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Thursday, April 12, 2012

Depression and suicide

I was on Relevant Radio this morning discussing depression and suicide with a man I’ve come to call my friend, Sean Herriott, and we started with this quick prayer to Bl. Enrico Rebuschini, who is featured in 39 New Saints You Should Know. (Following the prayer is an expanded version of our talk.)

Dear God, so many of our brethren are unhappy and want their lives to end. Through the prayers of Bl. Enrico Rebuschini who was bipolar, lift their depression and help them to emerge with a clear vision of Your will and the strength and courage to do it. We ask these things in the name of Your Son, Our Lord Jesus Christ Who lives and reigns with You and the Holy Spirit, one God, forever and ever. Amen.

On Tuesday, I learned a former colleague of mine had taken her life. This comes about a year and a half after my uncle committed suicide, and three months after I had gone into the hospital because I had entertained suicidal thoughts. Depression is something I’ve fought since I was 9, when I was in third grade. 
So I was driving to my counseling appointment yesterday listening to my favorite drive time show, “Morning Air” and heard its hourly feature, “Glen’s Story Corner. “ This was followed by Sean Herriott’s interview with composer Eric Genuis, who does a lot of prison ministry work, and by coincidence, both focused on reaching out to touch those who were hurting.
That got me thinking. 
My dear, beautiful, wonderful uncle.
It got me thinking about my uncle. For a whole week after he endeavored to end his life—and he lingered for about that same amount of time, never conscious for a moment of it—I was in shock. I remember taking a couple of days off from work and one day going to a water park with my family. And I just sat there with my baby in the wading pool. I couldn’t move, I couldn’t talk, I could hardly think.
My colleague who died in April and I weren’t close. But you should have seen this woman. Just gorgeous, and her interior beauty matched her physical attractiveness. Bright, funny, vivacious, charming, impeccably feminine, she just had a real good head on her shoulders. I had immediate respect for her.
In both cases, I asked, “Why? What if? What could I have done differently?”
And the answer is, at this point, nothing. I had no way of knowing. Just like people would have had no way of knowing what was going on with me if I had killed myself in January or had done so the last time I’d had suicidal thoughts before that, ironically the week before my uncle killed himself, or during my young adult years, or during my college years and in high school and in junior high school, which, when I was 14, was the only time I actually attempted suicide. People would have asked, “Why? What if? What could I have done differently?”
We can’t answer these questions any more than we can undo the past. But you know what? I realized listening to yesterday’s “Morning Air” program I could do something. So to the extent that I can help people with this—either because they are struggling with depression and hopelessness and a deep longing for death to come somehow, someway or they know someone who is—I want to.
So as someone with almost a whole lifetime of experience with depression, here’s what I’ve learned.
Yes, life is precious. And it is great. But let’s be real: There’s a very good reason why we call it a “vale of tears.”
For me it started with being bullied all the way through college. After a certain point, each new incident of bullying just reinforced this already embedded sense that I was worthless. As a result, I lived with constant depression. On those rare occasions where I caught myself doing negative self-talk, it was vicious.
To deal with this, I drank heavily, I ate comfort foods, I spent money foolishly, and I violated Catholic moral teachings, all in an attempt to either numb the depression or momentarily feel better. Just to give a picture of how bad it was, I had been accepted into the University of Utah. I was excited about going.
Then my dad found out about my considerable drinking problem (having fortified myself with liquid courage during the lunch break, I regularly spent the second half of the school day pretty well sloshed). That was it. He wouldn’t pay a dime for my tuition. I could go out and get a job or join the military, but he wasn’t going to waste a considerable amount of money on not educating a budding alcoholic. Thank God for my “Uncle” Jimmy, who talked him into giving me a second chance.
Obviously, there are as many different paths to mental illness as there are people. A woman with whom I was hospitalized couldn’t get over the loss of her son. In group session, she would wear an etched in stone frown that made the Easter Island statues look like they were laughing in an uproarious fashion. All the while, she would constantly stroke the wallet-sized senior portrait of her dead boy. Another woman, her husband walked out on her and their daughter. My hospital roommate’s father committed suicide, and he had several neurological disorders.
Most depressed people with suicidal ideations feel such shame, and that shame brings on profound feelings of worthlessness. The first time I attended a monthly healing Mass in the north of my state, I went up to the priest so he could lay his hands on me.
He prayed over me and half asked, “Baseball.”
“Excuse me?” I answered.
“Baseball,” he repeated slowly, quizzically. “Did you ever play baseball?”
“Uhm, yes, I did,” I slowly replied, nor sure where this was going.
“How long did you play?” he inquired, raising one eyebrow.
I told him in a tone that got quieter and more than slightly sheepish, “Just one year.”
“Because I wasn’t any good. I had a batting average of .001. Maybe. I think I got one hit the entire season.”
Now up to that afternoon, I had completely repressed any memory of playing baseball. My coach that lone season played me in every game, but only because he had to. How I dreaded going up to bat. How I dreaded trotting out to left field, because I knew that once their hitters found out I couldn’t field a fly ball, that’s where every hit would come. I could remember this wrong, but that’s how the memory feels. This touches on perception skewing, which we’ll dive into in a little bit.
