And why our healthcare system isn’t helping
If Grace was feeling blue but it wasn’t too serious, it was a Category 1. Winds were picking up and there might be some falling debris, but usually some music or a silly movie could calm things down.
If it was a Category 2 or 3, I’d start to worry. Sometimes she’d text: Category 2 … I think, maybe worse. Definitely strong. And I’d wait to hear back, hoping her foundations wouldn’t be ripped from the earth, all the while knowing she was in a dangerous sway towards a free-fall. Often a hot chocolate and a long chat would do the trick, and I would feel a swell of relief that she was stable, calm and safe.
But if it was a Category 4 or 5, things were serious. This was when the storm was rushing around her, and her fragile frame was being shaken apart, nearing total collapse. This was when she was heading for a complete ‘outage,’ where her foundations and her entire world was suddenly plunged into an all invasive darkness where nothing could escape.
There were a few rules with a Category 5. She would need to speak to Lifeline or call her dad or a friend, any hour of the day or night. Grace thought the hurricane system was a good idea. I remember her saying … “Jake, you don’t have to worry … I’m not going to do anything silly, I promise.”
The following Tuesday I received an out of the blue Skype call from a friend in London. He asked me if I was sitting down, and told me that he had been contacted by Grace’s boyfriend Peter. And then he dropped the bomb …“I’ve got some sad news man … Grace killed herself.”
My world did two things in that moment. It spun in circles and the walls came crashing down. I hung up without a word and sat there staring at a blue screen. Gutted and in shock.
I was a week away from moving to London. One week. This was not for a holiday, this was to start a new life, to try something new. And now I had to fly to Hobart and attend my best friend’s funeral, before I even had a chance to understand what was happening.
I booked a flight and was in Hobart 2 days later. I was given bogus directions and arrived late, but eventually I discovered her family and friends gathered around a small plot at the back of the cemetery. Grace’s little sister was crying and leaning over her grave. I watched as she dropped several roses over the coffin. It was everything you would expect a funeral to be … it was even raining.
In a Category 5 Hurricane: Catastrophic Damage May Occur
The warning signs are all we have to know when someone is teetering on the edge of life and death. There are no physical injuries or bleeding, or howls of pain to signal an emergency — the pain is beneath the skin, the screams are behind the eyes.
We try to understand suicide from a clinical perspective, by relying on the professional opinions of doctors and psychotherapists, by studying the various labels of mental illnesses and analysing statistics.
Such as these …
They call suicide a prominent public health concern. But it’s more than that … it’s an epidemic.
The National Media Initiative in Australia reported approx. 2,795 suicide deaths per year, over a five year period from 2012 to 2016.
In United States suicides in teenagers (15 to 24 age group) are higher than ever, with 5,079 suicides in 2014, making it the second leading cause of death for this age group. In California, the city of angels, there is a suicide every 2 hours and other states aren’t far behind.
Based on the 2015 Youth Risk Behaviors Survey, 8.6 percent of youth in grades 9–12 reported that they had made at least one suicide attempt in the past 12 months. Girls attempted twice as often as boys (11.6% vs. 5.5%) and teens of Hispanic origin reported the highest rate of attempt (11.3%).
The Dangers of Misdiagnoses and Malpractice
We are losing a generation of young people to suicide, and instead of discovering the true root of the problem, we often accept the first diagnoses.
Mental health misdiagnosis is now a glaringly widespread phenomenon that restricts people from achieving a more holistic level of wellness.
In 2007, a friend of mine experienced her first serious bout of depression. Her life, for reasons beyond her understanding, was collapsing around her like a house of cards. Claire had no clinical history of depression, but her doctor referred her to a psychiatrist all the same — a woman who was a qualified medical doctor, and a specialist in the diagnosis, treatment and prevention of mental illness and emotional problems.
During the session, the psychiatrist sat with her chin pressed against her clipboard and asked questions about Claire’s past history while she made notes. After about an hour she looked up and sighed. “You’re bipolar,” she said.
Within an hour she had diagnosed Claire with bipolar disorder and prescribed her with Lithium — a controversial drug that is known to damage the thyroid, kidney and cause weight gain, among other side effects.
One of the problems with our health care system is that too many people are willing to take doctors and ‘professionals’ at their word. And why not? We treat doctors as the wise old sages of all wisdom and knowledge, as Joseph Campbell points out …
“The doctor is the modern master … the knower of all the secret ways and words of potency.” — Joseph Campbell
We are taught throughout our lives to put our trust in doctors, as we might put our trust in a parent. But according to a recent study by Johns Hopkins, health-care negligence and medical errors are now the third-leading cause of death in the United States — claiming 251,000 lives every year, after heart disease and cancer.
When considering Grace’s bipolar disorder and her suicide, I can’t help but ask why did she suddenly give up? And that perhaps she was also a victim of health-care negligence.
Only a week prior to her death, Grace’s psychiatrist changed her medication almost overnight. Why he did this, no one knows. But anyone who is familiar with SSRIs will know that any abrupt disruptions to routine medication can be extremely dangerous. Grace’s doctor had a responsibility to ensure her safety, to handle the administration of such powerful drugs carefully. But he didn’t.
And while antidepressants certainly have their use, and have helped people climb out of the cauldron of hopelessness, they are also known to have serious — if not potentially fatal — side-effects, and should always remain a last resort, a bandage to dress a wound.
