Depression Kills, And It Isn’t A Choice

“Wow, I can’t believe he’d do that.”

“How selfish of her.”

“I could never do that to my children.”

“What a coward.”

This week, two high-profile celebrities took their own lives. The response to someone killing themselves is often judgmental, hostile and angry. Suicide, especially in the wealthy, visibly healthy and famous inspires resentment. What did he have to complain about? What about her life was so terrible?

If you spent any amount of time on a social media thread regarding Kate Spade or Anthony Bourdain this week, odds are good you witnessed (or perhaps participated in) what the cool kids these days call a dumpster-fire. One side was inevitably accusatory and eager to heap posthumous shame on the victims, while the other was probably flailing away, indignant, trying to explain that we can’t judge these people, and we can’t understand their pain.

Also, don’t speak ill of the dead for some reason.

Both sides of this debate miss the point. You’ll occasionally see the actual point, elusive and flighty, appearing at the edges of the argument, but I haven’t seen it honestly engaged with except in a few personal conversations and the odd meme or two.

As I write this, Fox News pundit Charles Krauthammer has just released what’s likely his final statement, announcing that despite aggressive treatment and high hopes, his cancer is no longer treatable, and his physicians have given him just a few weeks left to live. His statement was unexpectedly bright, bold and heartening—he’s had a good life and is grateful for it.

We all see the contrast in this week. A man who fought desperately for his life, against long odds, has now gracefully accepted that he’s lost… yet here he is, trying to comfort everyone else about his impending death and is sticking it out to the bitter end—while two healthy, rich and famous people just plain opted out. The absolute audacity of those two. The gall.

Except gall has nothing to do with the suicides of Spade and Bourdain. Depression is a physical, debilitating disease just as surely as cancer, Lou Gehrig’s disease or heart failure. It is a physical problem. Neural pathways in the clinically depressed do not function the way the average person’s does. They do not produce the chemicals—or enough of the chemicals—that let you, Average Reader, imagine next year, next month, or even tomorrow without dread, hopelessness or worse. Serotonin depletion isn’t something you can willfully fix on your own any more than someone with leukemia can smile his way into remission.

It’s easy to understand why people get confused by this—our laymen’s language fails to adequately differentiate between upset, sad or grieving and depressed. People consistently complain about how depressed they are that their favorite show got cancelled or that they didn’t get to see their favorite musician play at Red Rocks. They’re depressed that their partner broke up with them, their friend keeps flaking on them, or they flunked a class. Reaching deeper, people say they’re depressed when a pet, a buddy, a parent dies.

Those are painful experiences. Losing something you enjoy sucks. Missing out on experiences is regrettable. Grieving the loss of someone you love is inarguably one of the worst events we suffer through.

None of those things are clinical depression. Those are things that typically fall, correctly, under the adage that time heals all wounds, and it gets better. If it doesn’t get better, you may be clinically depressed and should consult a professional.

Effective treatment for depression has been eluding medical science, and frankly what’s widely on offer even here in 2018 isn’t all that great. There’s a sea of medications and a universe of therapies out there, and let me tell you, Average Reader, I’ve spent more than a decade of my life working through a few dozen or so of them. Just like so many other sufferers.

It came to point recently that upon meeting my new psychiatrist, I immediately requested electroconvulsive therapy. You’ll know this as ‘electroshock’ therapy and the stuff of classic movie nightmares wherein the patient is strapped to a table and fried into incoherence, left to spend their remaining decades drooling in a convalescent home.

Today, ECT doesn’t deserve that rap. It’s an extremely useful tool for the treatment-resistant depressives among us. It is, however, last resort. Fortunately for me, my psychiatrist pointed me to a less dramatic, but highly effective treatment (transcranial magnetic stimulation) and I’m a lot better for the time being, thank you for asking. Please note that TMS (and ECT) works because it alters the brain. It addresses and corrects a physical, neurological problem. Suggesting that someone “just cheer up” and chiding them to stop being such a drag, or pointing out the blessings of their life, incidentally, does not help anything or anyone.

The first celebrity death to really hit me was Robin Williams, who I met while I was on deployment overseas. His suicide caught a lot of people by surprise… although, not anyone who understands what real depression is and what it turns you into. William’s death hurt, but it wasn’t shocking. I wrote an article for my college paper about comedians and the subjectivity of humor. That piece touched on the unusually high mortality rate of funny people. It touched on how humor is often a coping mechanism.

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Pictured: two people battling clinical depression. 

Everyone must cope at some point in their lives. Someone whose brain is incapable of producing the feel-good chemicals they need to function normally can put on a show, often for years. Outwardly, they may look like the happiest people, the most ebullient, the successful go-getters. Those people deserve Oscars for their performance, because for a lot of us, the depression leads to passing around extremely simplistic advice that honestly doesn’t occur to us at the time, like “take a shower, if you can bring yourself to stand up” or “have you had a drink of water lately?”

When we lose someone to heart disease or breast cancer, we term their battles as bravely fought. There came a point when they couldn’t fight any longer, and their traitorous organs or cells simply overpowered them. We laud their determination and spirit and lament their loss.

Anthony Bourdain, Kate Spade, and the dozens of weekly suicides whose names haven’t ever been in lights fought their battles, too. That they made it as long as they did, battling a cruel disease that so rarely lets up, is a testament to how hard they fought. They weren’t cowards, and their legacies shouldn’t be tainted by everyone who angrily decides that the disease that killed them isn’t real enough.

Yes, if you are worried about a friend or family member, talk to them. If they’re suicidal, help them. Call emergency services. The treatments we have aren’t perfect, but they’ve saved so many lives. Advancements are being made every day. We’re getting closer all the time to depression being accepted as the disease it is. So help, in whatever ways you can.

And know that snarling online about the cowardice and selfishness of people you’ve never known, whose struggles you’ve never experienced, is in no way helpful. All you’ve accomplished is potentially silencing and shaming a stranger who sees your words and takes them to heart. Someone who, if it weren’t for the hostility and cruelty on a random Facebook comment section, might have an easier time reaching out for the help they need.

After all, most of us struggling with depression don’t have hefty bank accounts, critical acclaim and legions of adoring fans. Depression doesn’t care about any of that. Dying of depression can happen to anyone living with the disease. Don’t play Depression’s Advocate.

If you’re feeling like you may harm yourself, please reach out to the Suicide Hotline at 1-800-273-TALK (8255) or send a text message to the Crisis Text Line at 741741.

Don’t want to talk? Give “Everything is Awful and I’m Not Okay” a read and see if it helps.

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