Some Practical Thoughts on Suicide
fourhourworkweek.com
fourhourworkweek.com
Motto had a patient who committed suicide from the Golden Gate in 1963, but the jump that affected him most occurred in the seventies. “I went to this guy’s apartment afterward with the assistant medical examiner,” he told me. “The guy was in his thirties, lived alone, pretty bare apartment. He’d written a note and left it on his bureau. It said, ‘I’m going to walk to the bridge. If one person smiles at me on the way, I will not jump.’”
He jumped. And ever since I read that, I've made it a personal mission to smile at everyone I pass on the sidewalk every day. Not only does suicide have unknowable impacts on all of the people around you, but even your most insignificant actions could have an enormous impact on the people around you. Be good to others -- you never know how much it might mean to them.
How we act matters.
It should help to know that reaching the state of being one smile away from suicide implies a profoundly severe illness; the problem wasn't smiles, it was the way we route the ill to the mental health resources they need.
One needs to consider that suicide is not just an affliction of the mind, it's also a product of the circumstances a normal person finds him or herself in. It's not just the thoughts that need fixing, it's the circumstances too. Usually this is a chicken and egg problem: the thoughts prevent the person from fixing the circumstances himself, and the circumstances reinforce negative thoughts. This way somebody can get sucked deeper and deeper into a black hole of increasingly irrational negative thoughts. Even if the thoughts are clearly irrational to an outsider, they are not to the person themselves. Therefore suggesting that they simply fix their mind does not help. In their view their mind is not just what needs to be fixed, it's also the circumstances. We all should do our best to not create such circumstances and to fix them when they exist. In the story of the OP for example, it's fair to say that the behaviour of the professor played a big role in almost causing his suicide. If suicide is caused by circumstances a normal person finds him or herself in, do we not bear a collective responsibility to prevent it, even if it's just a smile?
On the other hand, we need to be diligent to avoid assuming responsibility for the actions of others. If we look at suicide prevention as an assumed responsibility, it can be hard to avoid feeling guilt when someone close to us takes their own life.
We should always be good to each other, and we should reach out to others in kindness, whether they appear to be in need or not. But, we should be careful with how we relate to the actions of others, lest we fall into a trap that we cannot get out of.
If you or someone you know is experiencing suicidal impulses, you are experiencing a medical emergency. Please get professional help as soon as possible.
There are a variety of conditions that can make a person suicidal. Depression isn't the only one.
In some of these cases, the resolution of the problem may involve changes to environment or circumstances. In others, the resolution might be chemical. In still others, prolonged inpatient treatment may be required in order to ensure safety.
What's true in all cases is that the decisions about how to proceed in resolving the emergency should be made by people trained to do it. As you can see from many other comments n the thread, our intuition on how best to help suicidal friends and acquaintances are, at best, unreliable.
And, the attitude of simplifying all of this to "get professional help asap" is not very productive. For one, not everyone can afford or access that kind of help. Two, pronto professional help can sometimes yield to bad choices very quickly. Blowing it up risks violating a depressed individual's privacy, they might see that as an action of offense. When a friend of mine was suicidal some odd years ago, I didn't just dial the phone for some professionals to get him, I tried to make it clear to him how much I valued his friendship and what it would do to me if he were to go away -- the guy is rocking life these days. Of course that's definitely not to say don't call for help, rather that this sort of thing demands a more considered response.
The national suicide hotline in the US is:
1 (800) 273-8255
Given no other modes of helping someone that will result in them obtaining medical help, and assuming that suicidal thoughts have reached a point where they are intrusive and there is evidence of planning or intent, a 911 call is not unreasonable (you can also drive someone to the hospital).
I have been in a position where I called a friend because I was frighteningly close to actually doing it. This is after many years of very aggressively pursuing professional mental help in therapy / outpatient settings (which all my close friends are aware of).
If my friend had called 911 after I asked them not to, I would have considered it a betrayal. It would have set in motion a set of events that would cause extreme distress for me, and (I am fairly certain) not provided any greater relief than the years of medications and talk therapy I was already pursuing.
And it would have breached the trust I feel in one of my closest friends in a way that I'm not sure could have been recovered. I believe this would have put me on a path towards having distance from my friends, and being more imperiled overall.
If I couldn't trust my friend not to call 911, I never would have called them. Unless that national suicide hotline above promises absolute confidentiality and not involving authorities, I guarantee I will never call it.
Everyone is different and I'm not giving any advice here. I'm just glad my friend didn't take the hard-line stance on this that you do.
It is incredibly important to understand that many inpatient facilities are profoundly hostile environments for some patients, despite claims of a "therapeutic milieu" (which is somehow exactly the same for both depressive and manic disorders; sure, of course that's credible /s). Based on my experiences at the only two such facilities in my metro area, I would be very, very, very hesitant to ever admit to suicidal ideation in the future. The idea of going back to such a place is enough to make me consider the risk of "going it alone", even knowing that doing so could be a fatal mistake. Comparisons to imprisonment are not exaggerations: it absolutely did feel like punishment, like I had no rights, like the staff merely treated me as a "problem" rather than as a patient or client. Some of the "professionals" were not worthy of the term, particularly the "clinical social worker" types (some of whom expressed, with complete confidence, deeply weird and absolutist "theories" of mental illness that correspond to no credible theory that I've read about in reputable literature).
(punchline: my depression was almost certainly caused by a chronic physiological disorder, one which neither facility screened for; most of the "treatment" I received was probably exacerbating my condition instead of improving it)
I guess if I had to make this venting "practical" I would say this: if you ever have a close friend or family member in an inpatient facility, and they tell you that they really, really need to leave because it's a bad place, believe them. No one else will.
There are a variety of things you can do before calling 911; "call an ambulance NOW" is not the message I am trying to send.
