As a society, we don’t understand suicide. Everything in our DNA works to optimize our chances for survival so, when someone appears to have chosen to die, we struggle to make sense of it.
When Kate Spade died by suicide a few days ago, I faced it with the same dread as I have faced all suicide reports since April 2017. That was when my child didn’t complete his own suicide attempt. I don’t know why he was lucky, why we were lucky, and he survived. I don’t know the difference between Kate and my son. Just like I don’t know the difference between breast cancer patients who die and those who survive.
But I do know suicide is a brutal, tragic way to die. And, it is not a choice. Depression, only one of the many conditions that can lead to suicide, is a disease. Sometimes it’s treatable and sometimes it’s treatment resistant, just like cancer. Imagine if Kate Spade had died from breast cancer and someone felt obligated to post the following online:
“Kate Spade is incredibly selfish and Horrid! To die of cancer and leave behind a vulnerable child that needs her mother.. (sic) such disgusting assholish decision! No amount of “cancer” should surpass the love of your child. She’s ruined her life! What a selfish bitch.” –random twitter expert
And here is the original Tweet:
Kate Spade is incredibly selfish and horrid! To murder your oneself and leave behind a vulnerable child that needs her mother.. such a disgusting assholish decision! No amount of “depression” should surpass the love of your child. She’s ruined her life! What a selfish bitch! pic.twitter.com/UjTT4tyGLy
I find it hard to imagine anyone writing and posting such a sentiment, yet armchair mental health experts have taken to the twittersphere to shame a woman who died by suicide. There are more tweets, of course, but they are all subtle or not so subtle variations on ‘she was selfish, weak, didn’t really love her child, and depression isn’t a thing’ theme. And then, of course there was the amazingly tone deaf pronouncement from Bethenny Frankel:
“Poor @katespadeny to be in so much pain. Success doesn’t make you happy. True love & peace does.”
— Bethenny Frankel (@Bethenny) June 5, 2018
As if sacrificing her love and peace to success was the cause of Kate Spade’s death instead of it being a result of a serious disease. Once again, we would never say such a thing to someone who had just died from a heart attack. When families beg for privacy after a tragedy like this one, these are the kind of things they want to avoid.
Along with PTSD kind of feelings for those who have had similar experiences, these tragedies illuminate the ignorance and stigma surrounding mental health disorders. On the rare occasions I have shared information about my son’s suicidality, I have been met with every reply from, “but he doesn’t have anything to be sad about” to “doesn’t he know suicide isn’t the answer.” What people don’t understand is most victims of suicide are not asking a question or looking for an answer. They are looking to end overwhelming anguish. Whether it’s real or not to you, it is excruciatingly real to them. And imagine how much pain someone must be in to be driven to attempt suicide in order to stop it? Marsha Ainsworth put it most succinctly when she observed, “Suicide is not chosen; it happens
when pain exceeds resources for coping with pain.”
Although many people seem to agree we need to end the stigma surrounding mental health conditions and suicide, there are very few tangible suggestions provided. For me, the first step is empathy and listening without judgement. Every completed suicide is different, every suicide attempt has its own unique history. To treat them all the same is to place another unneeded burden on the family members who are already reeling from the death or critical illness of a loved one.
So, before we go online and start passing judgement on victims of disease, before we start throwing around #selfcare, and telling people to reach out to a friend; maybe we should have a fact-based discussion about why suicide results from a disease, not a choice.
There are some great resources available for people willing to do even the barest due diligence. Dr. John Grohol, Psy.D. has an excellent blog post about it at PsychCentral. NAMI (National Alliance on Mental Illness) has a great stigma test at curestigma.org, with info on how to support people who suffer from suicidality. And there are countless local resources as well like this one from StopStigma in Sacramento.
I understand suicide and depression. But, I only understand it as it has manifested in my own life and the life of those I love. We need to listen to other perspectives and try to see with different eyes to come to a place where there is compassion instead of stigma. And this is hard. It’s hard because it is work, and it is awkward, and the topic is so charged.
But, suicide is the 2nd largest cause of death for people between ages 10 and 34, and it’s a leading cause in older age cohorts as well. On average, 123 Americans complete suicide each day. Those are numbers worth taking seriously. We need to have substantive conversations, because stigma is one of the greatest barriers to treatment.
My understanding of suicide and depression is deeply personal. In addition to parenting a son who suffers from suicidality, I have experienced suicidal ideations off and on since 1992. For me it runs the gamut from actually envisioning myself taking my own life to just a random thought that running my car into that train would be a good idea. I have a very OCD element to my disease. Figuring this out with my doctor helped find the right treatment for me. I’m lucky that my depression has not been treatment resistant.
But, it’s a long-term illness and medication’s effectiveness can wax and wane with natural life changes (i.e., The Change), ordinary life stressors (lack of sleep, lack of exercise), and extraordinary stressors (serious illness, death in the family). Depression is insidious. It sneaks up on you and silently overpowers you, until you don’t even realize it’s not normal to think getting out of bed takes just as much effort as running the Boston Marathon.
This is what it is like. For me. For my son it is different, for Kate Spade it was different, as it was for Anthony Bourdain, Delores O’Riordan, Robin Williams, my friend Wade, and on and on for so many others. We need to quit typing, and start listening.
Celebrity suicide brings its own special considerations. The O’Riordan death was very concerning to me. My son is a fan of the Cranberries, and it happened in close time proximity to his own attempt. I was worried that the reporting on it would trigger a setback in his recovery, or even lead to suicide contagion. The CDC has found increased rates of suicide centered populationally around isolated incidents (such as a suicide on a high school campus) and temporally in the months immediately following a widely reported incident (such as a celebrity suicide). Irresponsible reporting has been so closely linked to this contagion that the CDC developed responsible reporting guidelines in the mid-1990s.
In the aftermath of the Kate Spade tragedy, CBS wasn’t the only outlet to have ignored CDC recommendations for responsible reporting by describing details and mechanics of the Kate Spade tragedy (and I am not linking here because I have no interest in their irresponsible coverage receiving more clicks). TMZ used click bait headlines warned against by the CDC, and US Weekly, NBC, St. Louis Post Dispatch and myriad other media outlets chose to ignore the guidelines in their reporting. Some even felt it necessary to note the place and color of the item that was used in the tragedy, I’m assuming to pique some sort of prurient interest and to increase the chance of a click through.
It is worth noting both the Washington Post and the New York Times’ first reporting followed the CDC guidelines. Revisiting CDC recommendations in our new algorithm and click driven media environment sounds like a good idea. Although Anthony Bourdain’s death cannot be definitively linked to suicide contagion, his suicide following so closely on the heels of Spade’s brings a new sense of urgency to the problem of suicide reporting.
The internet has given us new and infinite ways to be horrible to each other. But it has also given us a powerful tool to help end stigma surrounding mental health conditions and suicide. If we can use it responsibly, maybe we can help save a life.