Op-Ed: Suicides of Bourdain, Spade remind us troubles many face

As last week’s entry showed – and as I know far too many of you can understand – last week’s suicides of Anthony Bourdain and Kate Spade shook me. Celebrity suicides always do. But, sadly, we know that the suicide contagion effect is real. I wanted to try to do something to stop it.

My local paper, the Morning Call, was kind enough to let me write this op-ed. I’m copying the text below, but if you can click on the link, please do.

We all have to speak up about this issue if we’re going to do anything about it.

When I opened Facebook on Friday morning, there was one sentence that I kept seeing, over and over again: “Not Anthony Bourdain!”

On Tuesday, it was: “Not Kate Spade!”

The death of two people who seemed to have it all was exceptionally tragic in and of itself. Unfortunately, the problem is so much more severe than that.

There is something particularly painful about suicide. Thankfully, most of you cannot fathom how someone could kill themselves, and that is a blessing.

But, please remember: Suicide and mental illness are disconnected from reality. People like Anthony Bourdain and Kate Spade seemed to have it all. But if you have some sort of mental illness, your brain and your heart may not recognize happiness or joy. It doesn’t matter who you are or how much joy you may seem to have — if you are mentally ill, your brain will not enjoy a life that “should be happy.”

Unfortunately, there is a suicide contagion affect: People are more likely to kill themselves after a high-profile suicide, and that risk is heightened among similar demographic groups. This may be a very dangerous time for people who face an increased risk of suicide.

To those of you who view suicide as an option, allow me a few words. They come from times in my life where I was so depressed I viewed suicide as an option. Give me the chance to talk to you as someone who spent hundreds of hours I’ve spent in therapy and takes anti-depressants to start every morning.

I beg you: Please remember that there is more than the pain of this moment. It’s a cliché, but it’s accurate: Suicide is a permanent end to a temporary problem.

I’ve written about this in The Morning Call before, but it’s worth telling you about my personal story again. My own suicidal moments came in college. I was a new student and scared out of my mind. I barely had any friends and I had been torn from everything I knew and loved. A bad roll of the dice in terms of genetics already predisposed me to depression, and I began to sink. I began to sink so badly that thoughts and plans of suicide began to float around in my battered brain.

Thankfully, I recognized I had a problem. I sought counseling and medication. Depression is part of my story. It always will be. I have struggled, but I have survived.

I am using myself to make a point. I was driving the other day, thoughts wondering, and my mind drifted back to this low point in my life. I was struck by this sudden realization: What would have happened if I had killed myself 17 years ago?

The answer is simple: My family and my closest friends would have been left with a hole in their heart, one which would have never really healed. Meanwhile, someone else would have lived my life, married my wife, had my kids. Someone else would have had the jobs I’ve worked and be representing the people of the 132nd District. Everything that should have been mine would be lived and loved by someone else.

And I was struck by what a waste that would have been. And what a tragedy. Choosing to end my life would have been an especially premature decision. My life is not free of pain, but by and large, it’s a good one. I wake up every day grateful for the decision I didn’t make.

I’ve had access to the treatment that I need. Everyone should be as fortunate.

Suicide is not an isolated problem. There were 45,000 suicides in 2016 in the United States — more than twice the number of homicides. That’s roughly 123 a day. Five an hour. One every 12 minutes.

Suicide is the 10th leading cause of death in the United States. It is the second leading cause of death among those aged 15-34. In Pennsylvania, it’s increased 34 percent since 1999. In Lehigh County, we’re losing roughly one person a week to suicide.

The money we spend in this area means something. Repealing Obamacare would have cut off mental health care access to millions of Americans and unquestionably increased suicide rates. We have a major mental health care practitioner shortage in this country. Millions upon millions of Americans cannot afford their prescription drugs. These things matter.

But I’m tired of hearing elected officials say that mental health matters. Don’t show me your words, show me your budget. Show me what programs you are creating to address suicide. Show me how you are dealing with the suicide among veterans and first responders. Show me what programs you are funding to ensure that we are caring for all Americans, no matter what they look like, where they come from and how wealthy they are.

