Let’s Talk About Suicide

The Netflix series (based on Jay Asher’s book of the same name), Thirteen Reasons Why, has recently become a growing trend (dare I say ‘phenomenon’?). Having recently seen it, I felt it important to try and address the elephant in the room: suicide.



Before proceeding however, I feel duty-bound to offer the following note of caution:

If you have not seen the show, I must advise you: you may want to strongly reconsider whether you really wish to watch the show; if you are suffering from sadness, grief, feelings of loneliness, isolation or guilt, or are battling a mental illness, I would strongly caution you against it. If you still wish to watch it, please ensure that a friend or someone you trust is aware that you are watching the show and will be there if you need someone. While beautifully made, it is not only poignant, but is very powerful in its depiction of suicide, and incidents that may lead up to it, including bullying (physical, emotional and cyber), gas-lighting, character assassination and slander, and even rape.



The most fitting understanding of suicide, perhaps, is one used by Andrew Solomon in his article in the New Yorker:

Most people imagine that resolving particular problems will make them happy. If only one had more money, or love, or success, then life would feel manageable. It can be devastating to realize the falseness of such tempered optimism. A great hope gets crushed every time someone reminds us that happiness can be neither assumed nor earned; that we are all prisoners of our own flawed brains; that the ultimate aloneness in each of us is, finally, inviolable.

To sum this sentiment in greater brevity, one must only consider the title of this article:

Suicide [is] a Crime of Loneliness

It seems to baffle many people, leading them to question why someone would take their own life or to just wrap their head around the notion that taking one’s own life was even an option for someone. Tackling this question is not easy, but is necessary. And who better to respond to it than Emile Durkheim, a French social scientist, credited as the Founder of the French school of Sociology.

Durkheim’s extensive work on the topic may be found in his book, “On Suicide: A Study in Sociology.” While Durkheim classifies various forms of suicide and provides a reasonable understanding of what might lead a person to go down any of those particular routes (for instance, egoistic suicide vs. altruistic suicide), his definition of suicide as a whole can provide some insight:

Suicide is applied to all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result.

In this definition, therefore, death is not necessarily the ‘end goal’ of the person who takes his own life, but it is, necessarily, a known consequence.

Of course, Durkheim viewed the subject purely from a sociological vantage point, and so cannot be considered a replacement for the psychological motivations behind such an act. However, the following words from the French sociologist seem to encapsulate an overarching thought process of the suicides this article sets out to discuss:

When this ultimate crisis comes… when there is no way out – that is the very moment when we explode from within and the totally other emerges: the sudden surfacing of a strength, a security of unknown origin, welling up from beyond reason, rational expectation, and hope.

Perhaps, suicide, at least for the purpose of this article, can then be summed up as the seemingly undeniable and irrefutable knowledge that because all means and modes of help, access, rehabilitation and treatment have been tried and exhausted, to no avail, therefore the only remaining door, though leading to the ultimate end, must be the only solution. (It is absolutely imperative to point out there that just because one might think this way, it is not true, even if it might seem as the only truth to them in that moment; the blinders of mental illness can, it must be admitted with grim despair, often prevent one from seeing the whole picture and the options available.)

Yes. Those are stark absolutes. But it would be beneficial to point out that the matter being discussed is, in and of itself, quite absolute in nature.

Solomon in his TED Talk titled Depression: The Secret We Share points out that:

If you have brain cancer, and you say that standing on your head for 20 minutes every morning makes you feel better, it may make you feel better, but you still have brain cancer, and you’ll still probably die from it. But if you say that you have depression, and standing on your head for 20 minutes every day makes you feel better, then it’s worked, because depression is an illness of how you feel, and if you feel better, then you are effectively not depressed anymore.

Though unsure about both the source and the veracity of the following, it’s something that has remained with me personally since I first came across it, highlighting the absolute desperation with which anyone wanting to end their life and/or suffering from severe depression will try and do absolutely anything they can possibly think of, in the hope that it might help:

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True or not, one thing does stand out: Everyone has their yellow paint.

Suicide is also not as uncommon as one might imagine. According to the World Health Organization (WHO), as of 2015, suicide was the second leading cause of death amongst 15 – 29 year-olds:

Top 10 Rankings

Considering the rate of suicide, it is estimated that there is one occurrence of suicide every 40 seconds. To put this into context: an average television commercial lasts almost 30 seconds.

