Depression. Despair. Suicide.

Deb_Aston, MSN, RN

Dark Secrets

Two years ago, there were several incidents of "jumpers" from a nearby parking garage that had occurred within a short time frame, and I couldn't get past the sadness and horror as I walked past it every day on my way to work. It touched me deeply, and I didn't even know them... but I knew of them, and seemed connected to them in some way. Each time it happened, it seemed like a dark secret no one would talk about. There was minimal information in the newspaper, and I had so many unanswered questions. There is a stigma that comes with mental illness that many do not feel comfortable talking about. So we don't.

When Suicide Hits Home

Something happened recently that shook me to my core; my daughter attempted suicide. She became so overwhelmed with her work in the news industry, with this relentless cycle of negativity and civil injustice, that she quite literally "broke". Her compassionate heart could not continue to write (and re-write, and re-re-write) about the horrific acts of violence and sadness in the world... that, and the tragic loss of life with the global pandemic, and the isolation of being in quarantine, was too much for her to bear, and she lost something that keeps most of us moving forward... hope. My own beautiful daughter became so depressed that she didn't want to live another day. That shocking realization is something that I was not prepared for... not my sassy, funny, bright, strong, successful daughter.... that can't be... under my own eyes, in my own house. How did I miss this? I felt like I had failed her.

Subtle Changes

In hindsight, I did see some subtle changes, but she was good at pretending she was OK... she stopped working-out with her virtual trainer because it was so hot outside. She stayed in her pajamas all day because didn't everyone who worked from home do that? She wasn't sleeping because she was working so hard writing for the news show that she produced. And me.... I am a Nurse, so I went to work like I always did, even under the stress of Covid. I came home late, sore, and tired... and I missed it. But thank God, I was able to stop her in time, and get her help. Yes, we have guardian angels among us.

Inner Demons

We have all felt sad, disappointed, and alone at one time or another in our lives. Those of us who have struggled with depression, or other high-risk factors such as loss, low self-esteem, rejection, or stress, have experienced varying degrees of darkness and despair; it’s not a fun place to be, and not everyone makes it out alive. Some have been in such a low place that they feel their only solution to overcome this immense pain and suffering is through one final extreme act of choosing death over an unbearable life. We all have our own inner demons that come out when we are at our most vulnerable.

Depression is an illness that often can be mistakenly viewed as a sign of weakness, or an inability to cope with everyday life. This is just not true. The American Psychiatric Association (2018) defines depression as a medical illness that affects how one feels, thinks, and acts; it can lead to thoughts of suicide if left untreated with the right mix of therapy and medication.

Death From Despair

Suicide has been described as death from despair. According to the Center for Disease Control (2018), suicide rates in the U.S. have increased 25% in the past two decades and are increasing among adults aged 45-64. Among those aged 15-34, suicide is the second-leading cause of death. These are scary statistics...especially when they hit so close to home.

Those of us in healthcare have seen the outcomes of an attempted suicide. My first experience as a young PICU nurse caring for a teenage girl who attempted suicide by hanging was extremely difficult; there was no happy ending or miraculous recovery for this young girl. This story was tragic, and yet it happens every day. She had gone through a bad break-up with her boyfriend, and the pain and rejection led her to self-mutilation, which didn’t dull the pain deep inside of her, so she hung herself. Her sister found her, and called 911. She was brought back to a life of vegetation. She wore a haunted look of pure rage, which seemed to be her only facial expression when “awake”. She had just enough brain activity to continue medical interventions. I still think about her from time-to-time and I wonder if she ever found the peace that she was looking for so long ago. I truly hope so.

What Can We Do?

What can we do to prevent our loved ones from choosing this ultimate act of despair? First, we need to be able to recognize the signs and symptoms of depression and not be afraid to ask if they need help or want to talk… or even if they have ever thought about hurting/killing themselves. We need to support better medical coverage for mental health and pre-existing conditions; we need to prevent those who have mental health conditions from being able to legally purchase a firearm; and last, and most important, we need to support them and not judge them. “There, but for the grace of God, go I”. Timing is everything, and if the pain and despair are recognized early enough, perhaps a life can be saved.

Linkin Park wrote a beautiful song about suicide called One More Light (2017). The irony that one of the writers, Chester Bennington, committed suicide a year later, speaks to his state of mind and intimate understanding of the effects of suicide for the ones who are left behind to try to heal from this great loss.

If you, or someone that you know, are having thoughts of suicide, please seek professional help; call a friend or family member, or call the

Suicide Hotline: 1-800-273-8255

References

American Psychiatric Association (2018). What is depression?

CDC. (2018). Suicide rates rise sharply across the US, new report showswashingtonpost.com

Linkin Park. (2017). One more light