Don’t give me your thoughts and prayers. Give me the money and the means to actually stop suicide.

To those who are afraid — to those who are anxious, addicted or alone — please know that there is hope. You may not be able to feel it, see it or believe it. But I suppose I am asking you to have faith — faith in yourself, in God, and in those who love you now or will love you in the future. As my own story exemplifies, there is always a reason to live, even if you may not know it at the time. As long as you breathe, you have hope.

Mike Schlossberg of Allentown is state representative from the 132nd District. If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline, 800-273-8255; in Spanish, 888-628-9454; for the deaf and hard of hearing, 800-799-4889; or by text, 741741.

The tragic suicides of Kate Spade and Anthony Bourdain

I just dropped my kids off at school. I swear, I literally just dropped them off at school, and said to myself, “When I get back, I need to write a blog entry about Kate Spade’s suicide.”

I sit down at my computer. I open the internet. And I see this: Anthony Bourdain, CNN host of “Parts Unknown,” killed himself in Paris. He was 61.

I wish I had the adequate words right now to express how I feel. More life lost to an illness that continues to haunt us, and one that far too many cannot fully understand.

A few points, I suppose, as I try to gather my thoughts.

  • If you need help, there are so many resources available to you. Call a friend, a colleague, a teacher, a loved one. And never, ever hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255.
  • Suicide knows no limits. No boundaries. It doesn’t care who you are or how successful you may be. People like Kate Spade and Anthony Bourdain seemed to have it all – money, fame, family. They seemed to have access to everything most of us could ever dream of. But the tragic truth is that none of that means a damn thing if you are in pain. The mind and the heart are disconnected from reality in the case of mental illness. That makes their suicide’s all the more shocking and painful to us all.
  • Please, please, watch how you discuss suicide. Avoid phrased like “committed suicide” or “completed suicide” – try to use “killed himself/herself” or “died by suicide.” For my friends in the media, here are some excellent recommendations.
  • The suicide contagion effect is real: A prominent suicide will often serve as a trigger for more, particularly within similar demographic groups. Please, watch your friends.

All of us have a responsibility to watch for each other – to care for each other. If you know someone who is in pain, care for them. Call them. Tell them you love them. The only way any of us survive us with each other. A mere phone has the potential to save a life.

Take care of each other. Today and all days.

Six questions: Interview with Francisco X. Stork, author of The Memory of Light

I have to be honest here: This one I came across in the course of doing research for these interviews, and I was so interested in the plot I read it. It was gripping, heavy, painful and beautiful. It’s absolutely worth reading.

From the blurb:

“When Vicky Cruz wakes up in the Lakeview Hospital Mental Disorders ward, she knows one thing: After her suicide attempt, she shouldn’t be alive. But then she meets Mona, the live wire; Gabriel, the saint; E.M., always angry; and Dr. Desai, a quiet force. With stories and honesty, kindness and hard work, they push her to reconsider her life before Lakeview, and offer her an acceptance she’s never had.

But Vicky’s newfound peace is as fragile as the roses that grow around the hospital. And when a crisis forces the group to split up, sending Vicky back to the life that drove her to suicide, she must try to find her own courage and strength. She may not have them. She doesn’t know.

Inspired in part by the author’s own experience with depression, The Memory of Light is the rare young adult novel that focuses not on the events leading up to a suicide attempt, but the recovery from one — about living when life doesn’t seem worth it, and how we go on anyway.”

Here are six questions with Francisco X. Stork, author of The Memory of Light.

1) Your book is heavily inspired by your own experiences with depression. What made you decide to “go public,” so to speak, with that experience?

The decision to connect the story in The Memory of Light to my own experiences was made shortly before the book went into production. It was then that I wrote an author’s note where I mentioned my own life-long struggles with depression and with a suicide attempt when I was in graduate school. I had talked about my depression and bipolar disorder in my blog before, but it was the first time I talked about the suicide attempt. I realized that there was still a lot of shame and guilt associated with that and I thought that I should try to confront that shame and stigma, just like the characters in my book. I also wanted the readers of the book who were suffering from depression or considering suicide, to know that I understood in a very personal way what they were going through and that the hope and light offered by the book was hard-earned and genuine.

