The death of Robin Williams came as a jolt to many people I know. Some may have read over the years about his battle with depression and alcoholism. We live in a world where suicide (along with substance abuse) has a stigma attached to it – denoting weakness and choice.
I’m by no means here to defend suicide, but I do think depression, substance abuse, and mental illness are largely misunderstood. Recently I was reading a conversation started by a cancer patient on social media, about going through hospice and fighting to life.
The reaction was one I had seen frequently – prayers and sorrow for the family but anger that someone would choose to end their own life.
The response to the post was very illuminating, with many arguing that depression is just as real as any physical torment. People often choose substance abuse – consciously or subconsciously – as a means to self-medicate. But at some point that no longer works.
It is a powerful and sometimes frightening thought. but the mind becomes one’s own enemy, telling people that life is hopeless.
In the end, losing a battle with depression may be no different than losing a fight with cancer.
Mental illness has a long history of being misunderstood. Before we had a modern understanding of the brain and brain chemistry, we used to lock up the mentally ill for fear that they were inhabited by evil spirits or possessed by the devil. In modern times, while psychiatry has found that medicines can normalize brain chemistry, mental illness continues to have a stigma attached to it.
It was not that long ago when I remember having a conversation with an individual who thought that psychiatry was random quackery that used medicines that either acted to suppress or were basically placebos.
But one of the more fascinating presentations I saw was a few years ago in San Francisco at the Public Defender’s Justice Summit. Presented there was research from the University of New Mexico where they did MRIs on the brains of people suffering from bipolar disorder and schizophrenia.
The fascinating thing about these MRIs is that you could see the regions of the brain of those afflicted with mental illness compared with the normal brain, and they were very different in terms of which areas of the brain were lit up and what colors there were in each section of the brain. For the first time, at least to the layman, it was very obvious that these conditions were the result of physical and chemical changes in the brain functions.
This was not simply something “in someone’s head,” this was a condition where the brain did not operate normally. The fine chemical balance in the brain was altered and that alteration had huge impacts on the individual’s perception of the world.
This was important in the realm of criminal justice because part of how we punish people is associated with their ability to control their actions and discern reality and separate right from wrong.
The criminal justice system, needless to say, is far behind where neuroscience is in terms of being able to deal with these issues.
At the same time, we as a society are just as far behind in our assignment of social stigma. We know that drug abuse such as methamphetamine can alter the way that the brain processes pleasure signals.
It is clear that our perception and understanding of things like depression must change. I don’t know the science of how to understand depression and the overlap of substance abuse which seeks to self-treat that depression, but it seems clear how we should think about this conceptually.
Mental illness, whether it is bipolar disorder and schizophrenia or depression, is just as real as cancer. A good friend of ours has fought cancer for years and now is in hospice. At some point, she may lose that battle with cancer.
Robin Williams fought depression for years. He had vast resources and wealth and support, and yet in the end, he was not able to overcome it and he lost his battle. At some point, you fight cancer or any other terminal or potentially terminal disease, you end up getting worn down, tired of the pain and feeling sick, and you give up that fight.
Maybe that is how we have to think about the death of Robin Williams. He fought the fight for years. He gave countless millions the laughter and the joy that apparently he himself was missing. And in the end, it consumed him and he lost the battle.
—David M. Greenwald reporting
Thank you David for this perspective. His death has hit me hard. Soon after we moved here and the last time my Mom was in Davis, we ‘met’ him at the Ben and Jerry’s: or I should say our uninhibited 10 year old ran after him and shook his hand. I like to think he was amused by her forwardness and was very gracious. Maybe becasue of the link with my Mom, I remember that day and especially him with fondness. Your story reminds us that we are all human at the core and all the ‘kings horses and all the kings men’ are often not enough.
Robin Williams was a kind and gracious man who gave great joy to friends and strangers alike. I mourn his passing and am sad that he suffered so much. This not what I would ever wish for him or anyone else. I am not angry, but heartbroken that death appeared to be the best choice for him and that he is gone. RIP.
I was also saddened by the news of Robin Williams death. I am a product of the society in which I was raised in which death is something that we are expected to fight often at unreasonable cost to ourselves and others. Not every society views death this way.
Over the weekend, the ACME Theater Company produced a play called The Rememberer. It is set in Washington state and is the true story of a woman kidnapped from her Native American tribe and raised in a school designed to “civilize” Native American children. One theme that was briefly touched on in the play is the continuity of life between this life and the next. There are many cultures in which death is seen not as defeat, but as a natural sequence of events which of course we will all experience. The focus is on living each day in “our world” to its fullest and accepting our rightful place in the next world as graciously as we have lived here. Personally, I find comfort in the thought of death is the appropriate transition for some, and that it is the perception of the survivors that frames the appropriateness of its timing.
Tia Will: I am a product of the society in which I was raised in which death is something that we are expected to fight often at unreasonable cost to ourselves and others.
George F. Will, 4/2/98: Remembering Dad
wdf1
Thank you for posting this. I have seen the struggle between members of families, within the medical community, and within my own family. My won mother began the slow process of visible decline in her late 80’s. She had been very active in her home and yard until then. She gradually began to lose the capacity to do physical activities. After a series of mini strokes, she began to lose her mental acuity, and began a very slow process of drawing inside. She no longer was proactive in seeking out activities but was calm and acquiescent with what my sister would tell her to do. Unfortunately this included eating. Now some of you will be shocked and perceive that I am advocating starving the elderly. This is not true. One mechanism of our body to protect and nourish ourselves properly is our appetite. My mother’s body was gradually and painlessly telling her that she had fulfilled her role here and that it was time to transition. My sister could not recognize and reconcile this with her belief that it was her duty to keep our mother alive as long as possible. My mother’s life was extended by months or perhaps years by nothing more than my sister’s three times daily insistence that my mother eat what she did not want and that her body was telling her she no longer needed. I feel very strongly that our lives, just like our bodies belong to no one but ourselves. As family members, friends, coworkers, neighbors I believe that we have a responsibility to support one another to the best of our ability. What we do not have the responsibility, or the right to do is to determine when or if another human being should end their own life either passively by food refusal or actively as
Robin Willimas did.
And we certainly do not ever know the contents of another’s thoughts or feelings around this highly personal and individual act sufficiently to judge them.