Some of the key facts regarding suicide, as per WHO’s Fact Sheet on Suicide are as follows:

Screen Shot 2017-05-14 at 2.25.59 AM

Despite this growing, alarming, and frightening trend, as well as repeated reminders by WHO and other experts that SUICIDE IS INDEED PREVENTABLE, there seems to be a lack of initiative on part of governments as well as members of the society at large to come together and work towards the common end goal of eradicating this menace.

The situation in my home country, Pakistan, is not much different. According to a report by the Human Rights Commission of Pakistan (HRCP) in 2013:

A whopping 174 people, including 45 women (26%) committed suicide across the country during the last month with more than half of them taking place in Punjab, according to a report.

The Human Rights Commission of Pakistan (HRCP) has stated in its recently-released report that out of these 174 suicides, 44% (76) took place due to some sort of family-related crisis while 28 people took their own lives in the face of financial troubles.

To put this into context (as depicted in the same news story by The Express Tribune):

suicide-2

Naturally (perhaps ‘intuitively’ is a more apt word) it becomes understandable that there must be measures in place to diffuse such a situation should it ever arise and to allow the victim to reach out and seek help and subsequently rehabilitate him. However, until almost five decades ago, this was not the case even in countries such as England and Wales, where, prior, an attempted suicide was a punishable offense, labelled as ‘self-murder’.

Unfortunately, Pakistan still remains in the dark ages in terms of its legislation. As a friend and colleague recently wrote in an article:

In Pakistan, attempting suicide is a criminal offence. Under Section 325 of the Pakistan Penal Code, it is punishable with either simple imprisonment extending to one year, or a fine, or both. Although suicide is not permitted in Islam, many Muslim scholars question whether punishment should also be meted out for an ‘attempt’ to commit suicide.

Instead of throwing the person who attempts suicide in jail to languish there for a year, why not send them to a rehabilitation centre and ensure compulsory treatment? Instead of levying a fine on them — especially in a society where the poor are statistically more likely to attempt suicide due to socio-economic constraints — why not invest money in their treatment and rehabilitation? A person who attempts suicide is not a criminal; he is a victim, in dire need of acknowledgement of his mental illness, a supportive environment and state policies that allow for treatment rather than punishment.

Reverting back to Durkheim, his words resonate with great relevance to the matter:

We do not condemn it because it is a crime, but it is a crime because we condemn it.

In the recent past, it has not just been those from relatively weaker socio-economic backgrounds who have attempted to take their own life. Pakistan has seen students of elite universities lose their lives to this black abysmal pit of desolation, with medical colleges at the top of the list. In an article I wrote back when two such occurrences took place within the span of the same week, I argued that:

There seems to be a veil of ignorance behind which the masses are choosing to position themselves, pretending as if they are not complicit or party to a suicide attempt that is taken place, allowing them to shake off any and all burden. What we fail to realize is that the prevention of suicide lies in a communitarian effort and not in individualistic pockets of awareness.

There are a number of parties at play here, that need to work collectively and inclusively to help each other towards achieving the bigger goal – no person should ever feel as if they must take their own life as the only means of ending their misery, pain, frustration, depression or anxiety

However, three attempts, of which two were successful, within the span of a week, carried out by an identifiable age group (20 – 30 year olds) and a particular ethnographic trend (students studying in medical colleges) needs to be regarded more seriously than a one-off occasion. This year alone, the Sindh Government is planning to spend Rs. 13 billion to carry out 120 development schemes for the eradication of the more visible problem that Pakistan faces – dengue. There seems, however, to be no budget allocated to mental health awareness in Pakistan, save for that being carried out by the private sector.

In this collective effort, there is a great onus that falls upon (educational) institutions to first understand mental health issues, and subsequently to address them responsibly with their communities. It is equally important for faculty members to be aware of the nature, realistic quality and severity of mental health problems as it is for students to be aware of their ability for support and empathy.

One thing that must be avoided and prevented, at all costs, is the romanticization of suicide and suicidal thoughts and tendencies. Many look towards artists who have gone down the path and feel that they must emulate their ‘idols’ and that this is the only way for them to go. What they fail to see, sometimes, is the absolute pain they were in.