2) How much of you can be found in your main character?

One of the reasons I made my main character, Vicky, a young woman is that I thought it was important to create some separation from my own experiences and the main character. If the character had been male, I would have a tendency as I wrote to see myself as the main character. The distance between me and Vicky gave me the ability to filter my own experiences and feelings and transform them into those of a sixteen-year-old young woman and to express these feeling the way she would. Of course, there is a lot of me in Vicky. But the novel is not a memoir and so what mattered was the creation of a unique character that would be real in the heart of the reader.

3) Much of your book seems to deal with the resilience – the ability of the main character to cope. Did your book consciously attempt to teach readers how to build their own resilience? 

For many of us, even with medication, depression is a chronic condition and even when we are “well”, it is always there lurking beneath the surface. So “resilience” or the ability to cope and to live useful and peaceful lives despite of it, is an important goal. This requires that we let go of images of “happiness” that our society gives us and that we create our own realistic version of a life that contains joy and meaning despite depression.

4) How was The Memory of Light therapeutic for you? Or was it? Did you find it dredging up old memories?

I’m not sure “therapeutic” is the right word. The book did not cure my depression or necessarily make me feel better for expressing heretofore hidden truths about myself.  When you seek to write fiction as opposed to memoir, the goal is to create an experience for the reader, something that touches him or her in a real way. The benefits for the writer, when fiction is done well, is the unforeseen discoveries about self and the world that the writing brings about. I understood and saw things about the illness of depression and how to live with it, that I had not understood and seen before. I felt less anger toward my own depression and was able to see the negative moods that come with depression with less condemnation and judgment and with a greater awareness that these negative states were not permanent.

5) What do you think readers can learn from your book about depression and recovery?

My hope is that in the process of reading the book, the reader will become involved with Vicky and the other characters in the book and grow to care for them. If that happens, there will be a good chance that the reader will be able transfer that same care and love to him or herself. The horrible thing about depression is the feeling that we are not good enough, that we are not worthy of all the good that life offers. But when you see a character like Vicky slowly learn to accept the good in her and in others, then it will be easier for us to feel the same about ourselves and about others.

6) The book is now about two years old. Anything you wish you had or had not done with it?

The Memory of Light took me a long time to write and I went through various drafts making sure that the final product would be one that offered hope to a person who was considering whether life was worth living. I’m happy with the book as it is. During the past two years I’ve heard from young people who were touched by the book and found light and hope because of it. That is what I hoped the book would do. The book is no longer mine. It belongs to the reader.

If you enjoy books about young adults and mental health, then I encourage you to check out my upcoming novel, Redemptionwhich will be out on June 5 but is available for pre-order at a discounted price today. Redemption is a young adult/sci-fi thriller about depression, anxiety and saving the world.

The most common age group to complete suicide is not what you’d think

For obvious reasons, you cannot discuss mental health without discussing the tragedy that is suicide. According to the American Foundation for Suicide Prevention, we lose nearly 45,000 Americans a year to suicide, making it the 10th leading cause of death in this country.

My experience when it comes to suicide and age is this: Most folks, generally speaking, think that suicide is something that primarily strikes younger kids, particularly those in high school. I think there’s a few reasons for this. First is suicides portrayal in popular media, such as the Netflix show 13 Reasons Why. This is just a personal hypothesis, but I think that those who are younger have broader communication skills – as a result, when a young person attempts or completes suicide, you are more likely to hear about it.

Interestingly, this assumption is not born out by the data. According to the American Foundation for Suicide Prevention, here is a breakdown of suicide completions by age:

Suicide By Age

As you can see, the most likely group to complete suicide is not teens or young adults; it’s actually those aged 45-54, followed by individuals who are 85 or older.

