[Author's note: The title for this post comes from the Don McLean song "Vincent" and references van Gogh's suicide. ("And when no hope was left in sight on that starry, starry night, you took your life as lovers often do...") It's important to note that this post will be an in-depth discussion of suicide and the emotions surrounding it.]
Looking at van Gogh's "The Starry Night" in person is a bizarre experience. It sits on a wall with a dedicated museum guard standing nearby, not letting anyone get closer than three feet away. The painting itself is much more beautiful in person than the college posters and over-produced totebags and postcards would have you believe. I'm not sure what makes it so stunning. The vivid colors aren't any more vivid than the best reproductions. Perhaps it is the texture that flat images imply but could never hope to recreate.
Standing in a crowd trying to reach in between people's heads with my phone to snap a halfway decent photo, I couldn't help but think about van Gogh and just how apropos this experience was. You stand there in a sea of people that doesn't notice you or care that you're there. The throngs of tourists are all experiencing something as they peer at this masterpiece, but they share none of it with you and they don't look to you to share your experience with them. You are one of many but singular, insular, alone.
It felt like a fitting but depressing tribute to van Gogh's life, even more so its end.
It seems as though suicide has become such a prevalent topic these days. It's not just the high-profile celebrities that plague the news feeds in my community, it's also the sudden (?), unexpected (?) spike in the deaths of people who stand, or rather stood next to us in the elevators at work or at the bar on Friday nights.
In the wake of a suicide, most public remarks can be lumped into one of two different types of responses. Both have merits, and both are also severely shortsighted and fail to solve the overarching problem: how do we provide help to those who need it, and how do we get those who need help to seek it?
The first response is an impassioned plea to those who are suffering: "Please seek help!" we implore. "I'm here for you. Here's a hotline you can call if you don't want to talk to your friends or family! Just stay with us. Stick it out. Push through. We need you, we love you."
The second response is usually prefaced by a condemnation (sometimes severe, sometimes gentle) of the above. This second philosophy hinges on the knowledge that those in the throes of depression often lack the capacity to seek help on their own for any number of reasons. "So you...we all need to be the ones reaching out to those who suffer," many such expressions conclude.
In most expressions of this philosophy, people also remind us that depression and suicidal ideation aren't always overt: "Reach out to everyone...even your strong friends." I saw one such insistent post end with, "Especially the strong ones, because they may be hiding the biggest pain."
I want to touch on why these two philosophies are, on their own, anemic and ineffective. Before I do, though, I want to make it absolutely clear that I am not encouraging people to stop reaching out. Later, I want to talk about what we can do to make these two approaches effective over the long-term.
My critique of these two schools of thought and my subsequent proposal come from my own struggles with depression and suicidal thinking as well as my several years working in the public mental health sector as an Attendant Care Technician and Assistant Case Manager at a county Community Support Services facility.
I'll reiterate that both ideas have some measure of value, but both suffer from a touch of flawed logic. Flawed in the sense that they don't consider the whole picture. My goal here is to help uncover the challenges both of the aforementioned perspectives face and offer up a long-term solution.
This philosophy misses how cataclysmically distorted a suicidal person's mind has become. They rarely see before them a world that makes sense, that cares, that has value. This is due in no small part to the fact that they do not believe they themselves make sense, care, or have value. I am an aberration, a nuisance, a hinderance, a mistake. They have convinced themselves (sadly, with very little effort) that they are not valuable and therefore not valued.
You have no doubt heard the assertion by ignorant or grieving people that suicide victims are "selfish" because they don't consider the pain that their loss will cause others. This is absolutely false. Men and women who are neck deep in suicidal angst almost certainly have factored the emotional wreckage they'll leave behind. The problem is that they have gaslighted themselves into believing that their loss will either have no impact on their survivors (remember, "I am not valuable; therefore, I am not valued.") or that the psychological toll their loss will cause on their friends and family is actually a trade-up from the stress of "putting up with" their unrelenting depression. They see sticking around as a greater burden to everyone than the pain of grief.
I can remember thinking at one point in one of my darker moments, "Grief is temporary. Everyone will forget or it will get easier. But if I'm here, I'm depressed. I will always be depressed. I will always be a source of pain and frustration." It is virtually impossible for someone who thinks that way to proactively reach out before they sink too deep.
What's great about the second response I detailed is that its champions understand the flaws of the first response. Instead of putting the onus on the person who's struggling, they put it on that person's support network. It acknowledges the danger of passivity (i.e., letting them come to you vs. you going to them). And while I do feel that this is a tactically superior approach to helping those in pain, it isn't as impactful (yet) as it could be.
First, let's consider what spectacular actors people can be when they want to hide something. Innumerable are the people who explain in the wake of a suicide, "I didn't know! He was always smiling! She never seemed down! They were always an emotional support for me when I would feel down!" This tells us two very critical things: 1. depression is a master of disguise, and 2. a large chunk of people who feel suicidal don't (won't?) acknowledge their depression to those closest to them.
