“If I’d been able to kill myself and afterward see their faces, then yes, it would have been worth it. People aren’t convinced of your sincerity, your motives, and the depth of your sorrows except by your death. As you long as you are alive, your case is uncertain, and you are entitled only to their skepticism. So if one were sure to enjoy the spectacle, it would be worth it to prove to them what they don’t wish to believe, and to astonish them.
But you kill yourself and what does it matter whether they believe you or not: you aren’t there to drink in their amazement and their contrition (so fleeting, moreover), to attend, as every man dreams, your own funeral.”
The Clinical Advisor for beyondblue, Associate Professor Michael Baigent, was joined by Professor Patrick McGorry and leading mental health experts this week speaking at the Flinders School of Medicine on Mental Health in Medicine: A seminar on mental wellbeing in medicine.
I was in the car and heard the report on radio. The discussion was about the suicide rate among doctors which, based research of 90 studies from around the world, is higher than in the general population. By way of explanation Professor McGorry said “Stigma and I suppose lack of awareness and mechanisms like denial are stronger actually amongst the medical profession, which is very worrying.”
When asked how the stigma could be broken down he said, “In a way the same thing that needs to happen with the whole community, just to basically have these issues spoken about much more freely.”
From my soapbox I speak so much about suicide I’m in danger of preaching.
Talking, trying to be supportive and accepting of various perspectives. I am following Professor McGorry’s advice and speakly freely (writing) and trying not to preach.
His family are reported to be heartbroken, understandably. Charlie Haddon’s dramatic death is distressing and tragic.
I am a little (but obviously not completely) lost for words, suicide is a complex issue and I stand more for suicide understanding than suicide prevention. It all makes me sad. I don’t know how in the world to make a difference, although I think about suicide in terms of cause and effect a lot. To draw a simple casual link for a complex social problem isn’t possible. There is not one or even a few things to do differently.
I think we are all a little more depressed than we ought to be and we’re all suicidal in degrees. What helps? After almost a year of blogging I can only think of;
– Heart – talking, caring, sharing, empathising
– Hand – holding hands and being there in simple and undemanding way
– Hope – if hope and resilience can be learned by rats we might learn it too
My emerging view is that rather than curing any one depressed person we need to support and accept what sits within ourselves, before anything starts to change it seems important to sit with what is. I don’t have the words yet and I do know that I’m slowly getting closer. A year is hardly any time at all.
In New Zealand last weekthe Coroner asked for debate about the restrictions on reporting suicide. The Chief Coroner said” My personal view is that there’s room for some gentle opening up of things …”
The media are bound by legislation that seeks to prevent “sensationalising, glamorising or romanticising suicide or giving it undue prominence”. Paradoxically new Zealand has the most strident laws restricting the reporting of suicide and a relatively high suicide rate by country.
The number of New Zealanders taking their lives per year is reported as 50 per cent higher than the road toll.
The less we share about suicide the less we know, and then it is hard to recognise the warning signs. How can the risks and dangers of depression be appreciated or anticipated when we don’t share what we know.
It is tragic that more open reporting of experiences is not possible and people feel uninformed,and more at risk, as a result. In Australia a month ago Professor McGorry called for suicide statistics to be reported on the television news and on the front page of every newspaper everyday. Professor McGorry and Judge Neil MacLean, the NZ Coroner seek to build community understanding. If we were better able to recognise the early signs of mental illness and support rather than stigmatise this might be a world more could live in.
If you’ve ever held ideas about the sort of people who die by suicide, the death of Elspeth Thompson might dispel some stereotypes. She’s described as a successful and dynamic woman, she was a gardening writer and a mother, who is said to have cultivated blooms in the most unlikely places. The coroner has just found that her death was suicide.
Elspeth Thompson left a note: “I’ve fed the dogs and put the heating on so that you won’t be cold. I’m sorry. So very sorry. But I’ve gone to the lake with a bottle and pills. I love you. I love Mary.”
An Australian Senate candidate for the conservative Family First Party, Wendy Francis, tweeted some comments on Sunday that appalled me, including this one:
“Gay marriage = kids with no mothers or no fathers, parentless generation; uncontrollable depression and suicide. Is that the Aust we want?”
Wait up Wendy – parents are not responsible for the depression or suicide of their children. Single parents are not responsible for the depression or suicide of their children. They are not.
Is there any evidence to support a causal link between the sexual orientation of your parents and your depression? I think not. Why is same sex marriage linked to depression and suicide by Wendy Francis? It makes no sense to me, or to the Australian electorate I hope.