Take Sylvia Plath, for instance, who took her own life because her depression became unbearable. In one of the seminal works on depression, Sylvia Plath writes in her semi-autobiographical novel The Bell Jar:

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Imagine the hollowness and the numbness of her life, frozen in time like an underdeveloped photograph from a polaroid camera. And what’s worse is the expectation people carry: if you’re rich or well off or have things you have always wanted, you must be happy.

the-bell-jar-9

There is absolutely nothing to romanticize about suicide or depression or any other mental illness. Not only does it serve to belittle the suffering of those actually going through a mental illness, it detracts from addressing the problem for what it is: a problem. Add to that a lack of credible information, and a general social media trend to ‘out-do’ everyone else, and you have a scary picture before you. The following excerpt from an article in The Atlantic addresses this head-on:

“There is more interest in the topic and more self-identification,” says Dr. Stan Kutcher, an adolescent psychiatry expert and the Sun Life Financial Chair in Adolescent Mental Health, who says he sees a trend of romanticized depression, of self-victimization. “I see that on lots of social media. Not just Tumblr,” he says.

Kutcher says the problem is in misinformation. Adolescents are getting a lot of information from the media, on websites such as Tumblr, or from their friends, not from reputable sources.

“In this waterfall of information there is a lack of critical understanding,” Kutcher says. “You see kids self-identifying as having that depression, but they don’t have a depression. They’re upset, or they’re demoralized, or they’re distressed by something.” In other words, adolescents are confusing the clinical disorder called “depression” with normal, everyday challenges.

“People use the word ‘depression’ if they can’t find their keys, or if they’ve had a fight with their mother or father, or if they’ve had an argument with their boyfriend or girlfriend, if they didn’t make the school team or didn’t do well on an exam,” Kutcher says. “When we use the word ‘depression’ for every negative emotional state, the word loses its meaning.” Kutcher says this over-diagnosis of normal human experience is indeed a social trend.

“The pendulum has swung from ‘let’s never talk about it and let’s never educate ourselves about it’ to ‘let’s everyone blab about it,’” Kutcher says. “It’s a very interesting phenomenon. How you respond to an affective state depends on what that state is. If I’ve been demoralized, I don’t need Prozac, for Christ’s sake.”

However, at the same time, it is through artists and celebrities and ‘famous’ people the world ‘looks up to’ and turns to in times of their own struggle that a trend of awareness (or just talking about it, really,) can begin. For the longest time, no one talked about mental health. No one talked about it… until it led to the great Robin Williams to take his own life (while it was initially thought that Robin Williams took his own life due to depression, it was later confirmed by his wife that his death was caused by Lewy Body Disease, a disease that attacks the body’s neural system; the primary understanding that depression led to his death is also not untrue, for depression can be one of the symptoms of LBD considering its attack on the body’s dopamine neurons).

However, even during his life, the knowledge of Robin Williams depression, though not as popular as his ability to add magic to our lives, whether by rubbing a lamp in Agrabah or by making all of us laugh, brightening up our darkest days, making us wildly fond of literature and reminding us that it’s not our fault, had surfaced. In an interview published in The Guardian, Decca Aitkenhead notes:

My worry beforehand had been that Williams would be too wildly manic to make much sense. When he appeared on the Jonathan Ross show earlier this summer, he’d been vintage Williams – hyperactive to the point of deranged, ricocheting between voices, riffing off his internal dialogues. Off-camera, however, he is a different kettle of fish. His bearing is intensely Zen and almost mournful, and when he’s not putting on voices he speaks in a low, tremulous baritone – as if on the verge of tears – that would work very well if he were delivering a funeral eulogy. He seems gentle and kind – even tender – but the overwhelming impression is one of sadness … 

I ask if he feels happier now, and he says softly, “I think so. And not afraid to be unhappy. That’s OK too. And then you can be like, all is good. And that is the thing, that is the gift.”

To come to terms with the fact that Mrs. Doubtfire struggled with depression or that the voice behind “Good Morning Vietnam!” would eventually die by suicide is nearly impossible. Why? Because, again, to a third person it would seem that everything was ‘alright‘ and everything was ‘going good‘ and it was all ‘okay‘, and so there was no ‘reason‘ for him to feel this way.

I refer back to Andrew Solomon’s article in the New Yorker to address this:

When the mass media report suicide stories, they almost always provide a “reason,” which seems to bring logic to the illogic of self-termination. Such rationalization is particularly common when it comes to the suicides of celebrities, because the idea that someone could be miserable despite great worldly success seems so unreasonable … So [Robin Williams] would have had little “reason” to commit suicide—as, indeed, most people who kill themselves have little “reason” other than depression (unipolar or bipolar), which is at the base of most suicide. 

