Depression Against Life

Anon for Now recently commented on the sense of renewal in life that served as a deterrent to suicide. This struck me as capturing the most baffling aspect of the temptation to end life. For what does the evidence of life on earth point to but the endlessly inventive will to survive? There is no more fundamental drive than the will to adapt, change, reproduce one’s kind under any circumstances. Yet so many in the grip of major depression or bipolar depression act against that drive toward life and destroy themselves. As Kay Redfield Jamison points out in Night Falls Fast, the presence of mental illness and/or substance abuse, or worse, the two together, vastly increases the likelihood of suicide. It’s among the top five causes of death in the United States for men and women between the ages of fifteen and forty-four.

What I have seen and sorrowed at is the cool determination of more than one friend to plan and carry out his own destruction. Karl Menninger described the drive to suicide as taking many forms in his classic study, Man Against Himself. These included self-defeating behavior, dangerous addictions, certain types of self-mutilation, aggressive and violent outbursts, purposive accidents and many other variations. Some of these can lead directly to premature death; many set the stage in a person’s mind as justification for ending a life regarded as failed or too painful or destructive to others.

I stood with a friend once – he was sixteen years older than I – on a rocky ledge on the coast of Maine looking down into the sea water crashing and swirling in a pocket among the boulders a hundred feet below. At that island’s edge, he wondered aloud about the fascination and lure the body feels when you stare into that mesmerizing violent and unending energy of waves breaking apart among the rocks beneath us. I have felt that as well, but there was something about his tone that made the remark and moment stay in my memory. He was a man of some means, an art collector, a philanthropist, a bon vivant who thrived on having about him the company of his gifted friends. He was not someone, it then seemed to me, who dwelled on the dark side of life.

Another time when traveling with him, I asked about his relationship to alcohol – he’d been working hard at giving up drinking – and talked also about the concept of shame. I brought that up because by then I had seen the full range of his moods and knew well there was a side of himself he hated. In that period, popular psychology was full of ideas about shame instilled by “toxic” parents and “dysfunctional” families. The point was that such shame was undeserved and could be put to rest by understanding its origins and by nurturing the “inner child.” The idea of shame hit home for my friend, but in a different way than expected. He seized on that as capturing a truth about himself, that his shame was valid since he held himself in low regard. I spoke to him about depression, since that seemed a part of what he was going through. He balked at the idea that he could be depressed, but shame he embraced. I think his sense of shame about himself was tied to his problems with alcohol but also to his being gay. Though he was open about his orientation, the generation in which he was raised instilled in him only contempt for his nature. He seemed to share that contempt. Shame was OK, depression was unthinkable.

Some years later when he was visiting me, he said strangely that he thought this would be the last time he would be making that trip. I didn’t want to understand his meaning and talked about a number of things in response, none of which related to his true intent. But he had the air of a man who had solved a persistent problem.

He went home, stopped answering any form of communication, locked himself in his house and proceeded to starve and drink himself to death. Some of his friends were too persistent, though, and got to him when he had a heart attack. From there he went to one hospital, but a series of painful complications required his removal to a second facility. He went through one crisis after another, and when I saw him next he was in an intensive care recovery unit: his breathing was machine-assisted, and a leg was about to be amputated.

The breathing machine robbed him of the witty tongue that was one of his hallmarks. With that corrugated plastic tube shoved down his throat, he could only laugh with his eyes, and also plead, and also say yes and no. What he wanted most of all was to be allowed to die. He made me understand that I could help him by removing the oxygen tube and so let the life choke itself out. Of course, I told him I couldn’t do that and pleaded with him gently to remember his many friends, how much they valued him, what a fine person he was. I asked him to let me read to him from the book everyone was writing appreciations in, but he would have none of that. The only way I could help him was to pull out that tube.

Talking with his friends as he lay nearby, obviously hearing everything, I argued that he had suffered from deep depression for some time and that had led to his attempt to kill himself. The others couldn’t accept what I was saying. It was all medical, his friends agreed. One said that depression was a perfectly reasonable response to what had happened to him and his present state – there was no deeper or earlier depression, and he hadn’t tried to kill himself.

My friend went through his amputation, his family was heralding the work of recovery ahead, but then a burst artery finally granted his wish, and he was gone. The hospitalizations and torture of his last months were hardly what my friend could have foreseen or wanted. But the urge to destroy his own life, which he saw as so flawed when in fact it was so rich, had won out.

I have shared the self-contempt and despair of depression, but so far the temptation to end life hasn’t been more than a fantasy or ideation. What is so chilling is the calmness and calculation of someone who has made this decision and then carries out a plan of many steps that takes time to reach its conclusion. I have imagined suicide as a sudden impulse, a flashing opportunity seized without forethought, but I’ve never approached that stage of cool deliberateness that takes hold in those who are really going to stifle the deep drive to survive that keeps the rest of us going.

I would like to honor the richly human lives that many friends lost sight of when they decided to end this existence.

Image Credit: Some Rights Reserved by Andy Saxton at Flickr.