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Friday, November 18, 2016

The #Experienced #Voice, #Thirteen #Reasons #Why to #Talk About #Suicide

Alone in the dark: Coast of Atlantic, Cape Town, South Africa – By Pouria Hadjibagheri
I've been listening to the discussion and hysteria over 13 Reasons Why. I just want to point out that you don’t hear from those who have stood on the edge and nearly gone over, just those around them.

If you experience depression as a dark, bottomless pool that sucks you down you only have a partial idea of the full-blown disorder. This is a depressed mood.

Major depressive disorder is living beside an invisible, silent ocean that pounds the shore without warning sucking you into a turbulent abyss. Carried helpless to places you would never go, tumbling without an idea of up, you struggle for control, for breath, for thought. Everything is depressed.

Then it withdraws, leaving you gasping, grateful and terrified. It may hit again at any second or not for years. Sometimes it dumps you ashore and vanishes, relief elates you until you learn that the wave was building into a tsunami.

It is powerful, relentless, and deadly. It is the depression of life, drowning of the will to live beneath the rumble of the void.

I have Asperger’s with anxiety and at least 33 years of major depression. I am very familiar with fighting suicidal thoughts and urges. At 22 I sat in my parent's living room after midnight with every pill I could find in the house and a guidebook to their effects. Only being unable to be sure I had a lethal combination stopped me. The next day I told my parents because I knew I would keep researching. I was determined not to make an attempt and end up completely helpless and trapped in my misery. A perfect definition of Hell.

In my experience, suicide is never a spontaneous act but one that has been considered for a very long time. Depression and anxiety pull you down in a long deep slippery spiral with a wide top half and very tight bottom, momentum and inertia building until irresistible and observable, all hope and choice eliminated. You know that these emotions are contagious, or you learn it fast as people turn away or catch it. Like everyone you know how to put on a mask and you do so for mutual protection, at once wishing to be invisible and praying to be noticed. These emotions. whether from fresh trauma or compounded history, turn perception upside-down so that good events feel bad and good one feel bad. You are always expecting the other shoe. Your decision-making goes out the window. You feel empty and alone. You feel physical pain similar to have a spear shoved through your stomach without killing you and then being tugged and levered. Sometimes it seems the spear has been there long enough for become part of you. This is often accompanied by racing doubts and a sensation that I can only describe as intense personal grief without a focus, including waves of rage, bargaining, acceptance, denial, etc.

The act occurs at the bottom of the spiral, or while bouncing up off the bottom and fearing to return. Ending the pain and the mental barrage of emotions and thoughts becomes all consuming, narrowing vision to what seems the only way to have a choice. Then even choice doesn't matter, just ending the pain. It isolates uou from your enviroment, other people, your reason, and then life.

You don't get suddenly placed in this state by one influence, although it can be the final straw. At that point though, nearly anything can be. Someone lost in this state needs to be drawn out and to have personal contact, particularly the touch of loved ones. It becomes a literal lifeline when teetering on the edge waiting for a slight shifting of the soil underfoot, a stray breeze or a moment of calm long enough to think “I don’t want to go through that again”, to make you twitch enough to fall. 

Opening the conversation is unpleasant but essential. Copy cats only copy the method not the idea or urge. The contagion effect shows to me that htere are many waiting on that edge, hoping for that nudge. They need to be stopped before getting there, because at that point even shifting enough to grab a hand can send them over. 

The graphic nasty nature of the suicide depiction is essential because it shows both that it isn’t a way to peace, an easy way out, and that revenge is always futile. She hurts herself and those she loves worst than her targets. If the news said that someone ended their lives by jumping off a bridge and and hitting the water like pavement, feeling their bones shatter before sinking into the water in agony as the fear of droning kicks in. Every involuntary movement bringing more pain and they fight themselves. And then a brief description of the corpse's final condition, or better, the surivor's since death isn't guaranteed. T

The image of loved ones seeing the corpse plus the idea that it might make things far worse might actually keep people from copying it. I know the fear of making my situation worse with an attempt largely saved me. Now, cognitive awareness keeps me from heading down that path. But, when the floor drops away and I’m overwhelmed by mental movies that all end the same, I take something to help me get a enough sleep to reset the mind and hopefully stop the images. It has worked so far and my medication keeps it very rare. 