Oh Tia, we share another memory. My mother slowly began to withdraw from active progress in her medical recovery from bowel surgery. First refusing PT then refusing to eat. We finally (probably later than we should have but wish it had been later!) realized she was telling us something in her actions and had a family conference with her compassionate MD and discharged her to a low tech, high love LTC where she received some of the best caring care I have ever seen. Money can not buy that sort of compassion. So yes I understand and after hearing your story am blessed we did not have family rancor about the decision which was hard enough to keep true to. I am not ready to accept Robin Williams’ decision, yet I agree with you about rights. But is a profoundly depressed individual in control of making rational decisions around his personal rights?
In 1981 I worked with a guy that had previously been Robin Williams’ personal assistant. He told the story of the cigar room. Apparently Mr. Williams liked to collect cigars and he had a huge walk-in humidor. But my coworker never saw him smoke a single cigar. Apparently the boxes were overflowing the shelves and were stacked on the floor. At some point my coworker had helped himself to a couple of cigars. At that point he said that he had worked for Mr. Williams long enough that he was sure he would not mind. The next day Mr. Williams asked him if he had taken cigars, and after it was admitted, Mr. Williams proceeded to yell a barrage of hostile and angry insults at his assistant. He did not fire him. And the next day Mr. Williams left him a box of cigars with a note saying he was sorry for the outburst.
For my coworker, the incident made four impressions: One – Mr. Williams must have a photographic memory. Two – he is prone to the most angry and profane outbursts. Three – he can be very apologetic and generous. Three – he was obsessive compulsive.
And he was massively talented.
It seems that substance abuse and depression are often tied together. I also see obsessive compulsive behavior in people I know to struggle with depression. There is no doubt in my mind that suicide is the end result of a disease of brain chemistry. And I think the disease is exacerbated by substance abuse.
I think one day medical science will identify the markers for people with these problems… and possibly the cause. Until then the best thing we can do is to make the friendly call. There are plenty of stories of suicidal people that were interrupted by a call, and changed their mind. We can’t solve people’s problems for them, but we can increase the odds that we get lucky in timing to be there when they most need a friend.
I have heard that he was soft spoken and kind.
I also wonder about the pressure he put on himself with a mansion in Sea Cliff, Tiburon, and Napa. Downsize!!
David wrote:
> Robin Williams fought depression for years. He had vast resources and
> wealth and support, and yet in the end, he was not able to overcome
> it and he lost his battle.
Back in the mid 90’s I was on my way to work one day and saw what I thought was a friend coming at me so I flashed the lights and waved out the window. It turns out it was not my friend, but Robin Williams (who had just dropped off his kid at school). A few days later Robin was again dropping his kid off at school when I was heading to work and he saw me first and flashed his lights and waved. Over the next couple years we passed each other often and it became a game where we would always wave (sometimes Robin would honk the horn and wave with both hands out the window always with a big smile). Years later I got a chance to talk with him at the Tour of San Francisco bike race (when a friend got me in to the VIP area) and I was surprised that he remembered the “guy that flashed the lights and waved to him” and he really seemed happy to meet me.
While I am personally sad to hear that Robin took his life and I know that depressed people have always taken their own lives I’m hoping that this high profile suicide might get people to look a little deeper in to the effect on the many (highly profitable) prescription drugs that while they help many people also increase the likelihood that a person will take their own like (or take a gun to a school or movie theatre and kill random kids). My wife’s brother in law is a (third generation) member of the US Army Medical Corps and while his Dad and Grandfather also worked with stressed out and depressed soldiers they did not give them (as many) mind altering drugs (or have such a shocking number of them take their own lives)…
This may be a bit off topic, but I support a right to die law for California. And on topic, I think the tragedy of suicide is the burden it leaves for family members.
Absolutely agree.
For me, I walk a line of outright disgust and sad empathy for those that commit suicide because of the horrendous pain they cause their surviving family and friends. It is a final absolute selfish act.
I am a bit at odds with my wife’s family related to the suicide of wife’s only two brothers, identical twins, at age 45 and 47. They both left a wife and two young children. Both used a handgun. The second one did it with his two kids in the next room and his oldest son found him.
I am still angry. At times I daydream about kicking the shit out of both of them… knocking some sense in to them and punishing them for what they have done to their kids and their family.
My mother and father in-law, who are devout Lutherans and the most caring and giving people on the planet, practice remembrance of the death date of both of their lost boys. And there are all these Facebook posts. I try to ignore it all. I don’t honor or try to remember the acts of selfish cowards even if they were my family and friends. But at the same time I forgive them for their great mistake. And I have sad empathy for their illness and pain that would lead them to do that terrible thing to themselves and their loved ones. But mostly I am constantly heart broken for the ongoing pain they cased everyone else.
But related to the right to die, the challenge with people seeking death is assessing their ability to make a rational decision.
Also, it is interesting that we have this ongoing (over-hyped for political reasons) debate about abortion and the related sanctity of life. One extreme view is that a baby is part of a woman’s body while it is in the womb and hence the woman has a right to terminate the baby’s life up until the time it is completely expelled from the womb. And some people are fine with that… assigning a moral argument to a woman’s right to choose… and rejecting any attempt for counseling her state of mind and attempting to convince her to make another choice.
And in consideration of this, it is absurd that we would not simply accept suicide as a personal choice and instead we commonly hold that suicide is a mistake and that the suicidal person can be saved with proper counseling.
What drives me crazy about all of this is looking at the scale of a human life with respect to natural history. If the universe is 16 billion years old, and the earth is 6 billion years old, and the history of humans is about 4,000 years old… and we live for about 80 years… then why end life early? It is gone in a blip as it is. Go climb a mountain. Go stand on the beach. Go experience the natural world in all of its glory. If you feel pain, thank God for the ability to feel.
Frankly, I think that many people suffering depression, although experiencing a real health issue, are primarily just lacking perspective. Life is hard for most of us. If we have not hit a wall yet, we will… probably many times before we die. But life is a gift in any case. We very well might be the only living beings in the universe capable of introspection and the ability to contemplate our own life. What a shame to prematurely throw away this miracle and blessing.
“I am a bit at odds with my wife’s family related to the suicide of wife’s only two brothers, identical twins, at age 45 and 47. They both left a wife and two young children. Both used a handgun.”
