her well enough to see the signs, and for that I will be eternally sorry.

But she left behind not just grief, but a lesson. Don't wait until "later" to tell the people you love that you love them. Because there might not be a "later". A part of me will always wonder if I had sent that email or left that blog comment or in some way said "that thing" (whatever it might have been), we might still have Suzanne with us today. And I'm positive that I'm not alone in that.

I said at the time, and I still believe this, that there are two types of people who commit suicide. The first kind are those who actively want to die. And sadly, for those you can do very little to prevent it. Because someone determined to die will eventually find a way to do it no matter what measures you employ to stop them.

But the second group are not ones who want to die as much as they just don't have a reason not to. And for these there is hope. Because underneath, they really want to live, they just don't want to live in this kind of pain. And who can blame them for that?

Lissa is correct in her assessment that we don't validate depression as an illness, despite decades of clinical evidence linking many -- if not most -- forms of it to organic causes. And the well-meaning friends and relatives of the sufferer all too often have all too little understanding of the disorder. They effectively tell the patient to "snap out of it" while the patient wants to scream "If I could do that don't you think I would? Do you somehow suppose this is fun for me?" Sadly, in the worst cases, the patient can't even muster the energy to express that thought.

Equally sadly, the subject isn't one that's usually discussed in anything approaching intelligent terms. There's very little more dangerous than an "armchair therapist" dispensing (usually bad) advice, and those well-meaning but typically uninformed people are usually the only ones who will discuss the subject at all. For the rest it's simply too uncomfortable a subject.

So I applaud this effort to bring this ever spiraling crisis out of the darkness for the masses. I think perhaps that the key to resolving the problem is -- like so many others -- awareness and education. And any attempt at that is worthy -- and welcome.

Anonymous said...

Mental Health will never come out of the closet until the medical profession itself starts treating those with mental illness with respect. As a perfect example, listen to the podcast on CBC's white coat black art from Oct where patients with mental illness are discussed. The entire tone of the piece is condescending and arrogant. Ten years ago I walked into a hospital asking for help because I was completely suicidal. I figured since I was enlightened and open, the hospital must also be. Instead I discovered that mental health might have come out of the closet amongst the intellectual set, but it certainly hasn't in the hospital system. I'd rather suffer in silence than go through that experience ever again.

bobbie said...

Your anonymous commenter is right. The medical profession has a lot to answer for.

I am looking at this from the other side - I am old and ill, and any time the good Lord wants to take me, believe me I am ready. But I am not sad or morbid about it. It's a simple fact, and I look at death as the last great adventure. But don't ever tell a doctor a thing like that. He will immediately assume you are depressed and possibly suicidal. And his attitude toward you will change drastically.

We must find a way to change the thinking of both doctors and the general public about suicide and about mental health. Not only for the sake of those who take their lives, but for their families and friends who are so devastated by it.

Marion said...

When my daughter committed suicide, I noticed immediately that to tell others of the fact made them feel far worse then if I had just said she had died. And so, unless people specifically asked what she had died from, I rarely bring up her suicide, even now.

People don't know how to react to suicide. Thanks for this post, Carmi, and all the comments which, for whatever reason, made me feel so much better this morning. I believe, finally, there may be hope when it comes to acceptance of mental illness.

Linda said...

Carmi - I read the obits daily. I pray for the souls who have passed, and for their families as they go through the loss. And I have noticed that the holiday season brings about many more obits than I care to see.

Now, on to your subject. Having scanned the previous comments, I have seen a lot, but not much from the perspective of someone who IS there.

You see, I suffer from depression. Clinical depression. I have suffered for 13 years (diagnosed, though I am sure it has been much longer than that). I ride the emotional roller coaster of sadness, loneliness. I don't have someone as supportive as Mark. My husband feels like I should just "shake it off". Even with meds, I've never been "right". I don't take meds now, and I struggle daily to keep life going.

There isn't a week that goes by that I don't think about suicide. I fight that thought all the time. I feel like everyone would be better without me...that *I* would finally be free of pain and sorrow.

Like Blond Girl, my husband believes that suicide is selfish. He doesn't have the insight that she has found. It's not selfish for someone depressed to think the world would be better. In our eyes, we want to do what is best for all out there, and not being around is what we see as the solution.

All this being said, I fight the thoughts daily. I remember that as a Christian, God gave me a reason to be here. And in His time, I will be called home. That, and only that, is the reason I still am here. Again, my husband says that is selfish...that I should think about my kids and him and THOSE reasons should be good enough.

He won't ever get it. And many physicians won't ever get it either. They don't see it from this perspective. Kathy Kronkite referred to it as "the black dog of depression" in her book "The Edge of Darkness". And it's a good way to look at it...if only others could see it this way.

Phronk said...

Thank you for posting this. That obituary is brave and encouraging. I do hope that, one day, "he lost a battle with depression" has no more stigma attached to it than "he lost a battle with cancer." The difference in blame attribution between afflictions of the mind and afflictions of the body has got to. There's still a long way before we get there, but at least signs like this show that it's going in that direction.

theMuddledMarketPlace said...

"Mental illness", that covers a host of options doesn't it?

There's depression that's handled well by the medics.
There's depression that handled badly by the medics.
There's depression leading to suicide.
There's that one that no-one-can-quite-decide-what-it's-called-but-it's-tough-living-with-them-sometimes.

All the above has applied at one time or another to various members of my family. In fact, until i was about 11, i thought the idea was that Everyone's extended family was gloriously exotic and very different.
i had no idea.

It was only as I got older and the lid of this box was raised somewhat ( and it's shadow tapped on my own life a bit) that i realised the sadness and the trauma that goes along with struggling with our or anothers mental health issues.

The stigma of reaching out for help only for everything to be flung back in the face and the door firmly shut- yet again.
Vacillating with expert care given in another place that's fantastic and brilliant and everything ends happily every after
And yes that does sometimes happen.
Good practice is around. People do recover. Totally.

However for most, i think there's a spectrum. There's the perfectly balanced person ( who i usually find tediously boring) Those in danger of inching along the depressive route. Some skipping blithly through life leaving an everso slightly exotic path behind them. And some....whose life is touched by something that tangles with their mind and leaves merely a shadow of their previous self.

Our geographical area is littered with cases that start badly and end tragically.
My most recent rant is here
Thank you for raising the issue here.