Understanding Suicide

Canadian poet, Margaret Atwood, says that it is not enough to say certain things just once. Some things need to be said, and said, until they don't need to be said again.

Every year I write a column on suicide and each of those columns usually prompts a flood of mostly grateful letters. The gratitude comes from the fact that those columns suggest that, in most cases, suicide claims its victims in the same way as does a heart attack, a stroke, cancer, or an accident. There is no freedom not to die. Suicide victims are, like victims of sickness and accidents, not responsible for their own deaths and suicide should not be a matter of secrecy, shame, moral judgment, and second-guessing.

For this year's column, I will not reiterate those same themes, namely, that suicidal depression is usually a terminal disease and is not a free choice that connotes moral and psychological delinquency. Rather I will give a first-hand testimony from William Styron, author of Sophie's Choice. A victim of suicidal depression he wrote, in 1990, a book entitled, Darkness Visible, A Memoir of Madness, within which he chronicles his own descent into suicidal madness and his helplessness as he spirals into that hell.

Since Styron is sharing, first-hand, the experience of suicidal depression, allow me to quote him extensively:

'The pain of severe depression is quite unimaginable to those who have not suffered it, and it kills in many instances because its anguish can no longer be borne. The prevention of many suicides will continue to be hindered until there is a general awareness of the nature of this pain. ... and for the tragic legion who are compelled to destroy themselves there should be no more reproof attached than to the victims of terminal cancer. ...

What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the gray drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this caldron, because there is no escape from the smothering confinement, it is entirely natural that the victim begins to think ceaselessly of oblivion.'

Styron then describes graphically how the depressed person becomes obsessed with thoughts of oblivion: 'many of the artifacts of my house had become potential devices for my own destruction: the attic rafters (and an outside maple or two) a means to hang myself, the garage a place to inhale carbon monoxide, the bathtub a vessel to receive the flow of my opened arteries. The kitchen knives in their drawers had but one purpose for me. Death by heart attack seemed particularly inviting, absolving me as it would of active responsibility, and I had toyed with the idea of self-induced pneumonia-a long, frigid, shirt-sleeved hike though the rainy woods.'

After reading virtually all the literature, medical and psychological, on the issue, Styron suggests the suicidal depression is, in the end, caused by chemical imbalance, despite the fact that other factors (lifestyle, childhood, moral values, memory) contribute. Modern sensitivities, he contends, make us reluctant to use old-fashioned words like madhouse, asylum, insanity, melancholia, lunatic, or madness, but 'never let it be doubted that depression, in its extreme form, is madness. The madness results from an aberrant biochemical process. It has been established with reasonable certainty (after strong resistance from many psychiatrists, and not all that long ago) that such madness is chemically induced amid the neurotransmitters of the brain, probably as a result of systemic stress, which for unknown reasons causes a depletion of the chemicals norespinephrine and serotonin, and the increase of a hormone, cortisal.'

Styron was one of the lucky ones. With his suicide already planned, he drew on some last gleam of sanity and, in that, realized that he could not commit this desecration on himself and his loved ones. He woke his sleeping wife and she drove him to a hospital. In its safety and given seclusion and time, he healed. He lived on to tell this insider's story.

That insider's story has a double value: Not only should it help us to understand suicide more deeply and exorcise more of its shameful stigma, but, in helping to expose the anatomy of suicide, Styron gives us better tools to help others (and ourselves) in its prevention.

Beyond that, a proper understanding of suicide should help us all walk more humbly and compassionately in grace and community, resisting the bias of the strong and unreflective who make the unfair judgment that people who are sick want to be that way.

The human heart is exquisitely fragile. Our judgments need to be gentle, our understanding deep, and our forgiveness wide.