Having a firearm at home greatly increases the risk of successful suicide.
http://www.hsph.harvard.edu/means-matter/means-matter/risk/
It does not raise the risk of attempting suicide. But it makes those down moments for depressed people much more risky. Keep in mind that very depressed people are not always depressed. They phase in and out. And they will come up again, and if they get treatment and stick with it, they may overcome their troubles. That is, unless they are successful in killing themselves when they are at bottom. And having a gun in the home for them is a very bad idea.
Just like razor blades, sleeping pills, alcohol, ropes, car exhaust and even sperm… all of these other things in the house,… you simply cannot solve the problem of termination of unwanted life by restricting things.
I have a problem with this track because it leads to no solution and distracts from the conversation about real solutions. You cannot prevent access to guns in this country, and you never will.
“you simply cannot solve the problem of termination of unwanted life by restricting things.”
I never said or even implied restricting anything. I made the factual point that having a gun in the home makes the likelihood of a successful suicide far higher. According to the Harvard studies, when all other factors are controlled for it nearly doubles the risk (7:4).
Ok. I get that. I guess I was making an editorial comment over your editorial comment that we stop focusing so much on that because there is not a solution to be had and it becomes a distraction for keeping the conversation focused on the real potential solutions.
Guns don’t kill people, people kill people. Mental health, emotional health, substance abuse, other medical conditions… these are all targets for real solutions. Access to guns for people with mental health problems is a worthy part of the discussion because there is socially and legal acceptance of the requirement that a gun owner needs to be of sound mind. However, beyond that we will go nowhere talking about gun restrictions for the purpose of reducing the occurrence of suicide.
That is my basic rub here… I don’t like it when this point is put out there because I believe it distracts us from discussing and pursuing real solutions.
Frankly, what a sad sad story. Maybe as twins they had similar problems, but it is hard to imagine doing it where kids could find the body and leaving a young family behind. I can understand your anger. Sadly, kids with a parent or sibling who commits suicide have an increased rate of suicide or attempted suicide. It is odd to focus on their death days. I have a son who died in a traffic accident, we celebrate his birthday and we light candles on and around his death day. It’s a day or mourning, not a celebration.
“Some may have read over the years about his battle with depression and alcoholism.”
I suspect these two afflictions often go together. In the specific case of Robin Williams, I heard him once say in a radio interview (on NPR, probably Fresh Air) that he was “a self-diagnosed manic depressive.” When such people are in the depressive end of that disorder, there is a risk for suicide.
Only slightly related … I happen to be the type of person who enjoys active sports, but has sufficient levels of fear that I am no daredevil. When I am skiing down a steep mountain, I never go for it. I make sure I am in control. If the light is poor and it’s hard to see very far down, I’ll make stops along the way just to make sure I don’t get out of control and crash. As a cyclist, when I am riding down a big hill, I’m always touching my brakes. I could go faster. But I don’t get a high out of that. It just scares me. I don’t want to be out of control.
I think people who are alcoholics (or addicts to other drugs) like being out of control. They are always wanting to go faster, get higher, etc. It may be because at an underlying level they are depressed, and they use the excitement of drunkenness or speed to medicate their depression. I don’t know any of that for a fact. But it generally fits my observational experience. I feel fortunate that I don’t have that daredevil or alcoholic gene and I have never suffered from depression.
One observation of mine along these lines is this: If you watch children at play, some percentage of them will be innate daredevils. Those are the kids who climb the highest in trees; who have no fear on diving boards, no matter how high; who, as babies, loved getting tossed way up in the air by their dads; who love to do dangerous maneuvers on bikes or skateboards; etc.. While it is probably not a perfect correlation, I suspect way more of these born-daredevils grow up to have drug and alcohol problems than children with ordinary (but not extraordinary) fears.
Very interesting Rich. I’m not sure there is a perfect correlation, but it makes sense that adrenaline and other happy hormones are craved by those prone to depression.
I think you are pointing out that there is a reckless behavior tendency.
The dude that cut off his arm to save himself after falling in a crevice while hiking on precarious rocks in Utah… alone… and then afterwards attempted suicide…. there is a perfect example of what your talking about.
But some people are not wired for that type of risk… but they might abuse drugs and alcohol instead.
The mechanics of drug addiction and alcoholism are hellish for someone prone to depression because they deaden the receptors for the craved happy hormones.
Don’t feel happy, so take a substance that provides short-term relief but at the cost of being less able to feel happy naturally, so take more substance and on and on and on. Once started, it is really, really difficult to break the cycle and repair the receptors back to normal.
Prescription anti-depressant drugs can help a person break the cycle, but they can be abused and mismanaged too.
“Prescription anti-depressant drugs can help a person break the cycle, but they can be abused and mismanaged too.”
part of the illness is failure to recognize that when one is off their medicine, they are not responding normally. part of the risk is that people go off their medicine when they feel better and failure to maintain their ritual. i don’t know the answer to keeping people on their medication.
Rich wrote:
> I think people who are alcoholics (or addicts to other drugs)
> like being out of control. They are always wanting to go faster,
> get higher, etc. It may be because at an underlying level they
> are depressed, and they use the excitement of drunkenness or
> speed to medicate their depression.
I don’t think that there is any connection between risk taking and depression, but the rush of say hitting 50mph on a road bike or skis (snow or water) for is just as “addictive” as cocaine for many people.
> I feel fortunate that I don’t have that daredevil or alcoholic gene
> and I have never suffered from depression.
I recently watched the movie “McConkey” (a well done documentary about a guy from Squaw Valley that kept pushing the envelope until he died leaving a widow and young daughter behind) with a childhood friend.
After the movie we talked about things we can do to tray and reduce the chance that our kids will want to ski off cliffs or jump off buildings. My friend (who is Jewish) said he recently read a study that Jews are not only much less likely to be alcoholics but they are also much less likely to engage in risky behavior like BASE jumping or paragliding.
> While it is probably not a perfect correlation, I suspect way more of these
> born-daredevils grow up to have drug and alcohol problems than children
> with ordinary (but not extraordinary) fears.
I would not call myself a “born-daredevil” but over the years I’ve been involved with racing BMX bikes, Road bikes, Mountain bikes as well as motorcycles, cars and trucks (off road). In every group of ski, bike, motorcycle or automotive racers there is always some “hard partying dudes” (alcohol and/or drugs) but in the almost 40 years I’ve been hanging out with guys who like to race and “push the envelope” I would say that they drink and use drugs FAR less than average.