Getting out of your head is essential. When many people talk about having suicidal thoughts, they refer to a contemplation, a desire, or an obsession. I've been there, but there it's just the edge of the abyss.

In my darkest major depressions, it hits me like a series of movies, looping endlessly in my mind, making reality seem the illusion. Completely immersive and inevitable in conclusion, they even show the aftermath on all involved. The repetitive inevitability is a self-destructive brainwashing of depair and doom blocking out all other thoughts, memories, and feelings. A trap of such excruciating, seemly infinite pain and existential isolation that everything else becomes insignificant. Self-fulfilling the dark prophecy forces one choice, one path of escape. And it even shows you how.

I basically try to remain immobile and escape into sleep, although the movie often continues there, unrelenting. sometimes it requires something with a sedative kick. Usually it ends upon waking and light returns. Fortunately such depths are rare these days thanks to medicine and coping skills. I also have the experience of seeing the movie end numerous times before, eventually.


Below is a program from This American Life that someone hoped would helped "snap" his friend out of it. You can't snap out of this and more than you can snap out from under a boulder. You need help being pulled out and having the weight relieved. I never heard medication mentioned in this. Only about 5% of it works and only on the most severe depressions but this man sounded severely depressed to me. Better a 5% than none. This is one gamble you have to stick with until it pays off. It took me tens years but I did find a combination that gave me steady relief. Not a cure. it still occurs, but far less frequently and intensely. That allows me to hold on until the light returns because I know it will.

Dawn does come. Hold on until the demon storm stops howling.

The best and strongest lifeline, by far is the compassionate touch and firm embrace of a loved one.

Compassion is the strength to help someone hold on and stand up.

We all need compassion.


Transcript

234:
Say Anything
Transcript
Originally aired 03.14.2003

Note: This American Life is produced for the ear and designed to be heard, not read. We strongly encourage you to listen to the audio, which includes emotion and emphasis that's not on the page. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors. Please check the corresponding audio before quoting in print.
© 2003 This American Life

Prologue.


Ira Glass

So Neil Chesanow, do you have a copy of your book, Please Read This for Me, there with you?

Neil Chesanow

Yes, I do, right in my greasy little claw.

Ira Glass

Perfect. Can I ask you to open up just to the opening page of the preface to read from the preface?

Neil Chesanow

"When you have something very important but really tough to tell the man in your life, wouldn't it be great if you could just reach for a book that starts the conversation for you? Imagine being able to turn to the appropriate page, give an open book to the man you love, and ask, 'Please read this for me.' 'What is it?' 'Just read it, OK? Page 73. It's only a few lines.'

Once the man you love has the book in his hands, a glance will do the job. Each page is an emotional telegram."

Ira Glass

Neil Chesanow's book is now long out of print. But back in the 1980s, when it was published, it represented, I think, a kind of utopian endgame for what self-help books could accomplish. Instead of explaining in a general way how you should handle this situation or that situation in your life, the book, Please Read This to Me, cut to the chase, went to the next logical step. It actually gave you a script. You're in this situation? Say this. Here are the actual words you can use to kick off the conversation you need to have.

Neil Chesanow

I tried to come up with a book that would not just tell you how to communicate, but actually spark conversation.

Ira Glass

Let me just read some of these titles to give people a sense of what some of these are like. Page 111, "It's time to admit you don't have a drinking problem. You're an alcoholic." Page 82, "You act like Cary Grant in public and Archie Bunker at home." Page 134, "I think about marriage all the time." Page 148, "Maybe I'm not ready to have a baby." Page 136, "You'd probably prefer if I were an orphan." Let me ask you to read the one on page 135.

Neil Chesanow

OK. This one is entitled, "It could be that I'm falling out of love." A difficult subject. "Once I thought I loved you. Now I'm not so sure. Yes, we've changed over time, but that's only part of it. I feel confused. I don't know what I feel.