If you're someone I know well enough to judge the credibility of a plan to kill yourself (which could mean "complete stranger" is the plan is particularly credible), and I become aware of such a plan, I would feel obligated to ensure you saw a doctor, with the word "ensure" chosen carefully.
At this point I feel like I'm replying to comments on these threads more out of habit and standard message board compulsions than anything else, and, given that the topic we're discussing is sensitive, I'm going to force myself out of the thread now.
The scenario I am describing to you is one in which I was seeing a doctor, regularly (once a week). I was already getting help. The only assistance I was not getting was inpatient, take-your-rights-away-for-a-while forceable assistance.
The guy above is right.
That's a pretty harsh and unrealistic generalization. Not everyone who commits or wants to commit suicide is "profoundly mentally ill". If you woke up tomorrow and your bank account were empty and your family were gone, would you consider suicide? Alot of people would, and it's not because they formed a mental defect overnight. Terrible things happen every day that can make otherwise rational people believe suicide is their most viable option.
Not overnight, but this event might trigger clinical depression which is a mental illness in which suicide might appear as a "viable" (sic!) option.
Suicide is simply not the response of a healthy individual in the scenario you described. One would either fight, flight or freeze without willingly harm oneself.
That's what makes it so dangerous. Because in reality it IS self harm, it's just that suicidal people can't truly understand that. And it's also true that it's an escape, and the pain stops when you're dead. The value system is distorted such that the loss of all positive feelings isn't weighed properly. Especially since depressed people tend to have far fewer positive feelings, and have a confirmation bias to be unable to remember those feelings existing.
That is the power of having a seriously screwed up brain. My symptoms improved not with antidepressants or psychotherapy or self-help, but with treatment for a previously undiagnosed chronic physiological condition. Despite having a "real illness", I've found validation for most of my experiences in first-hand accounts of people with "mental illness" (which is defined in such a way that the practical definition is "any psychological symptoms not explained by a lab test known to your GP"). Allie Brosh was mentioned by another commenter, and I definitely had a "holy crap, someone else gets it" moment when reading her "Adventures in Depression" comics.
After ~20 years of on-and-off psychiatric treatment (some fairly intensive, some not, none especially effective), I found a psychiatrist with enough sense to strongly recommend that I get the relevant lab test. He had to tell me to request it from my primary care doc, because according to the worldview of American health insurance a psychiatrist is not qualified to order said lab test. My primary care doc gave me a questionnaire. My score was just below the threshold where the lab test is considered warranted. He told me he'd figure out how to make it work. I guess he did, because I got the test, got it interpreted by ${DOMAIN_EXPERT}, and got a prescription for treatment that seems to be working pretty well (albeit not perfectly).
That said, I've never seen any harm in being generally nice and hospitable, and it can do more than a little good.
The so-called 'psychotically depressed' person who tries to kill herself doesn't do so out of quote 'hopelessness' or any abstract conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire's flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It's not desiring the fall; it's terror of the flames. And yet nobody down on the sidewalk, looking up and yelling 'Don't!' and 'Hang on!', can understand the jump. Not really. You'd have to have personally been trapped and felt flames to really understand a terror way beyond falling.
-David Foster Wallace, Infinite Jest
It was never the balance of fears.
It was pure exhaustion.
As time goes on, the doorways in your life seem to close and the only one left is marked "stop". Everything else is just ... ugh ... so tiring.
This feeling is an illusion. It's not real. But depression is a disease that attacks the mechanism that enables you to understand the world.
Exercise and sleep help.
*I have enough people who love me and depend on me that I know I'll never act on it, but it has become something I fantasize about probably a couple times a day, and many times more on bad days.
Also, it seems that "overwhelm" is what happens when we combine several bad things that don't have to be combined (various fears, various regrets, disappointments, etc.) into a single, nasty package viewed all at once. Finding a way to focus on them separately really reduces the magnitude of the overwhelm.
For most people depression is treatable and manageable. Make time to see a doctor. Simply not having to keep yourself afloat in tar is worth it.
Besides, Wallace wouldn't be the best advisor on the matter.
Not about justyfing their stupid reasons as legit.
Note (and everybody sidestepped it) that I specified that I'm not talking about the clinically depressed.
Yes.
>If so, can you identify any empirical evidence supporting that belief?
It's common knowledge to mankind for millenia that most suicides are connected to real-world stressful situations and that there exist people that attempted them that were not suicidal before (and neither after they were resolved).
If you want the scientific version of this, it's called "situational depression", is commonly (1 in 5 sufferers or so) connected with suicidal attempts or obsession, and is described thusly:
An adjustment disorder (AD) (sometimes called exogenous, reactive, or situational depression) occurs when an individual is unable to adjust to or cope with a particular stressor, like a major life event. (...) Unlike major depression the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. (...)
That said, unlike most people in here, I'm with the anti-psychiatry school of people like R.D. Laing etc, and blame even "major depression" to irrational and ineffective ways of living and external conditions. I believe that's responsible for far more cases that are casually nowadays ascribed to chemical inbalances and such (mixing correlation and causation). In the same manner, I find that most kids don't need ADD drugs but it's mostly a nice racket to prescribe them.
Note that this doesn't make me unsympathetic to major depression victims (that I believe are not chemically imbalanced). If anything it's the opposite: not only they suffer from sensitivity to external issues and living conditions that are concrete and extremely difficult to avoid (short of changing the whole of society or their whole surroundings and life path), but they're also drugged and numbed to make them blend in and accept them.
All that said, I'm a little confused by your invocation of "R.D. Laing etc". Usually, the name I see paired with R.D. Laing is Thomas Szasz, and I am far more receptive to the former than the latter. As far as I understand it, they had some pretty deep disagreements. Perhaps Foucault is closer to Laing than to Szasz, and you meant something closer to Foucault's formulation of mental illness, but I am less familiar with his ideas. I admit a certain reluctance to risk exposing myself to yet another flavor of pontification uninformed by experience (there are so many to choose from, and it seems that they uniformly exhaust my patience; I can only spare so much effort entertaining "learned" people who dismiss my lived experience as utter delusion).
