I read a post last week in which I think the author meant well, and I don’t think he intended to be very judgmental of a young lady in his community who had completed a suicide. He said that she ought to have considered the pain it would cause her family. He said she ought to have considered that her life was not her own to take because of God. He did acknowledge her pain and depression, but it was clear to me that he did not understand the illness of depression. He took her act of suicide to be a response to the situation in her life as opposed to what it is, which is dying of depression.
Dying of Depression
I consider that people who complete suicides "die of depression," because, although some do not realize it yet, depression is an illness, and it can be a very serious one. Speaking as someone who has been through depression many times in my life, I can tell you that it is not as simple as you might believe. It is very difficult for people who have never been suicidal to comprehend what it feels like.
Many people don’t realize that the same part of the brain is active when we are in mental pain as when we are in physical pain. Take a moment to consider whether you have ever suffered severe mental pain in your life. Most people have. What if that pain became prolonged? When you are in the depths of a severe depression, it is not sadness that you feel, it is profound despair. You feel a complete lack of hope, worthlessness, and a deep sense of self-loathing. Often, you feel you do not even deserve to be alive.
The Word "Depression"
It is unfortunate that we use the word “depression” for two reasons. One is that the word sounds mild. If there is a depression in the road, it is a small downward bump. Mental depression is not a small downward bump! The second is that many people use the word “depressed” every day when they feel a bit sad. “I got a bad grade in my class and so I am feeling depressed.” That is a valid use of the word “depressed” from the standpoint of the English language, but it is not equivalent to the illness of depression.
Depression Can Often Be Worse Than Physical Pain
I have had physical pain in my life, even severe physical pain such as the pain of childbirth with no medication, anaesthetic, or painkillers at all. In fact, I have also had dental surgery without a topical anaesthetic. While these were bad experiences, I can tell you that, by comparison, severe depression is far worse.
Why is it worse? It is worse for several reasons:
- When I was in physical pain, it was usually something I understood would go away in a set amount of time.
- Despite the pain, I had hope when I was in physical pain.
- In some cases, like when I had a gallbladder attack, I was able to go to the hospital and they gave me strong painkillers. There are no strong painkillers for depression.
When I am in a severe depression, I would prefer most forms of pain or agony if I were able to trade one for the other. It is a sickness of the mind to feel hopelessness, self-loathing, and mental agony. People who have never experienced it have trouble understanding. It might seem like weakness. I remember reading one very apt description by a person who was depressed. She said when she was depressed, just the act of making toast seemed insurmountably difficult. “You might as well ask me to move a mountain with a spoon.” Everything feels that way when you are depressed.
It Takes Strength and Bravery to Live with Depression
I have counselled people who are severely depressed. I tell them that they are strong and brave because, trust me, living with that sort of agony for even one minute, let alone every minute of every hour of the day requires great strength and bravery. It requires faith. It is a weird faith because you feel hopeless and dark and yet you continue to breathe.
SMART Goals Can Sometimes Help You if You Are Depressed
I often have spent three hours being my own cheerleader, convincing myself to just get out of bed and do some seemingly simple task. One thing I recommend to people who are depressed is to set SMART goals. Do you know what SMART goals are? They are Specific, Measurable, Achievable, Relevant, and Time bound. I will give an example in a moment.
How is this helpful? When we are depressed, everything feels overwhelming. It can be helpful to come up with one very small goal. When we achieve the goal, we have a feeling that we have succeeded. Feeling successful is a good step forward in moving away from depression.
Please don’t push advice on someone who is depressed or try to convince them to do anything. Make suggestions and be there for them without pushing. There is a fine line between showing you care and making the person feel even worse about themselves. When I mention SMART goals, this is for the benefit of people who are going through depression. Feel free to share the idea with a depressed friend or family member, but allow them to come to the idea if it works for them. If not, don’t force the issue.
An example of a SMART goal: I had a client once who was extremely depressed and not doing anything. She felt terribly guilty because she was not doing anything. I asked her what she would like to be doing. She rattled off a long list of things she felt she “should” be doing. I suggested that she think of one fun thing and one “productive” thing she would like to do each week. One in a week might seem like a very low bar to set. However, it is better to set the bar low.
Baby Steps for the Win
Setting the bar low is the Achievable part of the SMART goal. Once you achieve the goal, you can move the bar higher the next week. It is so important to have a sense that you are making progress. That is more important than having a laundry list of accomplishments.
She decided she wanted to study as the productive thing and go to a coffee shop as the fun thing. We made it specific. What would she study? Which day? At what time? For how long? The same with the coffee shop. Which coffee shop? When would she go? How long would she like to go? Would she go alone or with a friend or family member? If alone, what would she do there?
The Specific and Measurable aspects go hand in hand. If the goal is specific enough, it is easy to measure whether you made progress on it. For example, my client made a note of when she studied and for how long, etc. Relevant refers to the fact that the goal relates to getting well. The truth is that doing almost anything that is not self-destructive is relevant to getting well in the case of depression. Time bound refers to when you will check in on yourself about the goal. In the case of my client, we had weekly sessions, so we could discuss her progress on the goals.
This is just one way that you can help yourself to begin to move beyond depression, and when I first heard about it, I thought it was a new age gimmick. However, I have come to find SMART goals very useful, and I find myself suggesting them to friends and family without really thinking about it now. However, I usually don’t use the word “SMART goal.”