“How did you feel about that?” Father asked.
“Pretty lousy,” I told him, which was more polite than, “How the hell do you think I felt, genius.”
“I sense a feeling of shame.”
I didn’t say anything. I looked downward and off to my left, then straight down at the floor and then straight at him and gave a trio of stiff nods with pursed lips in affirmation.
“I sense a lot of shame. There’s a lot of shame in there,” he said, pointing his index finger and drawing it close to my heart. “People who are wounded like you are deep in shame. I know. I am, too. I was lousy at baseball, and it was terrible.
“I want you to go back your pew,” he continued, “and think about all the shame that’s in there, and then I want you to give that shame to Christ. Invite Him in there because He wants to go into the places where we’re most wounded so He can heal them. Give Him your shame. You’ve held onto it long enough. You don’t need it anymore. You never did.”
Boy, did that open the memory floodgates. That was a very painful afternoon. Had I not been there, though, I never would have realized what a profound impact shame has had on my life. Shame at being bad at sports. Shame at being the last one picked for a team. Shame at being picked on. Shame at desperately feeling unloved by any of my family except my maternal grandfather and paternal grandmother. Shame at being the perennial problem child. Shame at always being a problem, period. Shame at the way certain fraternity brothers who preached the most about being “bros” were the ones who accepted me the least and often showed their rejection in cruel ways. Shame, shame, shame, shame, shame.
That day also led to my eventual discovery that our dignity as human persons derives from one source and one source only: The fact that God has created us in His image and likeness. That He destined us for eternal love with Him in heaven. That He loves us so much that were we the only ones in history to have ever sinned, He still would have sent His only begotten Son to suffer and give His life in redemption of those sins. That through baptism, we were incorporated into the Body of Christ, and through the Passion, death, and resurrection of that same Christ, we became His adopted sons and coheirs to the kingdom and are thus a priestly and kingly people. That is the true and only source of our dignity.
So when someone—a bully, a parent, whoever—demeans us, does violence to us, deprives us of our dignity in any way, it is not necessarily indicative that we have a character flaw or that we are somehow not worthy. Instead, it is more likely a reflection of the problems they have and with which they cope by taking it out on us. This isn’t always the case, but it is more than occasionally the case.
Those with depression can also have skewed perceptions, which may result in a lack of proper judgment. After years of having one’s opinions invalidated, one not only assumes one’s opinions will be questioned simply as a matter of course, but, despite however hard one may fight for those opinions, will desperately wonder whether those who invalidate them might just be right. This leads to great indecisiveness, which can have the appearance of affirming the other person’s conclusion that we make faulty judgments. Then when someone—either through force of reason or, just as likely, power—overrides those opinions, it only serves to bring more shame, more insecurity, more of a sense that the world is a damned and lonely place. At least this is how it has been in my case, and that has contributed to my just wanting to check out.
For years, I asked myself, “Why did this happen to me?” I thought if I could answer that question, I could resolve my issues. The problem, however, was that the “Why?” was not only unanswerable, it only masked a much more dark question: “Did this happen to me because I am unlovable?”
Regardless of your situation, when you’re depressed, life never, ever seems to go your way. You feel cheated, like the deck is stacked against you, and that often leads to anger (which is simply a metastasized sadness) and despair (which is sadness metastasized in a different direction). When you think like that, it’s really easy to feel an all-enveloping despondency if you’re not careful. And a lot of times, you don’t even realize this because the thinking that accompanies despair becomes habitual.
Well, pretty soon, you lose interest in life. Getting out of bed is an unbelievable struggle. You lose concern for your appearance. Eventually, a series of thoughts grow into like a drumbeat: ‘I don’t want to go on. Life will never get better. I want to die. Please, Lord, let a bus hit me. Please let a semi-truck crash into my car.’ When God doesn’t answer that prayers—SURPRISE!—you start thinking of ways to end your life, and there are a lot.
So what do you do if you are so depressed that you have suicidal ideations (i.e., you’ve seriously contemplated suicide or at least desperately want your life to end)?
These various steps come from what I’ve learned so far:
1)     Acknowledge you have a problem
2)     Radically accept the past
3)     Acknowledge you can’t fight this on your own
4)     The idea of needing medication is humiliating at first, but meds are a key component, and they do make a world of difference
5)     Hospitalization (optional in a number of cases)
6)     Be aggressive when it comes to getting yourself the best care possible
a.       Don’t let people – doctors, nurses, whoever – tell you what you don’t need (what you do need is another story). Fight for your life!
7)     Get a support team in place
8)     Push for as much treatment as your insurance plan will give you.
9)     Regardless of insurance coverage, do those things you can on your own
10) Pray
a.       Thank God in prayer
b.      Praise God in prayer
11) Trust God
12) Do something good for someone
13) Smile
14) Forgive
a.      Confession and the Mass
b.      The Our Father “… and forgive us our trespasses as we forgive those who trespass against us.”
15) Love