My friend (who is Jewish) said he recently read a study that Jews are not only much less likely to be alcoholics but they are also much less likely to engage in risky behavior like BASE jumping or paragliding.
Ashkenazis, like me, do have very low rates of alcoholism. However, I have heard my tribe has somewhat higher rates of addiction to other drugs. I suspect it is genetics.
In terms of other risky behaviors and MOTs, it may be influenced by cultural factors as well as genes or education levels, etc. I also think that, generally speaking, people with less money are far more willing to take chances with personal safety than people who think of themselves as “having a lot more to live for.” If that is generally true, then it would follow that Jews are more cautious.
” . . . people with less money are far more willing to take chances with personal safety than people who think of themselves as “having a lot more to live for.” If that is generally true, then it would follow that Jews are more cautious.”
Say WHAT?!?!?
Okay: “What.”
In case your question is serious–I tend to doubt it is because what I said was so obvious–you might be interested in a University of Minnesota study (done by psychologists for the business school) which showed that not only do poorer people have higher risk tolerance in all sorts of things, but the mere fact that someone grows up poor will, ceteris paribus, make him more risk tolerant the rest of his life.
http://psychcentral.com/news/2011/07/07/growing-up-poor-leads-to-greater-risk-taking/27526.html
My “say what” was how does that then follow that Jews are more cautious?
I assume you are pretending to not know the obvious. But for the sake of others who may have just fallen out of the sky, here are the relevant, generalized* facts which lead to the relevant, generalized assumption regarding Jews and taking certain types of risk, like say, paragliding:
“Relative to the total U.S. population, Jews are more highly educated, have more prestigious jobs and earn higher household incomes. … The distribution of household income among Jews, especially at the high end of the income scale, reflects their relatively high education levels and high status jobs.” Source: http://www.jewishfederations.org/local_includes/downloads/4606.pdf
*Note: This is a generalized statement about risk taking for the general population and obviously does not apply specifically to all individuals within that larger, generalized group.
RR, I was not pretending not to know the “obvious”. I’ve heard about “Jews” being this-and-that including “rich”; but really, is not ascribing a so-called “positive” trait to a demographic group just as racist as ascribing a so-called “negative” trait? It’s just two end of the same stick. Being that my mom came from a very poor Jewish neighborhood in greater Boston and from a family that had a failed business, I have never connected being Jewish with having money. The village in Fiddler on the Roof depicted Eastern European Jews as rather poor as well. Yes, I know a lot of lawyers and comedians in the LA area are Jewish and so obviously those particular Jews have money, but I always considered them the exception. Apparently you site studies that show on average Jews have more money. That sure wasn’t “obvious” to me and I doubt it’s as “obvious” to others. I’m glad you said it was generalized, but really, what good are generalizations? When they are applied to individuals, so-called “positive” or “negative” trait-assumptions ascribed to groups can be harmful. What if someone thought I “controlled the banks” because I was Jewish? They might in a crazier times round me up by association and send me off to be killed (I assure you I know no bankers). This is why “positive” traits, when generalized, can be harmful. Really, RR, that leap from ”people with less money” to “far more willing to take chances” then comparing to people who have “a lot more to live for” to “it would follow that Jews are more cautious” is one of the most hysterical leaps in illogic I have ever seen proposed.
Alan, you are making a mountain out of a few mites of dust … for no reason. I’m not going to bother debating you.
I went to several self help groups at a JCC years ago.
One of the heavy-set leaders said: “Gentiles drink… Jews? … we eat!”
It was quite funny.
The People of the Books?
Robin Williams was an avid and very strong cyclist. He and George Bush rode together. Bush was also a recovering addict. Who knows, maybe they met in rehab. They were both pretty obsessive.
I heard him once say in a radio interview (on NPR, probably Fresh Air) that he was “a self-diagnosed manic depressive.”
This afternoon Fresh Air replayed Teri Gross’s 2006 interview with Robin Williams. She brought up the topic of manic-depression and asked whether he had that affliction. He flat out said no. She asked if he had depression. He denied that, too. I am now thinking it’s possible he never said what I remember him saying. I am not sure. It could have been on a later interview, after he had relapsed on drugs and alcohol. Either way, it’s obvious today, sadly, he did suffer from depression, his 2006 denials notwithstanding. And his performance style was certainly manic, though that does not mean he had manic depression disorder.
Suicide rates for adults aged 45 to 64 rose 40% from 1999 through 2011,according to the most recent data from the Centers for Disease Control and Prevention. The suicide rate for these middle- to late-middle-aged adults is higher than any other age group, including youth and the elderly, according to an analysis by the American Foundation for Suicide Prevention.
Researchers say baby boomers face challenges that are unique to their generation. High rates of suicide in adolescence for boomers, those born between 1946 and 1964, could be carrying over to middle age, said Julie Phillips, an associate professor of sociology at Rutgers University who has published research on the subject. Economic pressures since the financial crisis, deteriorating health conditions and the increased use and abuse of prescription drugs are other possible factors, Ms. Phillips said.
Other factors also have increased social isolation for boomers: “They haven’t shown an increase in religiosity as they age as have prior cohorts, and boomers are more likely to be single—divorced or never married—and without children than prior cohorts,” she said.
Dr. Arbore said the financial downturn looms large in the rise in suicides, especially in situations where older workers have been laid off and didn’t have the skills to find a new job.
So in terms of causation.
1. The free loving, drug-taking 1960s.
2. Boomer narcissism following the Dr. Spock “no spanking” awakening for how to raise children.
3. The advance of liberal secularism and lack of religiosity.
4. Democrat’s failure to return the economy to jobfullness while they instead pursued their dreams of moving one step closer to government run healthcare.
The rise in suicide rates among the “Boomer” cohort is well documented. But one should be cautious about attributing “cause” to the factors you name. For one, the rise in rates is not uniform, and as usual the devil is in the details. The article by Phillips and colleagues (Understanding Recent Changes in Suicide Rates Among the Middle-aged: Period or Cohort Effects?) points out that those with college degrees and who were married had significantly lowered rates of suicide. Most at risk were those with only a high school education.
My understanding of the trends in suicide rates after the economic turndown suggest that it cuts across all demographic groups, with as usual, rates higher for those in lower socioeconomic brackets.
