In January, a student from my alma mater flew all the way across the country to jump off the Golden Gate Bridge. I ended up reading a New Yorker article from 2003[1] about Golden Gate jumpers and this anecdote stopped me:
Motto had a patient who committed suicide from the Golden Gate in 1963, but the jump that affected him most occurred in the seventies. “I went to this guy’s apartment afterward with the assistant medical examiner,” he told me. “The guy was in his thirties, lived alone, pretty bare apartment. He’d written a note and left it on his bureau. It said, ‘I’m going to walk to the bridge. If one person smiles at me on the way, I will not jump.’”
He jumped. And ever since I read that, I've made it a personal mission to smile at everyone I pass on the sidewalk every day. Not only does suicide have unknowable impacts on all of the people around you, but even your most insignificant actions could have an enormous impact on the people around you. Be good to others -- you never know how much it might mean to them.
I knew her--the days after her suicide were pretty surreal, because I always needed to ask my self if I had just been a little more hospitable or a little nicer that one time, could it have made a difference?
How we act matters, but we are not as a rule inadvertently responsible for the serious medical conditions of others. Suicide isn't a disease of affection deficiency.
It should help to know that reaching the state of being one smile away from suicide implies a profoundly severe illness; the problem wasn't smiles, it was the way we route the ill to the mental health resources they need.
In my view it's a harmful oversimplification that suicidal people are simply sick and need to get their mind fixed. I know it's not what you meant, but that's what reflexively rubbed me the wrong way about this comment because I have seen this attitude multiple times from other people who did mean that.
One needs to consider that suicide is not just an affliction of the mind, it's also a product of the circumstances a normal person finds him or herself in. It's not just the thoughts that need fixing, it's the circumstances too. Usually this is a chicken and egg problem: the thoughts prevent the person from fixing the circumstances himself, and the circumstances reinforce negative thoughts. This way somebody can get sucked deeper and deeper into a black hole of increasingly irrational negative thoughts. Even if the thoughts are clearly irrational to an outsider, they are not to the person themselves. Therefore suggesting that they simply fix their mind does not help. In their view their mind is not just what needs to be fixed, it's also the circumstances. We all should do our best to not create such circumstances and to fix them when they exist. In the story of the OP for example, it's fair to say that the behaviour of the professor played a big role in almost causing his suicide. If suicide is caused by circumstances a normal person finds him or herself in, do we not bear a collective responsibility to prevent it, even if it's just a smile?
On the one hand, I agree, we should all do everything we can to prevent suicide. It's the right thing to do, and it may very often be the case, as in the above account, that small positive actions can have disproportionate results.
On the other hand, we need to be diligent to avoid assuming responsibility for the actions of others. If we look at suicide prevention as an assumed responsibility, it can be hard to avoid feeling guilt when someone close to us takes their own life.
We should always be good to each other, and we should reach out to others in kindness, whether they appear to be in need or not. But, we should be careful with how we relate to the actions of others, lest we fall into a trap that we cannot get out of.
That's a good point. It's good to be conscious of the fact that the person you're interacting with may not be in a healthy state of mind. Had the professor known that his behaviour would cause such distress to Tim Feriss, he wouldn't have acted like that (so he is not guilty: he didn't do it intentionally). If we are all a bit extra nice on the off chance that the other person is depressed, that would not only help depressed people, but also people who are not depressed. But I can see how it can be hard to avoid feelings of guilt like that. Perhaps it helps to view it the same way as charity: you can donate to a charity for the third world poor, but that does not mean that you have to feel guilty about poverty that you didn't fix. Similarly, you can donate to the "happiness charity" without feeling guilty if you cannot prevent all suicides.
If you or someone you know is experiencing suicidal impulses, you are experiencing a medical emergency. Please get professional help as soon as possible.
I did not say that you should not get professional help. You make it sound like it's the same as calling an ambulance for a physical medical emergency. It's not. Care needs to be taken in how to get that professional help, and the story does not end with seeking professional help. Don't "Your mind is dangerously ill. I've called these professionals to cure it." Such a response can immediately turn a person off seeking professional help, the exact opposite of what you hope to achieve. Do "You are in a difficult situation. Here's what I can do to help alleviate these circumstances, and maybe it's a good idea to get professional help to help you deal with this situation." It's always better to convince a person to seek help than to do it for them. Frame it as if the situation is at fault, and it's normal to have such difficulties in that situation and it's normal to require help for that. Do not frame it as a "psychological medical emergency" if you can at all avoid that. If the person does not want to get help you can always call professional help anyway.
I'm sorry if we're perhaps disagreeing pointlessly. So long as we're on the same page (as we may have been from the beginning) that significant suicidal impulses aren't something people should be talked out of by their friends, I'm not sure we have anything to productively disagree about.
There are a variety of conditions that can make a person suicidal. Depression isn't the only one.
In some of these cases, the resolution of the problem may involve changes to environment or circumstances. In others, the resolution might be chemical. In still others, prolonged inpatient treatment may be required in order to ensure safety.
What's true in all cases is that the decisions about how to proceed in resolving the emergency should be made by people trained to do it. As you can see from many other comments n the thread, our intuition on how best to help suicidal friends and acquaintances are, at best, unreliable.
"No."? Jules' thoughtful comment deserved better than that terse derision.
And, the attitude of simplifying all of this to "get professional help asap" is not very productive. For one, not everyone can afford or access that kind of help. Two, pronto professional help can sometimes yield to bad choices very quickly. Blowing it up risks violating a depressed individual's privacy, they might see that as an action of offense. When a friend of mine was suicidal some odd years ago, I didn't just dial the phone for some professionals to get him, I tried to make it clear to him how much I valued his friendship and what it would do to me if he were to go away -- the guy is rocking life these days. Of course that's definitely not to say don't call for help, rather that this sort of thing demands a more considered response.
I'm sorry that I can't say this any more clearly: suicidal depression, or intrusive and/or detailed suicidal planning or impulse, is a life-threatening medical emergency. People experiencing it require medical assistance. Please do not attempt to judge for yourself whether or how much assistance is needed.
The national suicide hotline in the US is:
1 (800) 273-8255
Given no other modes of helping someone that will result in them obtaining medical help, and assuming that suicidal thoughts have reached a point where they are intrusive and there is evidence of planning or intent, a 911 call is not unreasonable (you can also drive someone to the hospital).
My opinion is that your attitude about this is too categorical.
I have been in a position where I called a friend because I was frighteningly close to actually doing it. This is after many years of very aggressively pursuing professional mental help in therapy / outpatient settings (which all my close friends are aware of).
