Being Mortal

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I doubt it is possible to have access to the internet and be unaware that suicide has once again floated to the top of the news. If you were online and missed the fact that two famous and deeply gifted people took their lives this week, I’d like to know which filters you’re using in your various news feeds. You could sell it as a formula for downer-proof digital life.

In the several of the news reports about the deaths of Kate Spade and Anthony Bourdain, there were references to a CDC study which indicated a couple startling trends. First, the suicide rate has risen 30 percent or more in half of the United States. Second, the CDC found that about half of the people who committed suicide did not have a history of mental health diagnosis or treatment. This bit of information startled me.

Before hearing about this study I assumed that two things are true about suicide: that the person is indeed deceased, and that he or she had an untreated or undertreated mental illness. I even went so far as to consider that 40,000+ yearly suicides in the U.S. could indicate that we are still living in a stone age of sorts in mental health treatment, that for some people mental illness can indeed be a terminal condition.

Sadly enough, it is true that some people suffer from mental illness so resistant to available treatments that they face a real and persistent threat of death due to suicide. One of my friends committed suicide in 2016 for just such a reason. Combine a deeply disabling mental illness like bipolar or schizoaffective disorder with substance abuse (which can sometimes involve escalating dependence on prescribed, controlled substances like Xanax), and suicide is a definite risk. For individuals with a clinical picture like that, mental illness can become a terminal condition.

Now is the point where I realize that I am taking entirely too long to develop the notion that arose in my mind from reading references to the CDC study that indicated about half of people who commit suicide have no mental health treatment history. Long story short, I believe that we are living in an age where it is becoming harder to conceal serious mental illness. You don’t have to crack open very wide to intersect with a mental health diagnosis. In the case of my friend who took her life, she had an 18-year-long treatment history before her suicide. She lived in small, conservative communities for her entire life. She was a born and bred Rustbelt Republican, and she grew up knowing that mental illnesses are just as valid as physical ones.

If half of U.S. suicides involve people with no mental health diagnoses, I cannot escape the notion that a rising number of people are deciding that their lives aren’t worth living. It is possible that some people are making a rational choice to stop living for trivial reasons. Why? Because they do not value human life enough to preserve their own.

I believe that everyone does a fairly complex yet intuitive cost/benefit analysis of human life and that this analysis informs the value we place on our own lives. For example, if you believe that a blind person is worthy of a dignified, happy life, you would eventually adapt to life as a blind person if you happened to lose your vision. If in your heart of hearts, you believe that such a disability leads to a useless life, you could very well choose to end your life due to loss of vision and have no mental illness at all.

While it is vital to continue the battle of easing stigma and increasing access to mental health treatment, I also believe that is time to start a cultural discussion of the value of human life. As this value declines in our culture, it becomes more rational to think that one should stay alive only as long as one is healthy, young, wealthy, famous, or some combination of all that is prized in the here and now.

Both Kate Spade and Anthony Bourdain were well into middle age. I can’t help but think that whatever their personal reasons for suicide, their passing is symptomatic of our culture’s discomfort with aging. At 45, I am well into the long, rude awakening that aging is hard work. Have I broken some unspoken rule in advertising that I am already getting old? I’ve written several posts about my struggle with lumbar degeneration. In reality, my problem is just advanced aging of the spine. If you get old enough, there’s a good likelihood that your back will be just as bad as mine is.

I can’t be the only one who was so ill-prepared for getting older. I grew up in an era when looking young was paramount, with little regard for one’s insides– if you can be mistaken for a 30-year-old, then your insides must be that healthy, too. I am going to transgress once again in revealing that we start falling apart by degrees from the moment we are born. Ask anyone who’s had their wisdom teeth extracted after age 30, and you will hear that 30 is not so young.

In thinking of the rising suicide rate, I must remind myself that I decided long ago that life is worth living until its natural or accidental end, however hard one’s circumstances may be. Life is worth living even one is severely disabled, profoundly poor, or impossibly old.

Turn this thinking inside out. Consider a weather-beaten man wandering about downtown who looks like he has nothing but where the day may take him. No matter how he landed in such a life, his survival shows that he values his life against all odds. How much do you value yours?

How do you solve a problem like Cecelia?

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Her name was not Cecelia, but she could have worn that name like an ermine mantle, with her red curly hair and blue eyes that spoke of the frozen North. Her hair made me think of Viking escapades. At first sight of her, I recalled how St. Brendan spotted Judas chained to a rock in the North Atlantic and that I imagined long ago that the Vikings had also witnessed the captive Judas at sea, his significance lost on them. Both St. Brendan and the Vikings may have visited America, a land unknown to others of their homelands. Like them, Cecelia went to a place unknown but imagined by those of us left behind. Now Cecelia’s red hair has been buried since January, because that was when she took her life.

I feel it is apt to mention something as obscure as St. Brendan’s voyage to America because it ties into my memories of depression. I have trouble recalling the things I learned and my experiences while depressed, as if I had picked up a notebook dropped in the rain. A few passages are clear yet most of material has bled together. Hearing that detail of St. Brendan’s journey, that he allegedly saw Judas freezing and sodden, chained to a rock in the North Atlantic, is one of the limited academic memories I have of my college days due to major depression. I feel that I need to capture my memories of Cecelia now since my episodes of that disease are minor these days in comparison.

