<p>“These young people who have recently taken their own lives were not 90yo end-stage multi-system failure patients, they were not quadriplegics, they were not facing years of unrelenting suffering or hardship to their families.”</p>
<p>I don’t see your point.
I know they were not 90 or quads, my point was that you shouldn’t have to be, or that no one would question a suicide in those circumstances, but we would have to find a “cause/reason” for the younger person, because we can’t see that they are justified in choosing that manner of ending their lives. It must then be mental illness. MY point was that the latter does not have to be the reason.</p>
<p>^^^^^Mentally healthy people rarely react to life’s problems by planning and carrying out suicide via jumping out of one of the most famous tall buildings in the country. It’s far more likely (statistically speaking) that this person had a mental illness than that he was mentally healthy.</p>
<p>It concerns me greatly that anyone would think a problem or a change in life’s path for a 19 or 20 year somehow makes suicide a reasonable solution. And no, mental illness or instability is not desirable, but it IS normal and can/should be helped by all kinds of resources. Am I saying that an elderly person can’t decide against cancer treatment and die with dignity? Absolutely not. But even mental illnesses that have a high suicide rate (schizophrenia and bi-bolar disorder) can be treated successfully. </p>
<p>However, what we really need to be careful about is saying things like a straight A student who seemed to be kind and happy didn’t have a care in the world. That’s not fair. Obviously, something very deep and dark was happening that no one else knew and the kid was obviously suffering in silence. Even people who seem to have every opportunity can find themselves struggling. It doesn’t have to be fault or blame placed on anyone.</p>
<p>“Mentally healthy people rarely react to life’s problems by planning and carrying out suicide via jumping out of one of the most famous tall buildings in the country. It’s far more likely (statistically speaking) that this person had a mental illness than that he was mentally healthy.”</p>
<p>Amen to that. You are spot on. Psychologically healthy adolescents and young adults do not suicide. I have no doubt that this young man had a serious mental illness going on. The views expressed by IVe on this issue are way out of the mainstream. More resources need to be poured into research about suicide. The American Foundation for Suicide Prevention (AFSP) [AFSP:</a> Home](<a href=“http://www.afsp.org%5DAFSP:”>http://www.afsp.org) is a wonderful organization deserving of support.</p>
<p>Well, I think the definition of mental health is more problematic. Very hard to arrive at. So, if we decide that mentally healthy people do not suicide, then of course, those who do are not mentally healthy by previous definition.</p>
<p>I think it’s fair to say that the young person was in unbearable pain. We can call that an illness or not depending on our cultural assumptions and/or context. I would want to reach out to someone in that much pain whatever society chose to call their condition. Mental illness is one way of describing that subjective state.</p>
<p>“Well, I think the definition of mental health is more problematic”</p>
<p>I didn’t use the term “mental health”—you did. I used the term “psychologically healthy.” They are not necessarily the same thing at all. I don’t have time to get into a didactic discussion about this, but I’ll stand by what I said.</p>
<p>"I have no doubt that this young man had a serious mental illness going on. " Wow! such absolute knowledge! maybe is beliefs like that that keep people from reaching out if they need to.
In this society, suicide is wrong or a result of illness/flawed psychological health. In this country death is bad, and should be fought at all cost. Those premises can create a lot of pain.