If my friend had called 911 after I asked them not to, I would have considered it a betrayal. It would have set in motion a set of events that would cause extreme distress for me, and (I am fairly certain) not provided any greater relief than the years of medications and talk therapy I was already pursuing.
And it would have breached the trust I feel in one of my closest friends in a way that I'm not sure could have been recovered. I believe this would have put me on a path towards having distance from my friends, and being more imperiled overall.
If I couldn't trust my friend not to call 911, I never would have called them. Unless that national suicide hotline above promises absolute confidentiality and not involving authorities, I guarantee I will never call it.
Everyone is different and I'm not giving any advice here. I'm just glad my friend didn't take the hard-line stance on this that you do.
I agree. People talk about "professional help" like it's categorically a good thing. Unfortunately, that's not always the case.
It is incredibly important to understand that many inpatient facilities are profoundly hostile environments for some patients, despite claims of a "therapeutic milieu" (which is somehow exactly the same for both depressive and manic disorders; sure, of course that's credible /s). Based on my experiences at the only two such facilities in my metro area, I would be very, very, very hesitant to ever admit to suicidal ideation in the future. The idea of going back to such a place is enough to make me consider the risk of "going it alone", even knowing that doing so could be a fatal mistake. Comparisons to imprisonment are not exaggerations: it absolutely did feel like punishment, like I had no rights, like the staff merely treated me as a "problem" rather than as a patient or client. Some of the "professionals" were not worthy of the term, particularly the "clinical social worker" types (some of whom expressed, with complete confidence, deeply weird and absolutist "theories" of mental illness that correspond to no credible theory that I've read about in reputable literature).
(punchline: my depression was almost certainly caused by a chronic physiological disorder, one which neither facility screened for; most of the "treatment" I received was probably exacerbating my condition instead of improving it)
I guess if I had to make this venting "practical" I would say this: if you ever have a close friend or family member in an inpatient facility, and they tell you that they really, really need to leave because it's a bad place, believe them. No one else will.
This too is an issue that medical advice to friends and family regarding suicide covers explicitly: to wit: do not commit yourself to confidences regarding suicidal impulses. You may need to break those confidences to ensure the safety of those you care about, and the commitments may harm your own judgement about your best course of action.
There are a variety of things you can do before calling 911; "call an ambulance NOW" is not the message I am trying to send.
If you're someone I know well enough to judge the credibility of a plan to kill yourself (which could mean "complete stranger" is the plan is particularly credible), and I become aware of such a plan, I would feel obligated to ensure you saw a doctor, with the word "ensure" chosen carefully.
At this point I feel like I'm replying to comments on these threads more out of habit and standard message board compulsions than anything else, and, given that the topic we're discussing is sensitive, I'm going to force myself out of the thread now.
> If you're someone I know well enough to judge the credibility of a plan to kill yourself (which could mean "complete stranger" is the plan is particularly credible), and I become aware of such a plan, I would feel obligated to ensure you saw a doctor, with the word "ensure" chosen carefully.
The scenario I am describing to you is one in which I was seeing a doctor, regularly (once a week). I was already getting help. The only assistance I was not getting was inpatient, take-your-rights-away-for-a-while forceable assistance.
>It should help to know that reaching the state of being one smile away from suicide implies a profoundly severe illness
That's a pretty harsh and unrealistic generalization. Not everyone who commits or wants to commit suicide is "profoundly mentally ill". If you woke up tomorrow and your bank account were empty and your family were gone, would you consider suicide? Alot of people would, and it's not because they formed a mental defect overnight. Terrible things happen every day that can make otherwise rational people believe suicide is their most viable option.
Consideration of suicide is not the same thing as intrusive or deliberate and systemic suicidal planning. If it's a friend, ask: are you thinking about suicide? Do you have any plans? What are you thinking of doing? If there are plans, and they are credible, seek immediate medical attention.
> If you woke up tomorrow and your bank account were empty and your family were gone, would you consider suicide? Alot of people would, and it's not because they formed a mental defect overnight.
Not overnight, but this event might trigger clinical depression which is a mental illness in which suicide might appear as a "viable" (sic!) option.
Suicide is simply not the response of a healthy individual in the scenario you described. One would either fight, flight or freeze without willingly harm oneself.
Suicide is the ultimate form of flight. It's running away from life itself. To a depressed person suicide isn't self-harm, it's a way to stop the pain.
That's what makes it so dangerous. Because in reality it IS self harm, it's just that suicidal people can't truly understand that. And it's also true that it's an escape, and the pain stops when you're dead. The value system is distorted such that the loss of all positive feelings isn't weighed properly. Especially since depressed people tend to have far fewer positive feelings, and have a confirmation bias to be unable to remember those feelings existing.
It wasn't a philosophical problem for me. It wasn't that my value system was distorted, it was that my entire experience of existing was distorted. I could logically affirm that positive experiences are possible all I wanted, but they were somehow profoundly remote, in a parallel universe that I could vaguely remember but no longer existed in. It's not just that I had confirmation bias and fewer positive experiences, it's that my entire perception of everything -- every thought, every experience, every future possibility -- was so warped that positive experiences seemed like an impossible fantasy. More than once, I overcame a tremendous amount of lethargy and pessimism and tried to have a positive experience, and I simply couldn't experience it as positive, no matter how good it "should" have been.
That is the power of having a seriously screwed up brain. My symptoms improved not with antidepressants or psychotherapy or self-help, but with treatment for a previously undiagnosed chronic physiological condition. Despite having a "real illness", I've found validation for most of my experiences in first-hand accounts of people with "mental illness" (which is defined in such a way that the practical definition is "any psychological symptoms not explained by a lab test known to your GP"). Allie Brosh was mentioned by another commenter, and I definitely had a "holy crap, someone else gets it" moment when reading her "Adventures in Depression" comics.
(I'm being a little vague here, but given the still-extant stigma around "mental illness" and the amount of data collection that is now commonplace, I'm a bit paranoid about revealing enough to identify myself even under a throwaway account)
After ~20 years of on-and-off psychiatric treatment (some fairly intensive, some not, none especially effective), I found a psychiatrist with enough sense to strongly recommend that I get the relevant lab test. He had to tell me to request it from my primary care doc, because according to the worldview of American health insurance a psychiatrist is not qualified to order said lab test. My primary care doc gave me a questionnaire. My score was just below the threshold where the lab test is considered warranted. He told me he'd figure out how to make it work. I guess he did, because I got the test, got it interpreted by ${DOMAIN_EXPERT}, and got a prescription for treatment that seems to be working pretty well (albeit not perfectly).