I am truly dismayed that depression can be so misunderstood, misrepresented.
…and, for the record, I do want an Australia that understands and accepts same sex marriages.
I thought more conversation about depression and suicide was needed, now I am convinced. I mean, I am even more convinced this dialogue is necessary.
I’m not an addictive or automatic smoker, fortunately for me I can take ‘em or leave ‘em. Even so I struggle to watch an episode of Mad Men, where even the doctors have ashtrays on their desks, without longing for a cigarette.
Whatever additive tendencies I may have, smoking is not one of them. I enjoy every cigarette and contentedly go without a puff for years at a time. It’s not the same for others. Many, who know the risks and health affects of smoking and including some who disapprove of it, are also dependent on being able to light up another cigarette. Addicted.
There is a wonder drug, Champix, that blocks nicotine receptors in the brain and supports even the most addicted smokers to ‘give up’. Most will understand giving up to mean the cessation of smoking, and for some taking the drug giving up is more sinister, as some will die by suicide.
Now an argument rages about the greater harm cigarettes, which 16,000 deaths a year in Australia are attributed to, or Champix (the nicotine inhibiting wonder drug) the use of which was linked to 55 deaths by suicide in a week,in the US last November.
The US Food and Drug Administration now requires warnings on the medication “…highlighting the risk of serious neuropsychiatric symptoms in patients using these products. These symptoms include changes in behavior, hostility, agitation, depressed mood, suicidal thoughts and behavior, and attempted suicide. The added warnings are based on the continued review of postmarketing adverse event reports for varenicline and bupropion received by the FDA. These reports included those with a temporal relationship between the use of varenicline or bupropion and suicidal events and the occurrence of suicidal ideation and suicidal behavior in patients with no history of psychiatric disease.” http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm170090.htm 1 July 2009
Apparently Pfizer, who market Chapix, have said a causal link between the drug and suicidal ideation has yet to be established. Now they sound a bit a tobacco company…
Established causal link or not I wanted to mention that Champix has been linked to insomnia, aggression, depression, suicide and quitting cigarettes.
…whether they are restrained in the hand or confined in the swimming jar, the rats are in a situation against which they have no defense. This reaction of hopelessness is shown by some wild rats very soon after being grasped in the hand and prevented from moving; they seem literally to “give up.”
…after elimination of the hopelessness the rats do not die. This is achieved by repeatedly holding the rats briefly and then freeing them, and by immersing them in water for a few minutes on several occasions. In this way the rats quickly learn that the situation is not actually hopeless; thereafter they again become aggressive, try to escape, and show no signs of giving up.
Richter, C.P. On the Phenomenon of Sudden Death in Animals and Man. Psychosomatic Medicine Vol. XIX, no. 3, 1957
Hope can be learned, hedgehog.
Hope for me is holding someone’s hand.
Rats that were trained to hope swam, while locked in jars filled with water, for 60 or more hours. Inexperienced, or un-hopeful, rats would sometime persevere for as little as 15 minutes before giving up and drowning. It’s a horrifying and compelling study.
Why did some keep on swimming in a Nemo-esque fashion while others chose to give up? Hope?
I hope our government invests in ways to build hope in addition to rescuing the drowning. Both are needed but one has more power, and allows for greater self determination. For now keep on swimming, just keep swimming Nemo.
That someone chooses to die creates a sense of unease. It’s not the natural order (just ask the church) and increasingly suicide is talked about as preventable.
I often wondered how different my experience of loss might have been if Mottsu had died some other way. Would I have been offered more solace if he had died accidentally rather than quite so deliberately? Could I have talked more (not that I could have talked any less than I did) if he had been taken by some indiscriminate fatal illness?
In many religions killing oneself is as serious a sin as killing another. Apparently only God may take a life.
Apart from what God might or might not condone, there seems to be a deeper existential threat to society at large when someone dies by suicide.
“Affronted and confronted” is the phrase Colin Tatz coined this week to describe our reaction to suicide. He says, “We are, in many senses, as much affronted as confronted by each such event. But this is essentially because we view the individual as belonging to us, to our society. For some religions, life and death belong only to God.”
It’s not easy to understand suicide and I am not sure we try hard enough. The act is shocking and distressing for we who are left to piece together the story and, even so, there could more reflection about why react the way we do.
We could also reflect more about the desperation, the pain, the loneliness and angst that might compel someone to chose not to live.