Don’t live the cliché, “Denial: It ain’t just a river in Egypt.”

The first step is crucial: You have to acknowledge you have a problem. In the hospital, I took a test that showed I am bipolar. When I grew up, that’s how you described seriously crazy people. Understand that this is totally inaccurate. Some crazy people are bipolar, but not all bipolar people are crazy. Indeed, most aren’t. No one with type II bipolar disorder (which I have) is. Nonetheless, that is why it’s hard for me to admit having this condition even now, and it terrifies me, frankly, to admit to having this in public. Will people ostracize me? Will they reject me, avoid me, talk about me behind my back, gossip about me? (Well, of course, they will; it is human nature. That does not mean I look forward to the prospect. I've spent most of my life being the oddball out/sideshow freak, but since I have chosen to make my condition public, that is the result I will have to expect.) Will opportunities I otherwise may have had suddenly, conveniently disappear? To say, “Hi, I’m Brian, and I have a mental illness,” even if I only say it to myself in my brain, it makes me cringe. I hate it, but no one ever gets better by ignoring the truth. Anyway, acknowledgment of the problem is step one.
Radically accept the past

Next, you must practice radical acceptance of the past. The past stinks. It’s rotten we got such a bad break. However, it is gone. We can’t turn back the clock; we will never get a do over. We can only march forward, as painful or terrifying as that prospect might be.
The question then becomes: Where do we go from here? Go up. That can’t happen, though, unless we radically accept that the past is gone and beyond our reach. I didn’t say it would be easy, but is our only option if we hope to have healing.
Something else you’ll need to accept? This will never go away. You will battle mental disease the rest of your life. Cancer, you can get rid of that. Tuberculosis and other ailments, you can get rid of them. Mental illness, though? It’s like diabetes. You will never be “cured” in the traditional sense.
That fact was, putting it mildly, a little discouraging. All I could see was how exhausting this work can be at times. If I had prostate cancer and it was caught early enough, I’d have an operation or chemo or radiation or take some naturopathic treatment, and, boom, I’d be done.
Not so with mental illness. Bummer, dude. Again, just accept it and move on.
Humility is your best friend
Then, acknowledge you can’t fight this on your own. People with depression and suicidal ideations need professional help, and we need medications. If you think otherwise, go to any major city and look for homeless people. You will see many who have schizophrenia and have gone off their meds because they judged they were doing better and think they are fine now and thus don’t need them (simply proof of my Rule of Human Existence #1: Humanity’s capacity for self-deception is limitless). Meds are a key component. My behavior and outlook since I went on my regimen are like night and day. I’m much calmer, I’m more in control, and my mood is stable. That is huge, absolutely huge. If you don’t believe me, ask my children and beloved spouse what it was like to live with me—the guy who writes about saints for a living, mind you—beforehand (mea culpa, mea culpa, mea maxima culpa).
Don’t fear the hospital
A key thing for me was my hospitalization. That’s not for everyone, but if you’re suicidal, unless you’re going to lose your livelihood or something, it is for you.
I got hospitalized in this way: In early January, I had bronchitis, so at a regular medical appointment, my wife, who had accompanied me, told our doctor of my saying the previous night I no longer wanted to live. His eyes got wide, fearful even. The medical appointment ended there and then. He told me, “I can’t help you with this. I’m not equipped. No one around here is (I live in a very rural area). You need to drive to the hospital now, go to the emergency room intake desk, and tell them you want to kill yourself. They’ll admit you. Don’t wait. Go now. Do it today.”
As depressed as I was, this made me feel even worse. I was being hospitalized for depression. How low could I get? Boy, I must really be a loser, right?