That's a nice gesture and sentiment. But this kind of thinking would be a ridiculous way to live. A smile towards someone can be interpreted as you laughing at them, which wouldn't help someone who felt bad about themselves. Yes, you've got to consider this possibility if you accept that train of thought. There are simply too many variables and the state of people's mind is too complex to ever hope to save people from going over the edge by such small gestures and actions, or to avoid sending them over the edge by some totally innocuous and well-meant action.
The best quote on this topic that I know of is terrifying:
The so-called 'psychotically depressed' person who tries to kill herself doesn't do so out of quote 'hopelessness' or any abstract
conviction that life's assets and debits do not square. And surely not because death seems suddenly appealing. The person in
whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling
from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out
the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire's flames: when the flames get
close enough, falling to death becomes the slightly less terrible of two terrors. It's not desiring the fall; it's terror of the flames.
And yet nobody down on the sidewalk, looking up and yelling 'Don't!' and 'Hang on!', can understand the jump. Not really. You'd
have to have personally been trapped and felt flames to really understand a terror way beyond falling.
I've been depressed recently -- maybe not suicidally depressed, but depressed enough to think about it a lot* -- and for me it's absolutely a balance of fears. The weights of past regrets and past failures, the fear of facing them, the fear of future failure (I'm co-founding a slowly failing startup now), the fear of disappointing or alienating loved ones -- they all gang up and become completely overwhelming. The passage above captures it pretty well, though I haven't ever gotten to the extreme it's describing.
Exercise and sleep help.
*I have enough people who love me and depend on me that I know I'll never act on it, but it has become something I fantasize about probably a couple times a day, and many times more on bad days.
I don't have a solution, just an observation. I think your mention of the word "overwhelming" is very important. If there is a solution, I think it will be found in non-destructive (not drugs, not sleeping all day, etc.) changes in lifestyle, values, and focus--things that vary a lot from person to person and probably require experimentation--that prove effective at reducing the emotional feeling of being overwhelmed.
Also, it seems that "overwhelm" is what happens when we combine several bad things that don't have to be combined (various fears, various regrets, disappointments, etc.) into a single, nasty package viewed all at once. Finding a way to focus on them separately really reduces the magnitude of the overwhelm.
I should've pointed out that the experience of depression varies from person to person, there's a set of symptoms of which only a subset might be experienced.
For most people depression is treatable and manageable. Make time to see a doctor. Simply not having to keep yourself afloat in tar is worth it.
The problem is that the flames are real and unavoidable, while the metaphorical flames of those commiting suicide could be some BS easily overcome and forgotten later, like the bad grades in TFA (a lot of the people commiting suicide do it starting with similar BS reasons, not because they are "medically depressed").
Besides, Wallace wouldn't be the best advisor on the matter.
I'm someone who does not appear to be biologically predisposed to depression. I have attempted suicide (at age 17), I have been hospitalized for being suicidal (in my twenties) and I do still sometimes become suddenly suicidal.
I have a medical condition that sometimes suddenly and dramatically negatively impacts my brain chemistry. I also have a great many very serious problems that are hard to overcome. They aren't "easily overcome BS."
For some people, the metaphorical flames are a very serious matter. Not everyone has a cushy life where a bad grade is their biggest fear.
We shouldn't think that having a cushy life makes anything less real. By some people's standards, DFW's life was pretty cushy, but his suffering sounds real to me.
Do you think that people who are not clinically depressed (or suffering similar symptoms as part of another diagnosable illness; e.g. hypothyroidism, hypogonadism, inborn errors of metabolism, (pre)diabetes, sleep disorders, Parkinson's disease, dementia) compose a substantial portion of people who experience suicidality? If so, can you identify any empirical evidence supporting that belief?
>Do you think that people who are not clinically depressed (or suffering similar symptoms as part of another diagnosable illness; e.g. hypothyroidism, hypogonadism, inborn errors of metabolism, (pre)diabetes, sleep disorders, Parkinson's disease, dementia) compose a substantial portion of people who experience suicidality?
Yes.
>If so, can you identify any empirical evidence supporting that belief?
It's common knowledge to mankind for millenia that most suicides are connected to real-world stressful situations and that there exist people that attempted them that were not suicidal before (and neither after they were resolved).
If you want the scientific version of this, it's called "situational depression", is commonly (1 in 5 sufferers or so) connected with suicidal attempts or obsession, and is described thusly:
An adjustment disorder (AD) (sometimes called exogenous, reactive, or situational depression) occurs when an individual is unable to adjust to or cope with a particular stressor, like a major life event. (...) Unlike major depression the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. (...)
That said, unlike most people in here, I'm with the anti-psychiatry school of people like R.D. Laing etc, and blame even "major depression" to irrational and ineffective ways of living and external conditions. I believe that's responsible for far more cases that are casually nowadays ascribed to chemical inbalances and such (mixing correlation and causation). In the same manner, I find that most kids don't need ADD drugs but it's mostly a nice racket to prescribe them.
Note that this doesn't make me unsympathetic to major depression victims (that I believe are not chemically imbalanced). If anything it's the opposite: not only they suffer from sensitivity to external issues and living conditions that are concrete and extremely difficult to avoid (short of changing the whole of society or their whole surroundings and life path), but they're also drugged and numbed to make them blend in and accept them.
I guess it's only fair that I reveal my bias here: I am deeply skeptical of people who claim to have a philosophical or political "answer" to "mental illness". In my experience, most such people seem to be utterly unfamiliar with the effects of unusual physiological states on the mind, and ultimately find their inspirations in the more flowery and idealistic schools of philosophy rather than in the scientific crucible of rationality and empiricism (neither is sufficient on its own: the two must be joined to make any sense of the world; this is, at any rate, my reading of Kant and his critics).
All that said, I'm a little confused by your invocation of "R.D. Laing etc". Usually, the name I see paired with R.D. Laing is Thomas Szasz, and I am far more receptive to the former than the latter. As far as I understand it, they had some pretty deep disagreements. Perhaps Foucault is closer to Laing than to Szasz, and you meant something closer to Foucault's formulation of mental illness, but I am less familiar with his ideas. I admit a certain reluctance to risk exposing myself to yet another flavor of pontification uninformed by experience (there are so many to choose from, and it seems that they uniformly exhaust my patience; I can only spare so much effort entertaining "learned" people who dismiss my lived experience as utter delusion).
As it happens, I was prescribed an ADHD drug by the same psychiatrist who ultimately urged me to pursue the physiological diagnosis whose treatment I actually found helpful. I found that the drug was only modestly helpful at best, and he was quite receptive to my assessment that I should discontinue it. I actually still have almost a month's supply in my cupboard, have felt no temptation to (ab)use it, and am not sure whether I should turn it in to the DEA (it being Schedule II, which is supposedly accounted with some precision) or quietly dispose of it in the bags of my paper shredder.