One minute I say to myself, stick it out. Make it work. Don't be a quitter. And I feel guilty. It's not in my power to change you. That much I've learned. So I'm giving some serious thought to the only alternative left that I can think of-- a trial separation. If you have another suggestion, I'd like to hear it."

Ira Glass

Over and over in this book, Chesanow and his co-author, Gareth Esersky, take some of the most painful situations that people can have with each other and give surprisingly graceful one-minute speeches that a person could say or write or show to somebody else. There are a dozen about problems that people might have together in bed. 10 are about dealing with each other as friends. 10 are about the fights that couples have over money. One of the entries even ends with the sentence, "Let's become husband and wife." All of these are written for women because, Chesanow says, men don't buy these books.

Neil Chesanow

We specifically interviewed women to come up with the most difficult kinds of subjects to discuss.

Ira Glass

Let me ask you to read another one.

Neil Chesanow

I'd be happy to.

Ira Glass

Let me ask you to read on page 105.

Neil Chesanow

This one is titled, "Let's Get Religion." "There's something missing in our lives. We're so focused on relating to each other that we've overlooked an important aspect of relating to our world. I'm talking about religion, spirituality, God. A belief in God and a spiritual life can add--"

Ira Glass

When you read one of these after another, the book as a whole seems to have this almost touching faith in the idea that getting the words right might actually solve something or help something. But of course, if you want religion in your life and your partner doesn't, or if you think you've fallen out of love, or if you don't want a baby and your spouse does, I've got to say, your main problem is not what words to use. Your main problem is the situation itself. Neil Chesanow says that plenty of times he heard from women who used the words in the book and it didn't fix the problem.

Neil Chesanow

So there may not be magic words. There aren't always magic words, but sometimes that in itself becomes something vital for a woman to understand. Now she can tell herself, well, I really have given it my best shot. This message in Please Read This for Me really sums up my feelings. He's still not willing to respond. I think we're reaching one of those landmark moments where we have to decide whether we want to go on or not.

Ira Glass

Which brings us to today's radio program. Today, during this week in which talking is failing on an international level, from Washington and Moscow to Paris and Baghdad, we bring you stories that ask the question, what is talking good for, anyway? When does it work? When doesn't it work? From WBEZ Chicago, it's This American Life. I'm Ira Glass. Our program today in four acts.

Act One, How to Write a Note. In that act, a guy who thinks that words and reason might help his friend from trying to hurt himself. Act Two, The Battle of Words Versus Fear. In that act, one man decides to conquer his fears by listing them, all of them, one after another, all 183 of them.

Act Three, When a City Opens Its Big Mouth. The story of just how easy-- how astonishingly easy-- it is to get people of all ages and races and economic levels to open up and chat. You just need three little words. Act Four, Wedding Bells and Telephone Bells. In that act, Jonathan Goldstein and Liz Gilbert bring us stories of words failing-- in one case, in the worst wedding toast that any of us has ever heard of occurring at a real wedding. Stay with us.

Act One. How To Write A Note.


Ira Glass

Act One, How to Write a Note.

This first story on our show today is unusual. It wasn't originally made to be broadcast on any radio show. It was a tape made by somebody who had never put anything together for radio. He made it to give to a friend. Here's what happened.

Back in July of 1999, Jake Warga heard that somebody who he was close to in college, his friend Brian, tried to kill himself. Jake went out to visit Brian and he took with him this little MiniDisc recorder that he had just bought for himself that had this little clip-on microphone. During his visit with Brian, they recorded this long conversation they had. And then when Jake got home, he decided to edit this down and give it to Brian as a present.

He had no idea how to actually edit sound or do anything like that, so at some point, he jumped onto the internet and found a website-- a website, actually, that we've mentioned on our show in the past, called transom.org that teaches beginners how to edit and mix audio with links to free editing software. And Jake put together this story you're about to hear. And he sent it to Brian. His hope was that if Brian heard this tape, heard himself talking, heard his own words, it might convince him that he shouldn't try to kill himself again. That didn't work. Here's the tape that Jake put together.