This is not the forum for discussions like these anyway.</p>
<p>My family happens to have known two students who committed suicide in the past year at top colleges (different colleges). While one probably battled depression, I would have a hard time saying the other one was mentally ill. When I was young, I thought as you did ClarkAlum-- and then I got older and learned there is a lot of gray in life. The problem with saying that everyone who commits suicide is mentally ill is that then it’s actually easy to dismiss suicide as a threat with the thought that “well, my kid isn’t mentally ill, so he/she isn’t at risk.” It just doesn’t work that way-- especially when we’re talking about such young adults. Sometimes, people don’t have coping skills, or break down or are stressed beyond their breaking point-- and yet they’re not mentally ill. Perhaps they need to grow or perhaps (just perhaps) the stress of these schools is way more than they should be.</p>
<p>As far as this particular case, my heart goes out to this family-- his poor parents and siblings. What a terrible, horrible loss.</p>
<p>“While one probably battled depression, I would have a hard time saying the other one was mentally ill. When I was young, I thought as you did ClarkAlum.”</p>
<p>I’m a child & adolescent psychiatrist with 25 years of experience. The vast majority of young people who commit suicide have some form of mental illness. Unfortunately there are still many misconceptions about suicide as well as societal stigma about mental illness. Stress reactions and “breakdowns” that lead to sucide almost always represent underlying longstanding psychological problems. This will be my last post on the subject. In many ways we are still in the Dark Ages about mental illness and sucicide. It’s a shame, but hopefully developments in research will help us to better understand how to prevent suicide.</p>
<p>Sometimes I’ve noticed in my work with teens and young adults, and in speaking with thier parents, as well, that the words mentally ill are really frightening. I think, too, there is this tendency to assume that all mental illness is chronic. So, if you go to your physician because you had swine flu turn into pnuemonia, nobody believes because you have a pulminary illness that you are pulminarily ill. Mental illness CAN be chronic, but it can also be situational…Still, if someone has arrived at the place where they believe suicide is the best answer to thier problems (and here I am not including those who are fatally ill and want to end thier life with dignity, just to be clear), then they have some sort of mental illness.</p>
<p>definition of illness: an unhealthy condition of mind or body. definition of unhealthy? Not well. Ultimate worst case scenario for any illness? Fatality. </p>
<p>I just think it’s important to remember that having an imbalance in health, bodily or mentally, is not always some sort of chronic condition, but that even the situational depressions can lead to death. jmo.</p>
<p>ClarkAlum: I am sure you are quite knowledgeable in your field and that it’s fair to say that most suicides of young people do have underlying psycho-pathology. I don’t think other posters are responding out of ignorance. I think folks are responding to a doctrinaire tone. </p>
<p>And where is the harm in exploring philosophical issues about the nature of mental illness and the way we label and categorize people? Surely it can’t be denied that there is a cultural element in this.</p>
<p>I do have had run-ins with psychiatrists, personally and professionally, and have also had wonderful working relationships with some. No profession is exempt from error and tunnel vision, not to say that you are exhibiting these things.</p>
<p>As I said, I am sure your position is correct in most circumstances. I think the blanket generalizations raises questions. Have a good day.</p>
<p>“where is the harm in exploring philosophical issues about the nature of mental illness and the way we label and categorize people?”</p>
<p>There doesn’t have to be harm in that, but there can be harm in practice. Harm can come from the implication common in these debates that mental illness isn’t real. We don’t usually explore philosophical issues about the nature of cancer. Harm can also come from focusing on resisting labels as a means to avoid stigma, when societal ignorance and fear is the real cause of the stigma, not the label. In my experience, these discussions do not usually turn in a productive direction. That’s why people resist getting into them.</p>
<p>It is interesting. I have often wished there were a way to stop differentiating between mental and physical illness and just call it illness. Who would not tell a college student who had a horrible cough to go to the health center? And, yet, these same people might not want to suggest a visit to a counselor for someone who seems depressed or anxious.</p>
<p>I wish we had no differentiation and simply called it illness. There is no philosophical disagreement as to whether or not strepp or staff are an illness to be treated. Nobody would exhort someone with a broken leg to just suck it up and get over it. I wonder exactly where the fear comes from, sometimes, personally.</p>
<p>Point taken, but in the case of a young, physically healthy, smart 20 y/o with his whole life in front of him, or in the case of other young teens struggling with a treatable condition like depression or other mental illness, I would say suicide is something that should be “fought at all costs.”</p>
<p>mythmom~well stated, and I agree, dialog is always a healthy thing. </p>
<p>clarkalum~while always hard to truly hear tone thru email communication, fwiw, while you contributed solid information, I found myself feeling closed off when reading your responses.</p>