Foucault too, and the whole idea of mental illness as a societal construction (besides the verifiably clinical cases).
I don't see modern western medicine as a hard science like Math or Physics. It's the same "science" that touted lobotomy, electro-shock therapy (including for "gayness"), considered blacks inferior, overprescribed ADHD drugs, etc.
The problem with medicine, compared to physics, chemistry, etc, it's that its a huge business, the biggest on the planet so there's a huge monetary motivation for selling snake oil, and its procedures and practice were never formalized in a definite way nor are it's results as definite and verifiable as in physics, EE, etc, so it's also prone to fashion and fads.
Peer review by itself doesn't mean much if anything. Liberal arts journals (the kind Sokal published in) are also peer reviewed.
Listen. To anyone reading this thread, and similar threads in the past and future. The discussion may be amusing to you, or perplexing, or frustrating. It may even be pulling you down.
If you feel like you're going to harm yourself, call 911 right away, or whatever your local emergency number is.
If you are having issues, get help. Ignore all this talk. Maybe you're depressed. Maybe you just think you're an asshole, because it's hard for people to be around you and hard for you to be around people. That's not natural, we're social animals. It's not "wrong," it's a symptom.
Don't second guess yourself, don't overthink it, don't try to tough your way through, get help right away. If you have access to a doctor that's probably the easiest way to start. The doctor may treat you himself, or he may recommend some other treatment. The point of the initial visit is evaluation. They're trained to do this.
If you don't have easy access to a doctor or other professional, don't give up. If you're working then your employer may have an Employee Assistance Program. They're free, and you can get a few initial visits with an appropriate professional. EAP usually offers lots of unrelated services, including legal advice, so don't hesitate to ask HR or whoever for the brochure or information, they won't know why you want it.
You may have to go through your county's assistance resources, and that's potentially frustrating, but do it and be persistent. Get a friend or relative to help you navigate.
Me: My car won't start. I need to get rid of it.
Mechanic: Actually all we need to do is replace this solenoid. You should probably change the oil a little more often too. The car is actually pretty good.
Me: Oh, good. I'm glad I asked a professional. I kind of like this car, and I'd like to keep it.
>But statements like this are one of the reasons people are reluctant to get help. My problem is bullshit. I'm weak. What will people think? Regardless of whether the "reasons" or problems are real (to you) or imagined bullshit, people do kill themselves over it.
How does that change what I wrote? Is it the "to you" qualifier? As if things can't be objectively BS as reasons to commit suicide?
People kill themselves over all kinds of BS and not just by suicide. This includes nationalism, religion, and even as idiotic things as "dares".
In fact Tim in the article even admits about his own situation being BS. And it didn't take some huge experience to make him see that, or treatment, or medication: just a phone call from his mother.
Empathy is understanding that they feel really bad -- it doesn't mean justyfing the causes of that feeling too.
If you want to help people you need to make them see the BS-ness of those things (e.g. a failing grade), not overdramatize them as legitimate life-ending situations for them out of misguided empathy.
"As if things can't be objectively BS as reasons to commit suicide?"
You can't rationalize suicide attempts away. Just don't. Showing you care is good. Kindness is good. Any attempt at hard love or such is a recipe for disaster.
Because there is a very good chance you can't tell whether a person is clinically depressed or not. It is very common that they mask this during work etc. and when they get home they just crumble. There are three ways out of this: the person gets better by themselves, they kill themselves or they get medical attention and get better.
It is good to suggest medical attention. It is very bad to suggest anything that like that their feelings are due to bullshit reasons because depressed people can channel this into pure self loathing. It's a medical condition because you cannot rationalize it away.
Do. Not. Tell. Them. That they are making bullshit reasons. That will be a pretty strong disincentive to go to seek medical attention. It will probably make themselves even worse off.
Objectively "BS"? What does that even mean? You need to get a grip and stop your anger towards people who are feeling terrible. If you don't recognize the kind of imagery (the manly-man imagery) that is typically associated with your choice of words, please take a moment to reflect on it. You cannot say "I empathize with you. By the way your reasons for feeling this way are total BS" in the same breath and have any semblance of actual empathy. You feel yourself a clever wordsmith, I'm afraid, who packs a gun called "tough love".
It means that as far as things to commit suicide for go, a failing grade in some assignment or a rejection in high school, are not very important in the grand scheme of life. If someone attempts suicide over the loss of his family, it's more understandable than attempting suicide because you were rejected for The Voice.
>You need to get a grip and stop your anger towards people who are feeling terrible.
I'm not sure what you are projecting here. Qualifying something is not anger, and I'm not talking to people "who are feeling terrible", I'm talking to people on a HN thread. This is a discussion. It's not very polite to assume things and feelings for the other end.
>You cannot say "I empathize with you. By the way your reasons for feeling this way are total BS" in the same breath and have any semblance of actual empathy.
Yeah, because lots of people never took their friends aside (or vice versa) to try and help them overcome a dark patch, including suicidal thoughts and depression, by putting things in perspectove for them. So their version of empathy is "Don't bother me, go see a doctor and take your meds".
This conversation is like it's taking place in a bizarro alternative universe, when all suicide is caused by tangible chemically induced depression (which is the only form of depression in that universe too), and people never overdramatize their circumstances.
This might be an 21st century American thing, were individuals must absolutely remove any societal and personal causes for their situation. In these parts of Europe we find it OK for friends to help us see clearly what's trivial and what's not, and we had similar philosophies down to the time of Epicurus.
Whether or not somebodies sense of depression is triggered by something "trivial" or "stupid", it is likely genuinely causing them distress. Personally I wouldn't pull my friend aside and say, "Hey man you seem down, but the fact that you just broke up with your girlfriend is a total BS reason to be upset". Perhaps we are only differing in the way we like to describe the situation, but your language comes across as being unnecessarily "macho".
> It means that as far as things to commit suicide for go, a failing grade in some assignment or a rejection in high school, are not very important in the grand scheme of life.
Of course it's not that important. But that's not why they're killing themselves. That's just one more thing to push them over the edge. Behind it is a fundamental problem, and it's that problem that's making them vulnerable to something that seems trivial.
You are framing the discussion in a certain way, and then attacking other people for things they haven't said, and doing so aggressively and from a position of staggering ignorance. The fact you cite Laing is telling - he's almost totally discredited now.
1) when you find someone who is actively planning a suicide you have a choice. Keep them alive until they get to a professional, or treat them yourself. You wouldn't (I assume) stick a pen through the eye of someone having a heart attack, but that's the rough equivalent of what you're recommending people do to suicidal people.