As it happens, I was prescribed an ADHD drug by the same psychiatrist who ultimately urged me to pursue the physiological diagnosis whose treatment I actually found helpful. I found that the drug was only modestly helpful at best, and he was quite receptive to my assessment that I should discontinue it. I actually still have almost a month's supply in my cupboard, have felt no temptation to (ab)use it, and am not sure whether I should turn it in to the DEA (it being Schedule II, which is supposedly accounted with some precision) or quietly dispose of it in the bags of my paper shredder.
I don't see modern western medicine as a hard science like Math or Physics. It's the same "science" that touted lobotomy, electro-shock therapy (including for "gayness"), considered blacks inferior, overprescribed ADHD drugs, etc.
The problem with medicine, compared to physics, chemistry, etc, it's that its a huge business, the biggest on the planet so there's a huge monetary motivation for selling snake oil, and its procedures and practice were never formalized in a definite way nor are it's results as definite and verifiable as in physics, EE, etc, so it's also prone to fashion and fads.
Peer review by itself doesn't mean much if anything. Liberal arts journals (the kind Sokal published in) are also peer reviewed.
But statements like this are one of the reasons people are reluctant to get help. My problem is bullshit. I'm weak. What will people think?
Regardless of whether the "reasons" or problems are real (to you) or imagined bullshit, people do kill themselves over it.
Don't perpetuate an environment that discourages people from getting help. They're already not thinking rationally.
Which do you think will produce more survivors and thrivers:
"You're problems are probably bullshit."
"You should talk to a professional."
Let the professional decide if it's bullshit or not, and lead the person to the right treatment.
EDIT: removed swearing.
If you feel like you're going to harm yourself, call 911 right away, or whatever your local emergency number is.
If you are having issues, get help. Ignore all this talk. Maybe you're depressed. Maybe you just think you're an asshole, because it's hard for people to be around you and hard for you to be around people. That's not natural, we're social animals. It's not "wrong," it's a symptom.
Don't second guess yourself, don't overthink it, don't try to tough your way through, get help right away. If you have access to a doctor that's probably the easiest way to start. The doctor may treat you himself, or he may recommend some other treatment. The point of the initial visit is evaluation. They're trained to do this.
If you don't have easy access to a doctor or other professional, don't give up. If you're working then your employer may have an Employee Assistance Program. They're free, and you can get a few initial visits with an appropriate professional. EAP usually offers lots of unrelated services, including legal advice, so don't hesitate to ask HR or whoever for the brochure or information, they won't know why you want it.
You may have to go through your county's assistance resources, and that's potentially frustrating, but do it and be persistent. Get a friend or relative to help you navigate.
Me: My car won't start. I need to get rid of it.
Mechanic: Actually all we need to do is replace this solenoid. You should probably change the oil a little more often too. The car is actually pretty good.
Me: Oh, good. I'm glad I asked a professional. I kind of like this car, and I'd like to keep it.
How does that change what I wrote? Is it the "to you" qualifier? As if things can't be objectively BS as reasons to commit suicide?
People kill themselves over all kinds of BS and not just by suicide. This includes nationalism, religion, and even as idiotic things as "dares".
In fact Tim in the article even admits about his own situation being BS. And it didn't take some huge experience to make him see that, or treatment, or medication: just a phone call from his mother.
Empathy is understanding that they feel really bad -- it doesn't mean justyfing the causes of that feeling too.
If you want to help people you need to make them see the BS-ness of those things (e.g. a failing grade), not overdramatize them as legitimate life-ending situations for them out of misguided empathy.
You can't rationalize suicide attempts away. Just don't. Showing you care is good. Kindness is good. Any attempt at hard love or such is a recipe for disaster.
Because there is a very good chance you can't tell whether a person is clinically depressed or not. It is very common that they mask this during work etc. and when they get home they just crumble. There are three ways out of this: the person gets better by themselves, they kill themselves or they get medical attention and get better.
It is good to suggest medical attention. It is very bad to suggest anything that like that their feelings are due to bullshit reasons because depressed people can channel this into pure self loathing. It's a medical condition because you cannot rationalize it away.
Do. Not. Tell. Them. That they are making bullshit reasons. That will be a pretty strong disincentive to go to seek medical attention. It will probably make themselves even worse off.
It means that as far as things to commit suicide for go, a failing grade in some assignment or a rejection in high school, are not very important in the grand scheme of life. If someone attempts suicide over the loss of his family, it's more understandable than attempting suicide because you were rejected for The Voice.
>You need to get a grip and stop your anger towards people who are feeling terrible.
I'm not sure what you are projecting here. Qualifying something is not anger, and I'm not talking to people "who are feeling terrible", I'm talking to people on a HN thread. This is a discussion. It's not very polite to assume things and feelings for the other end.
>You cannot say "I empathize with you. By the way your reasons for feeling this way are total BS" in the same breath and have any semblance of actual empathy.
Yeah, because lots of people never took their friends aside (or vice versa) to try and help them overcome a dark patch, including suicidal thoughts and depression, by putting things in perspectove for them. So their version of empathy is "Don't bother me, go see a doctor and take your meds".
This conversation is like it's taking place in a bizarro alternative universe, when all suicide is caused by tangible chemically induced depression (which is the only form of depression in that universe too), and people never overdramatize their circumstances.
This might be an 21st century American thing, were individuals must absolutely remove any societal and personal causes for their situation. In these parts of Europe we find it OK for friends to help us see clearly what's trivial and what's not, and we had similar philosophies down to the time of Epicurus.
Of course it's not that important. But that's not why they're killing themselves. That's just one more thing to push them over the edge. Behind it is a fundamental problem, and it's that problem that's making them vulnerable to something that seems trivial.
Please try to understand that.
