On World Suicide Prevention Day, I wish I had a more hopeful message to deliver. But I don’t, really. I can say, however, that preventing suicide is more about preventing depression.
I miss my friend Annie. She fought depression for her entire adult life; by the time I met her, she was in her early 30s. She was a smart, funny, sly, beautiful woman, open and honest about her struggles with bipolar disorder from the very first evening I met her.
I loved Annie’s honesty, and I hated what depression did to her. For the first few years we were friends, she managed to keep the disease at bay, but then a disturbingly manic period was followed by a free-fall slide, a near-deadly overdose and an extended hospitalization. Afterwards, her friends and family scrambled to prop her up and reassemble her life, but Annie never fully recovered.
Eventually, after a painful and heart-wrenching several months of fighting and slipping, fighting and slipping, she died as a result of suicide.
Later, I wrote a book titled How to Survive: The Extraordinary Resilience of Ordinary People, which features stories of regular, every-day people bravely facing traumatic life events. I knew from the start that I wanted to feature Annie in my book, but at first it didn’t seem appropriate to describe someone who died as a result of suicide as a survivor.
Then I talked to Daniel J. Reidenberg, PSY.D., executive director of SAVE, a national suicide-prevention and education organization based in Minneapolis. I told him how Annie fought with all her considerable strength against the downward pull of depression, how she told me how much she wanted to live even though it hurt her just to open her eyes every morning.
Reidenberg told me what I thought all along: Annie was a survivor, but she was fighting against depression, a powerful, sometimes-unsurvivable foe.
When I was young, I thought that suicide was a failure, but witnessing Annie’s struggle taught me that even when a person is surrounded by love, sometimes the tugging downward pull can be too strong. Suicide awareness for me means gaining a deeper understanding of depression and the powerlessness some people can feel in its wake. Though many people with bipolar disorder lead long, healthy, productive lives, for Annie that wasn’t the case. No one, not even those who loved her most, could keep her alive.
Eventually I wrote a chapter about Annie and her family. Below is an excerpt.
Excerpt from chapter eight of How to Survive: The Extraordinary Resilience of Ordinary People by Andy Steiner
Misunderstood
Bipolar disorder is a powerful, deadly disease, says Daniel J. Reidenberg, PSY.D., executive director of SAVE, a national suicide-prevention and education organization. Life expectancy for a woman with the disorder can be as much as fifteen years shorter than average, he says, with completed suicide occurring in 10 to 15 percent of people with the disorder.
“Fighting depression is a daily fight,” he tells me, reminding me of Annie’s nearly constant struggle to push away the dark cloud of the disease. “Sometimes it’s an hourly fight. Sometimes for people it is a minute-to-minute fight.”
Though it can be as deadly as many cancers, mental illnesses like bipolar are much more difficult to identify, isolate and treat, Reidenberg says. At this point, no technology readily exists that can identify mental illness. You can’t scan a person’s brain for bipolar disorder, and though medications can help a person live with the disease, they are far from perfect. In the last years of her life, Annie struggled to find a perfect medicinal balance, a pharmaceutical cocktail that could keep her depression at bay while letting her feel like a functioning human being.
“Mental illness is the most misunderstood disease of the human body,” Reidenberg says. “We’re not at the point yet where we can take X-rays and diagnose mental illness like we can with a broken bone.” And the added complication is that mental illnesses like depression take away a person’s will to live. “How did your friend ‘fight’ her mental illness?” he asks me, rhetorically. To have the will to fight something when your brain is telling you you’d rather die takes exceptional strength and heroism.
“People say, ‘I’d rather struggle with depression than die from cancer,’” Reidenberg says. “But someone with cancer usually at least wants to live. They want to get better. A person with depression has little or no motivation to get better. I try to explain to people, For anybody who’s had a headache, they are horrible and nobody likes them. Imagine having a migraine, the worst of your life. Take that migraine and multiply that by a hundred thousand. That the kind of pain somebody suffers with a mental illness.”
Maybe it’s because I’ve witnessed my usually stoic husband curled up in a ball on the bathroom floor when he has been struck by a particularly vicious migraine, or because I watched as my beloved niece—after trying every medical intervention available—died painfully of cancer, but this analogy works for me. I understand that serious mental illness is not something to get over, but rather something to live with, for many people a lifelong struggle that cannot be cured or overcome.
“When depression takes hold, it wraps around your brain and it doesn’t allow anything in or out,” Reidenberg says. “All you feel is the depression. You become numb to everything else other than that pain. It hurts in the head, in the stomach, in the muscles. It hurts emotionally. It takes hold of you and it never lets go.”
SAVE https://www.save.org provides support, information and education about suicide and depression. Its 24-hour crisis support line is 1-800-273-8255.
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