2) treatment for suicidality has two components. i) keep them alive until meds and therapy can take effect. ii) give them meds and therapy. Suicide prevention is wider. If you're talking about suicide prevention as a public health measure you should probably state that. If you don't know the words to use to specify what you're talking about that should be a clue that perhaps you don't know what you're fucking talking about and should perhaps be a bit less arrogant.
3) as part of keeping someone alive until they can get help: there are things that we know mostly work, and things that we know mostly don't work. "Low grades? That's a bullshit reason to die! They're not that low; you can retake them; I got worse grades and I love my awesome job so your career path could be like that!" is something that we know mostly does not work. We know because we talk to survivors of suicide. Since there are 112 Americans per day who die by suicide we have plenty of people to talk to. If telling people their opinions was bullshit did anything to change their minds you and other people wouldn't be having this discussion - you'd have changed their mind or they'd have changed yours.
4) reactive depression is still depression. It's still an illness. The cure for reactive depression is to change the thing causing the reaction, but also provide evidence based techniques to build resiliance.
5) if just telling people they were wrong worked we wouldn't have had such a high deathrate from anorexia. About 1 in 5 people with this anxiety disorder die from it (this number is going down)
> be an 21st century American thing, were individuals must absolutely remove any societal and personal causes for their situation. In these parts of Europe we find it OK for friends to help us see clearly what's trivial and what's not, and we had similar philosophies down to the time of Epicurus.
There are reasons for the high death rate to suicide in most (but not all!) parts of the US, and this probably is not one of them. Decreased access to treatment; poor quality treatment; judgemental and stigmatizing views; increased use of criminal justice instead of mental health treatment; easy access to means and methods; etc etc.
> you need to make them see the BS-ness of those things
No, I don't need to make anyone see anything. And if they're anywhere near suicide, they don't need that message from me, they need professional help. Things are not rational, by definition, and they're dangerous. Don't fuck around with this, it's not a rationality petri dish or a debate.
I think you misapprehend the situation. Based on my experience with suicidality, the "BS" isn't what actually prompts the suicidal thoughts. Rather, it's post-hoc rationalization for the irrational feeling of having no future worth experiencing. In a broader sense, this is something that people do all the time: we experience an emotion, then try to explain it after-the-fact. Our brains are incredibly adept at inventing "reasons" for experiences and sensations that ultimately stem from bizarre defects of biology and other caprices of circumstance. The mythologies associated with sleep paralysis (the hag, incubi/succubi, alien abduction) are perhaps the most vivid examples of this phenomenon.
The point about suicidal thoughts is that the urge to have the thoughts is a symptom of a disease, a phenomenon that is occurring in your brain. And on top of the other symptoms of the disease these thoughts create their own suffering.
My advice is not to try to rationalize the urge. If you ask yourself the question "Why do I have to kill myself?" You will get answers. Bullshit answers, usually, but they don't look that irrational because of your state of mind. And a lot of the suffering is caused by these essentially fruitless discussions.
Another key point is to realize the impermanence of the mind and of the self. Though it sounds like a buddhist teaching, everyone who survived suicidal ideation knows this: You enjoy live, then you don't, then you do again.
The mind is never static. Finding that reality helps one to get a grip on the seemingly illogical phenomenon on suicidal thoughts.
> The point about suicidal thoughts is that the urge to have the thoughts is a symptom of a disease,
This is wrong. Thinking of it as a "disease" is a misunderstanding, it makes it impossible to truly understand it.
Alcoholism might be a disease... excessive alcohol consumption probably doesn't have any benefits. Suicide though? It sort of does.
You see, biological organisms aren't programmed to survive... we're programmed to reproduce. And that means not just laying the eggs, but making sure that at least some of the offspring survive. So it became advantageous if a parent (or even uncle/aunt) was psychologically capable of killing themselves or letting themselves be killed.
And we're not necessarily talking about throwing yourself in front of a rabid grizzly either. There are all sorts of circumstances (killing yourself so there will be enough food for the other to survive a famine).
The psychological machinery is all there for killing yourself. Hard-wired into your brain through countless thousands of generations of people who only lived because a close relative voluntarily died.
But evolution isn't intelligent, and it goes with a "what works most of the time" method of keeping a trait or not. And this is probably cross-wired in with quite a few mental illnesses and other questionably-useful traits.
It's a malfunction of a (once in a great while) useful tool.
On HN, it's anything other than the strict mental health party line on suicide. On other threads, I've seen people looking down on David Foster Wallace, as if they had a prayer of doing in their lives what he did.
I upvoted, because interesting comments on this topic are rare.
"This is wrong. Thinking of it as a "disease" is a misunderstanding, it makes it impossible to truly understand it."
I would classify it as a medical condition since that is how the modern society can provide attention to it. If one is clinically depressed and borderline on suicide the way to get help is to seek immediate medical attention.
I'm not sure what the philosophical difference is between a "malfunction" and "disease".
It's important on medical topics to distinguish message board noodling from actual vetted advice. I'm not a doctor but have spoken to doctors about this specific issue, and, like all of us, have access to the actual medical advice available on the Internet.
Every piece of advice I can find prominently states:
Do not argue with or attempt to invalidate the reasoning of a suicidal person. Listen. Ask questions to gauge intentionality ("do you have a plan? what is your plan?"). Vector them towards professional help. Do not try to fix suicidal people yourself.
Suicidal impulses are a medical emergency.
This may not directly apply to your comment, but it seems very likely to apply to the thread as a whole.
>Do not argue with or attempt to invalidate the reasoning of a suicidal person.
Merely saying this may not convince people. They need to know why this completely fails. While suicidal actions are largely impulsive (one reason why guns are a worse threat than other forms of suicide), the individual has spent a long time thinking about it. Nothing you can say will convince them that you have any understanding of their reasoning. To them, you are just like all the others who do not understand them (regardless if they are right or wrong in such an assessment).
By listening, you are likely doing something that no one else has done for them. It will often show them that you want to know their reasoning instead of just dismissing it. It may not be enough to stop them, but it often does delay them, hopefully long enough for a professional to get involved and take over.
> (one reason why guns are a worse threat than other forms of suicide)
I come from a family of avid hunters and gun owners. I don't personally own a gun. Not because of any political reason but because I don't want the ability to pull the trigger when I'm in my darkest of moods. At least without that I have to think about it long enough to hopefully snap out of it. There are a handful of times if you would have handed me I gun I think I would have pulled the trigger... Then when I look back it seems silly but the cycle repeats. One time I simply couldn't find my car keys and almost rage quite life. The car was in the shop.