1) when you find someone who is actively planning a suicide you have a choice. Keep them alive until they get to a professional, or treat them yourself. You wouldn't (I assume) stick a pen through the eye of someone having a heart attack, but that's the rough equivalent of what you're recommending people do to suicidal people.
2) treatment for suicidality has two components. i) keep them alive until meds and therapy can take effect. ii) give them meds and therapy. Suicide prevention is wider. If you're talking about suicide prevention as a public health measure you should probably state that. If you don't know the words to use to specify what you're talking about that should be a clue that perhaps you don't know what you're fucking talking about and should perhaps be a bit less arrogant.
3) as part of keeping someone alive until they can get help: there are things that we know mostly work, and things that we know mostly don't work. "Low grades? That's a bullshit reason to die! They're not that low; you can retake them; I got worse grades and I love my awesome job so your career path could be like that!" is something that we know mostly does not work. We know because we talk to survivors of suicide. Since there are 112 Americans per day who die by suicide we have plenty of people to talk to. If telling people their opinions was bullshit did anything to change their minds you and other people wouldn't be having this discussion - you'd have changed their mind or they'd have changed yours.
4) reactive depression is still depression. It's still an illness. The cure for reactive depression is to change the thing causing the reaction, but also provide evidence based techniques to build resiliance.
5) if just telling people they were wrong worked we wouldn't have had such a high deathrate from anorexia. About 1 in 5 people with this anxiety disorder die from it (this number is going down)
> be an 21st century American thing, were individuals must absolutely remove any societal and personal causes for their situation. In these parts of Europe we find it OK for friends to help us see clearly what's trivial and what's not, and we had similar philosophies down to the time of Epicurus.
There are reasons for the high death rate to suicide in most (but not all!) parts of the US, and this probably is not one of them. Decreased access to treatment; poor quality treatment; judgemental and stigmatizing views; increased use of criminal justice instead of mental health treatment; easy access to means and methods; etc etc.
Anecdote of one. Everyone is different.
> you need to make them see the BS-ness of those things
No, I don't need to make anyone see anything. And if they're anywhere near suicide, they don't need that message from me, they need professional help. Things are not rational, by definition, and they're dangerous. Don't fuck around with this, it's not a rationality petri dish or a debate.
I have a medical condition that sometimes suddenly and dramatically negatively impacts my brain chemistry. I also have a great many very serious problems that are hard to overcome. They aren't "easily overcome BS."
For some people, the metaphorical flames are a very serious matter. Not everyone has a cushy life where a bad grade is their biggest fear.
My advice is not to try to rationalize the urge. If you ask yourself the question "Why do I have to kill myself?" You will get answers. Bullshit answers, usually, but they don't look that irrational because of your state of mind. And a lot of the suffering is caused by these essentially fruitless discussions.
Another key point is to realize the impermanence of the mind and of the self. Though it sounds like a buddhist teaching, everyone who survived suicidal ideation knows this: You enjoy live, then you don't, then you do again.
The mind is never static. Finding that reality helps one to get a grip on the seemingly illogical phenomenon on suicidal thoughts.
This is wrong. Thinking of it as a "disease" is a misunderstanding, it makes it impossible to truly understand it.
Alcoholism might be a disease... excessive alcohol consumption probably doesn't have any benefits. Suicide though? It sort of does.
You see, biological organisms aren't programmed to survive... we're programmed to reproduce. And that means not just laying the eggs, but making sure that at least some of the offspring survive. So it became advantageous if a parent (or even uncle/aunt) was psychologically capable of killing themselves or letting themselves be killed.
And we're not necessarily talking about throwing yourself in front of a rabid grizzly either. There are all sorts of circumstances (killing yourself so there will be enough food for the other to survive a famine).
The psychological machinery is all there for killing yourself. Hard-wired into your brain through countless thousands of generations of people who only lived because a close relative voluntarily died.
But evolution isn't intelligent, and it goes with a "what works most of the time" method of keeping a trait or not. And this is probably cross-wired in with quite a few mental illnesses and other questionably-useful traits.
It's a malfunction of a (once in a great while) useful tool.
On HN, it's anything other than the strict mental health party line on suicide. On other threads, I've seen people looking down on David Foster Wallace, as if they had a prayer of doing in their lives what he did.
I upvoted, because interesting comments on this topic are rare.
I would classify it as a medical condition since that is how the modern society can provide attention to it. If one is clinically depressed and borderline on suicide the way to get help is to seek immediate medical attention.
I'm not sure what the philosophical difference is between a "malfunction" and "disease".
Deleted comment
Every piece of advice I can find prominently states:
Do not argue with or attempt to invalidate the reasoning of a suicidal person. Listen. Ask questions to gauge intentionality ("do you have a plan? what is your plan?"). Vector them towards professional help. Do not try to fix suicidal people yourself.
Suicidal impulses are a medical emergency.
This may not directly apply to your comment, but it seems very likely to apply to the thread as a whole.
Merely saying this may not convince people. They need to know why this completely fails. While suicidal actions are largely impulsive (one reason why guns are a worse threat than other forms of suicide), the individual has spent a long time thinking about it. Nothing you can say will convince them that you have any understanding of their reasoning. To them, you are just like all the others who do not understand them (regardless if they are right or wrong in such an assessment).
By listening, you are likely doing something that no one else has done for them. It will often show them that you want to know their reasoning instead of just dismissing it. It may not be enough to stop them, but it often does delay them, hopefully long enough for a professional to get involved and take over.
I come from a family of avid hunters and gun owners. I don't personally own a gun. Not because of any political reason but because I don't want the ability to pull the trigger when I'm in my darkest of moods. At least without that I have to think about it long enough to hopefully snap out of it. There are a handful of times if you would have handed me I gun I think I would have pulled the trigger... Then when I look back it seems silly but the cycle repeats. One time I simply couldn't find my car keys and almost rage quite life. The car was in the shop.
