Friday, April 18, 2008

Dead Man Walking

A couple of days ago, S came to know that a colleague of his had committed suicide over the weekend. S told me the whole thing was completely surreal. A talented, thirty something man, with apparently nothing wrong in his life (on the face of it) chose to end his life.

It was S’s first encounter with violent self inflicted death. We spent some time just thinking how it would be – to get up one day and decide that life was so unbearable that you had to end it THAT particular day. Whether this man, had second thoughts while leaving his house, how he said goodbye to his family, whether he had taken his house keys along, whether he had taken his cell phone along or just left it behind because he would never need it again. The ordinary minutiae of leaving for work every morning – how strange it must have been.

My closest encounter with suicidal tendencies was a few years ago. A friend, who stayed in the US, broke up with his girlfriend of eight years. He was devastated and used to come online to seek solace through chatting – often with me. At that time, he was on pain medication for a fractured leg and after a point of time; he started regularly overdosing on it – to numb the pain he said– not so much the one in his leg, as the one in his heart.

I was petrified. Petrified that he would take that one pill too many consciously or inadvertently. And here I was in a different country, with no friends on the spot who could actually do something to help him. And all I could do was talk through the night knowing that it was not enough, but hoping desperately that it would hold him and stop him doing something stupid, if only till the next day.

I have battled with mind-numbing, paralyzing grief and despair in my life as well – where I didn’t know where to turn and who to turn to. Where death might have seemed like a welcome relief. But there was this one tiny self preservation voice, or voice of sanity or cowardice or something which held me back from seriously contemplating suicide.

So I know what it is to be in such a black place, that even the air you breathe is viscous with dread, but yet, not give up on life. But I still wonder what that point of no return is for the people who do.

Are the thresholds of pain different for different people? Or is it the levels of cowardice that are different (the jury is still out on whether suicide is the most courageous or the most cowardly act of all)

Is it the ultimate exhibitionist act of a self centred person? A part of me says that people who do take away their lives have to be necessarily, absolutely, selfish since they don’t think about the trauma they cause on those left behind. I had met a gentleman whose daughter had just committed suicide a few months before I met him ( for the most INANE reason imaginable) He was going through the motions of being alive – In reality, he looked completely wrung out, as if his whole life force had been drained out of him.

But then yet, another part says, that in mind which is so tortured with pain and hurt, can hardly understand and empathize with the pain their action will have on someone else-just like people suffering in the last stages of a debilitating disease like cancer, might behave atrociously –be wounding and nasty with family members –where it’s the pain speaking rather than the patient.

I wonder how long people stay in that zone between deciding to end it all and the actual deed. The shadow zone. The figurative dead man walking – self condemned but functioning. Trapped in a festering, tormented mind – but with the knowledge that he needs to appear normal, lest people find something amiss.

Do they count the last times – this is the last time I go to my bank, this is the last time I kiss my child goodbye, this is the last time I will feel the drop of rain on my face, watch a sunset or walk down a road traversed daily for the last thirty years …

I wonder how they decide that this is the way to end it all. The man, who died two days ago, threw himself on the tracks – a particularly macabre and gory way to end his life.
How they go about the mundane actuality of it – going to a chemist shop to buy the sleeping tablets or the innocuous razor. Deciding the merits of two equally distanced railway stations. Choosing which dupatta shall be the fatal noose.

And I think my heart bleeds for those left behind – always. A death, even in the ordinary scheme of things, invariably leaves a residue of regret and guilt – of things unsaid and fences left broken. How much more will it be in such a case – the burden of remorse and self reproach, the weights of all the could-have, would-have, should-haves, is something they might need to deal with through out their life, even if there was actually nothing else to be done, nothing else they could have done.

The greater tragedy is that there is no easy way to pick up these signals of a person who is contemplating death. No red flags which one can see and do something about. Body language and depressive talk is too simplistic, there are many, who quietly go about the business without making a fuss.

Even if correctly diagnosed, the way to help them, how to prevent it, how to do something thus becomes a matter of chance and individual skill. The skill to take them to the counsellor, the skill of the therapist in counselling, the skill of the person to come out of it and be motivated to live again.

I wish therapy wasn’t such a bad word in the Indian societal system – where a person who claims to be taking counselling sessions is automatically assumed to “mental” thus unfit – where depression is something to be derided, hidden away, avoided, not acknowledged rather than something which can be set right – if only with a little sensitivity and empathy. I wonder when society will have the maturity to realize that clinical depression is a malaise just like a viral infection and the person can’t just snap out of it and be happy, no more than a person can will a fever to go away but given the right treatment WILL go away.

P.S This is going to be a two part post because I would also like to write soon about the non-clinical urban depression – the malaise which seems to be hitting a lot of people I know. Young, urban professionals which I fear is grossly underreported and understood.