Traditional antidepressants are considered “experimental” for treating bipolar depression in that none have been proven to be more effective than a placebo (sugar pill).
And more often than not, doctors are given major bonuses by Big Pharma to push such pharmaceuticals.
Between August 2013 and December 2015 nearly 400,000 opioid-related payments were made to more than 68,000 doctors, totalling more than $46 million.
Hope Theory, CBT and a More Holistic Approach
Hope is defined as:
A need or a desire for; to wish for: always wanting something new.
Without hope it’s virtually impossible to imagine any kind of future for ourselves. But hope without a framework is like believing in luck — it becomes a form of intangible superstition.
And that’s exactly how mental illness was treated in the Middle Ages, with cruel rituals, bedlams, lobotomies, and once – there was even a technique called trephination, where a patient would have holes drilled into their head to release evil spirits. And that’s just naming a few.
Fortunately we don’t live in the dark ages any more, and while no single paradigm exists for explaining mental disorders (a mystery even in today’s scientific community) and treatment is still being disputed — we at least have alternatives.
And this is why frameworks are so important.
CBT (cognitive behavioural therapy) is one of the more popular therapies around today. Popular because it is relatively simple in theory.
It is built upon the old adage that ‘knowledge is power.’ The more someone understands their own disorder, the better equipped they will be to change their thoughts and behaviour. In CBT you learn coping skills and techniques, such as monitoring your self critic (assessing your negative thoughts) and forming rebuttals — but it’s not for the lazy. It requires you to be actively aware and challenge your thinking patterns.
Another positive framework is a technique called Hope Theory. C.R. Snyder defines it as …
“A positive motivational state that is based on an interactively derived sense of successful (a) agency (goal-directed energy) and (b) pathways (planning to meet goals).”
Snyder goes on to explain that high hope individuals do not react in the same way to barriers as low hope individuals, instead they view barriers as challenges to overcome.
Hope theory can be subdivided into four categories:
- Goals that are valuable and uncertain are described by Snyder as the anchors of hope theory, as they provide direction and an endpoint for hopeful thinking.
- Pathway thoughts refer to the routes we take to achieve our desired goals and the individual’s perceived ability to produce these routes.
- Agency thoughts refer to the motivation we have to undertake the routes towards our goals.
- Barriers block the attainment of our goals and in the event of a barrier we can either give up or we can use our pathway thoughts to create new routes.
Then there are individuals who opt for alternative medicine and a more holistic approach, via meditation, yoga and the quest for spiritual enlightenment. And while it’s important to be wary of ‘witch doctors’ and those who claim to be healers, if one can’t heal the mind then perhaps they can heal the spirit.
A very knowledgeable therapist once told me …
“We are not human beings having a spiritual experience. We are spiritual beings having a human experience.”
I discovered later that it was a quote from French philosopher and priest, Pierre Teilhard de Chardin. It reminded me of the importance of ‘faith,’ to believe in something … be that religion, science or our own merits.
And while these psychological and holistic benefits seem kind of obvious — it can be difficult for a person to realise their own potential if they are coming from an abusive background, or still dealing with unresolved trauma.
It takes a level of courage to reinvent oneself, to want to exist even through the suffering (Buddhists believe that life is suffering). It’s a conscious choice, the choice of a person who understands that the events of the past do not always define the future.
And each time we look forward, we dream.
“There is nothing like a dream to create the future.”
― Victor Hugo
One of Grace’s biggest problems was that she felt her dreams were unattainable. Her negative self critic was so deeply ingrained and had gone unchallenged, until eventually she was trapped in a head of impossibilities.
Like when I told her I was leaving for London a week before her death …
“I wish I could do something like that.”
Grace compared herself to others a lot and believed she was dull and worthless — when she was anything but. She was the greatest cynic I knew, and at times would make me laugh so hard my sides hurt. But she saw herself in shades of grey only, as if her only defining qualities was being broken and wounded.
What Grace did not realise, is that it’s OK to be wounded. And that this idea of a perfect life, or other peoples’ perfect lives, is a fallacy. More than that, I wanted Grace to accept her failures, her imperfections, because they were a part of her. As David Richo points out …
“Our wounds are often the openings into the best and most beautiful part of us.”
She was a sensitive and fragile, beautiful girl who encompassed a whole spectrum of colours. But in the end, Grace broke her promise, not just to me but to everyone who loved her. In the end it was her choice, and instead of sleeping on it or phoning someone, she took a rope and hung herself in her garage.
She was 24 years old.
Grace denied herself of hope when she was only just getting started. She was training to be a nurse and would’ve made a great nurse … with so much compassion for others — if only she’d kept some for herself.
There was one other quote I remembered after her death. It’s one of those quotes you can imagine printed on a self help leaflet The Red Cross might hand out, but I love it all the same …
“Suicide is a permanent solution to a temporary problem.”
When a person takes their life, they don’t get a second chance to wind it back. They don’t get to apologise, course correct or try something different, return to study, go somewhere new and start again. They also don’t get to forgive themselves or others, seek compensation and justice, or cultivate love and courage and find a path towards healing and embrace life.
Most of all … they don’t get to try and see the world through new eyes, and that’s exactly the point of the human condition, to adapt, learn and grow.
This article was written by Jakob Ryce and originally posted on Medium.