A few random thoughts on mental illness and suicide

Robin Williams and Jeff Bridges in The Fisher King. Parry (Williams), who is homeless and mentally ill, retells the story of the Fisher King and the Holy Grail.

In light of all the ignorant and shitty things being said in the wake of Robin Williams’s incredibly sad passing, I want to say a few things of my own to offset all the ignorance and bullshit. This may be rough and disjointed, but here goes:

Suicide is not an act of cowardice. One of the weird paradoxes of clinical depression is that it tends to cause thoughts of suicide, but also tends to inhibit the depressed person from acting out those thoughts by leaving that person exhausted and devoid of will. Just being alive under those circumstances is an incredible act of courage, so wanting out isn’t “cowardly”, but rather quite understandable. At the same time, it can also be grisly and horrifying just to contemplate…yes, even under those circumstances.

When I was depressed, I was constantly exhausted, yet constantly filled with anxiety, with a sensation of burning in my veins. I had panic attacks, which made me want to flee whatever place I was in, but sapped my physical strength so that I could hardly move. This painful paradox led to a lot of suicidal ideation for me. When my boyfriend took me to Niagara Falls, I couldn’t cross a high bridge without thinking of how much easier it would all be if I only found the courage to step over the railing and let myself fall through the cool air into the waters of the drainage canal, 70 metres below. Yes, I measured the drop…by tossing a stone and timing the splash, then calculating the distance based on acceleration due to gravity. And whenever I passed a railroad track and saw a freight train coming, I felt an almost magnetic pull toward it, and a horrific urge to lay my burning neck down on the nice, cool rail. It was like the world’s most perverse physics class.

These thoughts of suicide brought me no relief; on the contrary, they contributed to the horror and exhaustion of an already gruesome battle. I did not want to die. I only wanted the pain to end. The fact that my illness was suggesting its own “cure” in such a dire manner was a terrifying experience that I wouldn’t wish on anyone, not even my worst enemy.

I wasn’t being weak when I had suicidal thoughts. It took great strength to resist them, but it would have taken even greater strength to act them out!

The reason why some people on antidepressants commit suicide? Disinhibition. Prozac is legendary for giving depressed people back the energy the disease has sapped from them. It is also notorious for giving them the energy to take their own lives, where the depression had taken that away. This is why some people who are apparently recovering well on antidepressants “unexpectedly” take their own lives. Before prescribing any drug, a psychiatrist must ask them: Have you ever thought of suicide, or tried to commit it? If the answer is yes, any disinhibiting antidepressant is contraindicated.

I had suicidal ideations. I was so paralyzed by my illness that I couldn’t ask for help even though I needed it desperately. I should have seen a psychiatrist, should have gone on medication. Interestingly, one of the books I kept reading and rereading obsessively at the time was Colette Dowling’s You Mean I Don’t Have to Feel This Way?, which was about how antidepressants help treat the chemical imbalances of the brain that cause depression. But I never found the inner wherewithal to call my doctor or ask for a psychiatric referral. I never went on medication. I ended up toughing the illness out, and eventually the grey fog lifted. But when I later learned how many meds are tied to suicide in patients who appeared to be getting better, I wondered if I hadn’t somehow dodged a bullet. After all, Prozac was very much in fashion back then…

No, going on medication isn’t a sign of weakness either. Nor does it have anything to do with a conspiracy to “dope” us all into submission. The right medication(s) can save sanity and lives. The problem lies not with antidepressants, but rather with careless prescribing. And since a lot of doctors here in Ontario are overstressed and overextended themselves, with patient demand outstripping the physician supply, it’s all too easy for prescribing mistakes to happen. Especially if Big Pharma companies aggressively promote the latest drugs to doctors in an effort to boost sales.

And, give me a fucking break, Lionel Fucking Tiger, psychiatric meds are also NOT about “feminizing” boys. Antidepressants are not made of estrogen! A kid who can’t sit still in class, listening and learning, is not a boy being a boy, but a troubled youngster in need of help. If a girl acted that way, everybody would see that there was something wrong with her; sex changes NOTHING. Nobody can succeed in life by simply being left to run amuck. Anyone who thinks medication can’t make a positive difference to troubled kids has never been one, seen one, or had to deal with one. So please, spare me the pop-psych bullshit about the “need” to “bring back masculinity” by avoiding “emasculating” drugs like antidepressants or Ritalin. Masculinity never even left the building, and to equate it with madness is an insult to men, just as equating femininity with tameness is an insult to women.

