Depression, Suicide, and the Self-righteous

About a month ago I was invited on facebook to join a group called Four guys, one destination, one mission: Suicide Prevention. The point of the group, obviously, is to prevent suicide. however, their methods seemed a little dubious to me. First of all, they are riding bikes across the continent to prove to those who are depressed that anything is possible. Second, they are trying to draw attention to the problem of suicide using this ride and the group. A noble cause you might say, but it seems to me that the people who made the group and also the people who joined and commented in it know next to nothing about what actual depression and suicidal thoughts are like. I wrote the person who sent me an invite to the group and stated these thoughts. They in turn asked me what I would say to a suicidal person. My response is the point of this post.

But before I get to what my response was, I should add this. I’ve been putting off saying anything about this until today. Today I saw another group simliar to the first one. This one is on facebook as well and is called Love is the Movement. The point in this one is to tell people on the day before Valentine’s Day that they are loved. Thats a nice thought. Except the people who are actually depressed will see straight through this veiled attempt at others trying to make themselves feel better. It would seem to me that people don’t know the difference between “the blues” and actual depression. Actually depressed people don’t care what you think. They will see you for the tool you are if you decide to show them any kind of attention on one day and tell them parrot “I love you and think you are important”. Doing this on one day, to anyone, is meaningless and only serves to let those who don’t bother to understand depression to feel like they are doing something.

At any rate, here is my response to “well then what should people say to suicidal people if not the above?”:

hmm.. what to tell them indeed. Actually this is a pretty complex problem and not nearly as simple to try and work out with someone as the people in that group would like to think it its. Generally there are two types of people who contemplate and/or attempt suicide (of course each case is different). Ill try and tell you what I personally think about both of them here.

The first type is the most common, they are what I would like to label as impulsive suicidal people. These individuals are typically prone to talk about suicide as a way to get the attention of those around them. They are normally basing their decisions on irrational logic in their head. A good example would be someone who wants to kill themselves because their girlfriend broke up with them or they lost a lot of money. The problem they are fixated on is an extremely temporary issue i their lives but to them it is all encompassing and they cant see past it. What they are seeking is something or someone to either remove the problem from their lives or fixate them on something else. If and when they decide to attempt suicide their method is typically something non-lethal (or something reversible) such as trying to overdose on aspirin or cutting their wrists, or something else that takes some time to work. Its not actually an attempt to die so much as a cry out that they need someone to help them out.

A good plan of attack for helping these people is pretty straight forward. First you need to let them talk to you. Let them know that you are available to talk and that you will listen to them if need be. If they trust you enough they will probably end up spilling all the problem on you in the course of just a few conversations. The problem is one that is usually identifiable from the outset and you can then try to help them deal with that issue. Instead of telling them things will be better, try relating to them if possible. Get them to relate to you as well. share stories and experiences that are close to what they are now going through and show that in those cases eventually things did in fact get better. You have to let them work through the stages of grief on their own with you as someone holding their hand, not as someone dragging them to “acceptance” in one sitting. Eventually the problem will either be resolved or accepted and the person will be able to stand on their own again. In my experience working with people like this the response time from initial “I have a problem!” to them being stable again is about a month.

The second type of suicidal person is much more difficult to explain and treat. I would label these people as truly suicidal. You have to understand first that the decision to end their life is not about a single event, perhaps not even a series of events, its their whole being that they want to escape from. The depression that precedes suicide in these people is something that isn’t easily conveyed to others who tend to have a cheery disposition on life. The depression they are facing is something that is life long, or at least longer than a year and is all encompassing. The best way to describe what its like is this: imagine that someone’s personality is like a star. In most people they shine brightly and occasionally have their problems but all in all are happy people. In impulsive suicidal people they are like temporarily dim stars that just dont have enough fuel to keep going, or have something in their middle that makes it so they cant shine. If left alone those stars will go out. truly suicidal people are like black holes. Their personality has collapsed in on itself and begins sucking in everything around it. The person at the middle cant reach out to anyone else without feeling the need to pull them into their own despair and so they tend to shy away from previous social pleasures. Even if they try and touch someone else to let them know of their problem any positive influence is quickly sucked back into the depression and crushed with tremendous force. Its a shroud of blackness that is nearly impenetrable and that follows the person no matter where they go or what they do. It haunts them even in their happiest of moments so everything is twinged with black. truly suicidal people want to escape this blackness which emanates from within themselves and to do that they rationalize that if they remove the source (their own self) that the torment will end.

There is no clear way of dealing with this. If it was just clear cut then it wouldn’t be that much of a problem. We could just say “god has a plan” and they would feel gods love and feel better. But the problem is that these people are actually rational. All the inversion gives them time and opportunity to think about their situation. In their case, if they are on the verge of suicide and happen also to be religious, they have normally already concluded that god has abandoned them or at least allowed this to happen to them. They have prayed and prayed to god to give them peace which has not come for years and years. They will not take any advice about god from anyone without a dark smile that speaks volumes about how much they now trust god to deliver them. Also, to them, everything will not be alright no matter how much time you show them. Their life has been a constant blackness for years and its now all they know. Show them the happiest moment and they will still find the blackness hovering above it, waiting for them to be weak.

The best course of action with this situation is to just be a friend to them. This is more intense than the previous type where you merely had to listen, for this type you must be interactive with them for as along as it takes. You have to be prepared to be sucked into their despair with them to help guide them back out. You have to be able to sacrifice for them. Unfortunately, in today’s society, people would take one look at this and say that it wasn’t worth it to them. The amount of effort and the amount of immediate return is slim if any. The problem here is, either you can get sucked in as well, or you can give up half way in and leave them twice as bad off as they were because they will feel abandoned or betrayed. They need a guiding light as well as someone to lean on, someone they can trust completely so that they will follow.

Eventually they will open up and in the twisting nether of their reasoning you will have to find the one or many root causes of the depression and help them to overcome them. These root causes are generally not so simple as the previous type. While they may appear initially to be something like “my girlfriend left me” theres usually something more underneath it all like “i hate myself and push people away” or “why do i have no confidence?” You have to identify this first and then let them know thats what you think. You have to get them to question their own rationality behind connecting all the bad events in their life to their depression and ultimately to the conclusion that death is the only escape. Once you can get them to accept these root causes you can then help them try to overcome them with time.

Even if you can eventually pull them away from the edge of death, there is no solution to the depression, only degrees of it. If in the course of finding the root causes you find voids that need to be filled, you can help them fill them. But in the end that twinge will probably always hang there for them. If you can, try to get them to see a physician. Sometimes medicine is a good help to have as depression of this sort is commonly biological as well as psychological. You can get their family and other friends to help you. You don’t want to tell them everything that you have been told as that would betray their trust, but you can let them know that they need help and need it from those closest to them. If everything works out perfectly you can minimize the depression and maximize the contentment. The process will take years and be a constant battle all their life.

Anyway, the problem I have with the group you joined is that it seems like the same old thing again and again from young adults. They want to be helpful and don’t know how to be so they invent ways of pretending to help to make themselves feel like they are doing something. Suicide hot lines don’t work for truly suicidal people, neither do groups like this. I personally believe that if these people want to help the truly suicidal and depressed that they need to try and understand what kind of problems and torments plague those they are trying to help. We can all sit back and say well this and this would work on so and so, but really it doesn’t do anything but make those who use such lip service feel like they have contributed to the cause. If you want to save someone, you have to sacrifice part of yourself to that person. It takes nothing less to save a life.

I hope I answered your question…

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