The famous sociological theorist Emile Durkheim believed that suicide was due to changes in cultural climate and reflected collective tensions in a society. Certainly these could be reflected in the sorts of things that Frankly mentions, but given the complexity of suicide, these are much too simplistic to be useful for suicide prevention.
Suicide cuts across all diagnostic categories – spiking for the mood disorders – and just because someone suffers from a mental disorder does not mean they will commit suicide. In fact the correlation between suicidal ideation and eventual suicide is quite weak. But having a mental disorder (and a history of suicide attempts) are the two largest risk factors for suicide.
I think the notion that we should be angry at the person who dies by suicide is a failure to recognize the suffering of the person. Certainly we can be angry because they left us and left their loved ones, but I think a more empathic and helpful response would be to put one’s own anger aside and try to understand what the person was going through and learn how to prevent more suicides. As the American Association for Suicidology said in the wake of Williams’ death – he was one of 108 people who died by suicide yesterday.
Finally, Frankly pooh-pooh’s the notion of means restriction as a way to reduce suicide. Means restriction is a valid component of most successful suicide prevention programs. The VA spends a fair amount of resources on this as does one of the most successful suicide prevention programs in the country – the US Air Force prevention program. Means restriction has lots of forms, not just issues around firearms. Bridge barriers (Washington, DC, Santa Barbara County, and Toronto), changes in the dosages and messages on acetominophen packages (England), and others. Regarding firearms (and I don’t want to get into an argument about this – Rich stated the data perfectly), there is strong evidence that in some societies, suicide rates can be reduced by reducing the number of firearms available. Check out the data on Australia.
Suicide is a public health problem. it is sad that the suicide death of a beloved performer should once again bring it to our attention. Yolo County is lucky to have a wonderful suicide prevention in Yolo Suicide Prevention and Crisis Services. They deserve the support of everybody in Davis and beyond.
Frankly
1. The free loving, drug-taking 1960s.
2. Boomer narcissism following the Dr. Spock “no spanking” awakening for how to raise children.
3. The advance of liberal secularism and lack of religiosity.
4. Democrat’s failure to return the economy to jobfullness while they instead pursued their dreams of moving one step closer to government run healthcare.”
Frankly, I have to wonder if you are not a part of the baby boom generation.
1. Not everyone from that generation took part in “free loving and drug taking”. I lived in SF in 68-70 and while the colorful hippies got a lot of press there were many times more people who were too straight to be hippies and too hip to be straight and many many times more ordinary people living their lives.
The “sixties” you refer to really began in 1966, peaked in ’67 with the Summer of Love and was in decline by ’69. The hippie era influenced mainstream culture for a decade but only lasted about 5-6 years.
Other influential counter culture groups from the “sixties” are skinheads, punks, greasers, frat boys and rednecks. IMHO they have survived and flourished and ply a greater active role in our current culture than “free loving and drug taking”.
The civil rights movement and the environmental movement began in the sixties and they remain cornerstones in “liberal” beliefs but being born in that time frame didn’t make everyone all the same. There are one hell of a lot of born again, Reaganomics obsessed, right wing nuts my age.
2. Dr. Spock. Please read the book. I did. He told me to put my daughter to bed and let her cry herself to sleep. He said children need to learn to comfort themselves and it created anxiety if the parent was anxious and would let them fall asleep alone. He didn’t suggest rocking her to sleep or a taking her to bed with us. Most of his advise was just practical science based explanations. He dispelled the popular belief of the era that it was unhealthy for children to be outside in the evenings because there were of “vapors” that make them sick. He was NOT opposed to discipline– that is a fallacy. He didn’t think shaming or hitting was an effective way to discipline. That is extremely mainstream these days but it was liberal then. I don’t think you can find a doctor or child raising expert today who will tell you to smack you child. He talked about making kids wash their own clothes on summer vacations because it was meant to be a vacation for the mothers too. That’s how he was raised. Please don’t just repeat truisms when you haven’t at least done some research. Dr. Spock was a kind, gentle, practical doctor who treated many children before he wrote his book on child rearing. The book was non-controversial until he opposed the viet nam war, then the book was blamed for young people objecting to the war. Those are facts check them out.
3. The United States is the most religious country in the world. People think we are kinda nuts about it.
From a 2012 Gallup poll:
The United States remains a largely Christian nation; more than nine in 10 Americans who have a religious identity are affiliated with a Christian religion. There has been little change in this portrait of religious identity in the U.S. from last year.
And from http://religions.pewforum.org/reports, we learn only 1.6% are atheist and 2.4% agnostic.
Like the other major groups, people who are unaffiliated with any particular religion (16.1%) also exhibit remarkable internal diversity. Although one-quarter of this group consists of those who describe themselves as either atheist or agnostic (1.6% and 2.4% of the adult population overall, respectively), the majority of the unaffiliated population (12.1% of the adult population overall) is made up of people who simply describe their religion as “nothing in particular.” This group, in turn, is fairly evenly divided between the “secular unaffiliated,” that is, those who say that religion is not important in their lives (6.3% of the adult population), and the “religious unaffiliated,” that is, those who say that religion is either somewhat important or very important in their lives (5.8% of the overall adult population).
Religion is alive and well in America and it’s well on its way to ending the separation of church and state as protected by our constitution.
4. Well, that’s your opinion.
Davis Burns wroteL
> The “sixties” you refer to really began in 1966, peaked in ’67 with the
> Summer of Love and was in decline by ’69. The hippie era influenced
> mainstream culture for a decade but only lasted about 5-6 years.
The “hippie sixties” most people talk about began around ’66 and peaked in the mid 70’s (with drug use peaking a little later according to the link below).
I was at a Cal graduation in 1969 as a kid (with short hair, a conservative suit and a tie) and about 90% of the men and boys I saw also had short hair and a tie. I was also at a Cal graduation in 1976 (with longer hair, a “leisure suit” and no tie and about 90% of the men and boys I saw under 40 also had long/longer hair and no tie…
http://www.deamuseum.org/museum_idarc2.html
I don’t disagree entirely. I was talking about the sixties but yes, in many ways what we think of as the sixties happened in the seventies more than the sixties–if that makes sense. There was so much news coverage in the early years and the coverage made the hippie movement mainstream. And that’s what I think we saw in the seventies– the incorporation and the moderation of the ideas espoused by those free thinkers. But there were other dynamic groups changing the way we thought as well–the anti war movement and the environmental movements.