Jake Warga

Last year, my friend Brian tried to commit suicide. He had checked himself into a new hotel that runs alongside the interstate, which happens to pass through the small college town in which he lives. And without ceremony or note-writing, he took a combination of drugs he thought sufficient enough to quietly end his life.

As people often do, Brian and I started getting lazy about communicating after I left college and moved out of that same college town. Emails became rare, and phone calls rarer. After the longest period yet of not hearing from Brian, I got a call from an old mutual friend of ours asking if I had seen or heard from him. I said I had not.

We made calls and eventually found him safe in the hospital. A few weeks later, I arranged a visit to see how my old school-- and Brian-- had changed in the years I had been away. And when I came to visit, we sat for three hours on a park bench late one summer night. He was still in the process of piecing together exactly what had happened. This is Brian.

Jake Warga

Let's talk about you.

Brian

There's not much to talk about.

Jake Warga

You were going to go to the hospital today, right?

Brian

Oh, yeah. I did. Yeah. The woman in the records department made a photocopy of my medical records from when I got admitted, and there wasn't anything too surprising or anything in there. But it was still interesting to read. But they said I was discovered at approximately 6:00 PM. I guess this was the next day.

Jake Warga

6:00 PM?

Brian

Yeah. I don't know why--

Jake Warga

They waited so long?

Brian

Yeah. Because I should have checked out around noon, I guess. But they said I was unconscious and unresponsive. I was reading the paramedics report. I was pale, cold, and clammy, and I was breathing only six respirations per minute, which is very slow.

And they said they found pill bottles and a bottle of alcohol in the room. And they cleared my airway and started administering oxygen. Then they gave me a 2 milliliters IV of something called Narcan, which is an antidote for opiates like morphine.

Jake Warga

Do you think it would have worked?

Brian

I think it would have. And I mean, maybe I didn't take enough because morphine is very serious. It's very hard core. It's very easy to OD on it. (JOKINGLY) It's hard core, man. And I guess it was really late that night or even early the next morning when I guess they were about to transfer me, and I woke up. And the attendant who wrote this report said that I said I was disappointed to be alive and that I had passed out before I could take the morphine.

And that part I do remember really vaguely. I remember waking up and feeling the nasal cannula in my nose giving me oxygen and seeing that IV bottle hovering over me. And the guy asked me, kind of sarcastically it sounded, so are you glad to be alive? And I'm pretty sure I remember saying no.

Jake Warga

Brian doesn't have that many friends. He's good-looking and funny, yet something inside prevents him from being confident in social skills. For example, it took a long time in our friendship before he told me, and I felt confident in asking, about his biological mother. He told me she died when he was young, that she had committed suicide. His father remarried soon after and raised Brian and his brother, who is now a doctor.

Brian

Although, there seemed to be some incongruities with the reports. I guess those paramedics and hospital staff can really hastily fill stuff out. They can really take a lot of license. My own mom's coroner's report was really-- it had some gross inconsistencies in it, or errors. My brother says coroners often just make stuff up if they can't find certain causes, like cause of death, I guess.

Jake Warga

Were you hoping to find similarities between your mom's report and your report?

Brian

Oh, no. I hadn't really thought of that. I brought her up just because they made some errors on hers, just like they had with mine. But with me, I don't think it was anything really major.

Jake Warga

About a week prior to this interview, Brian was arrested in San Francisco for possession of narcotics. Brian does not use drugs or alcohol. He had gone to the same bad part of town to buy the same drugs with the intent of trying again. I asked him about this trip to San Francisco.

Jake Warga

What were you doing there?

Brian

Same thing.

Jake Warga

Same cocktail?

Brian

Mhm. Pretty much.

Jake Warga

But it didn't work before.

Brian

I'm too much of a wimp to try other things, like other things that might be more violent but less immediate. I don't like violence in practice.

Jake Warga

I've read that suicide is a selfish act, yet I have never really thought of Brian as selfish. But I can understand why the relatives of suicide victims might go through that angry phase, that phase when they place the blame on the person who killed themselves to help with any feelings of guilt they might have. I asked Brian if he thought what he did was selfish.

Brian

I say it's selfish in the same sense that going to a therapist is selfish. You have a problem and you're doing something about it. You're doing something about it in the way you feel like coping with it.

