Friday, August 24, 2012

Myths about Suicide

So, I'm going to be taking part in the annual Out of the Darkness walk to support the American Society for Suicide Prevention in about a month's time. Suicide is an issue close to my heart, both personally and professionally. There's a good body of research on the subject, yet many myths persist--not only among the general public, but among health professionals (and even mental health professionals) who should know better. Following are those I've heard most often.

1. A person who talks about feeling suicidal isn't likely to actually commit suicide--ie, "If they talk about it, they won't really do it." I'm really not certain where this one got started, though I guess it might have something to do with the idea that talking about suicide is just 'blowing off steam,' or a manipulative gesture to get attention. Regardless, imagine applying this line of reasoning to something more mundane: for instance, imagine saying, "Someone who talks about wanting an ice cream cone isn't likely to actually go to Ben and Jerry's." That's pretty obviously BS, right? The same goes for discussions of suicidality. Any communication of suicidal feelings, thoughts or intent deserves to be taken seriously.

2. Don't bring up the topic of suicide with someone who's depressed--you don't want to give them the idea. Speaking as someone who's been there, if a person is severely depressed, there's a damn good chance the idea has occurred to them already. I've yet to meet a depressed person who, when asked about suicidality, replied: "Holy shit, you mean you can kill yourself? Like, that's a thing?" If you're worried that someone is thinking of hurting themselves, ask. Better to ask and get an answer--even if the answer is yes, and even if it's painful to hear--than to miss a chance to help someone who needs it.

3. Once someone decides to kill themselves, there's nothing anyone can do to stop it. Suicide is preventable. The majority of people who commit suicide are suffering from a psychiatric illness. Hospitalization to stabilize the acute crisis and ongoing psychiatric care to adequately treat the underlying illness can almost always resolve the suicidal feelings. In other words, once suicidal does not mean always suicidal.

4. Only older white men (or the poor, or teenagers, or whomever) commit suicide. While there are some groups at higher risk for suicide than others, every race, gender, socioeconomic class, ethnicity and sexual orientation is touched by suicide. Saying things like "young women don't kill themselves" is not only stupid, it's dangerous.

5. Most suicides occur without any warning. There's no way to anticipate or prevent them. No to the first assertion and no to the second as well. The majority of suicidal people DO offer clues to their intentions, though they may be subtle. For instance, a patient in a deep depression may suddenly appear to feel better despite not having had adequate treatment--the sense of peace may have come as a result of the decision to commit suicide. A depressed friend may start giving you her prized possessions, saying she doesn't need them anymore. A family member may say, "You won't have to be bothered with me much longer." Again--going back to myth #2--if someone makes statements like this and you're concerned they may be harboring suicidal thoughts, ASK and EXPRESS YOUR CONCERN.

Monday, August 06, 2012

Five Favorite Works of Fiction

It occurred to me the other day to sit down and think of my ten favorite books. Of course, I soon dismissed that as too difficult and decided to divide this task into several smaller ones. I've now selected my ten favorite works of fiction, ten favorite books of poetry/essays, and ten favorite non-fiction books. These are the books that have made me who I am; the books I would choose if I were stranded on a desert island. What are yours? I'll start with my ten favorite novels--in no particular order:
1. Catcher in the Rye, J.D. Salinger. Yes, I actually read it in high school, and yes, I actually liked it--despite being sufficiently young and innocent that I was appalled when I realized Holden had hired a prostitute. In fact, I went through a bit of a Salinger phase during my junior year of high school (similar to the Ayn Rand phase that a lot of people seem to go through in high school/college, except that it made me a more astute observer of human nature rather than a self-absorbed twit).

2. Things Fall Apart, Chinua Achebe. One of the great African novels, and a fantastic read. Barbara Kingsolver's 'The Poisonwood Bible' (which only narrowly missed this list, and which more people have probably read) is the white-girl yang to Achebe's yin. I'm not going to lie--I also just loved saying a lot of the Igbo names to myself over and over...Ikemefuna, Ezinma, Umuofia.They sounded like music.

3. Notes from Underground, Fyodor Dostoevsky. I probably identified with the protagonist (who's only barely a 'pro'tagonist...) more than I ought to've, considering he's defined by his ennui, sense of inertia, and an existential awareness that leads him to consider spite the best defense against necessitarianism. Then again, I read this in high school, a time when I also discovered Camus and Sartre and it first occurred to me that, holy shit, I could CHOOSE to skip Calculus one day, or not sign up for the absolute maximum number of hours at work (I still went to all my classes and never missed work, but I think the idea that I didn't *have* to kept my tightly-wound self from going completely round the bend). A lot of people also label it the first existentialist novel. So there's that.

4. The Handmaid's Tale, Margaret Atwood. Most people's introduction to the idea of dystopia comes from George Orwell, and I've read 1984 too, but as the possessor of a uterus I found Ms. Atwood's tale more relevant to my interests. What really terrifies me is that there are those (cough--Sarah Palin and Rick Santorum--cough cough) who would like to see this dream/nightmare brought to fruition.

5. The Bell Jar, Sylvia Plath. Plath--or 'Victoria Lucas,' the pseudonym under which the book was originally published--is the mother of crazy-chick lit (OK, maybe that was Charlotte Perkins Gilman...but certainly the mother of all mental-hospital chick lit). Kaysen's 'Girl, Interrupted' and Elizabeth Wurtzel's 'Prozac Nation,' the bevy of eating-disorder memoirs in the spirit of Lori Gottlieb's 'Stick Figure': there would be none of these if The Bell Jar hadn't been there first. As a middle-schooler with severe depression, what I wanted more than anything was my own Dr. Nolan--but absent that, this book, paradoxically, offered me hope both that I might someday conquer my own demons and that I might one day publish the story of that conquest and make some money into the bargain. 

The other five, after the jump!