Good post.
But “means restriction” as you call it is a bad idea in my opinion. We would be better off spending our efforts creating an army of “friends” and education for existing family and friends to recognize signs and to know the best way to reach out.
Means restriction is just an impersonal institutional psuedo solution that people tend to support becausre it makes them feel like they are helping but without having to invest any personal time or effort… but then you still have this depressed sucidal person. And based on how Robin Williams killed himself, you need to outlaw ropes and belts. How realistic is that?
Frankly
What I think that you are overlooking is the concept of harm reduction. The fact that an individual is successful in committing suicide of course does not mean that all means of suicide should be outlawed any more than a fatal accident means that all cars should be banned. However, this does not mean that cars cannot be made safer.
What we have with suicide is a multifactorial situation. It is not simply a lack of social connection. If that were true then a man like Robin Williams with a wife, children, and many, many friends and admirers would not be at risk for suicide. Suicide is much, much more complicated than that. In an NPR interview with Dick Cavett made a critical point. When asked how anyone could “do this” to their wife and children, his answer was simple and very telling.
Paraphrased what he said was “It’s easy. At that point they don’t matter because you can’t feel anything.
Depression is very complex. We tend to think of it as always being “in pain” so we should just toughen up and not be a coward. This is erroneous thinking. We are in the infancy of our medical understanding of depression.
However it is widely accepted that this is a biochemical disorder of the brain involving multiple neurotransmitters.
The person who is afflicted may be no more able to control the urge to die than a diabetic is to control his blood sugar without insulin.
For some individuals this urge may be transient. The point of intervention as you stated with friendship or temporary means restriction may get the person past that critical moment This is not an either or, but an and.
Until we have a fuller understanding of the biochemical basis of depression and suicide, we should be using all of the means available to us to prevent those suicides that we can for at risk, potentially treatable individuals.
Tia wrote:
> The fact that an individual is successful in committing suicide of course
> does not mean that all means of suicide should be outlawed any more
> than a fatal accident means that all cars should be banned.
Over the years it seems like most on the left just want to “save people” by banning the stuff they don’t like (kind of like people on the right want to “save people” by making them do stuff they like..pray before football games and/or go to church).
Most on the left (except in Ferguson) like cops to have guns so they don’t want to get rid of those, but they don’t like Republicans to have guns so they want to ban those “in the name of suicide prevention”. Dry cleaner plastic bags are OK, but banning plastic shopping bags is just one more way to save people (along with the fish and the environment) since if you can’t find a plastic shopping bag to hold over your head to suffocate yourself you might end up calling the suicide hotline (or come to your senses driving to a less “progressive” county that still allows stores to give out the evil fish killing bags…
Frankly, means restriction is far from “an impersonal institutional pseudo solution” etc. It has a variety of empirical evidence to back it up. Go to Google Scholar and type in “means restriction” and “suicide.” Take a look at the articles – the one by Daigle, or the one by Yip, Caine and colleagues. Or, dare I suggest, go to the “Means Matter” website and get past the firearm restriction pages to look at effective means control efforts that have saved lives – changes in pesticide packaging and composition in India and China; the change of coal gas to natural gas in England, and on and on. Just ask the Israeli Defense Forces about restricting weekend gun passes with their soldiers. Ask them about how many lives it has saved.
These are proven population-based methods that save lives. And they are one part of comprehensive suicide prevention programs. So these “pseudo” solutions are not so pseudo after all. And the large impersonal institutions (and the people in them) have made a real difference in people’s lives.
You will find me consistent in my rejection of central control over personal education, empowerment and responsibility. First, I think people that are compelled to put themselves in leadership positions over problems they are motivated to try and solve, tend to be the type of people that are either wired for, or because they invest so much of their efforts and become defined by them, gravitate toward and end justifies the means perspective.
I am fine with changes to infrastructure and building design, tweaks packaging, and safer product alternatives if it helps keep someone safe. But I am absolutely not in support of taking away reasonable, enjoyed, useful and necessary freedoms away from the population just because a very small minority might use the things as a means to commit suicide.
Making fast food and junk food illegal would probably solve the slower suicide of obesity. And I know there are extremists invested in that cause that think we should make all fast food, processed food and junk food illegal. That is an approach I will fight tooth and nail.
What we need is to teach coping skills. My great, great grandmother lost two husbands and six of her seven children before she passed away at 90. She coped.
Here is the message that needs to be repeated and repeated and repeated…
DR. KEITH ABLOW, MD, FORENSIC PSYCHIATRIST: Here’s the truth. Every life story, what happened to Robin Williams he came to believe, that this grand imposture depression robbed him of the belief that he had pages left of his life story that would be great.
Everyone does have that. It’s the absolute truth. I promise you. And if people will take little bit of a horizon and say look maybe tomorrow I still feel terrible but I bet that next season I will be restored if I deploy all the resources at my disposal. I promise 100 percent that can happen.
Robert wrote:
> These are proven population-based methods that save lives.
I can’t find a link but back when there was a debate on spending millions for the Golden Gate Bridge suicide net (that people can still jump out of if they really want to end it all) someone pointed out that when we fish a body out of the SF bay under the bridge or the cops respond to a gunshot in an urban area it almost always goes on the books as a suicide. It is really hard on a family when the death of a loved one is publically reported as a suicide so many other types of death are not “reported” as a suicide. I know this for a fact since a cousin drove his car off a cliff (after leaving a suicide note) and other than about 14 family members everyone (including the people that keep track of suicides for researchers) thinks it was a tragic “accident”…
Sometimes people’s broken lives spill over lines and boundaries they never imagined they would cross, as they suffer from a myriad of mental disorders and symptoms. Robin Williams serves as an unfortunate reminder and tragic example of such realities.
Those who suffer such mental breakdowns cross over demarcations of acceptable social decorum and expectations without even knowing they have done so. They often self-medicate with drink, or drugs, and/or a combination of both.
The cycle for those stricken with depression can be vicious and prolonged in that often they drink and drug to deal with the depression, and then resolutely swear off drink and drugs, only to find themselves trapped and alone with the same elixirs that sparked and maintained their demons.