This is one of the most terrifying aspects of depression for me. I can be functioning perfectly normally (obviously just on the surface), and then one morning I stub my toe or spill a glass of water and I just breakdown. All the frustration, anger, sadness, or whatever that I've been holding in just floods out and I want it all to be over. This is why I used to never drink (and now wish I'd never started), and also why I won't consider owning a gun. When you get depressed you may not be able to control yourself, but you can try to instill good habits in yourself when you're of a sounder mind. Or at least control your environment so you have fewer tools to harm yourself with.
OTOH, I generally make these comments when I'm in a more positive mood. That's the only time I can put words to what I experienced.
This bears repeating--in most places, this is homicide. :|
You haven't met a lot of depressed people. Many have jobs, and family, and friends, but still irrationally feel alone and don't feel trust in the people that love them.
Illustration: http://2.bp.blogspot.com/-mo7Y7akC7BQ/T52i2awn7iI/AAAAAAAAAK...
Society doesn't like sad people.
http://johnjayresearch.org/cje/files/2012/08/Aaron-Beck-chap...
And even then I would categorize these reasons as quite irrational reasons to kill yourself. People who are not currently in that particular state of mind don't see these reasons as rational and valid.
My point is to not argue with some one who is suicidal about his reasons. Even not with yourself, if you do have suicidal thoughts. Take the symptom seriously, start treatment, but don't take the thoughts and reasons themselves too seriously.
I don't speak for everyone who was suicidal obviously, but one of the answers to "Why do you want to kill yourself" is that you are unhappy and don't think you'll ever be happy again. I am not suicidal or as you say "in that particular state of mind" right now, but I can definitely see this as being rational or valid.
If you have been depressed for as long as you can remember, I can certainly see why you would feel as though things are hopeless. I like to think they aren't, but I wouldn't disregard their feelings and opinions as irrational. Like an aspiring musician or athlete whose prospects don't seem to be getting better, sometimes you feel like it's time to give up.
Have you ever been suicidal? Not trying to be rude; I'm just curious whether your opinions were formed because you had a different experience than I did is all.
I don't disregard anyones "feelings" if I call these feelings irrational. But these feelings are obviously caused by a temporary state of the mind. I did have those feelings, but I learned early on to not take them as seriously as they looked at first.
But it's hard to get to this perspective, I know. A Depression undermines the patient's ability and will to fight it. Some patients develop elaborate delusions about why they are this way. Most patients have less obvious "delusions" where they believe something not completely extraordinary but still wrong and harmful, like not being worthy of life.
I can recomment the youtube video "Sapolsky on depression", he explains depression from a biological viewpoint.
You need to re-read what bayesianhorse wrote more carefully, because you're not actually disagreeing with him. He said: "If you ask yourself the question "Why do I have to kill myself?" You will get answers" Attacking a straw man is bad enough, but attacking it with such vehemence is really not cool.
We tell people to exercise if we want to get stronger, but the mind is seemingly something that we either try to repress in an unhealthy way (alcoholism and friends), just blurt out/vent whatever it has been nagging us with lately ("talking about our feelings"), or meditate/mindfulness. The last alternative seems very promising and healthy, though sorely underutilized by most people, even the "my body is my temple". But I find it strange that there aren't more alternative (and complementary) approaches that are being suggested, like trying to think more constructively ("positive thinking" being a part of this).
People who see the mind as a separate and wild beast will probably say that the mind can not be controlled. And I would be inclined to agree. But I think it can be steered to some degree, or at least nudged.
The "observing" of these thoughts alone can improve the situation a lot.
Mindfulness training also improves the prefrontal cortex and thus the ability to control impulses and thoughts. The idea is to evolve the ability to choose to have a certain thought or not.
Knowing what to do is one thing, doing it is another. Meditation can immensely improve the latter!
Meditation is not a sufficient treatment for depression or suicidal thoughts, but it can help to avoid relapses, and it helps to deal with the consequences of recurring depressions.
Steps are generally: write down your automatic thoughts when you are feeling bad, identify how they are irrational or distorted, write down more accurate, balanced, realistic ones -> feeling better.
Anybody can think and believe any crazy idea as long as it's a fairly mainstream religion. That's our current state of affairs - we take any ideas seriously as long as many people take them seriously.
There's not much other criteria at play.
So people live with crazy incompatible ideas that keep causing internal conflict and what vague solution can you propose that'll sell? (Capitalism is the new religion, so things MUST sell :)) Right, 'mindfulness' - in other words, just don't pay attention to the internal conflicts you are continually having - they'll go away on their own.
They don't really, but we can't say ok, we have to use logic and sense to approach these things - because then archaic ideas like freedom of religion are going to fall apart.
So we are where we are, mindfulness, 'positive thinking' and other sterile methods that don't talk about the real problem - your mind is a big mess and it'll take a while to sort through it.
We as a society haven't even started - we're too busy coping with never-ending fuck-ups that stem from people in power not losing their heads for being incompetent. Of course they love it that way, they're at the top of the heap and beyond scrutiny, how convenient. Just don't get caught with hookers and blow.
Of course, people might also make emotion-based decisions to kill themselves, which might be a symptom of their depression or whatever, but that doesn't mean that all suicide must be a mistake. You'd kill yourself to keep the Borg or the Alien from getting you, wouldn't you?
If you're pro-choice w.r.t. abortions at all, then you should really be pro-choice w.r.t. suicide. If your logic for the first one was "it's their body, so it's their choice", you're inconsistent in your logic if you oppose the second one 100% of the time.
> illogical
Given that there's no good reason to be alive in the first place, it's perfectly logical. It's only ill-logical if you assume that what's good for the (selfish) genes and what's good for the individual are the same thing, which they're not.
Just let people make their own decisions.
And that disease of depression has been studied in so immense detail, that your point of view about it is plainly wrong. The suffering is clearly immense. And it is clearly temporary for almost all patients, especially with good treatment. It can't be rational to kill yourself to avoid temporary suffering.