> One time I simply couldn't find my car keys and almost rage quite life. The car was in the shop.
This is one of the most terrifying aspects of depression for me. I can be functioning perfectly normally (obviously just on the surface), and then one morning I stub my toe or spill a glass of water and I just breakdown. All the frustration, anger, sadness, or whatever that I've been holding in just floods out and I want it all to be over. This is why I used to never drink (and now wish I'd never started), and also why I won't consider owning a gun. When you get depressed you may not be able to control yourself, but you can try to instill good habits in yourself when you're of a sounder mind. Or at least control your environment so you have fewer tools to harm yourself with.
That's the weird thing about depression. At the moment it seems totally rational. Then you look back and think WTF? Like today. I look at the comment I originally made and there is no way I would even share that in the mood (positive) I am in today.
Indeed. The way I explained it to my ex-girlfriend (it ended because of my depression, though I didn't realize I'd fallen back into it at the time): In the moment I was perfectly rational, based on what I believed or "knew" to be true. But what I understood to be true wasn't, in fact, true. Or it was, but the scale was far less significant than what I perceived it to be. Which means that, to the outsider, I was clearly out of my mind (and was), but if they saw what I saw, and heard what I heard, they'd have come to the same conclusions. Goes back to this and other recent posts on things like catastrophic thinking.
OTOH, I generally make these comments when I'm in a more positive mood. That's the only time I can put words to what I experienced.
It isn't just depression. Look at a teenager in love. They will do something today fully defending it for being true love, but in 10 years they will lay awake at night cringing at the very same action.
> "Nothing, I've got a great job, seeing all my friends weekly, just started on a really exciting new side project,
You haven't met a lot of depressed people. Many have jobs, and family, and friends, but still irrationally feel alone and don't feel trust in the people that love them.
You evidently have never heard of Aaron Beck, the doctor whose new approach to treating depression has saved tens of thousands of lives during my lifetime.
"What's wrong with your life" is not the same as "Why do you want to kill yourself?".
And even then I would categorize these reasons as quite irrational reasons to kill yourself. People who are not currently in that particular state of mind don't see these reasons as rational and valid.
My point is to not argue with some one who is suicidal about his reasons. Even not with yourself, if you do have suicidal thoughts. Take the symptom seriously, start treatment, but don't take the thoughts and reasons themselves too seriously.
I don't speak for everyone who was suicidal obviously, but one of the answers to "Why do you want to kill yourself" is that you are unhappy and don't think you'll ever be happy again. I am not suicidal or as you say "in that particular state of mind" right now, but I can definitely see this as being rational or valid.
If you have been depressed for as long as you can remember, I can certainly see why you would feel as though things are hopeless. I like to think they aren't, but I wouldn't disregard their feelings and opinions as irrational. Like an aspiring musician or athlete whose prospects don't seem to be getting better, sometimes you feel like it's time to give up.
Have you ever been suicidal? Not trying to be rude; I'm just curious whether your opinions were formed because you had a different experience than I did is all.
My point is that "It will never be better" is objectively wrong for most people. There is a very small portion of patients who indeed don't improve after years of treatment, but for the absolute majority depressions can be treated in weeks or months.
I don't disregard anyones "feelings" if I call these feelings irrational. But these feelings are obviously caused by a temporary state of the mind. I did have those feelings, but I learned early on to not take them as seriously as they looked at first.
But it's hard to get to this perspective, I know. A Depression undermines the patient's ability and will to fight it. Some patients develop elaborate delusions about why they are this way. Most patients have less obvious "delusions" where they believe something not completely extraordinary but still wrong and harmful, like not being worthy of life.
I can recomment the youtube video "Sapolsky on depression", he explains depression from a biological viewpoint.
> you ask anyone who's suicidal what's wrong with their life, they will give you a litany of actual real-life things rather than, as you suggest, answer "Nothing
You need to re-read what bayesianhorse wrote more carefully, because you're not actually disagreeing with him. He said: "If you ask yourself the question "Why do I have to kill myself?" You will get answers" Attacking a straw man is bad enough, but attacking it with such vehemence is really not cool.
Right, I've had the experience that thoughts can deeply affect my mood and how I feel about life and myself. I wonder, though, why most people seem to simply leave it at that - "some thoughts are bad, be aware of that". Where's any kind of advice on actually dealing with this mind of ours? Sure, we have meditation and mindfulness, and at least meditation seems to be very effective for many things (I don't know enough about mindfulness). But is the mind really such a chaotic and uncontrollable beast that the only alternative is to focus/quiet it (meditation), or to symbolically shrug at the impermanence of its temperament?
We tell people to exercise if we want to get stronger, but the mind is seemingly something that we either try to repress in an unhealthy way (alcoholism and friends), just blurt out/vent whatever it has been nagging us with lately ("talking about our feelings"), or meditate/mindfulness. The last alternative seems very promising and healthy, though sorely underutilized by most people, even the "my body is my temple". But I find it strange that there aren't more alternative (and complementary) approaches that are being suggested, like trying to think more constructively ("positive thinking" being a part of this).
People who see the mind as a separate and wild beast will probably say that the mind can not be controlled. And I would be inclined to agree. But I think it can be steered to some degree, or at least nudged.
Mindfulness is not enough. For one thing, being mindful of your breathing won't help you a bit when dealing with unpleasant thoughts. But you can start to become more mindful of these thought, especially when not in a formal meditation.
The "observing" of these thoughts alone can improve the situation a lot.
Mindfulness training also improves the prefrontal cortex and thus the ability to control impulses and thoughts. The idea is to evolve the ability to choose to have a certain thought or not.
Knowing what to do is one thing, doing it is another. Meditation can immensely improve the latter!
Meditation is not a sufficient treatment for depression or suicidal thoughts, but it can help to avoid relapses, and it helps to deal with the consequences of recurring depressions.
I have found basic cognitive behavioral therapy techniques like the "three column method" to be immensely helpful in dealing with negative thoughts/moods. Especially in combo with meditation. Copy of the book 'Feeling Good' is about 10$ and will teach you how to do it and give lots of good examples in different practical contexts, or just google 'triple column method cognitive therapy'.
Steps are generally: write down your automatic thoughts when you are feeling bad, identify how they are irrational or distorted, write down more accurate, balanced, realistic ones -> feeling better.
It's a can of worms - there's this notion of freedom of religion for instance.
Anybody can think and believe any crazy idea as long as it's a fairly mainstream religion. That's our current state of affairs - we take any ideas seriously as long as many people take them seriously.
There's not much other criteria at play.
