Friday, October 2, 2015

Suicide and Survivor's Guilt

It's October second. Suicide prevention month is over, but we need to keep the conversation going. Jan wrote and excellent and very important post on suicide awareness. I won't reiterate the signs symptoms, because she lined them out so accurately. I do want to address another aspect of the tragedy of suicide. Namely, those left behind. The survivors.

It seems as though almost everyone has been touched by suicide. Well-loved actor Robin Williams' suicide on August 11, 2014 shocked the world. Robin Williams brought joy to many people and he had a great penchant for humor. Obviously, that didn't mean he wasn't suffering. If anything positive can come from the wake of such a tragedy it's that it got people talking. It put a face to the disease. Suicide is not a moral failing, a sin, or a weakness. I have read the buzz line, "Suicide is a permanent solution to a temporary problem". I am going to call bullshit on that quote. Yes, obviously suicide is permanent. Death is permanent. We know that. But mental illness, the kind of soul sucking mental illness that leads to death is rarely temporary. Also, the phrase "temporary problem" minimizes the torment that the person experiences. Robin Williams was in his sixties when he lost his battle with mental illness. How many decades did he spend trying to get better before he finally couldn't do it anymore? My point is that mental illness is real and we need to stop minimizing it. The cute little anti depressant commercials with the sad egg bouncing around until it finds a ray of sunshine and smiles don't really cut it. People need to know that seeking help and, when necessary, taking prescribed medication to treat mental illness is no more shameful than watching diet and taking insulin for diabetes. To me, insinuating that mental illness is "a temporary problem" feeds into the "just get over it" mentality. Understanding that managing a mental illness and taking medication is often a life long process just like the management of any chronic illness will make it easier for people to get help, and with help there's hope.

Today quoted Robin Williams' daughter Zelda about the loss of her father: "There's no point questioning it and no point blaming anyone for it and there’s no point blaming yourself or the world or whatever the case may be because it happened and you have to continue to move and you have to continue to live and manage."  This brings me back to my original focus. Every suicide reverberates through time and space affecting many lives. A little over a month ago I was outside playing with the kids when my next door neighbor walked over in tears. She said that her 27 year old step son who she had raised from the age of 15 had shot and killed himself late the night before. Her husband had flown out to California the moment he found out about his eldest son's passing. I hugged her and told her how sorry I was to hear the news. She went on to say that he had been the happiest kid, and while he had struggled with depressive episodes on and off, he had seemed to be doing better. She said something I think many survivors can relate to, "If only he would have told us, we would have done anything to help him". I responded, "There was nothing anyone could do". I didn't know the son,but I know his suicide wasn't their fault, or the fault of the girlfriend with whom he had broken things off with just days before. Of course, I'm sure there were many triggers, but the son didn't pick up the phone and call his parents or a friend or the emergency room because in that moment he wasn't in his right state of mind. He was sick. I don't mean he was "crazy". I mean biochemically and neurologically his brain was not functioning properly. The survival instinct that drives us and keeps us safe was shut off. Autopsies of suicide victims's brains suggest the disturbance of the HPA axis and implications of serotonin 1A( 5-HT1A) and serotonin 2A (5-HT2A) In other words, brain chemistry is compromised, muting the person's instinct to persevere and survive. Combine this with life events and feeling overwhelmed  with struggles that seem anything but temporary, and you have a catalyst. A perfect storm in the brain.

My neighbor has become very quiet. He keeps to himself a lot. Does he know it's not his fault?The grief of a loved one's death is compounded when that death is a suicide. It is nothing short of torture to live with what ifs, but the best thing to do is talk about it. Help to remove the stigma. Don't be ashamed. Many people conceal the cause of a loved one's death because they don't want them to be remembered "that way" and while I don't mean to say their is a wrong way to cope, I think this only perpetuates unnecessary shame. Education and action is power. For example, geting involved in an Out of the Darkness walk to support suicide prevention research is a great way to take action and experience camaraderie.

Survivor's guilt is defined as the condition in which a person feels a sense of wrong doing when they survived an event that others did not. (survivor's guilt) If you have lost someone to suicide, it is not your fault. I know you may not believe me, but it needs to be said. Maybe you had a fight with the person or had an estranged relationship. Maybe you look back on things they said or did and wish you had reacted differently. Maybe you are angry at them. You wish you had known, but you couldn't have. Your loved one was sick and nothing you said or did, didn't say or didn't do caused them to commit suicide. We have to work to promote education on mental illness and suicide. We don't have to be ashamed. We also have to remember to take care of the survivors. As Jan mentioned, family members of suicide victims are at a higher risk for suicide.Its time to stop the shame because monsters live in the dark. It's time to come out of the darkness and take care of all those who have been touched by suicide. It's not your fault.