Of course you can construct situations where it would be more rational. But really, if someone has suicidal thoughts, the assumption that this is an irrational, "insane" idea, is pretty much a no-brainer.
My understanding of his comment was that he was trying to convey the above, not necessarily argue that feeling depressed one day (or year!) makes killing yourself a fantastic idea. See:
"Of course, people might also make emotion-based decisions to kill themselves, which might be a symptom of their depression or whatever, but that doesn't mean that all suicide must be a mistake."
That's definitely not true. Most people who die by suicide have a mental illness, but not all of them. (And by "had a mental illness" I'm including those people who had an undiagnosed illness.)
I'm sorry, but that consideration just doesn't help. If the pain (or emptiness) is so strong that you just want everything to stop, this consideration is absolutely worthless and unimportant.
As I understand it (surely someone on HN has more exposure to this than I do; I've lost friends, but not myself experienced the impulse):
The "do's": listen, empathize, stay calm, be hopeful in tone, vector them towards help.
The "don'ts": argue them out of it, get emotional, judge, try to fix it yourself.
Also, many suicides involve alcohol (which, in some, produces a volatile state that mixes despondency and extreme anger) and drunk people don't exactly listen to reason.
I think that it can be worthwhile to remind the person that he has friends who'll miss him, dogs to feed, etc. I don't think that laying in with guilt is the way to go. You want to give them images of the people they care about being happy, not images of them being wrecked by their own possible death.
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I think that it's important to note that it's not a feeling of guilt that should be focused on here. It's a feeling of connection. There are people who care and can help if you reach out. There are people who care.
Of course it's not always enough. If it were, people would never commit suicide, would they?
There is a great deal to be said for holding on for others those times you can't hold on for yourself. After all, life is very much a series of highs and lows.. sometimes, you need to latch onto whatever you can to get you through the lows.
My parents love me, but they never asked me if I wanted to be born. If I was in pain that couldn't be treated and it made my life not worth living I would not feel obligated to continue living for their sake.
For me, most people I meet day to day, they don't even exist past our minor interactions, most of which are positive because I'm positive.
The few folks who I interact with on a regular basis - it is all positive, or else I'd stop interacting with them.
There are situations where you have to regularly interact with people who are going to be annoying (teachers in school, parents if you live at home, boss at work, etc) - you just have to learn self-defense tactics and work toward being more independent.
The people who are annoying - they are just incompetent at life. Their life sucks with me in it and with me not in it. The rest are either not affected or affected in a positive way.
So I don't know where you're at but if you're not a net positive to those around you - you have got some work to do.
The reason some people are mopes is as I mentioned in the last post - they just are. They're stuck. Don't get stuck wasting your time being 'positive' to them.
Be positive to yourself by not spending time around people who make you feel like shit and spending time around people you can learn from instead.
Easier said than done of course, one step at a time :)
For some, causing pain to those close is a forcing pulling them away from doing it.
For some, it doesn't matter.
For some, causing pain only makes them want to do it more.
"Feeling Good: The New Mood Therapy" by David Burns.
Depression and suicidal thoughts are often rooted in twisted, invalid logic that we don't recognize as such. For example, say that a stranger unexpectedly smiles at you. It would be logical to smile back, and perhaps even strike up a conversation to ask why they're smiling at you. The reasons are probably good. Maybe they're attracted to you. Maybe they just randomly thought of something funny. The risks of speaking to that person are minimal. A twisted, illogical reaction that many of us naturally have is to assume the person is smiling at our expense and that there's something we don't know. We fear what the person will do or say if we do anything to acknowledge their smile. Instead of smiling back, we retreat inwards, wondering what's wrong with us, why we're so pathetic, anti-social, etc.. Two people can experience the same event in wildly differing ways because of how they process them. For someone who is depressed, events that should be good can easily add to their problems.
Cognitive behavioural therapy focuses on catching those thoughts, identifying them as illogical, and deliberately countering them until the thought pattern in a given circumstance becomes naturally logical. In the situation above, you would need to recognize that you're assuming a lot about what the other person is thinking, recognize that the worst that can happen from striking up a conversation or just smiling back is not very bad, and that the potential gains could be very good. I had a fairly low opinion of most psychology until I came across this. It's actually helpful.
That said, I have experienced times in my life that have made me realise that the common views (e.g. you are free to do anything now; it will get better; etc) are false. They all stem from the idea that the individual is selfish.
The worst times I've had in my life were the times in which I tried really hard to be virtuous, to care, to right wrongs.
When I want more than just to 'succeed'. More than just to fix my life. My life is fine!
Bureaucracy, for example. 'Company policy'. It makes me angry and feel as if millions of humans have lost the ability to feel empathy, have been turned into robots. It's not about the fact I can't return a broken lightbulb; I don't give a toss about the 1 GBP. It's about the knowledge that most people don't care about right and wrong. Most people will obey the rules, they will do what authority says, they will take the path of least resistance.
Politics. My country treats the poor as subhuman whilst praising the rich. It fawns over 'merit'; which is really just random chance.
I could go on... basically, what happens when you realise that you're playing a rigged game? It doesn't matter if you win or lose. You can run away and hide. Or you can fight, all the while knowing that your attempts almost certain to be futile.
Once the box is open it never closes. I cope by employing nihilism, but the triggers are everywhere. Every 'intellectual discussion' about the merits of Red vs Blue, about the latest plan to Lock People In A Box for performing something mundane like shuffling some bits around.
And all around, the advice is to take drugs. Think differently. 'Come to terms with it'. Counselling... I don't want that shit. I want a city, a country, a world that treats its citizens well. If not as equals, at least as more than dogs.
i started to wonder if i actually did succeed after the first attempt in 2005, becuase life seems so different now than it was back then.
one of the things that finally stopped my suicidal ideation was the belief that i can never actually experience death. i discovered that other people with a background in physics had the same belief - quantum immortality.
http://markpneyer.me/2014/08/13/how-i-defeated-recurrent-sui...