P.P.S. Very morbid post this. Hmm.

20 comments:

Epiphany said...

I think that usually the decision of suicide is an impulsive decision..I mean the suffering may be prolonged...but the moment you realize that next minute you will be dead doesn't let you think about family and possessions....

As for the depression part..well that has always been a part of our(professionals) life...we just never thought about it before...

Roop Rai said...

hmm.

narendra shenoy said...

Invaluable point - your observation that clinical depression is a medical condition and one as serious as cancer or heart attack in that it will kill. The difference is that it would be far less lethal if only people recognized it as such.

A close friend lost his wife to something called post-natal depression. She jumped off the terrace and killed herself. She did not die immediately. On the entire journey to the hospital she was weeping and telling him she did not want to die. I found that EXTREMELY sad. Life is a bitch, sometimes.

rosa not so rose said...

i have never really seen death from close quarter, and it anyway scares the shit out of me. leave alone anyone taking their lives i wish everyone around me would just continue living on and on healthy and happy forever... :)

vEENs said...

I dnt knw what to say.

Cynic in Wonderland said...

back from jaunting all over the place.

epiphany - im not sure whether its impuslive in all cases, a lot of times i would assume that you spend some time thinking about it. ( maybe the cry for help variety of suicides)?


roop, veens - hmmm.

naren - yes it is. the incident yuo recounted is appalling if only someone had helped that lady earlier, she might have not attempted suicide at all.

rosa - death is a very scary thing to see. hope you dont see it at close quarters for a while yet.

Amodini said...

Cynic,
I agree - depression is so totally taboo in India that few people acknowledge it - and that compounds the problem. Most people see it as an "attitude" thing not realising that it is indeed a "sickness" like a physical sickness, and there isn't a way of just "snapping out of it".
I also think desis fail to acknowledge post-partum depression - which is very real and prevalent in desi women.

Isolde said...

Interesting post and comments on suicide. I've worked in mental health all my life, in Britain that is. I would add that for someone who is suffering from a clinical depression suicide is an irrational act arising from irrational thoughts. The mind is tortured by constant thoughts of suicide, of feeling convinced that everyone would be better off without them: intrusive thoughts which overwhelm any optimism or hope. Sometimes there is a need to act on these thoughts in order to try to erase them, without any real intention to die. But sometimes the thoughts become so loud, persistent and insistent that the person feels there is no other option. It could be argued that suicide is always an irrational act. I have, though, met some who have suffered so much and so long that to say hang on in there, it will get better, seems empty and shallow. But one has to. We can never withdraw support. It is important, if a person is known to be depressed, to establish the existence and level of thoughts of suicide. The danger signal is the planning stage: here the person needs constant company to guard against action until they are diagnosed and treated and the thoughts have receded. Assurances that the thoughts are entirely a result of the depression and that there is treatment can help. But some are simply unable to share their thoughts, cover them up, and will act without warning. Friends and relatives must not feel guilt: there is absolutely nothing they could do to prevent or avert the suicide. I feel so sad for all the guilt along with the grief, you see. Remember that depression is, as someone said, an illness which renders the sufferer a victim of irrational thinking.

Never Mind!! said...

Suicide according to me is definitely an act of bravery. Considering the grand scheme of things that is. But like Isolde said, I think its just the irrationality that drives a suicide rather than bravery which reduces it to a mere act of cowardice. But an interesting post and interesting comments.
Isolde: your comment was very insightful and thought-provoking.

Cynic in Wonderland said...

amodini - yes i am sure post partum depression is huge - its such a life altering event. and change is so difficult to handle. and in india, the thought that someone might be depressed after having a kid - a ghar ka chirag will be unthinkable.


isolde - how does one know whether a person is in the danger stage. is there any way of figuring it out? i guess for some people life with a complete absense of hope is not worth living and the task for others is to provide hope. but hope is eternal ..so catch 22 i guess.

never mind - its an act of courage in the deed but not the motive perhaaps..what do you think?

AmitL said...

Hi,Cyn-I honestly read only a part of this post-reading about suicides and why people commit them,is pretty depressing..and,makes one wonder what one can do to help them avoid it?

Incidentally,India Today had a cover feature on teen suicides recently.I couldn't read that one in full,too!!

Iya said...

First time on your blog. Came through desipundit... and couldn’t resist commenting... one of my closest friend tried committing sucide.. She was saved to be on life support for a long duration... the reason she did it was sheer helplessness.. She had no control whatsoever on her life.. Nothing was happening like she wanted it to happen... she was torn between her parents and her love and then she decided to end it all....

chandni said...

suicide is one issue I just don't have much to say about...I can never imagine what level of despair actually leads a person to end their life....

I don't think its about the other people left behind as much as for the state the victim was...may be they feel a level of despair where even loved ones are no relief...may be.

