Continuing the Dialogue about Suicide

Posted: August 25, 2014 in Uncategorized
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Even for those of us who live daily with the challenges of clinical depression and for whom death and suicide are dinner table conversation, Robin Williams’ suicide came as both shock and unexpected, immense loss.  As all of us work through what this means to each of us personally, and as a culture, though, it is my hope that his death will begin and sustain a serious dialogue on the critical issues surrounding clinical depression: its recognition, its treatment, the severe lack of balance in care vs. profit that exists in the mental health “industry” today, the gross misunderstandings that those who have not suffered from this illness carry with them, and finally, the end game – suicide.  That thing that nobody really wants to talk about but which is killing so many of us at an increasingly alarming rate every year.

Over the past couple of weeks, there have been countless articles and blog posts and television news stories about Robin’s death and just as many opinions and “professional” statements about the nature of depression and suicide.  Most, by far, have called depression an illness and suicide, in essence, an effect or product of that illness, an act committed “by the disease,” not literally, of course, but an implication that the individual has no control over the decision.  A few, though, have – boldly, cruelly maybe, and, with more support than one might think – suggested that suicide is 100% choice and that the person who commits this act is sinful or a coward or selfish.

Some examples of the latter:

When it comes to the issues of illness and health, people need for their questions to have black and white answers.  The medical community has established norms for blood pressure and pulse and the levels of all sorts of stuff in the body, which allows us to confidently say, “I have diabetes” or “my cholesterol is normal.”  Advances in CT and MRI allow radiologists to see and definitively diagnose cancers and microfractures and ligament tears.  But mental illness and the issues it presents lie in a space somewhere in-between, in a murky grey zone that most of society avoids like the plague.

Even the question of whether mental disorders like depression are actual illnesses has been up for debate in some circles. There’s been a lot of research, though, that connects brain functioning and even structure with behaviors, emotions, thoughts, and experiences associated with various disorders and provides strong enough evidence to the medical community that there is a separate and well-respected manual used as a guideline for identifying and treating mental illnesses: the Diagnostic and Statistical Manual of Mental Disorders, or DSM V.

Different types of depression affect individuals in various and unique ways.  Someone who is experiencing psychotic symptoms – delusions and hallucinations – as part of their depression will react differently to the world around them than will someone who  is not.   Similarly, someone whose depression is complicated by chronic physical illness, severe or repeated stressors, or loss will likely have a greater challenge in managing it than someone who does not have additional worries.

Suicide is, most often, a response to depression or another mental illness but it cannot and never should be viewed as the same experience for everybody.  People turn to suicide as a solution for a variety of reasons.   Most don’t truly want to die, but rather want to be free  from the intense, unbearable pain they are experiencing.  Depending on their circumstances, that might be emotional pain or it could be physical pain, or it could be both.  There may be other reasons.  Some illnesses have hallucinations and delusions as symptoms, and people who try to kill themselves are reacting to voices that tell them to do so or to the false belief that by doing so something positive will result.  Some people who are diagnosed with terminal illnesses kill themselves to avoid the debilitating effects, the financial or perceived emotional burdens on family of the disease. Others overdose accidentally on medication, either in a gesture intended as a call for help or as a purely unintended and unfortunate error.  The list of reasons go on.

It’s unfortunate that in our society suicide is often seen as a cowardly and selfish act, and even viewed as sinful by a great many “loving, forgiving” religious folk.  People who suffer from mental illness and grapple with thoughts of suicide, sometimes on a daily and chronic basis, are among the most courageous people I know.  It takes guts, not to mention a special kind of strength, to wake up to the kind of hell these people go through every day.  To suggest that a person is a coward for needing relief from a hell he cannot (or does not believe he can) escape, says more about the person standing on the outside than the one who has died.

And so it goes for the person who smugly calls him selfish.  On the surface, it seems reasonable. Take Robin Williams for example. He had a wife, children, millions of fans around the world that loved him.  His death truly affected a great many people.  And he had to know that it would, right? That by killing himself, he would be hurting a lot of people, including those closest and dearest to him.

Well, maybe.  And maybe not.  And NO ONE can answer that question, except him.

See, depression and other mental illnesses do strange things to our thinking.  When someone is considering suicide, he often thinks that he has no place in this world.  That family and friends would be better off without him.  That he’s a burden to others, and that if he died, everyone would get along much better, wouldn’t fight, wouldn’t have him to worry about.  Maybe even, that they wouldn’t even miss him if he were gone. Or that if he died, the financial problems could be resolved.  Depression skews our thinking.

I think that people use terms like “coward” and “selfish” and “sinner” because they are afraid and angry.  It is really hard for some to imagine how anyone could take their own lives, especially if that person is a productive member of society and has a loving family and close group of friends.  It forces people to reconsider what they thought was stable and sure, and to think about their own mortality.   It gives them an answer to a confusing situation that, a lot of the time, really doesn’t have one.  And it helps them compartmentalize what might have been a painful event.

It really doesn’t help anyone to call someone who died in such pain a coward or selfish or a sinner.  The only black-and-white with suicide is that when a person kills himself, he’s dead.  It may have been done on impulse, without thought; it may have been a measured choice, planned out in excruciating detail.  Judging people who are depressed or mentally ill and belittling them after they’ve died only spreads a message to others who are in a similar situation and perpetuates the problem.

Instead of judgment based on ignorance, we need more education, understanding kindness, compassion, and dialogue.  Robin Williams could be you.  Depression and suicide do not discriminate.


  1. megggpie says:

    I 100% agree with your post. I suffer from mental illnesses as well as most of my family. I sadly lost my brother to suicide 13 months ago, and me being one to deal with pain and the after math of a suicide does not believe it is a coward, selfish, or sinful act. Much of what you said about it is what I agree with. Thank you for your honest post. Losing Robing William to suicide triggered me back to my brother’s suicide. Hearing a lot of the accusations uneducated people are making about the suicidal frankly irritates me. We have to be the voice to change it. And yes I say that all the time, it does not discriminate, just like cancer doesn’t.

    • debaumer says:

      I’m so sorry for your loss, and want to thank you for continuing to move forward and add your voice to those of us who want to see a change in how all mental illness is viewed and talked about. Take care!

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