No, genius and madness do not go hand in hand, either. Being exceptionally bright doesn’t make you crazy. Neither does being crazy mean that you are automatically gifted with rare and incredible insights. Yes, sometimes the two coincide in the same person. But to claim that this correlation somehow equals causation is like saying that having brown hair causes you to also have blue eyes, or vice versa. Plenty of people have the one, but not the other. And the fact that some people have both simply means that mental illness can happen to anyone, even the best of us.

When I was depressed, my normally high intelligence felt remote, like it had abandoned me. My usual creativity was dead and gone. I had trouble carrying out a lot of mental tasks that would ordinarily have been easy for me. I felt guilty and stupid all the time. Later, when the fog lifted, I got those faculties back. But when I was in the fog, even just walking to work or school took all the strength I had. By day’s end, I barely had the energy to lift a fork. It was like my brain had died and gone to hell. I was definitely no genius when I was sick.

Normality is not boring; it is a blessing. My only fear is that it will desert me without warning again, as it has repeatedly done in the past. I have been healthy for twenty years now. It is work, but it isn’t half as effortful as simply trying to survive while in the grip of a major depression.

And finally: No, mentally ill people are NOT in need of a good pep talk. You can’t jolly them out of it. Believe me, my former boyfriend tried. All it did was make me feel worse. And the trip to Niagara Falls, which was meant to cheer me up? It only fueled my depression and anxiety. That city is the worst place in the world to take a depressed person who also gets panic attacks. Especially if, like me, you are already afraid of heights even when you’re perfectly well. And the fact that I found no cheer in the tawdry, tacky tourist attractions made me feel like a total wet blanket on my boyfriend and his buddies, who were determined to have a good time even if I couldn’t.

Don’t try to talk a mentally ill person out of being ill. You can’t do that. All you can do, at the end of the day, is listen. Offering to do just that is often enough. And yet, too many people can’t even do that. It’s because they can’t fathom how badly a depressed friend needs someone else who is willing to hear it. If you’ve never been depressed, how on Earth would you know? So don’t presume to know anything. Don’t try to tell your sick friend anything. Ask.

You have no idea how much your friend is dying to tell.

4 Comments

  1. Lil Owl says:

    Thank you for posting this, especially the details about how Prozac works. I am really sorry about Robin Williams. I’m delighted you came through your trial . J.K. Rowling also had such an experience, and used it in her Harry Potter books.

    Just for the sake of completeness, perhaps you can write
    1) how did this start for you, and in retrospect, what could you have done differently – given 20/20 backwards vision of course.

    2) – what did you do to come out of this

    In Toronto there was a well-liked woman psychiatrist, who suffered from post partum depression. She rationalized about how she was a worthless human being, and fooled her immediate family who were watching, to get out and jump in front of a subway train. Youth is not necessarily any protection – I know of a 12 year old who attempted suicide several times, was put into a hospital and finally cured.

    • Sabina Becker says:

      Well, sadly, the response to both of your questions is: 1) Nothing, and 2) NOTHING. There was no inciting incident. I did nothing to cause it, and could do nothing to cure it. It just happened, and I waited it out. That’s the horrible truth.

  2. Beijing York says:

    I love “The Fisher King” and that bittersweet film does capture so much of what Williams might have been through but not necessarily able to find solace/healing.

    This is a great and very personal post, Sabina. Thank you. It’s also a reminder of how ill prepared many of us are in accepting, understanding or dealing with those suffering depression in our own circles.

    The worst offenders, bar none, have been those knee jerk religious right pundits who claimed Williams damned himself for not turning to religion. Big giant FU to those bastards.

    • Sabina Becker says:

      Amen to that. I hope it never happens to me again, but if it does, I hope someone else notices and drags me to the doctor. Because I wasn’t strong enough to drag myself.

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