I don't think, in the end, people should live for other people. They should really live for themselves, just like you shouldn't go to school for a decade to become a doctor or a lawyer or whatever just because your parents want you to be that because you want to do what your parents want you to do. You should live your life as you want, as you see fit.

And it doesn't necessarily mean you haven't considered other people's reactions. It just means that maybe you have and you've decided that, unfortunately, you still want to go forward with it. I don't want to spend the rest of my life alive and miserable just because someone else doesn't want me to die. I don't see much sense to that.

Jake Warga

In an effort to catch up on letter-writing, Brian would occasionally write long emails filled with wit, humor, and sometimes desperation. He's an excellent writer. I asked him why he didn't write a suicide note.

Brian

I'll admit that was rather selfish. I know that people were wondering what the heck is up. I could have sat down for probably what would have been several hours to type something up. At that point in time, I was just very fed up and impatient and just I wanted it all to end. I just didn't want to screw around with anything else. I could've also cleaned my room first, too.

Jake Warga

As we were talking, an ambulance passed by in no particular hurry.

Brian

There's what I probably rode in. It cost over $800 to be transported from--

Jake Warga

A few blocks?

Brian

Yeah. According to their time table, it took them eight minutes to get from there to there.

Jake Warga

I guess that's pretty far.

Brian

Yeah, that's an appreciable distance, I guess. It's worth eight minutes. 2 milligrams, 2 tiny milligrams of Narcan opiate antidote is $6.

Jake Warga

As I write this, I wonder if I'm making Brian's note for him. Am I documenting this story for him, or for whom he might leave behind? This was not the first time he tried committing suicide, and, in light of his recent arrest, not his last.

Jake Warga

Do you think you found the only way to cope?

Brian

The only viable way, so to speak. I don't get the impression most people are that happy, anyway. They just grind their way through life. They'll have kids, and that'll give them an artificial reason to live for a while. And then the kids grow up and forget about them.

I know the mind is a really powerful thing. People can do just about anything they really put their minds to, but it also takes a tremendous amount of self-motivation. As my therapist says, it has to come from within, and it doesn't feel like there's much within.

Jake Warga

What's your relationship with death?

Brian

I was brought up in a Protestant family as a Lutheran, and I haven't renounced that faith. I just feel I've stumbled in a big way, and I haven't gotten up or haven't been able to get up. And I'm hoping that I'll just go to heaven after I die. But of course, there is a lingering fear of hell because it's not a-- it's highly stigmatized, suicide. But I don't think I believe in sins that are, what do you call them? Cardinal. Yeah. I think it's just another kind of sin.

My cousin, Amy, who's an atheist, told me that her dad, who's a Lutheran minister, told her that, if you kill yourself, you go to hell because you're not alive to repent and ask forgiveness for that sin. So therefore, since you have not repented for that sin, you'll go to hell.

And I think that's ridiculous. Just think of all the sins you haven't repented for in your life, even if you tried to. I know you haven't tried to, but-- so I do have a fear of dying, but it doesn't always outweigh my other fears or my other--

Jake Warga

Fear of living?

Brian

Yeah.

Jake Warga

After sitting at a park bench for so long, and after Brian confessed to having talked more than he ever has, we were more than overdue for a stretch. And after a while of walking around aimlessly, we picked up our old habit of trainspotting and penny-smashing.

[TRAIN WHISTLE BLOWING]

Brian

Jeez.

Jake Warga

Quick.

Brian

I would have loved to--

Jake Warga

You're taking it slow.

Brian

I probably shouldn't run with this thing. I don't know if I can record while being jostled.

Jake Warga

It'll catch up.

Brian

[LAUGHS]

We are now running to try to catch the train. We're running past lions. We're now up on the tracks. Here come the lights.

Jake Warga

At this point, Brian and I are running alongside the train as it's beginning to stop at the nearby station.

[TRAIN RUNNING]

[SCREAMING]

[TRAIN HALTING]

Jake Warga

Well, train's here. No pennies.

Brian

Oh, brother. I have a penny or two.

Jake Warga

Give it up.

