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Illuminating the reasons for suicide
By BILL DURYEA, Times Staff Writer
© St. Petersburg Times, published July 21, 2000
Dr. Kay Redfield Jamison, a professor of psychiatry at Johns Hopkins University School of Medicine, is the author of Night Falls Fast: Understanding Suicide. The book, published last year, has won popular as well as critical acclaim, which is all the more notable given society's discomfort with the subject and disdain for the act itself.
And yet suicide is the third-leading cause of death among age 15-24 in the United States and the second-leading cause among college students. Approximately 30,500 Americans kill themselves every year. (Roughly 1,300 people each day make an attempt serious enough to require medical treatment.) By contrast there are roughly 20,000 homicides a year.
Jamison's work on the subject has shattered many misconceptions about suicide, one of which is that it is an inexplicable act. The road to suicide is well-marked, Jamison argues. And because suicidal behavior is so predictable, Jamison says, it is all the more regrettable that more medical professionals do not recognize suicide as a preventable public health crisis.
In the wake of Hillsborough State Attorney Harry Lee Coe III's suicide last week, media coverage in this newspaper and elsewhere focused on the events immediately preceding his death. We asked Jamison if it is reasonable to think an explanation for Coe's action could be found by examining the final days of his life.
JAMISON: I think it's reasonable to focus on that in part. Certainly (recent events) would be very important, and certainly he had a majorly traumatic thing happen to him, but I doubt that is the only thing that would be important or relevant. There are a lot of other things that would be relevant as well.
TIMES: What would those things be?
TIMES: Would we necessarily know whether he was affected by depression?
TIMES: So mental illness plays a very significant role, in 90 to 95 percent of the cases . . .
TIMES: If this information is known, and you certainly have been doing your part to get it out to the public, why does society seem so reluctant to treat depression and suicide as manifestations of a disease?
Even with illnesses such as bipolar (disorder) or manic-depression, which is highly associated with suicide, even though it's a very genetic illness, one of the most genetic illnesses in medicine, people still tend to think that it's a mental or psychological disorder. The very fact that we call these mental illnesses, for example, means that we focus on one small part of what these illnesses are. Depression is as much an illness about sleep disorders, about a lack of energy, about agitation, about perturbed mood as it is about thinking. I mean there are many, many aspects to depression other than just "being mental."
TIMES: And part of bipolar disorder is that some of the manic episodes can be rather intoxicating to the person who is experiencing them, that there seems to be benefits to the mania, greater acuity, for example.
TIMES: How do you go about changing those perceptions?
TIMES: When you first addressed your own manic-depression and suicide attempt in your book An Unquiet Mind, you said you were afraid of what might happen if you spoke out . . .
TIMES: But that anything would be preferable to dishonesty and silence.
TIMES: What has the reaction been?
TIMES: Have you detected over that time any change in society's attitudes toward psychological disorders?
My concern is that people who are in incredible pain and thinking about suicide or just in incredible pain because they are depressed or psychotic don't know that they can find help. That seems, in a civilized society, to be pretty awful. It's bad enough to have these illnesses without feeling you have to be so dreadfully alone with them.
TIMES: I guess also there's the added complication that refusing to take medication is almost a hallmark of some of those illnesses.
To me the responsible thing to do is to get psychiatric care and get it taken care of. Our society says exactly the opposite. Every reinforcement in this society is to keep quiet and do nothing. I think that's terrible. It means that either you're going to have a lot of people lying or you're going to have a lot of people in unnecessary pain and possibly with impaired judgment.
These are very common illnesses. It's not like we're talking about some very strange, rare disease. You're talking about, in the case of depression, up to 20 percent of society will have at least one major episode and in the case of manic-depression 1 to 2 percent. So these are not uncommon illnesses at all.
TIMES: Where does media do harm and where does it do good when it covers suicides?
When suicides are reported in a sensational manner with a great deal of graphic detail about how it was done and where and romanticizing it and basically saying, the child was this great child and all of sudden he or she just killed themselves, as opposed to saying they had mental illness in a matter of fact sort of way. Reporting it, rather than sensationalizing it.
TIMES: Does the Human Genome project and the science it is creating give you more reason to be apprehensive or hopeful?
But overwhelmingly the positive side of being able to diagnose people more accurately and earlier, before the illness progresses, because these illnesses have a progressive toll on the brain. Particularly schizophrenia and manic depression. Each time you have a psychotic break it's a real toll, just like you can't keep having repeated heart attacks, you can't keep having these recurrent episodes of psychosis.
Being able to move in early and save people's lives from completely falling apart is terribly important. Much more important, to understand what's causing these illnesses means that you can develop treatments that are far more specific and presumably with far fewer side effects, so people will be more willing to take them.
Where to call for help
Crisis prevention and suicide hot lines are available throughout the Tampa Bay area. In an emergency, do not hesitate to call 911 from any location. Here are crisis numbers:
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