On Suicide

As time moves forward, many of my friends are dealing with the tragedy that is suicide, I found myself sharing this with a friend.  I do believe it is useful for many.

Michael had been suicidal off and on for much of his adult life. From family, I heard bi-polar. From a former in-patient psychiatrist, I heard narcissitic personality disorder. From the head psychiatrist of the Cleveland Clinic, I heard, "Don't get involved in his games," "he's doing okay now, but you and I know most likely one day he'll drive himself into that bridge," and when he finally died at his own hand, I also heard, "Man, he really had started to show joy and I thought just maybe I thought he'd beat the odds." His primary diagnoses were the entire litany of personality disorders, but I know the root was PTSD. Childhood abuse. Rendered him completely incapable of telling the truth and deeply manipulative if he felt threatened. He felt his whole life was threatened every time he was triggered and fell back into despair. Nonetheless, he was untreatable because he would never discuss the roots of his illness with a doctor. Would self-unmedicate and then go back to his family doc for minimal meds. We know that the hippocampus and amygdala are affected by depression, making the symptoms much worse and causing physical shrinkage of the amygdala and it becomes a viscious cycle. We know that those with untreated depression and bipolar disorder have more volume loss. We also can compare those people to non-depressed immediate family members and not see the same volume loss. We also know that the adrenalin surges of PTSD are so visceral that as the body habituates to reacting like that, no amount of rational thought can stop it. That's one reason why treating people with the kind of trauma that precedes PTSD with blood pressure meds can help them avoid the problem all together. But, over time, if the body reacts that way with triggers, it takes intensive dialectical behavioral therapy and EMDR to have any hope of alleviating that visceral and uncontrollable response. But we also know that psychiatry is often far from science. Far from able, and many people who suffer from psychiatric problems, particularly those with comorbid personality disorders with depression can be difficult to treat. The most powerful thing anyone said to me was my friends' 16 year old autistic kid, Isaac. We were meeting for dinner at a local restaurant and Isaac looked at me in a mirror (they were waiting at the bar, which was mirrored at the time) and said, "Elaine is that you?" I said yes. He turned around, high-fived me and said, "You are not dead." He greeted me like that every time he saw me for about a year after Mike died. I guess for anyone dealing with the suicide of a friend or loved one, you need to know that there was NOTHING she could have done and nothing she did to cause her mom to shoot herself. Eight years after my husband's life, I am still discovering more things that either I can't understand or help fill in more details. There is no way I can ever understand what was in his head, what caused him to do many of the horrendous things he did in his worst moments or what actually caused his decent into mental illness of this type. What they say is frequently deflection from reality. There is nothing rational about it. What I do know is that when a person commits suicide, they are exhausted from the struggle and just can't do it anymore. Mike was such a good man in his better moments.