September 26, 2002
3:34 PM   Subscribe

One of my co-workers commited suicide. There were no apparent signs; on the contrary, she was young, dedicated, driven, and personable. I was shocked to learn that suicide is the 11th leading cause of death in the U.S. It doesn't make sense to any of us, but it makes you think a lot more about the lives of the people we often spend eight hours a day with.
posted by mad (71 comments total)
It's been a shock to everyone that knows her. Confused, we walked around today with questions without answers. It seems so strange that there is little we can see or do to help people before this happens.

The little background I do have is that she had been depressed and medicated, but showed no indications that things were bleak.

Have my eyes been closed, or is this a growing problem?
posted by mad at 3:44 PM on September 26, 2002

That is really sad, indeed. I've noticed that everyone I know who's known a person who killed themself recognised none of those signs. I think those lists of 'warning signs' are a palliative, and that the reasons that someone gets to that point are largely unknowable.
posted by GriffX at 3:49 PM on September 26, 2002

suicide attempts by college-age men and women rises in the fall - CNN

Theres one answer.
posted by stbalbach at 3:52 PM on September 26, 2002

When I was in high school, not to long ago, a freshman boy shot himself in the head in his family bathroom. He was a good, smart yet quiet student. He came from a middle class home with two parents. It was a shock to his family, his friends and his teachers. Either everyone missed all of the signs or there werent any.
posted by Recockulous at 3:53 PM on September 26, 2002

It sounds like you might need to talk to someone about this, mad, like a counselor or a minister/rabbi/etc. They could help you sort through your frustration, confusion and anger about what has happened. I suggest you turn off the computer (we can't help you here) and call someone to talk this over.
posted by arco at 3:56 PM on September 26, 2002

While reading the few comments in this thread, I realized that I was listening to and singing along to Flipper's Life (the lyrics seem kinda hokey without the music). Will Shatter, RIP.
posted by gluechunk at 4:03 PM on September 26, 2002

don't feed the troll.

Of course. Thanks for the reminder.

And mad, my sympathies. Everyone wonders what they could have done, or if there were warning signs they should have noticed... sometimes there just aren't any, and there's nothing that anyone could have done.
posted by jokeefe at 4:07 PM on September 26, 2002

The hardest thing about figuring out if someone is at risk for suicide is that depression doesn't always manifest as weepy, low self esteem, isolating, lack of enthusiasm. It often manifests as anger, hostility, risk-taking behavior; particularly in men and in people with Bi-Polar Disorder type II. Also, people will try to act as if everything is normal out of fear of being incarcerated in a psych facility indefinitely, or fear of being thought badly of by family, friends, and associates.

The other misconception is that suicide is always a methodical,well planned event. It can be an impulsive, heat of the moment act, too. I guess what I'm trying to say is that is quite possible that she didn't display any of the signs traditionally associated with suicidal behavior. You shouldn't beat yourself up over "not seeing the signs." Not every person who kills themselves sticks to the classic profile of suicidal behavior.
posted by echolalia67 at 4:13 PM on September 26, 2002

An ex-boyfriend of mine killed himself. I knew he was confused and a little depressed, but so were a lot of people just getting out of college. I was shocked. I know a lot of depressed people, but I had no idea he was that agitated. It's frustrating not to know. I mean, who ISN'T really depressed at some point? What made him do it?

Ten years later I still wonder about it. What could I have done even with me in San Francisco and him in Mississippi? Anything?
posted by aacheson at 4:16 PM on September 26, 2002

mad, many crisis centers offer support for survivors of suicide, that is, people who are left behind by those who have suicided. Start at the American Association of Suicidology and click on the Crisis Centers link. Look up some centers in your area and call them. Pass the numbers on to the people that knew her. You can also go directly to their support group index here.

You will beat yourself up for a while wondering what you could have done. It takes some training and education to recognize the signs of suicidal behavior and more training and education to counsel a suicidal person. While you can try to get someone help, you can't stop them from harming themselves if they are truly determined to do it. In the end, it is their decision and it is not your fault. I just passed my 10-year anniversary on a suicide hotline and one thing I've learned is that I will not be able to stop someone who has made up their mind to suicide.

Ask the local crisis center for signs of suicide or look here on the AAS site for the signs and suggestions on how to help a suicidal person.

crackheadmatt: you're an asshole
posted by joaquim at 4:18 PM on September 26, 2002

i've known 4 individuals who've taken their own lives (in the traditional sense*) and of them only one, my best friend, was obviously "symptomatic". a lot of people are extremely good at keeping their feelings to themselves so a set of symptoms isn't going to be much help at all, and in the end be harmful to the survivor's sense of responsibility. sometimes things like this just can't be prevented. or maybe i've just learned too much acceptance over the years... there is sometimes an element of choice to suicide as opposed to just transient, treatable depression.

(*a definitive one time event such as pulling a trigger, intentional overdose etc, as opposed to long term self abuse, which i consider suicidal)

here's another suicidology site.

crackheadmatt - keep in mind there's no such thing as a hot troll.
posted by t r a c y at 4:27 PM on September 26, 2002

I'm so sorry about your co-worker, mad.

My younger brother (26 years-old) committed suicide earlier this year. He was an extremely smart, popular, attractive young man, who was dong well at NYU Business School. He also never exhibited many of the symptoms outwardly, although he certainly led a fast life. I've written extensively on my website about this -- friends have commented that writing online is "my therapy." It probably is to some extent.

Here are some additional statistics. Suicide is the 3rd leading cause of death among people aged 15-24. More people die from suicide than from homicide. Men succeed at suicide more often than women.

There are some good books for sucide survivors you may want to read: In the Wake of Suicide and Night Falls Fast: Understanding Suicide.

This topic is of particular interest to me, even moreso because my fiance suffers from bipolar disorder, and statistics say that one in five people who are Bipolar commit suicide.
posted by popvulture at 4:27 PM on September 26, 2002

Thanks to everyone for the kind words.

I've talked to many people about it, and while I still have questions that nobody can answer, I'm ok. It just struck me as such a human trajedy thrust into the workplace- where we often get caught up in work/business and forget about the people behind all the meetings, projects, strategy sessions, etc.. It made me think a lot more about my other co-workers, and just how important that smile and hello can be to someone.

