  My answers on the survey below regarding depression and suicide sounded rather flip and I don't want to leave it at that. It's a serious subject that causes a lot of pain for everyone involved. A person who attempts or succeeds at suicide is obviously in a lot of pain for a long time. The people who love them are hurt; they may feel abandoned, angry, guilty, helpless, emotions too complicated to adequately put into words. Psychiatrists and therapists are frustrated when a patient's depression is resistant to treatment and sometimes they question themselves and their ability to help their patients. Often they feel helpless.
When a patient attempts suicide they beat themselves up wondering why they didn't see it coming. They ask themselves, "Did I miss some important warning signs? Why didn't he/she call me? Don't my patients trust me? Feel safe with me? Am I really helping anyone?
Did I fail to take this person's feelings seriously enough? Should I be in this profession? Am I failing my other patients? Why couldn't I save this person? " I borrowed the title for this little piece from a friend's answer to this same survey question. (What follows is by no means a refutation to her response.
It just got me thinking about suicide) To just give up and quit and leave everyone else, the people who care about you most in fact, to clean up the mess and try to make sense of it all, is certainly selfish. It's even cruel. A suicide is devastating to everyone it touches. If the suicide is successful the survivors never recover. It becomes a part of their psychological make-up forever after and colors their perceptions of all events and relationships that follow. How could it not?
But clinical depression is more complicated than that. It isn't a simple matter of feeling sad or overwhelmed or hopeless. Suicide isn't necessarily a decision or a solution to one's problems, or the 'cry for help' cliche we hear about on tv news features that try to explain it. Those feelings certainly are a part of it, a part of being human. There a many degrees of intensity with which people experience these feelings. The period of onset and duration of the depression vary greatly.
My depression was brought on by life circumstances that were multi-faceted and that got worse instead of improving over time. It isn't necessary to write the specific details here except to say that it was a chronic depression over the course of 10 years that finally wore me down. My situation was finally bad enough and I was finally weakened enough that I decided to leave my marriage and move back to a city I hated to a family I didn't want to be dependent on and become a single parent again, even though I knew from experience what we all would have to sacrifice. Jumping from completely unbearable to mostly unbearable. Shortly after this decision was made an event occured that was completely devastating. Even though I was taking medication at this point I reached beyond my limit and completely collapsed.
I was quite literally a broken human being. I was hospitalized briefly and then began my attempt at recovery in a new (considerably less than ideal) place. During this time I had bouts of sadness, rage, hurt, and a sense of meaninglessness and disconnection from the rest of humanity so intense I would have done ANYTHING to make it stop. I was soooo tired. I got tired of my own hurt, of my own anger. I didn't want to hear about it anymore.
I didn't want to think anymore. Intellectually I understood the intensity of these feelings would eventually lessen, and at times it helped to know that. But often the 'right now' was absolutely and devastatingly unbearable. And knowing I had ceased to function brought guilt and shame and self-loathing. The sense of being a burden to those taking care of me was overwhelming. I would have given anything to get away from myself, even for an hour.
Even to sleep would have brought tremendous relief. But I was unable to sleep without medication. Eventually even the medication didn't help. I thought about dying constantly. I just wanted it all to go away so that I could get on with my life. I would have welcomed amnesia.
Since I have children dying simply wasn't an option. At the same time I was painfully aware that I was damaging them anyway. That the people who wanted to help me were frustrated and worn out. That relief for all of us was a long way off. The night I took all of my remaining medication at once was one of those weary, angry, lonely, guilt-ridden nights. My children were in another city in another state with their father.
I just wanted a break from the persistant torture coming from my brain. I would have confessed to shooting the Pope if I thought it would make the noise stop. I just wanted to sleep. I didn't contemplate suicide. No decision was made. No rationalizing.
No concious thinking at all. I just wanted to sleep. I took 2 of the pills that were supposed to calm me down and 1 that was supposed help me sleep. Still I felt trampled and still I was crying. I shot off an angry e-mail to my husband and opened a bottle of wine. I still felt miles underground in the cold black pit and I took 2 more of each pill.
At that point all judgment was blurred and it seemed to make sense to keep swallowing pills until I passed out. Eventually I did. To this day I remember nothing that happened before waking up the next afternoon in a hospital. I don't remember calling my step-father, which I'm told I did. I don't remember a policeman kicking down my door, or the paramedics or the ride to the hospital in an ambulance. I don't even remember my son sitting with me in the emergency room, hugging me and crying.
He tells me I was quite awake and annoyingly animated and charming. I wouldn't know. He has reported that the ER doctor was frustrated that I repeatedly pulled the i.v. out of my arm. I kept asking him where he went to medical school and what he thought of his training there. Where did he do his residency and why did he choose emergency medicine?
Did he feel confident it was the right decision for him? At that moment he probably had his doubts. I don't remember any of this conversation, or drinking charcoal or anything else they did to keep my heart from stopping or my lungs from giving up. In my case there was mental illness involved. The concensus is Bipolar Depression - by all accounts powerful stuff. But it isn't at all clear, even to the professionals, if illness exacerbated my reaction to circumstances or if circumstances caused the illness.
Brain affects perceptions that affect experiences. Experiences rewire the brain that will do the perceiving. What is clear is that doctors and family members didn't 'cause' what happened. There is noone to sue. There is a lot going on inside our heads that nobody understands yet. Nobody should be expected to understand it all.
It is entirely possible that the human brain is so sophisticated that it isn't sophisticated enough to comprehend everything it does, let alone why. And there are universal thoughts and feelings and ideas, but no 2 minds experience the world exactly the same way and not everyone brings the same skills to the table. "You should"s and "it can't be that hard"s are not really fair to anyone. None of us is in a position to weigh in on what should be easy or natural to another person. But that's a whole other topic. (And in my opinion a fascinating one.
) So for now I salute all of your brains. They're working hard out there and doing a remarkable job. 