I'll circle back to that in just a moment...
Response 2 concerns me for another reason. I mentioned earlier that people with this philosophical approach to suicide demand us to check in on all of our friends to ensure we "catch" the ones who are in pain. It presupposes that if we cast a wide net and offer mental health checks to quite literally everyone, then we will save the ones who are actually planning their exit.
But people struggling with mental illness aren't idiots. They know when people are casting a wide net and when they're making specific, pointed attempts to connect personally with them, not just one of many.
I can recall during my mental healthcare days clients talking about this very idea. As a tech, may of my clients shared woes with me while concealing them from the psychiatrists and case managers who were there to treat and support them. It was because I was there, face-to-face, at least once a week. They believed - and frequently verbalized - that the doctors and case managers were apathetic to their personal challenges. "I'm just a case file. They have 50 other people to think about." Casting a wide net may be necessary, but I don't trust that it's as effective as we'd like it to be.
Third, and perhaps least-considered, is the psychological toll that this "anyone and everyone might be suicidal right now!" tactic will have on you, the do-good'er trying to save a life by assuming all lives could be in danger. You are tasking yourself with a Holmesian mystery that may never be solved. You're piecing together a puzzle with only 1/4 of the pieces. You're looking at a Magic Eye poster that's labeled "cat" but that shows complex algebra formulas in a discombobulating yet muted 3D. You will - we all would - drive ourselves mad trying to sniff out the one (or two? or three? or four?) friend who is in the greatest need of our personal connection.
And that brings me back...
No matter the approach we have taken with people who have killed themselves, most of these tragedies have one thing in common: the victim's inability to seek help and/or their refusal to accept help when it was offered. And why is that?
A proposal for a long-term solution:
Stigma. Poor mental health is so severely stigmatized that people would rather languish in a lonely hell than look for salvation. Back when I was a mental healthcare worker, stats claimed that only something like 10% of those suffering from mental illness actually sought help of any kind. Hopefully that stat has improved in the decade since, but I'd venture a guess that if it has, it's been minimal.
So how do we fight against stigma? How do we convince our struggling friends and family that it's okay to come forward? Most people think it lies in the responses above: proving you are there for them and willing to provide asylum. But that's not it.
No, the solution is to talk. Openly, honestly, candidly, frequently. And not talk about how open and willing you are to help. To so many sufferers, that is just lip service. They lack faith in the idea that you/we could possibly know anything of what they're feeling.
The solution, then, is to talk about our own struggles. Whether your history includes a diagnosed mental illness, just the occasional bad day or two, or something in between the two extremes, it is absolutely critical that we all have more - and deeper - personal dialogues about our mental health histories with the people in our lives.
I have seen some public Twitter, Facebook, and Tumbler posts from folks sharing their struggles, and I think that's a start, but the real solution is in reaching out personally. It matters a lot. If and when a friend finds themselves sinking into the emotional quicksand of depression, they will remember that you struggled and that you told them. That knowledge is far more likely to be the buoy that encourages them to do the same than a post we make to all 1,762 of our Facebook friends about how much we care.
I want to state it once again: it's not a bad thing to share broadly. It's just that we have to remember that nothing will ever be a substitute for direct, personal contact. For face-to-face deep-dives about the pain we have/had. There's such profundity in seeing someone else, in being seen by someone else, in having heartfelt dialogue that says it's not only okay to hurt and okay to share it, but that those things are in fact normal.
I should clarify here that this solution isn't just about normalizing the idea of sharing our pains and struggles. It's also about educating others. How did you survive? How do you cope on the daily? What did you do to climb out of the ocean of despair? And if you've yet to climb out of it, what do you do to keep from drowning?
Remember that statistic about how few people seek help? Well, one of the most useful components of therapeutic intervention is the education on coping skills and techniques that can reduce the impact of depressive episodes and anxiety. If we share not just how pained we were but how we managed that pain and survived despite it, then those listening can recall those tips in times of need. You may save a life without even realizing it.
Finally, be sure to include an addendum to your stories. Let people know that your struggles don't prohibit you from being there for others. Don't just say that you are there if they need you; tell them you want them to reach out if they need you. You are honored and privileged to be there for them if they should require aid.
It is still important to reach out when you need help, and more crucial still to reach out to those who may need help. But none of that will be effective if the person in need does not feel comfortable or confident or accepted enough to share. And that starts with all of us.
There's no panacea for severe depression and suicidal ideation, and this proposal is still only a small part of the greater whole. But with more openness and more effective outreach, we can make great strides over time.
In Blue (Just Like You)
Surges and swells like heaving breaths
That push all the earth beyond death
Stars ripple with glory in the inky night
Even the pitch around us carries light
And you render me so kindly
So much grace have I seen
Paint me in blue; blue just like you
Paint me in green; greener than your envy
Paint me in the brightest yellow;
Brighter than the sunflowers you grow
And paint me in layers; thicker than desperate prayers