Our company is bringing in a counselor tomorrow, as they did for September 11th, for those who really broke down.

Moreover, I'm saddened that around 29,000 people/year commit suicide in the U.S. and it took this tragic event to show many of us just how vulnerable people can be. Despite her appearance of a late twenty something corporate professional with nowhere to go but up, we're all fragile- some just more delicate than others.
posted by mad at 4:30 PM on September 26, 2002

aacheson: Don't blame yourself! My brother's girlfriend is plagued with many of the same questions.

There may not have been anything you could've done, even if you were right there with him. My brother loved his girlfriend so much. He left a note for her telling her how much he loved her and how great she had been for him. She loved him too.

He actually got up out of bed they were sleeping in together (at 5a.m.), went up to the roof of his Manhattan apartment building, and jumped off.

You can't stay awake watching someone every single hour. It's also very hard to know when someone should be committed to a hospital. So, please don't blame yourself. I know it's hard not to.
posted by popvulture at 4:33 PM on September 26, 2002

aacheson: What could I have done even with me in San Francisco and him in Mississippi? Anything?

I've often taken out-of-town calls at the crisis center from people (Significant Other Calling -- SOC) who are concerned about someone local (SOC Regarding -- SOCR). The first thing we try to do is to get the SOC to persuade the SOCR to call us. This is a useful tool because it empowers the SOCR and shows them that they CAN take steps to help themselves. If that doesn't pan out, we will call the SOCR directly providing we can use the name of the SOC. We do that so the SOCR doesn't get the impression of "Big Brother" interfering in their lives; they will understand that someone they know (the SOC) cares enough to reach out. I've posted some links to crisis centers elsewhere in this thread and I see that others have done the same. When you're concerned about someone far away, find a center in their area and call them. (Unfortunately, it will cost you the long-distance fees. Your local center probably doesn't have the funds to make long-distance calls.
posted by joaquim at 4:37 PM on September 26, 2002

When I lived in Hamburg, Germany I experienced two suicides at close range. The first was my co-worker who hung himself in the woods outside Berlin after his American girlfriend threatened to expose their relationship to his wife. When I saw his beautiful wife and two children crying at his funeral, all I could think about was what an utterly stupid, selfish prick he had been to kill himself like that. His girlfriend had a memorial service for him in the US, which I found quite tasteless and inappropriate, all things considered.

Shortly afterwards, I had a jumper fall past my office window. I worked on the 17th floor of a 20-story university building. There were a lot of suicides in Hamburg, perhaps partly due to the depressing effect of the constantly gray, rainy weather. Our building was apparently a popular spot for jumpers because the door to the roof was always unlocked (it was a weather research center). He was a philosophy professor. I never found out why he jumped, maybe he'd been reading too much Nietzsche?
posted by MrBaliHai at 4:42 PM on September 26, 2002

echolalia67: It often manifests as anger, hostility, risk-taking behavior; particularly in men and in people with Bi-Polar Disorder type II.

Thanks for a broad and scary generalization of a complex phenomena.
posted by Tystnaden at 4:47 PM on September 26, 2002

Popvulture: as a severe type I bipolar (rapid cycler, etc - basically the worst kind), the suicide statistics always confuse me. Many bipolar people I have met (including my fiance) tend to offset their disorder with a marked increase in intelligence, although I realize this is purely anecdotal evidence. I've had severe depression and a cry-for-help attempt at 18 (when my disorder was still in onset), but since then nothing. The simple rationale I came up with shortly after the cry for help was, essentially, this:

There is no possible consequence of not dying worse than the known consequence of dying.

Later, I found the above summation, given that it was superior to my own I now make use of it when expressing the concept. From that point forward, no matter how depressed I was, no matter how much it felt like the pain of constantly destroying my life in the usual bipolar spiral was simply not worth continuing my existence, I ran into that one cold, hard piece of logic. A safety wall against the final brink of despair. I mention all this here in the hopes that the above meme spreads. The reason this all confuses me, is that it seems like intelligent adults should realize all this with a minimum of effort, and their seeming failure to do so frustrates and worries me.

For a brief statistic: my fiance this morning found a news story stating that suicide is now the leading cause of death for males under the age of 30 in Britain. Just a thought, but maybe this is what comes of your standard bright Euro atheist realizing the truth of existentialism while forgetting the above?
posted by Ryvar at 4:50 PM on September 26, 2002

You will beat yourself up for a while wondering what you could have done. It takes some training and education to recognize the signs of suicidal behavior and more training and education to counsel a suicidal person.

Absolutely, well stated joaquim.

I used to work in a transitional living facility (half-way house). No one at the house suicided while I was there but the senior counselors told me of a guy who had. He was the facility's success story: guy overcomes schizophrenia, gets a job, starts attending college at UC Berkeley, had several articles written about him in local newspapers. He jumped off the GG Bridge; left a note telling his family that he was afraid that he might have a relapse and he couldn't bear to upset and embarrass his family. You can never really know what's in people's mind.

And aacheson, I doubt that there was much if anything you could have done. That was one the hardest things lessons I had to learn. People make the choice to kill themselves. They might be upset with people in their lives, they might be overwhelmed with problems in their life, but ultimately they made that choice for themselves, not because of what other people in their lives did or did not do.
Yes, people who contemplate suicide, in general, have a very serious mental health problem and their outlook on the world is very distorted. But unless you are a trained professional or are emotionally and physically close to the person it can be very hard to tell. All you can do is let the people in your life know that you love them and will do anything in your power to help them if they find themselves in a bad situation.
posted by echolalia67 at 4:51 PM on September 26, 2002

People make the choice to kill themselves. They might be upset with people in their lives, they might be overwhelmed with problems in their life, but ultimately they made that choice for themselves, not because of what other people in their lives did or did not do.

beautifully put, echo....and mad, maybe you can find some solace in that--she made an active choice to end her suffering and sadness...(maybe not the choice you or I would make, but we're not her...)
posted by amberglow at 5:01 PM on September 26, 2002


If I had a blog....

I doubt I'd be the only MeFite to disclose suicidal tendencies. My recent bout of depression [ended c. 4-6 weeks ago] was not one which led to planning self-harm. I did sincerely attempt, as a young man with a broken romance going off, to o.d. on paracetamol [aka Tylenol?]. Would have worked, had not a regular customer, a 16 yr. old girl with her own futile interest in me, cycled 4 miles to my room & demanded entry. She made me walk back, sought advice from a doctor who was a parent of her best friend, and I lived [I'm glad to say], with no hospitalisation, no visit to the shrink, nothing on my record.

