Saturday, November 28, 2009

trying to understand...still..



Two months ago a close friend of mine committed suicide. Almost immediately after I initially received the news I told myself that it was useless to really attempt to understand why he did it. I think this is more attributed to intellectualizing rather than allowing myself to really be affected, to really feel the impact.

In these last two months I've found the mourning process to be quite strange. I've cried only twice but had many difficult days where it has taken all my strength to push forward through daily routines and days of work.

Just recently I remembered a book I had read a year or so ago entitled Night Falls Fast: Understanding Suicide by Kay Redfield Jamison. I thought perhaps reviewing it might assist me.

"Psychological pain or stress alone - however great the loss or disappointment, however profound the shame or rejection - is rarely sufficient cause for suicide. Much of the decision to die is in the construing of events, and most minds, when healthy , do not construe any event as devastating enough to warrant suicide. Stress and pain are relative, highly subjective in their experiencing and evaluation. Indeed, some people thrive on stress and are at sea without it; chaos and emotional upheaval are a comfortable part of their psychological lives. Many individuals at a relatively high risk for suicide - for example, those with depression or manic depressive illness - functional extreely well between episodes of their illness, even when in situations of great pressure, uncertainy, or repeated emotional or financial setbacks.

Depression shatters that capacity. When the mind's flexibility and ability to adapt are underminded by mental illness, alcohol or drug abuse, or other psychiatric disorders, its defenses are put in jeopardy. Much as a compromised immune system is vulnerable to opportunistic infection, so too a diseased brain is made assailable by the eventualities of life. The quickness and flexibility of a well mind, a belief or hope that things will eventually sort themselves out - these are resources lost to a person when the brain is ill."


In short when one is depressed one is irrational. But is the thought of suicide so irrational? I dare to ask myself this question in a difficult attempt to play devil's advocate. I have never had the desire to die. I have always wanted to see how the story ends, to know that during trying times I would always push forward. Now is THAT odd? Is it odd to have never considered suicide?

I maintain that suicide is largely irrational as what had held value in a person's life is often pushed to the side when one beings to contemplate their own demise. The idea of remaining alive does not maintain itself even knowing that family and friends will have to accept the aftermath. In fact many individuals who take their own lives truly believe that their loved ones will be better off without them. Can we agree that that thought is certainly irrational?

When a person comes to the point where they are ready to die at times the person is actually quite calm. Can we also agree that calmly planning one's death is also irrational?

"In its severe forms, depression paralyzes all the otherwise vital forces that make us human, leaving instead a bleak, despairing, desperate and deadened state. It is a barren, fatiguing and agitated condition; one without hope or capacity; a world that is a A/ Alvarez has put it, 'airless and without exits.' Life is bloodless, pulseless and yet present enough to allow a suffocating horror and pain. All bearings are lost; all things are dark and drained of feeling. The slippage into futuility is first gradual then utter. Thought, which is as pervasively affected by depression and mood, is morbid, confused and stuporous. It is also vacillating, ruminative, indecisive, and self-castigating. The body is bone weary; there is no will; nothing is that is not an effort, and nothing at all seems worth it. Sleep is fragmented, elusive or all consuming. Like an unstable gas, an irritable exhaustion seeps into every crevis of thought and action."

Despair. My friend's explainations of his despair didn't seem to warrent death and his intelligence I suppose was not enough to block his emotional woes. I suppose reading what I already know can help reaffirm my insecurities however, I don't think I will ever understand.

Even before my friend's death suicide has for quite some time been an intriguing concept for me. It has not been of intrigue in some morbid romantic manner but rather because despite my own personal life experiences and those that I have been near, I have not been able to wrap my brain around the concept. Perhaps I never will. But as a mental health professional and as a human being and friend I will continue to try.

I miss my friend..

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