In the past, I've been in situations that I probably shouldn't have lived to talk about and often wondered if I really did make it out alive. Or did my perception of reality diverge from the dimension I was in and continue in a dimension where I defied the odds and lived. Thinking in terms of multiverse[0].
You still might see me do so, of course.
You can't let bad experiences, bad people, and just plain bad luck make you start thinking about suicide. The reality is that most people that consider suicide don't do it. However, merely entertaining suicidal thoughts can be a caustic force in your life, as these thoughts affect every aspect of your life, and more importantly, hinder your ability to move on from the situation that caused the thoughts in the first place.
When your life crumbles, chances are it wasn't built on a strong foundation to begin with. As long as you're still breathing, you have an opportunity to rebuild it.
It's telling that the author was able to check out a book on suicide, but didn't seek medical help. That would require a) getting past the stigma of suffering from depression b) calling up a doctor or therapist c) suffering through the long mental health wait times that exist in most countries, d) being sent to a CBT therapist, given a self-help book or website e) being referred to a psychiatrist f) finally being prescribed something.
It can be months before a depressed person gets any kind of treatment at all. And they are the last people to have the energy it takes to navigate a byzantine healthcare system, or have a friend or family member help them (many people still believe depression is a character weakness and will punish the patient for speaking out).
Antidepressants aren't all that dangerous, even when compared to other over-the-counter drugs like Plan B. They're not happy pills, they often won't even make a miserable life bearable, but they do give the patient enough energy to deal with his/her problems. Given the number of lives lost to suicide, and the high disease burden of depression, I think the safety tradeoff is absolutely worth it.
I'm aware this comment is going to attract a lot of ill-will and uninformed comments about anti-depressant efficacy/ woo about happy pills etc. so I direct you to read this FAQ first. https://medical.mit.edu/faqs/antidepressants
I don't know how old you are, but in many cases, elderly folks have time to wind down their lives in a graceful way, to the point where saying goodbye is bearable.
Obviously people can still die accidentally/early, and ultimately you'll outlive about half the people you meet, but there is a way to learn to appreciate the time you have together, and to let go when that time ends.
Owning up to that is the first step toward recognizing how incompetent you are at being happy.
I used to be a moping ball of negativity myself once upon a time - it just doesn't work. Sooner or later you have to recognize that the way you are isn't working and take steps to change that.
Today sounds like a good day to start.
Having something planned -- an easy commitment, but not a heavy intimidating responsibility -- gives people a sense of purpose to move foward through their day/week/month, buying time for luck and expert assistance to come together.
This in addition to steering toward professional help.
white water kayaking,
hike the Pacific Crest Trail,
sail across the ocean,
challenge yourself at a sport, biking, swimming, climbing?
take a safe amount of MDMA and go to a music festival?
listen to some alan watts [1]
try fresh cannabis [ideally from Washington/Colorado/California], and music
However, once my brain was processing my every action as futile, I was often too depressed and incapacitated to shower, or even to get up and make food when I was hungry. In that state of mind, things like kayaking and hiking were functionally impossible. Music remained, but my brain retreated to the comfort of Radiohead's "Street Spirit" or "Creep" (etc).
My point is that it's almost like being a different person. Reality is persecution, logic is warped, and intentions from good days do not always carry over.
I was fortunate to have understanding and patient friends who helped me work on this during my good days. Kayaking is still unobtainable, but now I am able to turn to, e.g., "Katamari on the Rocks"[0] for music, and Alan Watts as well. The Zen Habits reminder to breathe [1] is a permanently open tab in my "distractions" group.
As the quote from Infinite Jest says[2], the flames become terrifying. I can only speak for my own terror, but the help and support I've received have made it easier to face and combat. Long talks with friends, smiles from strangers... it has all been important. Thank you.
[0] https://www.youtube.com/watch?v=SsB3IfttE50
> include wording like “impossible situation,” which was reflective of my thinking at the time, not objective reality.
Distorted thinking tells you that the only way to escape the impossible situation is death. If distorted thinking told people to go whitewater rafting we wouldn't have 112 Americans dying by suicide each day.
https://www.afsp.org/understanding-suicide/facts-and-figures
It can lead to insight that produces lasting change.
Please heed this last part: if you choose to treat suicidal urges in this way, tell someone what's going on so you can have support for the following week. The crash can be dangerous to someone in an unstable place.
Cutting out fast food / snacks / soda (substitute fizzy mineral water), and making the effort to do fresh stir fry veggies with some ginger, spice, and coconut oil has been life changing. I no longer feel tired all the time, or get drowsiness after I eat. '
Going for a hike, or cautiously ingesting a small amount of cannabis has done as more to reinvigorate life and eradicate dismal states of despair and bleakness as I could ever imagine.
But they're of little use to someone with severe depression planning out their suicide. In fact, "empowerment" can trigger the opposite reaction: it emboldens the person to finally carry out their plans. For this reason, activities that would usually be good signs (e.g., someone starts hitting the gym vigorously after starting new meds) can in fact be warning signs that another suicide attempt is on the horizon.
However, depression can manifest in feeling like the only thing that is available for purchase is nothingness. If you "know" that whatever you buy will turn out to be an box full of nothingness then having a magical credit card isn't very exciting.
Potentially fatal illnesses are medical emergencies, not mood shifts or errors in judgement.
Depression is a state of mind, often (but not always) induced by circumstantial situations, financial, existential, diet, stagnation/exercise... the cause of Depression for many can be resolved, with effort - and it takes a significant amount of effort for someone with depression to do things as simple and necessary and normally enjoable as eating a meal or taking a shower.