Explaining her end has one thing in common with my apologetics for leaving my daughter’s father. No matter how many times I explain it, the theory or theme is different than the time before, yet no new explanation really eclipses a previous one. It’s almost like walking through a labyrinth loaded with random fun house mirrors. The reflection changes, cannot be taken at face value, yet the person (oneself) being reflected is in a concrete sense the same. Would it be better to keep walking and ignore these distortions? Or I must I consider these reflections to get out of this labyrinth?

Often I consider that I was arrogant to think that I could mentor her out of her darkness, and that I failed to believe that her struggle was any worse than mine had been. Time and time again I assured her that she could find a way to survive because I had done so. I admitted to her that my depression lasted for most of her life (she lived only 29 years) and that I had been so afflicted at times that I prayed God would take me and blot out any memory or evidence of my existence so no one would mourn me. I told her that my healing began when I lowered my expectations to the point that I had done well enough on any given day if I lived through it, that I was a success if I stayed alive until a death caused by anything but suicide. To live until God in his wisdom decided I had had enough was my only goal, the sole aim that did not aggravate my depression when it was at its worst.  Once I had lowered my expectations so radically, my healing began. I was pleased little by little by the tiny accomplishments of the day to day, restored at a glacial pace.

One of the cruelest aspects of mental illness is that our story may not help other sufferers, that each of us lives a distinct private hell that seems too disimilar to the trajectory of other’s illnesses to find much comfort or guidance in someone else’s story. Instead of understanding that Cecelia was blind in this regard, I would periodically feel too angry or frustrated with her to deal with hearing more of her downward spiral. By then she wouldn’t be giving me updates on her life for a time, probably tired of hearing me tell her once again that she could make it through because I had.

Now I know that her illness was much more complicated than mine. She had a dual diagnosis of mental illess and substance abuse, though she did not abuse illegal drugs. Her drug dependence was confined to legal substances, prescription medications supplemented with astounding dosages of Benedryl and sporadic use of alcohol. The combo she took on a daily basis could have provoked the sleep of Rip Van Winkle in the uninitiated, but this regimen was not enough to relieve her anxiety and insomnia. Her medically sanctioned, long term dependence on these substances had annihilated her capacity to sleep naturally. For her, the pursuit of a cure or even reliable relief proved to be worse than the disease itself. She did try inpatient treatment, day programs, even a 12 step program. Somehow her involvement in these measures only deepened her dependence, like going on a diet and eventually weighing more than you did when the diet started. Is there such a thing as Yo-Yo rehab?  Could there ever be an Oprah of Recovery? Someone vulnerable yet brave enough to show their struggle with addiction in real time, as Oprah has with her attempts at weight loss?

While it is possible that my history of depression was worse at times than hers, there is no doubt that her struggle with addiction was harder than any affliction I’ve experienced. In the core of me, I feel that there is the unfortunate potential to become an addict, but my circumstances have not developed that problem too much. I am addicted to nicotine and caffeine, had bulimia as a teenager, and have had more than my fair share of compulsive overeating. None of this comes close to taking heavy doses of two, sometimes three different benzos on a daily basis and topping it off with at least 200mg of Benedryl a day . . . and adding glasses of wine if sleep is still elusive. This was not some extreme exercise in hedonism or self indulgence. Imagine being unable to sleep and an facing apocalypse-grade panic if you did not take these substances.

A week before she died, she mentioned to me that she was up to taking 600 mg of Benedryl a day. I thought she was exaggerating, which in retrospect is an odd assumption because she was not prone to inflating such numbers. Except regarding her involvement with men she was better off never knowing, she was the most candid person I’ve known.

When I heard that she died, I assumed she had died of a drug overdose. Her progression of dosing did not make this impossible. I had dreamed that she would die in this manner two years before her passing, that she would die in a hotel room while snow was on the ground. I did not reveal this dream to her but instead urged her to either seek inpatient care or rehab to adjust her medications. Not long after that dream, I had another dream in which my sister was her midwife and she gave birth to a radiant red headed baby girl. I did tell her about the birth dream because I hoped that it might offer a glimmer of hope for the future, for she wanted most of all to get her life in order and become a mother. I look back on this and now see that telling her about the birth dream may have been depressing to her because she also had PCOS which would have made conception difficult for her. The thought of getting well and then climbing the mountain of possible infertility may have seemed too much to bear. In the days after she died, I heard that one of the last things she said was, “I will never be a mom.”

Drugs were not the cause of her death. She posted a question on Facebook about a local news story, as if she were waiting for an answer, then went into the bathroom of her hotel room and hanged herself. She contacted many people in the week before her death, sounding worried about the meds she was taking but slightly hopeful about the future and taking a small job offer. I wonder if these measures were to allay suspicion of her pending suicide. She called us to say goodbye and wanted no one to try talking her out of it.

Her state of mind was a terminal condition. We hear how people lose or win their battles against major physical illnesses like cancer, but I have yet to hear those terms used for mental illness. Perhaps it is time we did. Cecelia was one of the 40,000+ Americans who will lose their battles with mental illness this year.