What is very frightening, however, are the overall trend lines. For far too many of these age groups, suicide completions are on the rise, and have been for some time. But no where is this trend more pronounced than among those who are between 15-24, which have seen a nearly 20% spike since 2012, a rate of increase far outpacing those in other demographic groups.

There are many potential reasons for this, including rising rates of depression and anxiety among teens in general, the use of smartphones ad cyberbullying that comes with social media.

Regardless of the reason, the trend line is obviously incredibly disturbing, but it remains vitally important that we deal with suicide for the public health crisis it is among all age groups.

 

Facebook to enhance efforts to stop suicide

I’ve written before about how bad social media can be for your health.  It can be terrible for anyone, but particularly young people.  Unfortunately, there is research which shows that social media may be contributing to a rise in teenage suicides, and that it is almost  certainly contributing to increased depression and anxiety among teenagers.  Those findings are even stronger for woman then men, and teenage women have also seen a higher increase in teenage suicide (please keep in mind, correlation does not equal causation).

There’s some good news on the horizon: It seems that Facebook is unveiling new tools to catch users who may be at risk of attempting suicide.  According to Facebook’s website, it will be doing three things:

  • Using pattern recognition to detect posts or live videos where someone might be expressing thoughts of suicide, and to help respond to reports faster
  • Improving how we identify appropriate first responders
  • Dedicating more reviewers from our Community Operations team to review reports of suicide or self harm

As noted by the Washington Post, Facebook will be using artificial intelligence to scan posts and comments for suicidal potential, allowing posts to be found sooner and addressed to authorities:

Facebook said that it will use pattern recognition to scan all posts and comments for certain phrases to identify whether someone needs help. Its reviewers may call first responders. It will also apply artificial intelligence to prioritize user reports of a potential suicide. The company said phrases such as “Are you ok?” or  “Can I help?” can be signals that a report needs to be addressed quickly.

n the case of live video, users can report the video and contact a helpline to seek aid for their friend. Facebook will also provide broadcasters with the option to contact a helpline or another friend.

This…well, this is actually great.  I have repeatedly come down pretty hard on technology in terms of it’s impact on mental health, but this is unquestionably a good thing.  What’s most interesting to me is that Facebook is using artificial intelligence to try to reduce suicides; technology causes a problem, and technology is then used to limit said problem.

There are, of course, limits to the effectiveness of this new initiative.  Yes, it can potentially catch a person in crisis and stop them from hurting themselves.  But it won’t do anything to stop a person from reaching that point.  Social media can still do enormous harm individuals from a mental health perspective, and that’s why it is so important that anyone using social media do so responsibly and in a manner which ensures that they won’t make themselves more depressed.

Still, it’s good to see Facebook acknowledge this issue and try to do something to fix it.

An in-depth look at suicide statistics in the United States

Before you can truly solve a problem, you have to have a better idea of what that problem is.

In my policy-making career, I’ve taken a long look at suicide reduction.  I’ve come to the conclusion that there is no one-size fits all approach; different demographics require different solutions.  We know there are certain groups more likely to commit suicide, and those groups require different interventions.

First, here’s a look at what the American Foundation for Suicide Prevention has found.  The basic statistics are tragic:

  • Suicide is the 10th leading cause of death in the United States.
  • 44,193 Americans die by suicide.  That’s an increase of 25% since 1999.
  • For every completed suicide, there are 25 attempts (Note: Terminology matters – “committed” or “successful” suicide have negative connotations, and “completed” suicide is a much more appropriate term).

Now, this is a broad overview.  Let’s take a closer look at these numbers in-depth.

Gender

According to the CDC:

Males take their own lives at nearly four times the rate of females and represent 77.9% of all suicides.

One of the reasons for this: Men are more likely to attempt suicide via a firearm, which is much less survivable than other suicide methods.  This is also despite the fact that women attempt suicide three times as often as men.

Race

In most mental health related fields, it is members of the minority community who are on the wrong end of the statistics.  That being said, for race, the reverse is true: Whites have the highest suicide rates of any ethnicity, followed by American Indians.  African Americans, Hispanics and Asians are well behind.