Instead, I just walk people through the process if they seem interested.
Avoid Guilt Tactics
It makes me sad when I read something that shows me that someone doesn’t understand depression or suicidality. I used to work on a suicide hotline. One of the things they trained us to not do is make the person feel guilty about their surviving relatives. If you have a loved one who is suicidal (or if you yourself are suicidal), the best course of action is to get professional help.
How to Find Out if Someone You Love is Suicidal
If you suspect that someone you care about might be suicidal, how can you find out? By asking them. Be blunt. “Are you suicidal?” They have done studies on this, and it will not put the idea in someone’s head. That makes sense. If you are not suicidal and someone asks you if you are, would you suddenly think, “Oh, yes. That sounds like it is a good plan”? I think you would not.
If they say that they are suicidal, take a deep breath. This person has chosen to live so far. That is why they are talking to you. Chances are good that they will continue to choose life, and you have to have faith and hope for the best. Ask them if they have a plan, and if they do, ask them what the plan is. That might sound extremely morbid, but it is not. For one thing, if they do not have a specific plan, you should still take the situation seriously, but it is not as serious as if they do have a specific plan.
If they do have a specific plan, it is important to know that because then you know the situation is serious. You might have to get a little pushy about getting this person professional assistance. It is always better to be empowering and to convince the person to get their own help. They are more likely to survive in the long run this way.
Acutely Suicidal Client
I had an acutely suicidal client once when I was a counselor. He told me the exact date he planned to kill himself and how he planned to do it. I would have liked to have him taken to the mental hospital, but my supervisor was not in agreement, they don’t necessarily lock people up for just being acutely suicidal here anyhow, and the truth is, it might not help. I have heard on the suicide hotline from people who felt better after a stay at the mental hospital, and also from those who felt worse afterward.
I really wanted him to live, and I know this demon of depression very well. I said to him, "Your ONLY job right now is to breathe and to live. All day, all night. If you do that, you have done everything and you win against this illness." People rarely tell a depressed person that they are strong or brave, but if most people had to face the crushing despair and darkness, I think they would see that it is strong and brave to face it, breathe, and live.
I was very grateful when he arrived at his appointment the next week (and for all our subsequent sessions). When I asked him what he did that week, he said, "I lived." I was very, very pleased and proud of him. I know how bad that darkness can be. It was no mean feat.
How can I describe depression to someone who has never suffered from it? I cannot. I tell people who are depressed to hold on. I tell them to hold on because I know that depression is like a wave. It comes, and it is horrible. It feels like it will drown us. However, if we hold on, it will not drown us. The depression will pass, and we will remain. Our only job when we are severely depressed is to live. We would not ask more from anyone who was extremely ill. Just because you cannot see the illness, that does not mean it is not there.
However, we must remember not to judge people who complete suicides or, for that matter, their families. It is neither weakness nor selfishness, as some have suggested. Rather, it is tragedy.
Imagine that you were on fire. That is the worst physical pain they say a human being can suffer. What would you do to end that suffering? Would you just endure it? If you would, you are strong. Strong like the people who endure the hell pain of depression. That is what it is. It is an emotional pain on a par with being burnt alive except no one can see the fire. You can’t even see it yourself, which makes you doubt your sanity for being unable to do the simplest things and for feeling so bad when nothing is apparently wrong.
When you are depressed, many people tell you to “feel better”. They give you words of wisdom, medication, advice, religion. All of this is not particularly helpful.
I never judge people who complete suicide. How much pain would you have to be in that death by your own hand would seem a better option than continuing to endure the pain?? I have tried to convey it to people when I am in a depression by saying that I would prefer to not be depressed and be forced to walk around with a knife stabbed into my thigh all day long.
People don't understand how emotional pain can affect us. Severe emotional pain is as bad or worse than physical pain. I say it might be worse because people don't understand how much pain you are in when it is "only" emotional. They don't give you painkillers, which is probably a good thing so we don't all turn into addicts, but it is hard. We must try to help people who are depressed, and we must not judge people who complete suicides.
If you are feeling depressed or suicidal as you read this, please get help. Call a local suicide hotline, and if you have no idea how to do that, call the local emergency number. They will most likely give you the number for the suicide hotline. When I worked at the suicide hotline, many of our calls were routed from the emergency number (which is 911 here in Canada).
The psychologist Michael Yapko famously wrote, "Suicide is a permanent solution to a temporary problem." While we must not judge people for completing suicides, at the same time, when we ourselves suffer from depression, it is so important to remember that this horrible state of mind that is so painful is also temporary. It doesn't feel that way. It feels hopeless. It sometimes feels like it just keeps coming back. However, those are feelings, and those feelings are caused by this illness of depression, and they are lies.
The truth that I can tell you, as someone who has been depressed on and off for 25 years, is that things improve. I still have depressions, but they are lighter than they used to be. I have learned many tools to manage my illness, and they help. They help to make it less severe, and they help keep it in remission longer. It often feels like "nothing helps" when I am in the depths of a depression, but when I am feeling better, I can clearly see that this is a lie. Many things help, but nothing is an absolute cure. Then again, there are people for whom there are absolute cures. For example, some medications might work wonders for some people. Some people might be cured by exercise. Others might be cured by therapy.
Then, there are people like myself who use tools from therapy, meditation, medication, exercise, supplements, and nothing works 100%, but everything helps a little bit. All of those little bits can add up to a big bit.