Nor is suicide an ultimate manifestation of “selfishness” or “cowardice,” as the reason-mongers often argue. Suicide is not a casual behavior; for all that it may entail impulsivity, it is also a profound and momentous step for which many people don’t have the force of will … It implies the defeated acknowledgment that if things aren’t better by now, they won’t be getting better. Robin Williams’s suicide was not the self-indulgent act of someone without enough fortitude to fight back against his own demons; it was, rather, an act of despair committed by someone who knew, rightly or wrongly, that such a fight could never be won 

The same qualities that drive a person to brilliance may drive that person to suicide. Highly successful people tend to be perfectionistic, constantly striving to meet impossible standards. And celebrities tend to be hungry for love, for the adoration of audiences. No perfectionist has ever met his own benchmarks, and no one so famished for admiration has ever received enough of it … Suicide is a crime of loneliness, and adulated people can be frighteningly alone. Intelligence does not help in these circumstances; brilliance is almost always profoundly isolating.

Furthermore, Matt Haig addresses this ‘gap’ between how things ‘ought to be’ and how they ‘are’ succinctly but effectively in his book, Reasons to Stay Alive, a memoir (of sorts) that takes us through his personal experience with depression and anxiety and how he (eventually) emerged victorious over his suicidal thoughts:

Actually, depression can be exacerbated by things being all right externally, because the gulf between what you are feeling and what you are expected to feel becomes larger … It is said that insanity is a logical response to an insane world. Maybe depression is in part simply a response to life we don’t really understand. 

Of life itself, there are various vantage points that may be taken. Milan Kundera, the French-Czech author of thought-provoking existentialist works writes in The Unbearable Lightness of Being:

He remained annoyed with himself until he realized that not knowing what he wanted was actually quite natural. 

We can never know what to want, because, living only one life, we can neither compare it with our previous lives nor perfect it in our lives to come … 

There is no means of testing which decision is better, because there is no basis for comparison. We live everything as it comes, without warning, like an actor going on cold. And what can life be worth if the first rehearsal for life is life itself? … 

Einmal ist keinmal, says Tomas to himself. What happens but once, says the German adage, might as well not have happened at all. If we have only one life to live, we might as well not have lived at all.

Kundera’s seemingly desolate portrayal of life does indeed lead one to wonder what the ‘point’ to life is or if there even is one. Perhaps a befitting response to this may be borrowed from Emily Dickinson, a poet who struggled with depression:

That it will never come again is what makes life so sweet.

Suicide is never the answer, even when it seems like the only one. As is famously said, suicide is a permanent solution to a temporary problem. The black clouds of depression and anxiety pass. They may leave behind memories of a number of overcast days, but they do pass. And some day, the sun will shine again; even if right now it does not feel like it and it feels as if that day may never come, it will.

Very recently, courtesy Matt Haig’s book, I discovered a wonderful article in the Atlantic by Joshua Wolf Shenk, titled Lincoln’s Great Depression. Before this, I was oblivious to the fact that President Abraham Lincoln had suffered from depression. But as Haig points out, Lincoln did not achieve what he did despite his depression; rather he did so because of it. As Shenk notes:

Lincoln’s look at that moment—the classic image of gloom—was familiar to everyone who knew him well. Such spells were just one thread in a curious fabric of behavior and thought that his friends called his “melancholy.” He often wept in public and recited maudlin poetry. He told jokes and stories at odd times—he needed the laughs, he said, for his survival. As a young man he talked more than once of suicide, and as he grew older he said he saw the world as hard and grim, full of misery, made that way by fate and the forces of God. “No element of Mr. Lincoln’s character,” declared his colleague Henry Whitney, “was so marked, obvious and ingrained as his mysterious and profound melancholy.” His law partner William Herndon said, “His melancholy dripped from him as he walked.” … 

In January of 1841 Lincoln submitted himself to the care of a medical doctor, spending several hours a day with Dr. Anson Henry, whom he called “necessary to my existence.” Although few details of the treatment are extant, he probably went through what a prominent physician of the time called “the desolating tortures of officious medication.” When he emerged, on January 20, he was “reduced and emaciated in appearance,” wrote a young lawyer in town named James Conkling. On January 23 Lincoln wrote to his law partner in Washington: “I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth. Whether I shall ever be better I can not tell; I awfully forebode I shall not. To remain as I am is impossible; I must die or be better, it appears to me.” …

Lincoln replied that he could kill himself, that he was not afraid to die. Yet, he said, he had an “irrepressible desire” to accomplish something while he lived. He wanted to connect his name with the great events of his generation, and “so impress himself upon them as to link his name with something that would redound to the interest of his fellow man.” This was no mere wish, Lincoln said, but what he “desired to live for.”