Well, it was the best thing that could have happened. I received excellent care, and I got to think and reflect. I also did a lot of writing, and the two together helped me make sense of a lot of things.
You are your best and truest advocate
Now I could have left the hospital and been done with it. Of course, I would have eventually gotten back on the same squirrel cage wheel of being extremely depressed and feeling like I wanted to die. In other words, I’d be going nowhere fast.
Instead, I left knowing I needed to be aggressive in pursuing better mental health. Furthermore, now that I knew what the problem was (despite how humiliating that felt), the means existed for me to do this. I was actually excited and hopeful.
Fighting depression and warding off suicidal inclinations is like fighting cancer. You have to do whatever you can with whatever means you have to fight it.
The first thing I did was to get a support team in place, and they’re there to help me if I’m having suicidal ideations. My first line of defense is my wife. But if she’s not available, I have my cousin and my sister, who I trust and who I know love me.
Now, I’m lucky. I have a great insurance plan that covers my weekly visits with my behavioral therapist. If you do, too, push for as much as they will give you. Again, be aggressive. This is your life we’re talking about.
A lot of people don’t have such good insurance, though. Regardless, push for as much as your plan will give you.
Lack of insurance isn’t the end of the line
With or without insurance coverage (for those without, see here, here, and here for a few ideas/options), there are things you can do on your own. I’m not suggesting these will or should take the place of professional care, but they will help (see above for what I wrote about how you can not do this on your own).
For instance, I’m convinced I’m here today because the times when I was most depressed, I took pains to do the things I didn’t want to such as dressing nicely and making the bed because I knew it would help.
            In the morning, I get on my knees, and I pray a morning offering. If I’m super tired (which lately is most of the time), I simply garble a, “Thank you, Lord, for getting me through this night, and thank you for having made me a Catholic.”
            Or I might do the traditional morning offering, or I may riff on it like so:
“Thank You, God, for getting me through this night and giving me this day, and thank You for having made me an adopted son of Yours through Your one, holy, catholic, and apostolic Church. I give You this day with all its joys, works, sorrows, and sufferings. I entrust these things to You, for You are all good and have promised me that You have made plans for my welfare, not for evil, and plans to give me a future full of hope (cf., Jer 29:11). I trust in this promise because You are Truth, and You can neither deceive nor be deceived.”
Then I thank God. When you count your blessings—no matter how few they may seem—it becomes evident that not everything in your life is wholly rotten. Maybe most of it is, but not everything, and that’s a start.
But trust God and His grace. Fall into His arms and don’t let go, and then thank Him and, just as importantly, praise Him, for He is good and His mercy and love endure forever.
Now if you’re like some of my friends who have been raped or were the victims of molestation or incest or bullying or whatever—in other words, people who found themselves in horrible situations that they didn’t cause—that’s an awfully hard pill to swallow. Fake it ‘til you make it. Or like the man in Mark 9:24 says, “Lord, I believe, help my unbelief.”
Acts of service/Being Christ to others
Next, do something for someone else, especially if it is someone whom you don’t like or with whom you ordinarily wouldn’t associate.
One of the subjects in 39 New Saints You Should Know, Bl. Marie of Jesus Crucified, wrote, “If you think to do good for your brother, God will think of you…. [If] you make a heaven for your brother, it will be for you.”
When someone is depressed, they have an intensely inward focus. By doing a kind deed for strangers or adversaries or that awkward or uncomfortable person two cubicles down, you break out of that stranglehold.