None of this did I tell my family, so when my brother did successfully end his life, 10 years later, they had had no learning from my attempt. Neither of us wanted pity, help, or medicine. We wanted the hurting to stop. One of us got it right.
posted by dash_slot- at 5:04 PM on September 26, 2002

Thanks for a broad and scary generalization of a complex phenomena.

Tystnaden, I certainly did not intend to make a scary generalization of the disorder. My experience with it is that you have all the hypomanic energy minus the fun euphoria, thrown into the mix with the soul-crushing hopelessness and stomach churning fear that is clinical depression. That's my experience and for me, it's pretty fucking scary when it happens. Additionally I was told by my shrink that I had a pretty typical case .

Your description fits with the DSM-IV definition but I've often found the DSM-IV to be very broad and vague in their descriptions of disorders.

Vague description + horrible personal experience = previous posting. I certainly didn't mean to give a distorted view of this disorder. Sorry if I offended you
posted by echolalia67 at 5:08 PM on September 26, 2002

Ryvar writes: There is no possible consequence of not dying worse than the known consequence of dying.

Ryvar: While I personally agree with what you wrote, I can also see that there are certain circumstances where someone might decide that there are possible consequences of not dying worse than known consequences of dying.

For instance, one obvious example is the people who chose to jump out the windows of the Twin Towers of the World Trade Center. They did so, because they may have perceived death by falling to be less painful than death by burning. I probably would've done the same thing in their case. Would we call what they did suicide?

Sure, that is an extreme case, but some people's ongoing mental pain (anxiety, severe depression) could be compared to the physical pain of burning. Luckily, there is medication that can help. For Bipolar and other seriously depressed people Lithium and Depacot and SSRIs may help to alleviate the mental pain.
posted by popvulture at 5:14 PM on September 26, 2002

Damn, an apology?

The Internet has gone to hell.
posted by Tystnaden at 5:26 PM on September 26, 2002

...some people's ongoing mental pain (anxiety, severe depression) could be compared to the physical pain of burning. Luckily, there is medication that can help...[my emphasis] - posted by popvulture at 5:14 PM PST on September 26

Yup. Whole lotta 'ifs' & 'buts', but I guess that is true, some/most of the time. Some folk are really rational (though perceived as ill) when they do it. It's up to them.
Don't worry, you guys in MeTa currently: I ain't hijacking. I'm sharing, is all. Which is hard for me, as a survivor of my own, & my bro's, suicide. I'd rather direct responses to me - if any - not be posted in here, I have an email address. I am not inviting, just diverting.
posted by dash_slot- at 5:28 PM on September 26, 2002

Popvulture: Actually, I'm on Depakote, Neurontin, and Trileptol (a Tegretol substitute, Tegretol is a lithium substitute) at the moment. SSRIs in a type I will only make the mania worse, as I can attest - I was misdiagnosed with clinical depression at 18 and the Celexa (spelling?) I was given sent me straight into a psychotic episode full of demons flying out of the walls and tearing open my intestines - something I could actually feel - and talking to people who weren't there.

I guess my point is, I'm a severe case, and I'm quite familiar with mental anguish at its extrema - on a daily basis my head BURNS with the fire of the sun's surface - and that sudden logical insight not only stopped my second attempt, but has eradicated suicidal thoughts entirely for me. Maybe it will do the same for other people. My pain might put the experience of living in the negative from my perspective, but death of any kind in this metaphor is negative infinity.

As for the WTC, I don't think that counts - if you know you're going to die, taking the painless route is the only sensible action.

Finally - something I've noticed. After three years of mania, constant destruction of my originally stellar life, fits of rolling on the ground in 'pain' at the fires in my head (remember when Jack from The Nightmare Before Christmas has that one scene where his skull is on fire? Tim Burton is bipolar and I always thought that was a reference), a trend has emerged. I've come to love depression. Mania is so terrible, so terrifying, that being severely depressed oddly makes me . . . happy. In an odd way, the severely bipolar end up having it easier than their less-manic counterparts.
posted by Ryvar at 5:43 PM on September 26, 2002

dash_slot: Well, there are obvious and extreme drawbacks to the various antidepressant medications (which I understand somewhat intimately, since my fiance is on lithium and Zoloft). They can have *a lot* of unpleasant side effects and interactions with other drugs and alcohol, including:
- risk of toxicity
- shaking hands
- sexual disfunction
and many others.
But for a seriously depressed or Bipolar person the medications seem to be much better then not taking anything, especially after an individual finds the right combination for him/herself.
posted by popvulture at 5:50 PM on September 26, 2002

Ryvar: Right on. Another interesting thing about depression not known to many non-sufferers is that one does not necessarily lose either curiosity or sense of humor. Both are, in the (apparent) absence of much else, reasons to live. "I can't die yet, Lord of the Rings hasn't come out!"

Popvulture: Jumping out the window of the WTC is an example of a last-straw choice. Stay in and you will die. Jump out and there's maybe a 1/10,000 probability you won't die (terminal velocity, what you land on, wind conditions, etc). Better than nothing. Same goes for resisting hijackers. That's 'heroism' - seeing the chance, and taking it, rather than quivering in a heap and letting chance take you. [Hands up those who want me to go on and on about the illusion of volition ... yeah, didn't think so :-) ]

Now, crackheadmatt's comment (and I speak about him, not to him, it is poor etiquette to speak directly to a troll) does have a foundation. We do regret the deaths of those we like, for whatever reason, and attractiveness is such a reason, more than the deaths of those we don't like or don't really care either way about. That's the honest truth. So, Mad: your feelings for this woman will affect your response to what she did, and that's OK. Her life and death are in her own hands, not yours. Time only runs one way, there are no do-overs. Not knowing she was going to suicide, there was no reason for you to intervene in her life. What other people do is only your fault if you knew about it beforehand, and were in a position to stop it.

