LOCAL

Time to shine a light on suicide, and banish the shame

SuicideDiseases and IllnessesRobin Williams
Instead of asking a depressed friend, "Are you OK?" we ought to ask, "Have you felt so bad you wanted to die?"
Mental illness can undermine logic and overwhelm good intentions.

I was 19 when my cousin shot himself to death. He wasn't addicted or mentally ill. He was 20 years old, going nowhere and tired of feeling like a disappointment, to his family and himself.

For years I carried a burden of guilt. I believed I could have saved him if only I'd been nicer or paid more attention; that what he'd needed was a hug, a night out, a little encouragement.

We understand suicide better now than I did then — but still not well enough to make sense of the death of Robin Williams.

The comedy icon had a constellation of conditions that put him at high risk for suicide: a history of depression and addiction, physical ailments, career setbacks and financial concerns.

Still we struggle with the notion that someone so talented, so rich and so universally beloved would be so desperate to die that he'd try to slit his wrists with a pocket-knife and hang himself in a closet when that failed.

Our collective confusion is playing out online — through heartfelt tales of personal struggles with mental illness and clueless comments that heap blame on Williams, his family and his friends.

Like this comment on a message board soon after his death: Why was a severely depressed person left alone for over 12 hours and why did his wife leave the house for hours without even checking to see if he was ok? Very strange.

As if her vigilance could have kept her husband's demons at bay.

Kay Redfield Jamison will tell you it doesn't work that way.

::

Jamison is a professor of psychiatry at Johns Hopkins and the author of a searing memoir, "An Unquiet Mind," chronicling the turmoil of manic-depression.

When Jamison toured the country promoting the book and speaking about her illness, people approached her at every stop with photos of loved ones who had committed suicide. "It broke my heart," she said. "The guilt just doesn't go away."

Most felt angry — at themselves and the person who was dead. "They tended to see [suicide] as an angry act, a selfish act," Jamison said. "That's a really understandable reaction, but it's really off the mark."

Jamison began studying the subject, poring over suicide notes and talking with people who had attempted to end their lives. She wrote about the process in "Night Falls Fast: Understanding Suicide."

"Overwhelmingly, what people say is 'I just couldn't take it anymore,' " Jamison told me in an interview this week. "These are not just people who were weak and moaning and groaning. It's a level of pain that's simply unendurable."

Most people who turn to suicide are trapped by depression or other disorders that warp their thinking. "They feel they are intolerable burdens to the people they love. They can't stand that, on top of their own pain. They reach the end of their rope," she said.

Jamison understood the peril of those emotions. Early in her career, the promising young UCLA psychology professor had downed a batch of lithium pills and tried to kill herself.

::

When she was younger, Jamison made a pact with a brilliant and wealthy friend, who was also manic-depressive:

If either began contemplating suicide, they would drop everything, spend a week on the beach together and find reasons to stay alive.

Years later, she got a phone call: her friend had put a gun to his head and a bullet through his brain. He had not reached out.

His rational mind, his riches, his satisfying career, his support from friends ... none of that could keep him from taking his life.

Mental illness can undermine logic and overwhelm good intentions. "Madness carves its own reality," Jamison wrote in her memoir. "No amount of love can cure madness or unblacken one's dark moods."

Depression is more than sadness or bouts of melancholy: "You are irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You're frightened, and you're frightening."

That's something to remember as we try to make sense of Williams' death. We don't know the architect of his demons, but we see the fallout from what must have been unfathomable pain.

His friends, in hindsight, say they'd seen signs: He wasn't returning phone calls, his eyes were dull, he seemed oddly detached. But no one knew what to say.

I suspect none of us would. That's what has to change. The best way to honor Williams may be to drag depression out of the closet and place it center stage.

We hesitate because it's awkward to talk about; it feels invasive to ask and shameful to admit. So we tiptoe around a topic that calls for us to be blunt.

Instead of saying "Are you OK?" to a friend who seems hopeless or depressed, we ought to ask directly, "Have you felt so bad you wanted to die? Have you thought about taking your life?"

That's what Jamison suggests. It's not a nudge toward suicide, but a way to shine a light on the dark and dangerous feelings that lead to more than 30,000 suicide deaths in this country every year.

Over time that sort of conversation may help ease the shame of suicidal urges, steer more people to professional help and shake the public stigma that adheres to mental illness.

For now, all of us trying to make peace with the loss of Robin Williams ought to keep in mind this line from Jamison's book:

Suicide is not a blot on anyone's name; it is a tragedy.

sandy.banks@latimes.com

Twitter: @SandyBanksLAT

For more information, see The Times' story about how to recognize and get help for depression.

Copyright © 2014, Los Angeles Times
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