Lincoln found meaning. He found meaning even in the depths of his despair, when all seemed lost and no hope seemed to loom upon the horizon (keep in mind that Lincoln also lost a son during his tenure as President). He embraced his melancholy, rather than trying to fight it or deny it. He embraced it. And as they say, the first step to solving a problem is accepting there is one.

Perhaps acceptance, then, is the first step, and also perhaps the hardest step to take. Not shying away from talking about it, finding the courage to reach out and ask for help, and then learning to accept oneself for who one is, seems to be the way to overcome the monstrosity of suicide. Of course, to someone who feels there is nothing left to live for, or that the pain of existence is greater than the pain of letting it all go, these will seem like mere words, but take my word for it, and at least give this a true, sincere shot.

There is so much in the world to discover, to explore, to live through and to learn from. And there are so many who might be going through the very same thing, hiding behind thick masks and slippery veils, deflecting their issues and any discussion on them with humour and ill-timed jokes, using anger as a coping mechanism to fend off the people trying to reach out in fear of hurting them if they get too close or just secluding themselves from their friends and family and becoming more reclusive by the day. And I know that if we all come together, and be there for each other, and evolve as communities, you or I or our friend or our brother or sister will not have to go through any of this.

And if you are going through this – PLEASE REACH OUT! Reach out to anyone. Reach out to everyone. There are people who will not understand and that’s fine as well. Not everyone understands the pain of a heart attack unless they’ve either seen it up close or they’ve gone through it themselves. This isn’t much different, and so if someone gives you a harsh comment or laughs off how you’re feeling, know that it is because of their lack of awareness and it has nothing to do with you. If you already have someone you trust, reach out to them. If you don’t, reach out to the first person you meet. If you believe in religion, reach out to God. Pray to Him. Talk to Him. Let it all out. But whatever you do, please stop trusting social media. A ‘like’ is no guarantee that what you posted is good, and another person’s photograph is no proof that his/her life is so amazing (remember how we talked about coping mechanisms in the last paragraph?). You don’t believe me? Try this simple Google search and see for yourself how simple it is to get more ‘likes’ or ‘followers’ on any social media platform – hack the algorithm. There is nothing genuine about something that claims to be social but isolates you in the process.

I assure you, there is a lot of support in this world; we just need to be willing to ask. Things will get better. And as the adage goes:

This, too, shall pass.

This article I chanced upon on social media left an indelible mark on me, and I would like to share it with you – especially if you’re going through a tough spot:

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If you’re reading this and you think you can spot the signs in someone you know or know someone who has reached out to you but are unsure of what to do, I am no expert, but I can safely offer you two pieces of advice.

1) Listen. Don’t preach. Don’t claim to know what they’re going through. Just listen. Don’t judge them. Give them a safe space. And don’t tell them how they ought to feel. They’ve come to you because everyone else has already done that. What no one seems to do anymore or have time for is to simply lend an ear and a shoulder. If they don’t mind physical contact, hold them. Hold them until they feel a little more secure and safe.

2) Help them get the professional help they need. Assure them there is no stigma. Be with them. Support them each step of the way. Go with them to the psychiatrist/therapist if that will help them. Follow up with them. Ensure they are taking their medication or meeting their appointments with the therapist. Do NOT try to do something you are not competent to do, because, as you may know, this is a literal life-and-death situation.

I am going to leave you with the following TED Talk by Sergeant Kevin Briggs, who was stationed for many years at the Golden Gate Bridge, which has seen more suicide attempts than, I assume, it would care to remember, in which he discusses the role he got to play in (his attempt towards) saving lives and actually talking to some of those who were at the bridge with the intention of ending their life. This talk might move you, and it might make you happy to be alive, but even if it does neither of those things, it will show you suicide for what it really is, and what you can do to play your part to help prevent it.




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