There might be a next time, there might not. Maybe you should speak to your co-workers, neighbours, relatives etc more than you do, but it shouldn't just be because of an off-chance of preventing their suicides, it should be because you care about them and are interested in them. Which will do a little bit towards preventing their suicide, but it's still up to them to live their lives, and you to live yours.
posted by aeschenkarnos at 5:57 PM on September 26, 2002

BP-II Depression?

Lamictal. Hands down the best for BP-II and rapid cyclers that don't respond/can't handle lithium (shout-out to Eskalith-CR!).


and the literature is pretty good on it.

Fish Oil is pretty good as well. Lithium without the side effects for some.


posted by Tystnaden at 5:59 PM on September 26, 2002

Popvulture: While we're on a tangent, a suggestion from someone who has been on several medications, and whose fiance has been on even more - your fiance might want to consider Trileptal. In my experience, it packs the benefits of lithium without any of the 'cloudiness' (although this is obviously individual-specific) and has far less side-effects than lithium or Tegretol. Unlikes the latter two, you don't have to get regular blood testing, and I've experienced no side effects that weren't already there (my hands have been shaky since I started Neurontin).

It's honestly the best bipolar drug I've ever encountered - this won't hold true for everyone (my fiance did well on it initially but was part of the .1% that gets a full-body minor rash), but with the general lack of significant side-effects it can't hurt for her to ask her psychiatrist.

On preview: Tystnaden - fiance does very well with the Lamictal/Seroquel/Lithium Carbonate combo for BP-II, knocks-you-out nature of Seroquel aside. Lamictal + Seroquel alone = 'bitchy-tits', though.
posted by Ryvar at 6:11 PM on September 26, 2002

Suicide seems to be growing as a problem, which seems odd if you think about how much supposed progress has been made in medicine over the last fifty years. I say supposed, because our insurance system nullifies any potential benefits of the new knowledge. I know someone who, despite having a suicide plan in place, managed to get to a doctor to ask for help. While they were able to provide a perscription that day, the earliest appointment with a covered therapist was 2 months away.

And it wasn't even canda!

Of course the same doctor only gave the patient a vague warning of "potential sexual dysfunction", when the actual risk was a bit more... extreme ("in 33% of the cases reported, surgical intervention was required...permanent dysfunction").
posted by nomisxid at 6:25 PM on September 26, 2002

Speaking as someone who's gone through many similar experiences as mentioned already - planned suicide, rapid-cycling bipolar, medication - I can tell you that if you want to "pass," and not let anyone, esp. coworkers, know your real state of mind, its very easy. I've been completely suicidal and gone to work or school with no one the wiser. Sometimes, you want to hide what you're thinking and how you're feeling because you don't want to hurt those around you, sometimes because you fear the repurcussions, like alienation or unwanted hostpitalization, and sometimes, just sometimes, you're really serious about shuffling off this mortal coil and don't want your plan foiled.

Feeling suicidal is an incredibly lonely feeling, but considering all the above, I wonder how many people really have felt this way and never told anyone.

And yes, I've also had that stat, that 30% of bipolar sufferers kill themselves, roll around in my head. And I came up with my own "logical fact" that has kept me from ever actually doing it. Whenever I've felt that I have everything figured out and its too bad to suffer, I think:

The human mind is fallible, therefore I could be wrong.

If I believe things can't better, they just might, because I could be wrong. If I believe that life is meaningless - which I don't, thanks to Taoism and a wonderful relationship, among other things - I know I could be wrong. If I believe that the only way to end my pain is to end my life, I could be completely wrong. The simple idea that no matter how smart I am or how convinced of something I am I could always be wrong has kept me alive. And, thankfully, I've been proven wrong many times.
posted by billpena at 6:28 PM on September 26, 2002

This takes me back to my first was a large, Fortune 500 company. When I first started there, I had to do relief (breaks, vacation fill in, etc) on the switchboard (yes, kiddies, this was Before Voicemail) so I got to know just about everyone in the company, if only on a nodding/smiling basis. There was this one man, an older gent (well, older to me at the time - maybe in his 50s)...he was just one of the nicest, most upbeat people you'd ever want to meet. When I'd give him a phone message, he'd thank me extravagantly and then add some sort of compliment (you look so nice today, blah blah ... all BS since it was via phone and he couldn't see me.) Anyway, I finally met him face-to-face on year at the Christmas party. He was just as sweet in person, very genteel, very cordial. The only hint of sadness I ever perceived from him was when he mentioned that the next day he was going to go visit his wife's grave.

Well, we all returned from Christmas vacation, and shortly thereafter the word got around....this kindly gent would not be returning to work. His brother had found him on New Year's Morning hanging in his garage.
posted by Oriole Adams at 6:41 PM on September 26, 2002

To all those indulging the tangent on medications - keep it coming, please. My psychatrist has been tip-toeing around the possibility that I'm bi-polar for a while now, and frankly I haven't told her the worst of it because I fear the medication. The euphoria is better than any drug I've stumbled across. The anticipation of that state is what carries me through the soul-crushing lows. Not the best way to live, but in my mind the alternative is some kind of zombification. Maybe that's not the case.
posted by Banky_Edwards at 6:57 PM on September 26, 2002

I'm saddened that around 29,000 people/year commit suicide in the U.S.

Just to compare, last year in Japan (where I live), 31,042 people committed suicide. For the desperate here, it feels next-to-impossible to ask for help. It's the cliche that it's kind of shameful to ask for help.

Strangely for me, I have suffered extreme depression for long periods in my life, yet I've never had a suicidal thought.

I've come to love depression. Mania is so terrible, so terrifying, that being severely depressed oddly makes me . . . happy. In an odd way, the severely bipolar end up having it easier than their less-manic counterparts.

I agree with that. I grade my depression on two basic levels:-

1. general depressive feeling that's heavy, giving feelings of apathy and listlessness

2. despair. A manic feeling, restlessness, very bad.

I definitely prefer depression.
posted by SpaceCadet at 7:01 PM on September 26, 2002

two people have comitted suicide since school started in august here at the university of georgia. one took a plunge from a 9th story bathroom window, the other one hung himself ( i think ) in his dorm bathroom. not a whole lot has been said to protect the victims (should we call them victims?) and their families. still pretty unnerving though.
posted by sixtwenty3dc at 7:07 PM on September 26, 2002

My sister killed herself on June 28. She was 36 and had been in and out of psych hospitals for twenty years with anorexia, borderline personality disorder, and assorted OCD and bipolar features. She was also really funny and cute and my only sister, and I loved her.