But if I try to analyse myself, I think ending one's life demands a level of bravery beyond me. To inflict pain on oneself however shorlived...but potent enough to kill is just too difficult

Sud said...

Its interesting how depression is considered something to be hidden away. Remember reading in this month's "Mind Matters" (soc gen research), Montier writes how its clinically depressed people who are actually realistic. Depressive realism he calls it. And how the rest are really far too optimistic. Wonder if I really want to be depressed and risk to all to have a realistic view of the world.

Cynic in Wonderland said...

amit l - yes it is, i try not to think about it most of the times, but i guess sometimes one needs to

iya - so you know i suppose - how it is to be one of the person left behind. sigh

chandni - it does, doesnt it. i cant imagine how much courage it needs to do it. i dont think i have that kind of courage, no.

sud, i guess depressive people see the world for what it is, the others maybe living in some fools paradise - but i guess i would risk being a fool than a realist.

galadriel said...
This comment has been removed by a blog administrator.
Anonymous said...

Interesting.

Funny how for last one hour, I have been reading, and loving, your writing but the moment I finished reading this one, I hit the comment button. And now that when I have, I seem to have run out of words.

Funny thing, this life.

And, oh yes, before I forget, you write well.

PS:- In your vocab, do I qualify as the phantom reader? Lurking in the shadows and so forth? :)

Cheers!
S

Cynic in Wonderland said...

Thank you Anon S. And I hope you delurk. i LIKE getting comments. It makes my day!

Isolde said...

"isolde - how does one know whether a person is in the danger stage. is there any way of figuring it out? i guess for some people life with a complete absence of hope is not worth living and the task for others is to provide hope. but hope is eternal ..so catch 22 i guess"

Sorry I took so long... but was too busy last time your comment came to my notice... Danger signals can vary so much from person to person. I would suggest that you might notice changes in the behaviour of someone you know well - perhaps a reluctance to go out, a withdrawal, quietness, loss or sometimes increase in appetite, lack of concentration, poor memory, inability to enjoy life, lack of energy, prolonged change in sleeping habits [particularly waking early]. When all or some of these become persistent [beyond a month, perhaps] and unbearable the person will usually find it harder and harder to work efficiently, achieve deadlines or even the simplest tasks. Then it is quite obvious help is needed and a relative or friend would usually feel impelled to encourage them to seek help. The presence of suicidal thoughts is a clear danger signal - any assessment will always include such a question. The presence of a plan or of thoughts about a possible method is more dangerous because the next step is to act on those thoughts if they become more and more persistent.
There is always hope as you say, but it is our ability to see and believe that which is less consistent. Perhaps depression, once deep and ingrained, is more about a loss of ability to think rationally than an active loss of hope, although I think the latter can and does happen it is a precursor following much trauma rather than a consequence of depression, although again, in some cases a person will be aware of a sense of hopelessness or loss of belief life could ever improve again. These are just a few possibilities in this arena; there are so many variables it would be dangerous to suggest there is only one scenario which warns of the impending possibility of suicide. Some people are very used to hiding their real feelings; some do so to varying degrees all their lives. We are actors, and life a stage... who knows how real our thoughts and actions are, how much we do is generated by our own selves and how much is a reaction to others or a misapprehension of the world around us? But that's perhaps not a useful conundrum here, I digress!
I would add that there is sometimes a very simple solution to all the above symptoms - I've seen them disappear literally overnight when a person's sleep improved on giving up drinking fresh coffee late at night! Sleep improved, energy returned, ability to cope and concentrate along with it... if only all our difficulties could be solved so easily!

"it's an act of courage in the deed but not the motive perhaps..what do you think?"

I think courage does not come into it for the person on the brink of suicide. There's a sense of being impelled, as if all other senses have closed down - a sort of blinkered view where all other considerations have been dealt with [such as thoughts of others; often the overriding feeling is that those we love will be better off without us in this state for example].

I can't emphasise enough that irrationality has taken over once suicide is enacted. The person suffering from deep clinical depression is unable to think clearly or logically, so therefore courage and cowardice are no longer a factor.

Anonymous said...

Isolde definitely has fair amount of experience to talk about it. Just adding to it, clinical depression is just *one form of* neurological disorder which might make one contemplate suicide. There, obviously, are other manifestations of the same and as Isolde has put it correctly, it is not really about courage/cowardice. It simply is a defunct brain which stops thinking in ways which otherwise might be called rational.

I have seen people give in and kill themselves and I have seen the ones who have been in the red zone and pulled out of it. The reasons were strictly medical, some survived and some did not. I dont know how much courage does it take to do it but one thing I definitely know is it takes a hell lot of focus to NOT do it. One slip and thats it. Over :)

Apologies for spamming the comments section.

Cheers!

- S
(again)