So people live with crazy incompatible ideas that keep causing internal conflict and what vague solution can you propose that'll sell? (Capitalism is the new religion, so things MUST sell :)) Right, 'mindfulness' - in other words, just don't pay attention to the internal conflicts you are continually having - they'll go away on their own.
They don't really, but we can't say ok, we have to use logic and sense to approach these things - because then archaic ideas like freedom of religion are going to fall apart.
So we are where we are, mindfulness, 'positive thinking' and other sterile methods that don't talk about the real problem - your mind is a big mess and it'll take a while to sort through it.
We as a society haven't even started - we're too busy coping with never-ending fuck-ups that stem from people in power not losing their heads for being incompetent. Of course they love it that way, they're at the top of the heap and beyond scrutiny, how convenient. Just don't get caught with hookers and blow.
No. Someone may well work out perfectly logically that there's nothing more for them to do in life. And that's their choice. You're pathologising someone just for coming to a certain conclusion.
Of course, people might also make emotion-based decisions to kill themselves, which might be a symptom of their depression or whatever, but that doesn't mean that all suicide must be a mistake. You'd kill yourself to keep the Borg or the Alien from getting you, wouldn't you?
If you're pro-choice w.r.t. abortions at all, then you should really be pro-choice w.r.t. suicide. If your logic for the first one was "it's their body, so it's their choice", you're inconsistent in your logic if you oppose the second one 100% of the time.
> illogical
Given that there's no good reason to be alive in the first place, it's perfectly logical. It's only ill-logical if you assume that what's good for the (selfish) genes and what's good for the individual are the same thing, which they're not.
That's just not the reality. If you look at suicides, you pretty much always see someone who was depressed for a long time.
And that disease of depression has been studied in so immense detail, that your point of view about it is plainly wrong. The suffering is clearly immense. And it is clearly temporary for almost all patients, especially with good treatment. It can't be rational to kill yourself to avoid temporary suffering.
Of course you can construct situations where it would be more rational. But really, if someone has suicidal thoughts, the assumption that this is an irrational, "insane" idea, is pretty much a no-brainer.
It only seems insane to someone completely averse to nihilistic thought processes. If you believe that everything in this life and universe are effectively meaningless then ending your own microscopic existence is basically irrelevant.
My understanding of his comment was that he was trying to convey the above, not necessarily argue that feeling depressed one day (or year!) makes killing yourself a fantastic idea. See:
"Of course, people might also make emotion-based decisions to kill themselves, which might be a symptom of their depression or whatever, but that doesn't mean that all suicide must be a mistake."
> That's just not the reality. If you look at suicides, you pretty much always see someone who was depressed for a long time.
That's definitely not true. Most people who die by suicide have a mental illness, but not all of them. (And by "had a mental illness" I'm including those people who had an undiagnosed illness.)
"It was only then that I realized something: my death wasn’t just about me. It would completely destroy the lives of those I cared most about. I imagined my mom, who had no part in creating my thesis mess, suffering until her dying day, blaming herself."
I'm sorry, but that consideration just doesn't help. If the pain (or emptiness) is so strong that you just want everything to stop, this consideration is absolutely worthless and unimportant.
You're being downvoted, but if you read advice on how to help people currently experiencing suicidal impulses, one of the first things you learn is not to try to combat them with messages of guilt or obligation.
As I understand it (surely someone on HN has more exposure to this than I do; I've lost friends, but not myself experienced the impulse):
The "do's": listen, empathize, stay calm, be hopeful in tone, vector them towards help.
The "don'ts": argue them out of it, get emotional, judge, try to fix it yourself.
This is great advice. While suicide is often associated with depression, because people with major depression are often suicidal, the predominant attitude at the time is often one of unbearably intense anger or anxiety. Getting judgmental or combative is going to increase that.
Also, many suicides involve alcohol (which, in some, produces a volatile state that mixes despondency and extreme anger) and drunk people don't exactly listen to reason.
I think that it can be worthwhile to remind the person that he has friends who'll miss him, dogs to feed, etc. I don't think that laying in with guilt is the way to go. You want to give them images of the people they care about being happy, not images of them being wrecked by their own possible death.
Different people can be helped by different things. I think it's rather odd to take something said by somebody who was in the middle of planning his own suicide, and who got stopped because a certain event made him think about something he hadn't considered, and say that thinking about this particular thing doesn't help. It helped him, therefore clearly it can help.
I think that this particular issue is very sensitive, and very personal, and very individualized. Indeed, sometimes a reminder of the ties we have to the living world is a good thing at any time. For some, thinking of others and the impact their death might have on those around them is in fact enough to get them through a particularly bad spell.
I think that it's important to note that it's not a feeling of guilt that should be focused on here. It's a feeling of connection. There are people who care and can help if you reach out. There are people who care.
Of course it's not always enough. If it were, people would never commit suicide, would they?
There is a great deal to be said for holding on for others those times you can't hold on for yourself. After all, life is very much a series of highs and lows.. sometimes, you need to latch onto whatever you can to get you through the lows.
That depends. For some the guilt may be enough. For others it just makes them more miserable or they point out that it is not really fair that they should suffer.
My parents love me, but they never asked me if I wanted to be born. If I was in pain that couldn't be treated and it made my life not worth living I would not feel obligated to continue living for their sake.
What about the thoughts of how much better people's lives would be without you. I've have too many nights where I've just sat there in the dark thinking how much better life would be for everyone around me if I wasn't here. I've gotten over it though medication and therapy and still chug along, cause frankly, I've got too much stuff _I_ want to accomplish before death. I guess this is why I don't have or want but a select few people that are close to me in my life.
For me, most people I meet day to day, they don't even exist past our minor interactions, most of which are positive because I'm positive.
The few folks who I interact with on a regular basis - it is all positive, or else I'd stop interacting with them.
There are situations where you have to regularly interact with people who are going to be annoying (teachers in school, parents if you live at home, boss at work, etc) - you just have to learn self-defense tactics and work toward being more independent.
The people who are annoying - they are just incompetent at life. Their life sucks with me in it and with me not in it. The rest are either not affected or affected in a positive way.
So I don't know where you're at but if you're not a net positive to those around you - you have got some work to do.
it has nothing to do with being "net positive" to those around you. You can be the best thing that has happened in people's lives. call it low self esteem, self worth, whatever, its just that for some reason, no matter how positive you are to them, you always feel like a burden.
The reason some people are mopes is as I mentioned in the last post - they just are. They're stuck. Don't get stuck wasting your time being 'positive' to them.
Be positive to yourself by not spending time around people who make you feel like shit and spending time around people you can learn from instead.