In many cases though drink and drugs are either only secondary, or not even a part of the equation.
Depression and other mental disorders really know no boundaries; they often invite spurious evaluations and reactions. To view the aftermath of a mental breakdown with an array of psychiatric tropes and solutions might arrest initial misgivings and discomforts for those afflicted and for those who care for the afflicted.
However, I hardly believe that the fog of psychiatry with its reliance upon finding the right cocktail of meds and motivational programs often anchored in banal truisms, ever reaches the vast majority of its patients.
At certain points along one’s struggle with depression money issues might not only get in the way of recovery, but actually be at the root of the depression. For either too much money or not enough of it often seems to find an unhappy osmosis in those stuck in the throws of depression.
After all the therapy sessions, medical stays, and brace of curative cocktails, patients will inevitably try to stabilize themselves once again in routine–until the next breakdown, possibly. Meanwhile, so-called friends will drift away to other Gatsby-like parties and and other distant, mesmerizing green lights, as family members find themselves at odds with the responsibilities and strains of never-ending care and worry, and outsiders simply look in with an uncomfortable assuredness and familiarity that often amounts to nothing more than morbid curiosity and self-righteous indignation.
Those who suffer such broken lives never set out to find themselves on such borders, caught in the crosshairs of public attention peppered with assured moral rectitude. And they never dream of dragging themselves or their family through such a quagmire. But shit happens.
If you have been down this road, you know it’s a long journey to wellness. If you are lost somewhere along the jagged ascents and descents of a path marked with mental depression/disorders, then find the core of your being in those who care and will never give up on your ability to chart a better and healthier path.
We all need help. We all suffer. And most importantly, we all can help each other not only make it to the next morning, but make that next morning and day an amazing one.
Those who have succumbed to their demons are not weak, they are not cursed, and they are not damned. They are just unfortunate and deeply missed by those who love them.
Nice post.
Those who have succumbed to their demons are not weak, they are not cursed, and they are not damned. They are just unfortunate and deeply missed by those who love them.
I disagree though that people that commit suicide are not weak. They were certainly weak at the moment they make that fateful mistake. Strength of coping with difficulty is the main remedy.
Thinking about this from a very pragmatic and objective perspective, we are simply talking about emotional stress. And going further, it is really only brain chemistry cause and effect, or dysfunction, that is the root of problem of suicide.
My father had a very difficult childhood. I remember not long ago having a conversation with him about his childhood. I commented that he remembered much more about his childhood than I did, and it seems to have a constant affect in his behavior and interaction in his present life. He said that I hit on the key of what he struggled with all his life. He could not even cope with his history.
Shit happens and then we are supposed to grow and get stronger. What does not kill us makes us stronger, right?
I see most of this as a struggle for perspectives. So many people as so lousy at perspective. They wallow in their grief and pain and cannot envision worse circumstances. If they could only open up their mind and really understand just how bad it could be living someone else’s life having real and profound difficulty, I think the gift of perspective could save them.
The lessons of the pain and suffering that Jesus endured at age 36 is supposed to help Christians to gain perspective. How bad are our problems really in comparison to that?
Frankly wrote:
> I see most of this as a struggle for perspectives. So many people as so lousy at perspective.
Ii is not that “people as so lousy at perspective” it is that people’s “perspective” is based on their own life.
If you grew up during the depression and lived in a 800sf 2br 1ba home with 5 kids in one bedroom you will probably feel happy living in a modest 1,500sf Davis Home.
If you grew up watching Lifestyles of the Rich and Famous, MTV Cribs and Keeping up with the Kardasians and in a 6,000sf 5br 6ba home you will probably be depressed living in a modest 1,500sf Davis home.
Overall I find that most women who are doing better than their Mom’s were at the same age to be happy and guys that are doing better than their brothers and brothers in law to be happy…
Isn’t it a shame that our happiness is defined by what others have or don’t have?
During the time of Jesus, the Romans taxed the Jews so much that it would cause otherwise self-sufficient families to end up in poverty begging for food. Their main beef with the Romans and their individual and collective dreams for happiness were largely to see their tax rates decrease to the point that they could just survive and not go hungry.
But eventually the Roman empire went away and the taxman was lynched.
And happiness over the loss of taxation was short-lived only to be replaced with something else perceived to be unfair or inequitable.
If perspective is based on own life, then just expand the reference to history and global instead of sibling and neighbor.
Frankly, using Jewish history as a template is problematic. For many centuries during the blossoming and spread of Christianity it was very easy for a Christian to point at a Jew and say “You (your people) killed the Son of God” and use that as a pretext to “punish” by taking away some or all of the worldly goods of the person(s) being pointed at. That was human nature exercising the most direct way to acquire wealth. Might makes right.
Choosing lessons from history where the participants were on a more equal plane is indeed a good point of reference, but one always has to be sure that the history one is referencing isn’t heavily colored by bias.
History is always colored with bias. The victors write the history. If the native Americans wrote our history and it was taught, distilled, in our schools we would recite the first thanksgiving as a lesson in the unintended consequences of helping strangers survive.
Agreed. That is the point I was trying to make to Frankly. Be careful not to choose history that is rife with built-in biases. My belief is that the one he chose fails the “too much bias” test.
During the Middle Ages the landed gentry institutionalized the process of extracting wealth from others. The eldest son inherited the family lands. The second son went into the church where extracting 10% of each person’s income in the form of tithing guaranteed the second son both income and wealth. The third son went into the military as an officer and took wealth from others to establish his own personal fortune without jeopardizing the wealth of either of his two older brothers.
The Roman Empire had shown its gentry just how effective the military operating on the outer edges of the empire could be in adding plunder to the wealth of Rome. Middle Ages third sons simply repeated that well established pattern.
Frankly
“If perspective is based on own life, then just expand the reference to history and global instead of sibling and neighbor.”
I agree with this point completely. And I would expand upon it. I would include treating ( and taking care of) other humans just as we would our family members and neighbors. Why should we limit either our perspective or our good will or our willingness to help others in need ?
Frankly
“They were certainly weak at the moment they make that fateful mistake.”
I do not believe that this is a universal statement that can be made about suicide. This is taking a very complex issue and viewing it from a very simplistic point of view. So for the moment let’s leave the specific case of Robin Williams and consider some other scenarios.