The day I left my first healing Mass, there was a young lady in her early twenties. She was somewhat heavy set, not huge, but by no means svelte. She wore jeans, a black polo shirt, and a denim jacket and had her longish hair tucked up under a tan baseball cap that she had pulled down so low that it practically covered her eyes. She had sat in the back and did not come up to be prayed over until she was the last person to do so.
As I sat in my pew thinking about my shame, praying about all of this, and giving it to Christ and inviting Him inside, I was also watching her. I saw Father pray over her, her crumple to the floor and start sobbing, and the attendants gather around her to give her comfort. I sensed that the Holy Spirit put this sentence into my head: “God loves you, and He wants you to know this was not your fault.” It seems I was mean to deliver this “message” to her. Uh. OK. Not real comfortable out doing this. The push to do so, however, only grew stronger.
Finally, I walked up to her, still weeping on the floor, expressed how I felt uncomfortable doing this but that I felt like I was compelled to do so, and delivered the message. Then I went back to my pew to continue praying.
At the end, the woman attending her came up and whispered, “Thank you. That was exactly what she needed to hear.”
Was I responsible for this? Absolutely not. I take no glory in this because I fought it. I didn’t want to do it at all, but only did so out of obedience. So to the extent it was a healing action for this lady, I can only credit the Holy Spirit. The point is that she never would have heard “exactly what she needed to hear” if not for a willingness to step out in faith to serve someone in Christ, to be Christ to that person. All of us are called to do this, it feels really good to do it, and it is especially beneficial for the depressed to serve others, although not necessarily by claiming to be the vessel of the Holy Spirit, mind you. I certainly make no claims to be such.
Next, smile. Make it a habit to smile at people you pass by in the day. If you’re not depressed, your smile—whether at a random stranger or someone you know—because, as Glen quoted Fulton Sheen yesterday (“A smile across the aisle of a bus in the morning could save a suicide later in the day.”), you may save that person’s life. If you are depressed, smile. It will lift your spirits.
Yesterday, after hearing both Glen and Eric, I made it a point to smile at people and say something simple such as, “Good morning. How ya doin’?” And people smiled right back. Big beaming smiles, too.
It was great. It encouraged me to smile more and to try and brighten someone’s day however I could. Yesterday was honestly one of the best days I’ve had in a long time. I was in a fantastic mood. When I came home, even though my wife was grumpy and went to bed early, leaving me with all the evening chores, and even though the kids weren’t necessarily the most cooperative little angels on the planet, I felt hardly any stress.
Smiling really works. It sounds so facile, so simple, even simplistic as to be moronic, but oh well. It works.

And for anyone, regardless of their mental state, forgive. Lack of forgiveness often is the root cause of so much mental instability. A friend of mine refuses to forgive a man who broke her heart. Well, that has caused other problems for her. Like love, forgiveness is a choice. It’s not about forgetting. I have to daily forgive those people who hurt me during the 13 most formative years of my life. It’s not easy, but I keep telling God, “Lord, I forgive them. Please, You forgive them, too.”
If you’ve done something for which you’re ashamed, whatever that is, forgive yourself. The first step for this is to go to confession. In fact, keep close to confession and Mass. Make both a regular part of your life, with Mass weekly, of course.
Let go of that resentment, hurt, and anger, especially if it’s toward you. Give it to God. Easier said than done, I know, but just do it. Again, fake it ‘til you make it.
Finally, love. Love is not a feeling. Rather, it’s an act of the will. It’s a choice. First, love God. Second, love your neighbor. Third, love those who persecute you. Finally, love yourself. These are the things Jesus told us would get us into heaven, where we’ll be happy throughout eternity.
Therefore, ask yourself this: If these things will make us happy in heaven, then why wouldn’t they during our time here on earth?

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