Tuesday, April 21, 2009

Understanding Suicide

During the past few weeks or so, I've noticed that on some mornings, I've been waking in a state of depression, which is a bit alarming as I know all too well just how devastating a full-blown clinical depression can be.

Obviously, I'm struggling deeply with the wear of chronic physical pain, and my brain chemistry is starting to give way, just like it did five years ago when an infection, which I thought had been cured two years earlier after 18 months of agony, took up residency in my jaw and face again (and has been there ever since).

As any hope for a cure seemed so hopeless back then, I slowly began to sink into a hole so black, so absolute, that all roads seemed to point to just one solution if I was ever going to get out of pain, and that solution was suicide. This led to a stint in the local hospital's psych ward, and then a few weeks later, admission to a psychiatric hospital.

With all of the physical complications I've endured as a result of this blood disorder, frequently spending weeks in the hospital at a time, I can say with absolute certainty that nothing--nothing--is as painful as a major clinical depression. And nothing, it seems, is as misunderstood by so many, particularly when it's accompanied by suicidal ideation.

For most people, suicide is unthinkable, so when a loved one takes his or her own life, we can get lost in a state of confusion and anger. I recall reading a book by a psychiatrist a few years ago who'd lost both of his sons in a 13-month period--one was a six-year-old who'd died of cancer and the other was a teenage boy who'd killed himself.

What was shocking, aside from the obvious tragedy of losing two children in such a short amount of time, was that the doctor talked little about his teenager, saying only that suicide was the ultimate "selfish" act, and he chose instead to write about his six-year-old, as the younger boy's ordeal was most likely easier to understand. The boy was, in a sense, an innocent victim of his disease, unlike his "selfish" brother who took his own life.

I remember feeling such shock that this esteemed psychiatrist, of all people, didn't understand the fatal power of depression.

A few years ago, I was hired as a freelance medical editor for a few months, and I was lucky enough to edit tons of the latest materials about depression and suicide. Perhaps what's most misunderstood about clinical depression is that it's not just a state of malaise or of feeling blue; it's a medical disease that if left untreated will only worsen throughout one's lifetime.

In the same way that Type II diabetics cannot absorb their own insulin, when clinical depression occurs, receptors in the brain close, and a person can no longer absorb their own serotonin.

Why this shutdown happens is still a mystery. Take, for example, a set of twins, both raised by the same parents in the same circumstances. In response to a tragedy, one twin will go through a normal grief period while the other will go into a major depression, and no one knows why. All that's known is that a person simply cannot function without serotonin, and the act of suicide is simply a way to get out of excruciating psychic pain.

In my own case, before I got depressed, I was going through one of the happiest periods of my life. For years I'd worked to get myself to a place where I'd perfectly balanced my work life (freelance writing and editing) and my creative life (songwriting and painting), and felt more inspired and joyous than I had in years.

This is what made the sudden return of chronic pain so devastating, and what ultimately made my receptors close to the very chemical so necessary to live.

It's hard to describe suicidal depression, but essentially, it's a loss of control over our own emotional state. Ordinarily, when one is down or feeling blue, there are things that can lift the spirit, like inspirational readings, listening to music, and talking with others. But when one is clinically depressed, absolutely nothing works to lift the darkness, and slowly the will to live can begin to erode.
In the same way one in chronic pain can lose hope that anything will ever change, the depressed patient also loses hope for a cure, and a battle surfaces between our primal will to survive and an aching desire to no longer feel this hell on earth.

In that sense, the act of suicide is the fatal outcome of a deadly disease, not a moral choice by the patient. Far from being selfish or cowardly, when a depressed patient reaches the decision to end his or her own life, nothing is more harrowing or frightening, because there's the realization that pain has overrode the fundamental desire to live. It's hard to imagine that anything in life could be that painful, but unfortunately, these states exist, and the last thing we should do is judge someone in this unthinkable quandary.

In my own case, I knew that I'd reached the limits of my endurance five years ago when I awoke one morning and felt no love whatsoever for anyone in my life anymore (even my mom), as every emotion had become eclipsed by pain. I was shocked at this revelation, because I knew the things that had been keeping me alive--namely the desire to not hurt anyone in my family--were no longer operating. I intuitively knew that I had about 24 hours left to live, and so I called a suicide hotline, which in turn called an ambulance for me, even though my local hospital is just two blocks away.

That's how bad I was; I couldn't even walk this short distance, as every ounce of energy was going into just staying alive and not swallowing the bottle of pills that offered permanent relief.

In time (four agonizing weeks or so), the antidepressants began to work, but not everyone is so lucky, particularly those who've struggled with depression repeatedly in their lives. Studies have shown that clinical depression actually damages the brain, and if left untreated, the illness only gets worse throughout one's lifetime. As the years roll by, the depressions become more frequent, more severe, and require less stimulus to set them off. That's why intervention with medication as soon as possible is so paramount to healing.

Studies have also shown that antidepressants can actually have a curative effect, meaning that if the first depression is treated with medication and therapy, the likelihood of it happening again decreases sharply.

Of course, there are those patients who use a suicide attempt as a cry for help, or as a means to get attention, and some of them do end up dying. But for the patient who is suffering from severe and extended clinical depression, suicide is nothing more than a way out of a type of pain that can never really be put into words.

I've heard it said that suicide is "a permanent solution to a temporary problem," but this isn't quite accurate, at least in terms of a major clinical depression. For some, the problem is debilitating and lifelong, and for these patients, suicide is the means to finally rest, even at the cost of life itself.


Monday, April 13, 2009

A Toll On My Soul

I was procrastinating on Saturday, as usual, so when I went to pick up my pain medication at the pharmacy across the street, I found that they'd closed a little early, and I was absolutely freaked that I wouldn't have enough meds for the following day, yesterday (Sunday).