Thank you for speaking up, everyone who has. I'm still struggling for any words at all.
posted by swerve at 7:12 PM on September 26, 2002

People are sad, I don't think it's too hard to understand given the state of the world today. Sometimes suicide seems like the way out of sadness. That's what my grandmother thought and unfortunately she succeeded. I don't have any special answers or profound thoughts about this but I do know people are sad, really sad, including myself.

It's too bad humans are so shitty to each other, our world and the other species that live here. If we could figure that out I don't think we would have suicide rates hovering at 30k annually in places like Japan and the US.
posted by jasenlee at 7:17 PM on September 26, 2002

BP-II Depression?

Lamictal. Hands down the best for BP-II and rapid cyclers that don't respond/can't handle lithium (shout-out to Eskalith-CR!).

I'm on Wellbutrin & Cerlexa with a Neurotin chaser. It seems to be working pretty well, although I've had really bad insomnia with some minor "racing thoughts" action for a month now.

I am very, very lucky that the hypomania/depression combo doesn't happen often - I can go for 5 years without an major episode,I'm primarily have have chronic clinical depression but have the occasional hypomanic episode. They're usually fairly pleasant while it's occuring, but cringe-worthy in retrospect.

Fish oil - that's good to know. Kinda explains why I crave sushi when I'm really depressed and stressed out.

Ryvar: as a severe type I bipolar (rapid cycler, etc - basically the worst kind)...

Man, that's tough. I've seen what rapid cycling can do to a person and it makes my psych problems look like a pleasant stroll in the park by comparison. I'm glad you've found a medication that gives you some relief from your symptoms. I heard last week that they have discoved that a medication used to treat epilepsy is effective in treating BP, forget the name.
posted by echolalia67 at 7:29 PM on September 26, 2002

Banky_Edwards:frankly I haven't told her the worst of it because I fear the medication. The euphoria is better than any drug I've stumbled across.

I hear it bandied about in Mental Health circles a few years back that Bi-Polar disorder, like epilepsy, if left untreated, can progress into an increasingly more severe, more debilitating form of the disorder. The phenomena is called "Kindling." This woman disagrees with the kindling hypothesis but it's definitely worth looking into.

I also remember hearing about EMFs (electromagnetic fields) such as the ones given off by computers, TVs, etc., as being possible triggers for manic episodes. Any opinions?
posted by echolalia67 at 7:52 PM on September 26, 2002

Echo: re: epilepsy - interesting. IIRC, all mood stabilizers (does not include anti-psychotics like Seroquel, nor Lithium) are seizure drugs that find a second life in treating bipolar disorder - for instance all three I'm on are seizure drugs.

Bipolar disorder generally gets worse with age, and MUCH worse left untreated. The completely unvalidated but well-known idea of the disorder getting worse with each successive generation dates back to, iirc, Van Gogh. As far as EMFs are concerned, I've spent the past 21
months in front of my 76lb 21" IBM beast-monitor and next to 5 computers literally every waking moment. As I've been doing just fine since starting the Trileptal three months back, I'm going to have to say EMFs don't hold much water based on my personal experience - as with all things here, YMMV.
posted by Ryvar at 8:25 PM on September 26, 2002

I've dangled on the sharp edge of the knife my fair share. For me, it's generally an attempt at escape from chaos. When I'm around large crowds of chaotic people, such as concerts or dance halls, the mania in my mind kicks in and I feel the compulsive need to escape to calmer surroundings. To find peace in myself. When chaos begins to fill my lifestyle and mind, suicide becomes the only place to escape to. The only calm place left I can find.

Of course, not all suicides are for the same reasons, but I can't help but feel that the increases we see in suicides over the past decades may have something to do with the chaotic, busy nature of our present culture.
posted by fatbobsmith at 8:32 PM on September 26, 2002

For all those looking to get real hardcore about their mental (or otherwise) illness, I suggest you check out Medscape to start. Get a medical dictionary and discuss what you find there with your doctors.

I started Lamictal years ago once the initial positive reports starting coming out. With the articles in hand, a good understanding of the risks involved, and the weight of Harvard doctors behind me, the Dr. agreed to try Lamictal after we had a very long conversation about it.

The more medicine/biology you know the better, but as a patient you *can* grasp enough of the material to help you stay well. Being "smarter than the doctor" has literally saved my life when stuck in some crazy ER "No, I can't have ibuprofen because it interacts with my Eskalith." Etc..

Medscape is legit, science-centric, and is *free*. It even has CME credits. You need to register, but their privacy policy is trustworthy.

(Bedtime, excuse any errors please--I have rock salt in my veins.)
posted by Tystnaden at 8:52 PM on September 26, 2002

"There is no possible consequence of not dying worse than the known consequence of dying"
Ryvar: Where do you live, in a bubble? The most solid comfort I found in living my life is that if I wished I could just stop it.

"people who contemplate suicide, in general, have a very serious mental health problem and their outlook on the world is very distorted"
echolalia67: I beg to disagree with you most emphatically. There are rational people who may view at some point the quality of their lives unacceptable, who don't romanticize death and are not slaves to religious or medical superstitions, and carry a sense of integrity about themselves as to the conduct of their destiny.

"maybe you can find some solace in that--she made an active choice to end her suffering and sadness"
amberglow: I believe that may be the issue to a lot of people.
I may add, without discounting the reality of mental illness, that for some of us a moment may come, perhaps in the middle of no significant activity or discomfort, when an opportunity arises and one may say, "ah, the hell with it" and just thoughtlessly pulls the trigger.

What I find more interesting than suicide itself, is the various ways people commit it pointing to some particular, specific personality quirk, or response to....something.
posted by semmi at 8:53 PM on September 26, 2002

Today I commuted for 2 hours on a jam-packed commuter train into Tokyo. EVERYBODY looked miserable. I feel such a communal sadness when standing inside these trains. I mean, there's not much to look forward to (office work), not many opportunities to express ourselves or simply laugh. Tonight's commute will be exactly the same. We are killing our souls and sometimes literally ourselves all for the economy.
posted by SpaceCadet at 9:21 PM on September 26, 2002

Damn, what a depressing thread to end my night on.... I don't really want to join in on the confessional thing at the moment, but I do want to let all of y'all that have know that I'm glad you're still here. Hey, everyone rides a bummer from time to time, some harder than others. But if you off yourself, how do you find out what's next?