1) The individual who has an incurable and excruciating illness. Are they weak if they want to decide the timing and manner of their own death ? I would say not. For me, it would be the family members who were being “selfish” if they were to insist upon keeping such an individual alive in order to believe that they had “done everything”. I have seen this on a number of occasions.
2) The individual who has no close friends and relations considers themselves to be alone in the world. Is it not their choice whether they want to reach out and reconnect or whether to move on to their perception of the next stage of their being.
3) What about the individual who is truly entrapped in an unendurable situation. Let say physically trapped either by people whose intent is to torture them or by a physical circumstance which they cannot escape such as a lone pinned hiker with the knowledge that their are predators near by. Do they really have to wait to be tortured or eaten alive, or do they not have the right to chose death by their own hands.
4) What about the individual who genuinely believes that there is a greater good to be gained through their death.
You are making the assumption that all suicides are done under the circumstance of depression. But there are many different individual scenarios and many different philosophies of what life and death actually mean. It is surprising to me that you especially, who believe so firmly in individual responsibility and right to control our own destinies leave this philosophy behind when it comes to the ultimate decision, whether or not to continue in this phase of our existence.
Tia – Your #1 and your #4 might be examples where individual weakness is not valid. It would depend. But there is tremendous moral hazard in entertaining this notion that suicide is justified in any way shape or form for the majority of cases.
Let’s try this moral equivalence. Say someone emotionally and psychologically troubled and depressed takes a gun and shoots and kills several people. Do you not consider that person weak? Do you have great empathy for them, or do you support others being angry at that person for what she/he has done.
Think about. The dead feel no pain. The pain is what their loved ones feel.
So someone committing suicide does the same as someone killing someone else. They both create pain for the living.
And both are deserving of the label of weakness at that moment they made the decision, and our anger at them is justified even as we might have great empathy for their own pain.
My observations regarding psychiatric care in no way offer a nuanced evaluation of the struggles and realities associated with the malady of mental disorders and demands that are thrust upon facilities operating under the constraints of laws and budget wows in this community and elsewhere. That type of research would require an assignment and investigation that could be both very demanding and difficult. My thoughts are purely commentary, meant to provoke a further discussion, one that isn’t cluttered with technical verbiage and reliance on loose-fitting labels like bipolar and schizophrenic and manic depressive. Diagnostic labels often result in meds that provide an initial stabilization for patients and then a growing dependency as they try find their way back to “normal”. I don’t think that I really addressed that reality very effectively in my post.
My hope is that someone else will pick up those scattered pieces and offer further observations to a very important topic. And already there have been two thoughtful responses.
Furthermore, I painfully understand the struggle to see a person who commits suicide as weak or selfish ; have also compared their delusional struggles and desperate acts to other types of deprivation and suffering. And how can one equate the struggle of child in the throws off cancer, for example, with the irrational and terrible decision one makes when taking their own life. You can’t.
The act of suicide is a crossing over that leaves deep rifts and unanswered questions for those still standing on the other side of the chasm that they leap into.
Elder Olson penned this introductory verse to his book on Dylan Thomas. My father use to read it aloud to me when trying to quiet our anger and grief over our a family loss many years ago. I still read it now and then and struggle with its message:
Farewell, who would not for a farewell;
Sail the ship that each man must sail alone;
Though no man knows if such strange sea-farers
Fare ill or well,
Fare well:
Learn, if you must, what they must learn who sail
The craft that must sink; sail, till the tall cloud
Is closer to the keel than that far floor,
And to those deepest deeps descend, go down;
Though you fare ill, you yet fare well, to be
King of an empty empire’s kingdom come,
Amid the ruins and treasures of that sea;
Learn, if you fare well,
There in the apocalypse of the waves
What twilights deepen on the drowned man drifting
Atlantiswards, what hues light herons’ wings
Aloft in sunset skies when earth is dark,
What unheard chords complete all music’s close,
When, fierce as rubies in the vein-dark mine,
The lit blood blazes as the brain goes black;
Last jewel of all the world of light until
The kingdom come of greater light, and death of night, and
death
Of Death, that shall also die,
When all fare well.
I see past the weakness in such untimely and horrific deaths; I see ragging fear and horror that drives one to such acts; I see someone adrift in a descent that holes one up in a darkness devoid of assurances and reasoned voices; I ache that I couldn’t stop it from happening.
There is a weakness of mind and a confusion that drives one to such acts. I don’t know about the rest. I only know that reasoned and positive voices can provide sure steps on safer grounds for those who might be hurting and falling away friends and family who care for their well being. Fare the wells always works better than farewells.
For those of you that can access WSJ articles.
I did not know. Very cool.
Did he every visit the local museum?
http://online.wsj.com/articles/robin-williams-and-dario-pegoretti-the-comedian-and-the-bike-builder-1407970079?mod=trending_now_2
Also just read that his ex-wife claimed he had just been diagnose with early Parkinsons. Don’t know if this is factual, but reality would be just a little bit easier to take if so.
I leaned something about Robin Williams that kinda’ rocked my family’s world.
Apparently there is a connection with Parkinson’s and depression. Someone diagnosed with Parkinson or pre-Parkinson is 3 times as likely to also be diagnosed as having manic depression or bipolar, etc.
My Davis cop brother inlaw took his own life six years ago. He had developed shakes and was diagnosed with pre-Parkinson. He did not tell anyone because he was worried about it effecting his livehood. We only learned this after his death. He was trying to get on disability because the shakes and cognitive problems caused by the disease combined with the stress of the job being a detective were becoming intolerable for him. He was also drinking a lot. He got declined a few days before his suicide. Apparently stress amplifies the symptoms of depression, so his job and the circumstances he was put in by his boss, contributed to his declining condition.
So, if you know anyone diagnosed with Parkinsons Disease or pre-Parkinsons, pay closer attention to them… especially if they have a stressful job.
I watched a few interviews and I saw a hand tremor. Had a friend with Parkinson’s so I recognized it. But don’t jump to conclusions when you see a tremor. My husband has a tremor and doesn’t have Parkinson’s. One does not equal the other.
Re: lowers income= more risk taking. One of my daughters lives far below the poverty level. She is the most cautious person I know. She does all she can to avoid risks of all kinds to an extreme. Actually all three kids are risk adverse. My families of origin are very poor and some remain poor and my experience is surviving poverty requires great caution. So much for generalizations.