<p>I agree that while “statistically speaking” the majority of people who die by suicide (AFSP documents 90%) struggled with some form of diagnosable and treatable psychiatric illnesses – such as major depression, bipolar depression, schizophrenia, alcohol or drug abuse, posttraumatic stress disorder, or some other anxiety disorder, bulimia or anorexia, personality disorders especially borderline or antisocial. </p>
<p>However, imho it is the ability to really hear what another is struggling with (not simply diagnose) in order to be of significant help. as parents we need to understand what our child/college student is experiencing, without judgment, so that they do know that in those dark moments, and many of our kids have them, they know we will truly “be there”. My hope is that they will reach out to tell us when they are in pain.<br>
same with our clients, we need to demonstrate an openness in order that they come back to continue to deal with whatever painful issue is troubling them…</p>
<p>I too wonder, is it possible we are observing nuances to suicides that are different than they were a decade ago. in the case of Phoebe Prince and the type of harassment, "anti"social networking and bullying thru texting perhaps even a relatively psychologically strong teen mind cannot handle this. I am not pretending to know, but I do support our exploring this. As a clinician and a mom with three teens, two in college, I have a strong investment in increasing our understanding.</p>
<p>“the ability to really hear what another is struggling with (not simply diagnose)”</p>
<p>Seems to me like “simply diagnosing” would be a good start. For most of the people we’re talking about, even that never happens. That’s a big part of the reason they die. </p>
<p>I certainly agree that treatment is not likely to be effective if the patient does not encounter compassion, and that parents can never go wrong encouraging open communication with teens.</p>
<p>agreed, simply diagnosing would be a good start…I’m not sure we actually know that the diagnosing never happened. it may have, and recommended care, ie. therapy and/or medication may have been discontinued…</p>
<p>“clarkalum~while always hard to truly hear tone thru email communication, fwiw, while you contributed solid information, I found myself feeling closed off when reading your responses.”</p>
<p>lindz126–I’m certain that you are an outstanding therapist with an uncanny ability to detect a lack of empathy and compassion in an individual whom you’ve never met or with whom you’ve never interacted on the basis of a few electronic postings on a listserve.</p>
<p>That being said I’ll remind you and others that this thread is not about me or other the other posters and their motives or attributions. It is about a young man with an obvious mental illness who tragically ended his own life. An event like this pushes a lot of different buttons, and tends to expose misunderstandings about mental illness and about suicide. That is clear by the posts of those who for whatever reason need to believe that this young man was not mentally ill, or who continue to regard mental illness as a “label” or some type of personal failing, or worse (in my opinion), consider suicide in an otherwise healthy young adult as a rational choice for dealing with difficult life issues. </p>
<p>Suicide is a complicated human behavior. We still know very little about it, and what we do know to date has not led to effective prevention. In fact the suicide rate in this age group, which had fallen for 2 decades, has in the last 3 or 4 years begun to rise again? Why? There are several theories, but the one I believe makes the most sense and is backed by some “scientific” explanation is the FDA’s imposition of a black box warning (for suicidality) in the prescribing information for antidepressant medications in 2004. This has led to a reduction in the use of antidepressants. It wasn’t until the late 1980s when Prozac became the first SSRI (selective serotonin reuptake inhibitor) antidepressant to hit the market that the suicide rate in this age range went down. Why? Because the SSRIs were easier to tolerate, easier to dose, and much safer than the previously available antidepressants (largely the tricyclics, which though effective, had many more side effects, and were lethal in overdose).</p>
<p>The FDA’s action was, I believe, politically motivated and not driven by adequate science. That is another long story altogether. The fallout of the FDA’s actions has been devastating. In the meantime we still don’t really understand how to prevent suicide. Until the barriers around stigma of mental illness are completely broken down I’m afraid we will continue to see more of these tragic events.</p>
<p>lindz126, for your sake and sake of those who may feel “closed off” by reading my posts on this subject, I promise this is the last one. Please support organizations like the AFSP ([AFSP:</a> Home](<a href=“http://www.afsp.org%5DAFSP:”>http://www.afsp.org)) which is funding research in the understanding of and prevention of suicide.</p>
<p>I think that it is first by listening to our loved one that we may discover how troubled he/she might be. Then diagnosis is a valuable tool to help steer treatment in the right direction. And Lindz, you say that we must listen without judgment. If we judge that our loved-one is in psychological trouble and we then help him to get the help he needs, that kind of judgment can be a life-saver. I am certain that none of us parents would just negatively label a loved one and walk away.</p>
<p>And, ClarkAlum, I found your posts informative and helpful.</p>
<p>“The FDA’s action was, I believe, politically motivated and not driven by adequate science. That is another long story altogether.”</p>
<p>It sure is. I testified at the FDA hearing in Washington and it was such a charged, antiscientific atmosphere; Scientologists and their allies packed the meeting with supporters who booed/cheered according to their opinion. (It’s quite an experience to have one’s testimony to federal agency booed.)</p>