Mad -- sorry 'bout your situation.
Crackheadmatt -- you're a dickbag.
posted by spilon at 10:35 PM on September 26, 2002

"all I could think about was what an utterly stupid, selfish prick he had been to kill himself like that"

I don't really subscribe to that line of thinking. If someone is ready to take that kind of step, expecting them to drag themselves on through life for the sake of the wife and kids... well. Their grief and the trouble caused to them by his death is so damn easy compared.
posted by ed\26h at 2:03 AM on September 27, 2002

I think that one thing that could help prevent some of these suicides is more public education about disorders such as bipolar. Your average Joe on the street knows next to nothing -I myself didn't know there were two types of bipolar till I was diagnosed with the milder form. To say I was shocked was an understatement. People need to KNOW that there is help out there, and they need to know this is a treatable, MEDICAL brain dysfunction.

BTW, one of the hallmarks of bipolar can be impulsiveness. Interestingly enough, the depressive part of the cycle is not the most dangerous. There is a type of "mixed" state whereby a person has the sadness AND the energy to carry out suicidal impulses. One can literally be okay one moment and suicidal the next.

For those interested in meds or other info on the bipolar spectrum, the bipolar forum has the best info and articles I have seen-with tons of links to other sources as well.
posted by konolia at 3:55 AM on September 27, 2002

Why is it that we feel anger towards people who kill themselves? I recall when Kurt Cobaine ended his own life how the sorrow and confusion were underscored with a discernable undercurrent of anger and resentment. People who had never faced this man’s demons, who never felt his anguish or ecstasy, people who none the less felt connected to his music or his fame or his whatever suddenly felt somehow cheated because they were violently disconnected from a man they thought they knew.

We try to rationally discern whether it is courage or cowardice which allows someone to purposefully untether themselves from the anchor of their mortal bodies. We try to grasp the incomprehensible, that which allows someone to cast their soul unbounded into the currents of the unknown, unsure whether those currents will smash them against the rocks or will instead set them free from their demons at last. It is difficult to comprehend such desperation.

Comic Steven Wright has a line that goes something like, "I plan on living far, so good". The humor of that statement stems from the rational portion of our mind which knows full well that one day we will inevitably lie dead, confronting that childish, irrational part of ourselves that insists that without us the universe simply cannot be. It seems that humans, especially those of us stemming from a Judeo-Christian tradition, have a tough time envisioning a universe that is anything other than a permanent, consistent, personal correlation. Death, in any of its forms, contradicts this level of comfort.

There is no other thing which humbles more efficiently than death.

The apostle Paul wrote that 'Hope will not disappoint'. There is resentment in suicide that hope failed the people who knew her. There is anger, perhaps, at our own lack of faith and understanding.

Emily Dickinson wrote that 'Hope is the thing with feathers / That perches in the soul / And sings the tunes without the words / And never stops — at all.' Death is a thing without feathers that flies none the less of its own accord. There is no reasoning with death, no compromise, no treaty. Death chooses its own terms. Perhaps this is why we have anger towards those who kill themselves. It seems they have made a devil's bargain. We battle the concept of death with hope each day, yet we periodically get reminded that death will win somehow. Without faith in a power greater than death, unfounded or otherwise, hope is little more than a futile exercise.

Bruce Springsteen wrote 'For what are we / Without hope in our hearts / That someday we'll drink from God's blessed waters / And eat the fruit from the vine / I know love and fortune will be mine / Somewhere across the border'. Death shatters our illusion of earthly permanence, but faith and hope for what lies across that border provides our only appeal against a final verdict of a long dreamless sleep.
posted by ElvisJesus at 4:00 AM on September 27, 2002

Ya know, the more I see of psychological drugs, the more I'm inclined to believe that the psychological profession has absolutely no idea what they're doing.

This last summer I met a mathematician, a brilliant guy from a very rich family, who suffered from a hearing impairment. His father is this enormously rich doctor; they ship him all over the place to get the best care possible. Eventually he starts manifesting these migraine headaches, which, piled up with the hearing problem, give him a feeling of intense isolation, and throw him into a deep depression. Which, parents to the rescue, sends him to the best psychologists in the world, none of whom can find a drug to make his day bearable. The headaches, and the depression, get worse, and the drugs are doing far more harm than good.

About a month ago, we're doing some research and find that intense migraine-type headaches are a side effect of one of the 'more effective' drugs he's been on for the last two years. Two weeks ago he was found dead, alone in a car in the middle of nowhere, wrapped around the trunk of a tree. Maybe it wasn't suicide, but the evidence still stands that the best psychologists that money could buy were basically killing the patient on the table.

I've seen three lives completely wrecked by psychological drugs, and a number of other people who are completely dependent on some sense of security that the drugs offer them. And the more I learn and read, the more disillusioned psych majors I know, the more pharmaceutical researchers I run into, the more I understand that these people in need of help are being lead around by a medical profession that, in ego and ignorance, is little more than a killing machine.

the answer, I think, isn't in drugs, but in philosophy. But the reasoning behind that will take a bit more than a single posting.
posted by kaibutsu at 4:50 AM on September 27, 2002

My personal opinion is that committing suicide is one of the most selfish acts, I save my pity for the loved ones left behind.
posted by johnnyboy at 4:53 AM on September 27, 2002

There are rational people who may view at some point the quality of their lives unacceptable, who don't romanticize death and are not slaves to religious or medical superstitions, and carry a sense of integrity about themselves as to the conduct of their destiny.- semmi.

posted by dash_slot- at 5:16 AM on September 27, 2002

Which, parents to the rescue, sends him to the best psychologists in the world

If he needed psychoactive medication then he should have been seeing psychiatrists, not psychologists. Even so, patients and family et al. caring for them should always exercise due diligence, and checking the listed side-effects of a drug should be SOP for anyone taking that drug.

As for answers in philosophy not drugs, I submit that each person with a mental illness is looking for an individual answer, and that psychopharmacology and 'talk therapy' might best be seen as adjunct not mutually exclusive treatments.
posted by sennoma at 5:21 AM on September 27, 2002

Selfish? Maybe. Maybe selfish because they see no other out, no other avenue to a return to life.

