Writer Andrew Solomon refers to suicide as "...a permanent solution to a temporary problem." And when it happens, the inevitable conversations are held in private and public forums: "Why?" "What did he have to be depressed about?" "We've all felt depressed, we've all had tough times..." and so grows the distance between depression as feeling and depression as a disease.
Depression is an elegant disease. It presents itself quietly, humbly with no pretense of being anything more than a touch of sadness -- melancholy. Its elegance is seductive and persuasive -- and as sadness grows, the roots of its cause seem worthy of its growth. And at some point, one that isn't known, the balance shifts and the sadness far outpaces its cause. Sadness becomes despair, and with it comes exhaustion, paralysis, and the grey enveloping mist that alters the shape of things. There is no language to describe it because despair has no physical shape. The ability to remember feeling good, or rather, what feeling good feels like, is lost. There is no beginning, no end, just the sinister present. People become alone with themselves in a way that is not meditative, but rather, a calm and steady savagery that left untamed, in the end, kills -- over 39,000 people a year in the U.S.
I was recently in Montana, which consistently ranks among the top three states with the highest rate of suicide. In meetings with child advocates and service providers, depression and suicide were a persistent theme. They spoke of it as an epidemic -- as though it were a virus -- consistently present and difficult to eradicate. The issue seemed to insinuate itself into every conversation about teenagers. I've spent many years working with teenagers and these conversations stuck with me.
Back home, I asked several of my friends if they'd ever known someone who'd committed suicide. I stopped, when on the sixth ask, I got the sixth yes. I wasn't surprised. I was seventeen when I heard that my friend Jack had shot himself -- it was autumn and his younger brother had found him in the woods. Later, when I was home from college, I heard of a girl I'd known in high school who'd killed herself freshman year in college. All were teenagers -- leaving behind, parents, siblings, friends, but mostly, leaving behind their future -- something once laced with vitality now left unrealized and decaying.
According to the CDC and the Children's Safety Network, suicide is the third leading cause of death for people between the ages of 10 to 24.
The last CDC national Youth Risk Behavior Survey showed that almost 16 percent of highs school kids had seriously contemplated suicide, 12.8 percent had made a plan, and 7.8 percent had attempted suicide.
In 2011, the suicide rate for teens and young adults aged 15 to 24 was 11 percent -- roughly 4,600 a year -- that's slightly over 12 a day. The early warnings are often ignored. Approximately 80 percent of people who commit suicide have talked about killing themselves -- and in the case of kids and young adults, peers often don't take it seriously, and adults chalk it up to adolescence.
When Robin Williams died, depression and suicide again stirred the debate between illness and weakness. You'd expect that as more people "come out" about their depression, it would be demystified -- by now we should know better. We have examples in politics, entertainment and sports -- Lincoln, Churchill, Buzz Aldren, Terry Bradshaw, Tipper Gore, Jon Hamm, JK Rowling, Jim Carey -- all have, at different times, been public about their depression. Still, I'm not sure our attitudes have changed. From the Greeks and Romans until now, the pendulum has swung between seeing depression as personal weakness to a disease of the brain. The Anatomy of Melancholy, published in 1621, described depression as a psychological illness. But roughly one hundred years later, ironically during the age of enlightenment, depression as a personal weakness was the prominent view.
My colleagues in Montana said folks, young and old, don't like to talk about their "problems" for fear they will be thought of as "weak" and therefore don't seek help. Indeed today, with slightly over half of Americans (54 percent) thinking of depression as a personal weakness, it's not surprising that 80 percent of those who are depressed are too embarrassed to seek treatment. Over the past 400 years, we've gone back and forth -- and still, we haven't settled on what is true -- depression is a treatable illness. And, in the absence of this more informed view, we're left asking ourselves, again and again, why kids slip into this tragic permanence.
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Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.