The point is, if you're going to do something as extreme as quit life, you might as well try to see if your depression may just be caused by a lack of exercise or "tunnel vision" of your perception of the world that could be drastically contrasted through experiencing therapeutic mild doses of MDMA [1][2] or cannabis or pharmaceuticals.
[1] http://www.maps.org/ [2] http://boingboing.net/2015/05/05/crowdfunding-medical-mdma-a...
Suicidal depression is a medical emergency.
On a bad day people can find "go to shop and buy myself an icecream" an insurmountable challenge.
That being said, avoid weed on depression, and find dissociatives. The third person perspective on your life they provide can be a life saver. Just be careful as you can get quite intoxicated by this effect.
But most importantly: Be with others. Family, friends, random guy in a bar, whatever. Even if it doesn't sound appealing (nothing does when you're depressed) just do it, talk to them.
When you're going trough hell, don't stop walking.
I'd stay away from the drugs, except in a monitored therapeutic context (which is probably still illegal, but may be helpful). Depression can be secondary to anxiety, and drugs can cause panic attacks. A bad trip is essentially a panic attack boosted by persistent altered consciousness. I'm not anti-drug but there are people who shouldn't use them (I'm one of them; I don't even get drunk).
Severe depression also makes it hard to do any of these things. But people don't usually commit suicide in the thick of a depression; they do it in the period of emotional volatility that tends to happen at the end of a depression. They're exhausted by having been depressed, but not depressed at the time of the event.
Anyone who is having suicidal thoughts, even if he's pretty sure he'd never act on them, should see a professional first and foremost and get the depression and, if they exist, panic issues treated. Then taking up the sports (which aren't especially dangerous; even scuba diving is safer than inactivity per minute) is a great call. Developing a meditation discipline is also a great idea.
http://mefiwiki.com/wiki/ThereIsHelp
Disclosure: I run the server.
I applaud founders/engineers/leaders who speak transparently on the topic. shout out to Kyle at Keen.io for his very personal post in reaction to brad feld's own https://medium.com/@dorkitude/entrepreneurship-and-depressio...
Well if the afterlife is terrible, you're going to end up there at some point anyway. So unless your religion says that suicides are punished, I don't quite see the argument.
Pascal's Wager can be used as an argument against any practice that some religion frowns upon, for that matter. If you accept his argument (I stopped doing that many years ago).
EDIT: and though we, in this realm, have no definite knowledge of what the Afterlife (if any) is, there is no guarantee in the Afterlife. So maybe you'll end up betting on Pascal's Wager through all such realities, indefinitely. And who's to say that, even if you have a wider and "higher" perspective, that you can ever be sure of the true nature of reality, and that there is nothing "above"?
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None of us know what is going to happen when we die. There are many beliefs, but no guarantees.
The original statement was a reminder to think twice if you are contemplating suicide because whatever you think is going to happen after you die might not actually happen.
If you know the basics of the human body such as the brain, hormones, etc, I think it's pretty clear what will happen when you die. It's the same thing what happens to a computer when you shut it down. Do you know Occam's razor?
Anyone can believe what they want of course, but it won't impact reality.
Most of them do in one form or another, especially the Abrahamic tree.
Not actually true, otherwise all Buddhists would become monastics, which they don't.
Buddhists believe that positive karma is accumulated over many lifetimes, and negative karma is extinguished after periods of suffering.
In Buddhist thought, it's often enough to simply live a reasonably 'good' life, then you'll be reincarnated into a heavenly realm, or possibly another human body, etc... There are degrees of everything, and very few Buddhists (if any) believe they're going to achieve liberation after only a single lifetime. Even the Buddha was thought to have lived hundreds of lives, eventually culminating with his miraculous (by traditional accounts) life 2500 years ago...
Though what you've written here doesn't contradict my current mental model of Buddhism, I might have been wrong in assessing Buddhist's motivation as universally being about eventually ending suffering. Maybe some are content with a good, pleasurable existence, and not necessarily Nirvana? Though the fact that not all Buddhists are monastic doesn't in itself imply that - even if being monastic leads to more quickly achieving Nirvana, maybe some Buddhists don't feel that they are in such a rush, at least in their particular lifetime?
> There are degrees of everything, and very few Buddhists (if any) believe they're going to achieve liberation after only a single lifetime.
That's why I wrote """eventually escaping suffering"""!! I said nothing about escaping suffering in the span of one lifetime. Only that they choose to devote their life to the goal of eventually achieving this "escape". Note that I contrasted this goal with people who commit suicide; people who commit suicide - because of depression and suicidal thoughts - do it to escape suffering in one particular lifetime. Hence, why I contrasted this with Buddhism as "a more immediate suffering". I thought my choice of words, to deliberately contrast these two kinds of sufferings, would be enough to get the point across to someone who understands Buddhism (probably better than me). But I guess you were in a lecturing mood. Good for you, buddy; we've all got to have hobbies. And web forums are as good a place as any to do that.
Please follow the Hacker News guidelines and refrain from personal rudeness when posting here.
Judaism doesn't either. That's a Christian thing, not an Abrahamic thing.
Buddhism doesn't categorically outlaw suicide but it's against violent or angry suicide and it definitely proscribes suicide as a way out. The bad karma you were trying to escape, plus possibly more, will be waiting for you on the other side. The self-immolating monk, Thích Quảng Đức, might turn out OK if he had compassionate intentions; but in general, suicide is still very bad.
The people that I mostly have in mind are people that bet on Pascal's Wager. People that are not necessarily Buddhists, or even religious to begin with. From their standpoint, it might not be that crucial to bet on Buddhism, since it they're wrong they won't have to pay for it for ever and ever.
(Gotta say that I was surprised to see M. O'Church talking about Buddism, btw.)
At any rate, I don't think humans are capable of comprehending eternity, so I'm not sure how meaningful Pascal's Wager really is. While there's objectively a huge difference between 10^14 years of torment and an eternity of it, I can't say that I can begin to fathom either one.