Most people can't make it to 30 without knowing someone who committed suicide. Car accidents kill over 40,000 each year, and we have licenses to drive cars, air bags, and other safety measures. In some ways, it's too bad that people don't get a better license for living, learning the coping skills to make it through largely intact during the rough times.

Having said all of that, I had my own brush with that old familiar friend earlier this year when the woman I thought I was going to start a family with left me for another guy. Nice. Came close. But that's what hopelessness does to a person... it brings them to the edge, and what they do at that edge says not only something about the person, but the circumstances and abilities they have to either walk away. Or end it.

Suicide is a complex subject, and there's no single or right answer to help people do less of it. Talking about it is certainly a good first step, though. I'm glad to see so many people so willing to discuss it here... And for those who are suicidal, I've had this listing of suicide resources online for over 7 years.
posted by docjohn at 5:33 AM on September 27, 2002

crackheadmatt: You made me laugh outloud !!
posted by a3matrix at 5:34 AM on September 27, 2002

"people who contemplate suicide, in general, have a very serious mental health problem and their outlook on the world is very distorted"
echolalia67: I beg to disagree with you most emphatically

And I respectfully disagree with you most emphatically, semmi. Note that echolalia67 said "in general" -- his/her quoted statement is a very good generalisation. There are few lives that are so unrelentingly, unrelievably awful that suicide really is the best option. If one honestly disagrees with echolalia67's quoted statement, that in itself can be a warning sign.

In posting this, I don't mean to play down anyone's suffering, or make any comment on individuals who have shared their own stories in this thread. It is important to realise that one of the insidious effects of mental illness is that it distorts the sufferer's perception. I don't mean psychosis, I mean a steady removal of one's personal reality from one's objective situation. If it really seems that the only way to stop the pain is to do yourself in, it's time to get help -- if for no other reason than that you may well be wrong, and unable to see how wrong you are!
posted by sennoma at 5:40 AM on September 27, 2002

Kaibutsu, there are flaws in your story.

Many of the drugs I take or have taken are also prescribed for migraine relief. Besides, I don't put ANYTHING in my mouth medwise that I haven't done the research on. I KNOW what side effects I am risking. For example, one drug I take has a very rare side effect of a rash that may be fatal. Well, I found that risk acceptable especially since slow titration lessens the risk-and I was diligent to keep an eye on my skin.

There are people out there that object to psychopharmaceuticles on a philosophical level. Some, like the scientologists, are so firm in their objection that they lobby strongly against psych meds for anybody. But I can say that there are many individuals out there that would have no life whatsoever without meds. Are meds the total answer? No, but they keep people alive long enough to work on the other parts of the happiness puzzle.
posted by konolia at 7:54 AM on September 27, 2002

A girlfriend of mine who was in a non-US military reported that women in combat zones were issued an extra personal pistol, so they could shoot themselves if captured. There was no expectation for women to bear up bravely under sexual abuse and torture. Men, sorry, youse guys were supposed to keep it together under torture without the suicide option. Sexist world, ain't it? (A not-so-cheerful, but nonetheless practical thought as we inch closer to wartime.)
posted by sheauga at 9:30 AM on September 27, 2002

a3matrix: go back to Fark and take crackheadmatt with you.
posted by swerve at 9:37 AM on September 27, 2002

Why is it that we feel anger towards people who kill themselves?

Great comment, ElvisJesus. The amount of contempt I have seen from people both in and out of the medical profession toward attempted/successful suicides is beyond belief. I have even seen it toward people with terminal illnesses who suicide. I suspect it makes people angry because they don't understand it, can't empathise with it, and fear it happening to them or someone they know.

I think what semmi said is sometimes true, I think some people are rational when they decide to kill themselves, I think for some people there is no therapy or medication that will help, and for others their lives just aren't worth living for whatever reason. I think for some people their mental illness is as terminal as others' physical illnesses are.
posted by biscotti at 10:13 AM on September 27, 2002

I have come pretty damn close to suicide a couple of times. Interestingly, I always perceive active suicidal ideation with alarm and fear. Wishing I could just go to sleep and never wake up, that's fine, I can live with it. Racing thought compelling me to down a bunch of pill, cut my wrists, drive to the GG Bridge...that's when I pick up the phone. It's that part of my brain that said "nothing in your life is so bad that suicide is the appropriate solution" that always saves my ass.

My other logical thoughts in those moments are:

" None of my loved ones deserve the burden of my suicide. They would do anything they could to help if I tell them what's going on."

"What if I kill myself and relief from my pain/a change of luck was just around the corner?"

"You don't know what's on the other side of death. What if it's worse than this?"

And the big one:
"What if I try and fail and suffer some devastating injury from the attempt? What if I only break my neck and end up a quadrapelegic? What if the pills don't kill me but I suffer severe brain damage?"

I guess I'm just too much of a pessimist to kill myself. My mantra is that little poem by Dorothy Parker:

" Guns aren't lawful, nooses give, gas smells awful, you might as well live"
posted by echolalia67 at 11:03 AM on September 27, 2002

What's the matter swerve? No dark humor?

You read the post, then you read the first comment by our esteemed crackhead, and you laugh. The sheer insensitivity of it, the audacity of it, it is priceless.

As for the suicide, it is sad I guess. Or is it. Quitters never prosper, they just quit.
posted by a3matrix at 11:51 AM on September 27, 2002

a3matrix: I guess suicide just isn't funny to me.
posted by swerve at 12:10 PM on September 27, 2002

It isn't the suicide that was funny. That is my point. It was crackheads post that was funny, but not in a laughing with him kind of way. You laugh at something that ridiculous, or you get all bent out of shape. I chose to laugh at it. Never mind the fact that it is an obvious troll and no doubt was done with every intention of pushing everyones disgust button.

Suicide isn't funny, it is sad. Sad that people throw in the towel, stop trying, give up.

Life is a challenge. Every day you have to do what ever it is you do to get through, so you can do it again the next day. Hope is, that things will some how improve at some point. To reach the point in your life that you feel that it will never improve, and then quit in the most significant way, is sad.

Have a nice weekend.
posted by a3matrix at 12:18 PM on September 27, 2002

You laugh at something that ridiculous, or you get all bent out of shape. I chose to laugh at it.