More research certainly needs to be done in this realm, but at least one researcher suggests that, “White older men, however, may be less psychologically equipped to deal with the normal challenges of aging, likely because of their privilege up until late adulthood.”

Age

While suicides have been increasing across all age groups, those of middle age (45-64) have the highest rates of suicide, followed by those 85 or older.

What is particularly striking and tragic is where suicide falls in terms of leading causes of death.  It is the 3rd highest cause of death for those 10-14 and 2nd for those between the ages of 15-24 and 25-34.

Method – and gun ownership

49.8% of all completed suicides result from firearms, with suffocation (26.8%) and poisoning (18.4%) as the next most used method.  It is important to note that there is a strong link between gun ownership and suicides.  Suicide rates are higher in states where there are high levels of gun ownership, and lower where there are low rates of gun ownership:

The lesson? Many lives would likely be saved if people disposed of their firearms, kept them locked away, or stored them outside the home. Says HSPH Professor of Health Policy David Hemenway, the ICRC’s director: “Studies show that most attempters act on impulse, in moments of panic or despair. Once the acute feelings ease, 90 percent do not go on to die by suicide.”

But few can survive a gun blast. That’s why the ICRC’s Catherine Barber has launched Means Matter, a campaign that asks the public to help prevent suicide deaths by adopting practices and policies that keep guns out of the hands of vulnerable adults and children. For details, visit www.meansmatter.org.

As I hope this entry has demonstrated, “suicide” should not be viewed as a monolithic disease or condition.  It varies from person to person, group to group.  We have to treat is as such, and ensure that any treatment effort addresses the many various demographics that suffer from suicidal idealization or attempts.

Google launches depression screening tool

I caught this over the weekend and found it to be very interesting: Apparently, Google has launched a tool that serves as a brief depression screening.

First, about the screening.  It is the PHQ-9, which is only nine statements.  It asks users to select the level of agreement with nine statements, ranging from “Not at all” to “Nearly every day.”  They include items like, “Little interest or pleasure in doing things” and “Feeling tired or having little energy.” The information can then be shared with the user’s health care provider and used to seek treatment.

This is noteworthy for many reasons.  The screening will pop up in the event that “depression related searches” are made, similar to the way that the number for the National Suicide Prevention Lifeline (1-800-273-8255) pops up for suicide related searches.  Given the prevalence of Google in modern life, this can, hopefully, help make people more aware of mental illness and steer them to treatment options.  This is also particularly important, given the spike in suicide-related Google searches.  That spike, incidentally, is tied to 13 Reasons Why on Netflix, a show I suspect I will be writing about in the future.

Indeed, I’d argue that the most significant reason that the availability of the depression questionnaire is important is because of the major rate of spikes in suicide that we are seeing.  Suicides are rising across the board, but particularly for young girls aged 15-24, who have seen suicide rates increase to 40 year highs.  Obviously, this is the generation that is the most technologically dependent, so increasing their awareness about mental illness and treatment options can be a very, very good and healthy thing.

As good of a thing as this is – and it really, really is a good thing – depression screenings are not without their problems.  There are some studies which report that versions of the PHQ can demonstrate “poor specificity in detecting major depression” or false positives.

That being said, for the sake of argument, let’s assume the absolute worst about the PHQ-9: That it leads to an unacceptably high amount of false positives for depression.  Google’s use of it is still a great:

  • First, false positives is very different than false negatives.  A single accurate, positive test about the PHQ-9 can steer people into treatment and give them the help that they so desperately need.
  • Second, it can help move positive views of mental illness in a positive direction.  Too many people still view mental illness as a weakness or something that can simply be conquered by willpower.  That, of course, isn’t the case anymore than a broken arm can be healed by well-wishes.  Having a source viewed as positively as Google advertise depression screenings can, hopefully, convince people of the importance of seeking treatment for mental health.

As always, I’d love to hear your thoughts.  Let us know in the comments!