For someone in chronic pain, narcotic meds are a type of deal with the devil, for on the one hand, they provide a certain amount of relief and respite--a sense of control over miserable circumstances--but on the other, they rob you of your normal emotions, even if, like me, you don't necessarily feel high anymore (not unless you take too much, which I've been wont to do now and then).

When I saw I had just one 10 mg Oxycontin pill yesterday morning, I knew it wouldn't be enough for the day and this made me nervous, but what was actually disturbing was the realization of how much a part of me these pills have become.

While they do ease the pain somewhat, they also take a toll on my soul, and it's hard to imagine life without them now. In a strange way, they fill the space that is the loneliness one feels with chronic pain. When I take my pills, the world is a little brighter, a little softer, and I'm happy to passively sit back and let it pass me by. But it's never without some regret, for when I watch TV, it's like I'm watching others live life for me, and I'm envious of their healthy, vibrant lives.

If it's a true crime show, I wonder what it's like to passionately catch crooks all day; if it's a TV drama, I wonder what it's like to live the life of a successful, creative actor; if it's a reality show...well, OK, I rarely envy those folks, especially any of those Real Housewives babes. If I lived in a world where I ever had to go to a "big hat luncheon," I'd slit my wrists. But I do envy their healthy, pain-free life.

In the past few months, I've even become something of a recluse, which is just plain weird for me, considering my personality. But the pills actually make watching lots of TV interesting, which is what I learned yesterday, as without the pills I was absolutely bored to tears by just about everything. I almost didn't know what to do with all the time, not because of the pain so much, but because I no longer recognized myself. Spitfire Mary Ann has turned into a human lump on the couch. I didn't even feel like shaving my head, which is saying something, because I always get a big kick out of that.

I can tell I'm withering, as I now shave my noggin every two weeks or so, as opposed to every five days. I used to love the fiery feelings my hairless dome would bring up--such adventure, such mischief--but it's as though there's few feelings at all anymore, except exhaustion from all this endurance.

I have to remind myself that I haven't given up--that the therapies I've set in motion take time to come to fruition. Hopefully, I'll get accepted into NYU's psychoanalytic program, so that I can probe the mind/body connection in all this, and once that happens, I'll have more surgery. I want to do things differently this time. I want to be more aware of what's happening in my subconscious before I go under the knife again, which is a curious goal considering I really have no feelings to report, other than an opinion on that cool Chariots of the Gods show on the History Channel yesterday, which wasn't boring at all.

I have to admit; watching all those talking heads speaking so enthusiastically about the possibility of ancient aliens made me wonder what it's like to be an anthropologist. Who would I be without all the pain, all the pills?

It's a beautiful, sunny day today, but it may as well be raining, 'cause I doubt I'll be going out. I know I should push myself, but I'm no longer chasing my dreams and passions anymore. I'm instead running from the monster as fast as I can, only to find he's keeping up quite well and resting comfortably, in fact, in my own body. The only ammo I've got is this friggin' pill, which tames him temporarily, but tames me, too. I'm just so sick of all this crap, all this pain, all this confusion, all these pills.

Now where's the remote?


Saturday, April 04, 2009

A Big Bubble of Love

It caught me completely off guard. On Wednesday I was walking down Washington Street, a main shopping avenue here in Hoboken, and I was suddenly overcome by what I can only describe as a deep sense of peace.

The night before I did some jaw exercises, which mysteriously alleviated the pain (usually they don't work), a state that lasted into the next morning, so at first I thought this newfound contentment was just a result of having a good day catch me by surprise. But there was an otherness to it that I'd never quite felt before--a feeling that it wasn't coming from within me, but rather something that was surrounding me, like a big bubble of love.

I was so invigorated that I decided to keep my appointment with my life coach, Nancy Colasurdo, and afterwards had the energy to do multiple errands around town, which ordinarily would feel like lifting boulders but instead felt effortless.

In a nutshell, I suppose I was just plain calm for the first time in months.

When I got home that evening, I didn't check email for some reason, which is unusual for me. It wasn't until noon the next day that I finally opened my inbox, and to my complete astonishment, there were dozens of emails alerting me to all of the responses to my new blog at Salon. (Even though I publish primarily at Blogger, I recently signed up for a blog at Open.Salon.com, which takes your feed and reproduces your blog post for post, creating a perfect duplicate.)

When I began reading the comments, I was overwhelmed by their compassion, intelligence and offers of prayers, which made me wonder: Was this the reason for that sense of peace the day before?

Wednesday morning, I did read one Salon comment from Vonnia in response to one of my posts in which she said, "I'm holding your hand, and I won't let go." It was so powerful, so sincere, so touching that I carried those words with me throughout the entire day. And I was so surprised at the intensity of my reaction to them, as they felt just so real--like someone was really there holding my hand, bearing silent witness to my suffering with a type of strength and fortitude I couldn't summon on my own.

Who was she, this anonymous woman who offered such a simple promise that has me in tears as I write this?

And who were of all these amazing souls, for that matter, who took the time to write such powerful, warm words straight from their center, who got down in the trenches with me to offer such solace, such understanding, such compassion.

I truly believe that the combination of everything was that fuzzy thing that wrapped around me that afternoon, a full day before I knew where it was coming from.

There are forces out there that we still don't understand, that we haven't fully harnessed, for if I could feel so strongly this outpouring of love, imagine what we could do as a people if we focused our prayers (in whatever form they take) in a collective way on specific issues. Perhaps we really could change the world just by channelling the love in our hearts. That might sound naive, but I know what I felt Wednesday afternoon.

While I've written a lot of words here, there are none that can express my gratitude for this generosity of spirit from perfect strangers. For a chick who's got a lot to say about everything, I'm speechless.