Out of respect for those of us not laughing, it might have been polite to keep your laughter to yourself.

Have a nice life.
posted by swerve at 12:22 PM on September 27, 2002

Suicide is horrible. It is often getting the *final word* with your family...I had a neighbor whose father, in the middle of a thanksgiving dinner with the kids and grandkids and all went into the bathroom and cut his throat with a straightrazor. He fucked those people up plenty good, taught them some kind of a lesson. Even non-suicide unexpected death is hard to take. A friend of mine got hit by a car while crossing the street last year and was DOA. It blew me away.
posted by Mack Twain at 12:25 PM on September 27, 2002

I have a few things to say on this topic. First, I think the pharmaceutical companies have greatly altered what is deemed "depression that should be medicated." Here I cite personal experience.

When I was 14, I was living with a sexually, physically, and emotionally abusive father. I reached the point where I could not fathom 3 1/2 more years of it. I went to the school guidance counselor, who only offered to "talk with my father". I tried to make him understand that that could result in a beating that would end my life, but since I had no bruises at the time, he could do nothing. Fortunately, in the midst of my attempt, a friend called and talked me down. Less than a year later, I was diagnosed with mild depression, not bad enough to medicate.

Eight years later, I was having irrational anger and crying fits. I talked to a doctor, who was very eager to get me on Zoloft.

On the subject of suicide being selfish, here's the way that friend I mentioned talked me down. He asked me who I thought I was that I didn't have to suffer through the crap just like everyone else. He told me I was a coward. And he was right. With the exception of extreme cases, somebody always has it worse, and has the balls to hang in there.

Then, there's the whole debate about whether or not a person has the right to commit suicide. As far as I know, it is actually illegal in most US states, while in some Asian cultures, if you shame yourself, it is considered the "proper" thing to do. There are scores of pro-coice arguments when it comes to deciding the fate of an unborn child, but suicide is wholly considered wrong.
posted by Miss Beth at 3:14 PM on September 27, 2002

Miss Beth, in your case what Zoloft could have done is get you to a place where therapy could help you get past what you needed to get past. I know myself that counseling when I am in a bipolar cycle is pretty much wasted. I also know people who have been in so much stress that their emotions just needed a rest. A short stint on meds accomplished that. They were then able to concentrate on fixing whatever got them in the pit in the first place.

I disagree intensely with the coward label. Yes, there are some for whom that label may be accurate. But there are many people who fight and fight desperately to stay alive.

Frankly shaming someone might work in the short term but I think it is very harmful in the long term.

And another thought. Diseases like bipolar and unipolar depression have been proved to be hereditary. Many who grew up in abusive households may not realise that the abusing parent was mentally ill (not that that is an excuse for abuse, just a fact.) Thereby, if one endures abuse and has the genetic predisposition-well, then there are two separate things to deal with for health's sake.

I think the one great big hairy common denominator for suicide in most cases is the feeling that one is alone. Whether that is skewed thinking caused by brain chemistry, or reality-a suicidal person needs to know he/she is cared about and not judged.

Finally I call horseradish on the idea that everyone has the same ability to deal with life's crap. If you had a broken leg, and I told you you were a lazy bitch for not jogging for thirty minutes every day, who would be the one with the problem? If people have a metaphoric "broken leg" in their emotional makeup, it is worse than cruel to be expected to act otherwise.
posted by konolia at 3:48 PM on September 27, 2002

My sincere sympathies to those who are dealing with the pain suicide leaves behind.

It was mostly the thought of what it would do to my family that carried me past a stare-down with an Exacto knife a few years back.

Yes, there are some fairly revolting side effects of Zoloft - think of a gun that has had it's firing pin removed - but that thankfully does wear off. I can't describe the beneficial effect of it as euphoria, exactly, because it isn't. It feels a lot more like it has leveled the playing field in my head, and given the good in life an even shot with the bad at being noticed and appreciated and remembered.
posted by John Smallberries at 5:49 PM on September 27, 2002 [1 favorite]

First, as something of an aside, I don't think that suicide rates are necessarily on the rise -- I think the rate of reporting and the volume of honest, socially acceptable discussion about suicide and mental illness is on the rise. But that's just me.

Now on to my real point: I think that something that's important to point out to people who might be reading this thread for advice/reassurance about their own mental health -- and I'm sure there are some out there that are keeping a low profile -- is that drugs that help treat mental illnesses are not magic pills that make it all go away forever.

I like the "level playing field" analogy -- after half a lifetime with chronic clinical depression/major depressive disorder, which onset around the age of 13 (if not earlier), I found that as an adult not only did I have no control over my moods, feelings, or responses, but I also had no "normal" coping skills. The environment in my head was out of control. I eventually, at the urgent request of my Now-Husband, joined a depression study (free treatment) and later found out that I'd been on St. John's Wort. It's worked pretty well for me for 3 years now, when I am careful and keep my doses on schedule.

However, for some people (like me) clinical depression (of the chemical imbalance variety) is just the way your body is. This is something that I will probably dealing with, in one way or another, for the rest of my life. I have to understand that someday I will probably need something stronger than 900mg of an herbal supplement daily. I have to understand that there is no magical way to "get better", and I have begun to learn coping skills that help me navigate my life.

I'm 25, and last year a co-worker of mine, the same age as me and best friends with one of my best friends, shot himself, and died. He exhibits no outward signs to his co-workers, and certainly seemed to be happily moving forward in his life "just like everybody else". What happened to him was devastating to me, and to everyone around him. However, it forced me to acknowledge that I had lived from the age of 13 to the age of 21 without anyone ever saying anything to me or asking any kind of serious questions about the state of affairs inside of my mind. To put it another way, I "passed" for "normal". The only person who ever directly confronted me about my illness, what it was (and could be) doing to me, what it was doing to others around me who loved me, and what I was going to do about it, was my husband.

mad, for every action, there's an equal and opposite reaction. I think that when things like this happen in our lives, it's a little bit of a wake-up call. How are we treating ourselves? How are things going with us? It's not about what you could have done for her -- but it may be a good reason to think about what you could be doing for you.

(Sorry -- didn't mean to be quite so wordy!)
posted by dryad at 3:37 PM on September 28, 2002

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