Brian

You give it up, homeboy.

I don't know. Anything else?

Jake Warga

Do you ever cry?

Brian

No. I hardly remember the last time. It's probably been almost 10 years. I came close, though, in December of '92 when I came home after visiting my grandma over Christmastime. My grandma had shown us a bunch of pictures of my biological mom and told us some stories about her.

These were photos I don't think I'd ever seen and stories I don't think I'd ever heard. I came home and I was taking a shower late that night, and while I was in the shower, I wept just a little bit. But it wasn't really full-fledged.

I kind of feel like I'm emotionally constipated. I guess that's a major part of my problem. People need to express their anger and whatever else they're feeling. I've actually tried to. I've tried because I knew I wanted the release because I knew it would feel good. But I just couldn't do it. Very frustrating.

Jake Warga

We're in the last nine minutes of this cassette.

Brian

(FAKE WHINY) Oh, there's nine more minutes.

Jake Warga

(FAKE WHINY) I kind of want it over now.

Brian

I can't think of anything else to say. I'm not the kind of guy who can just rattle off his famous last words or big words of advice. Don't have kids unless you had a good relationship with your own parents, I guess, because you can seriously screw them up by saying negative things to them or even neglecting them. Apparently, that's a highly debated cause of sudden infant death syndrome-- not giving your baby enough physical attention.

One of my psychiatrists said I'm failing to thrive. That's a phrase commonly used for infants who mysteriously die. I'm thinking-- I just kind of amuse myself with the thought that my case is a belated case of sudden infant death syndrome.

I don't think my dad failed as a parent, as he worries that he has. I think he did a great job. It's just, along the way, I contracted a disease and it doesn't have a very optimistic or bright prognosis. And not even the best parent can prevent that.

Jake Warga

At the end of editing this story, Brian is still alive, living in the same small town. I don't know if he's getting better or not.

Ira Glass

Jake Warga. He sent this tape to his friend Brian in 1999 and waited for a reaction. Brian emailed him. He wrote, "How did you learn about the music that you included in the interviews?" He liked some of the pieces, but said they, quote, "Might be a tad overdramatic." And he wanted to know if Jake's computer had a filter that can make him sound less stupid.

Brian also asked Jake if he had any plans to publish this story. He told Jake that he thought Jake would have an easier time publishing it if he were dead. Nearly two years later, in the spring of 2001, Brian did try to kill himself again, and this time he didn't survive. Jake added this epilogue to the story.

Jake Warga

On May 9 of this year, Brian's body was found in his room. He had injected himself with a lethal dose of morphine. He was 31 years old. I had sent this tape to Brian sometime after our interview in hopes that, by hearing himself, like looking long and hard into a mirror, he would realize what he was saying, that he would snap out of it. Though he appreciated my efforts, I did not change him. And I came closer to realizing I never could.

Brian left packets for a few people, myself included. In them were copies of letters he wrote years before, explaining some of what he felt at the time, and tapes of the interview we did that night. He actually had to make cassette copies for his brother and cousin from the MiniDiscs that I sent him.

I've had to ask myself now that Brian's dead, why do I want to share this tape? One reason is I want to take something from death, to rob it, for a little while, of the mute it imposes. I also hope that it might help someone who feels like Brian. Or, for friends and family left confused, some sense of closure they may not have had if death were allowed its silence.

So Brian, I'm relieved your pains are over. And now it's time for ours to begin. You will be missed.

Ira Glass

Jake Warga. He teaches storytelling at Stanford University. Thanks to Jay Allison and transom.org and KUOW in Seattle, where Jake's story has appeared. If you or somebody you know might need help, the National Suicide Prevention Lifeline is available 24/7 at 1-800-273-TALK. That's 1-800-273-8255.

[MUSIC - "I SEE A DARKNESS" BY BONNIE PRINCE BILLY]

Coming up, three magic words that make tough New Yorkers pour out their hearts to strangers. And I'm not talking about "hand it over" or "yes, you've won" or "I love you." Also, your fears listed in a minute from Chicago Public Radio when our program continues.

Everything is always in process
Only compassion defeats dehumanization.