Easier said than done of course, one step at a time :)
For those experiencing everything from mild depression to strong suicidal thoughts, I'd recommend the combination of cognitive behavioural therapy, if you can afford a therapist, and this book:
"Feeling Good: The New Mood Therapy" by David Burns.
Depression and suicidal thoughts are often rooted in twisted, invalid logic that we don't recognize as such. For example, say that a stranger unexpectedly smiles at you. It would be logical to smile back, and perhaps even strike up a conversation to ask why they're smiling at you. The reasons are probably good. Maybe they're attracted to you. Maybe they just randomly thought of something funny. The risks of speaking to that person are minimal. A twisted, illogical reaction that many of us naturally have is to assume the person is smiling at our expense and that there's something we don't know. We fear what the person will do or say if we do anything to acknowledge their smile. Instead of smiling back, we retreat inwards, wondering what's wrong with us, why we're so pathetic, anti-social, etc.. Two people can experience the same event in wildly differing ways because of how they process them. For someone who is depressed, events that should be good can easily add to their problems.
Cognitive behavioural therapy focuses on catching those thoughts, identifying them as illogical, and deliberately countering them until the thought pattern in a given circumstance becomes naturally logical. In the situation above, you would need to recognize that you're assuming a lot about what the other person is thinking, recognize that the worst that can happen from striking up a conversation or just smiling back is not very bad, and that the potential gains could be very good. I had a fairly low opinion of most psychology until I came across this. It's actually helpful.
Foreword: I do not believe I have ever been in a mental state that could be considered as 'depression'.
That said, I have experienced times in my life that have made me realise that the common views (e.g. you are free to do anything now; it will get better; etc) are false. They all stem from the idea that the individual is selfish.
The worst times I've had in my life were the times in which I tried really hard to be virtuous, to care, to right wrongs.
When I want more than just to 'succeed'. More than just to fix my life. My life is fine!
Bureaucracy, for example. 'Company policy'. It makes me angry and feel as if millions of humans have lost the ability to feel empathy, have been turned into robots. It's not about the fact I can't return a broken lightbulb; I don't give a toss about the 1 GBP. It's about the knowledge that most people don't care about right and wrong. Most people will obey the rules, they will do what authority says, they will take the path of least resistance.
Politics. My country treats the poor as subhuman whilst praising the rich. It fawns over 'merit'; which is really just random chance.
I could go on... basically, what happens when you realise that you're playing a rigged game? It doesn't matter if you win or lose. You can run away and hide. Or you can fight, all the while knowing that your attempts almost certain to be futile.
Once the box is open it never closes. I cope by employing nihilism, but the triggers are everywhere. Every 'intellectual discussion' about the merits of Red vs Blue, about the latest plan to Lock People In A Box for performing something mundane like shuffling some bits around.
And all around, the advice is to take drugs. Think differently. 'Come to terms with it'. Counselling... I don't want that shit. I want a city, a country, a world that treats its citizens well. If not as equals, at least as more than dogs.
My thoughts exactly. At times I actually feel guilty for not killing myself because I therefore submit myself to unfair terms, which is worse than death. If our world is not fixable, we can not lead it to the state we might like, why pretend?
i tried killing myself many times. every time, something would happen last minute that changed things, and then life seemed to have a different character afterwards.
i started to wonder if i actually did succeed after the first attempt in 2005, becuase life seems so different now than it was back then.
one of the things that finally stopped my suicidal ideation was the belief that i can never actually experience death. i discovered that other people with a background in physics had the same belief - quantum immortality.
I've often wondered about this, but never knew there was a term for it.
In the past, I've been in situations that I probably shouldn't have lived to talk about and often wondered if I really did make it out alive. Or did my perception of reality diverge from the dimension I was in and continue in a dimension where I defied the odds and lived. Thinking in terms of multiverse[0].
Even if you cannot experience death, but you can experience a horrible near miss with massive brain damage. For quantum suicide to work, you'd want to be completely unconscious when it happens, so that you never observe any injury.
I once had someone I looked up to and admired very much tell me that if he had gone through some of the things I had, that he would have committed suicide. Shortly after he said that, he effectively stole nearly $13M from me. I sometimes wonder if he did it thinking that it would make things so much worse for me that I actually would commit suicide (because that's what he would have done), and I wouldn't be around to fight him for it.
You can't let bad experiences, bad people, and just plain bad luck make you start thinking about suicide. The reality is that most people that consider suicide don't do it. However, merely entertaining suicidal thoughts can be a caustic force in your life, as these thoughts affect every aspect of your life, and more importantly, hinder your ability to move on from the situation that caused the thoughts in the first place.
When your life crumbles, chances are it wasn't built on a strong foundation to begin with. As long as you're still breathing, you have an opportunity to rebuild it.
Something I think could help people in these situations but doesn't have much popular support - over-the-counter antidepressants.
It's telling that the author was able to check out a book on suicide, but didn't seek medical help. That would require a) getting past the stigma of suffering from depression b) calling up a doctor or therapist c) suffering through the long mental health wait times that exist in most countries, d) being sent to a CBT therapist, given a self-help book or website e) being referred to a psychiatrist f) finally being prescribed something.
It can be months before a depressed person gets any kind of treatment at all. And they are the last people to have the energy it takes to navigate a byzantine healthcare system, or have a friend or family member help them (many people still believe depression is a character weakness and will punish the patient for speaking out).
Antidepressants aren't all that dangerous, even when compared to other over-the-counter drugs like Plan B. They're not happy pills, they often won't even make a miserable life bearable, but they do give the patient enough energy to deal with his/her problems. Given the number of lives lost to suicide, and the high disease burden of depression, I think the safety tradeoff is absolutely worth it.
I'm aware this comment is going to attract a lot of ill-will and uninformed comments about anti-depressant efficacy/ woo about happy pills etc. so I direct you to read this FAQ first.
https://medical.mit.edu/faqs/antidepressants
Kids often bring joy. Consider reaching out to kids (who are already born) and helping them enjoy their life, and brighten yours.
I don't know how old you are, but in many cases, elderly folks have time to wind down their lives in a graceful way, to the point where saying goodbye is bearable.
Obviously people can still die accidentally/early, and ultimately you'll outlive about half the people you meet, but there is a way to learn to appreciate the time you have together, and to let go when that time ends.
It's not the "getting left behind" angle that I don't like. It's the fact that I have to wait +/- 20 more years for them to die before I can FOAD because that is what society expects.
You need a reality check - you're placing blame on outside factors (like your parents) for not being where YOU'd like to be in life.
Owning up to that is the first step toward recognizing how incompetent you are at being happy.
I used to be a moping ball of negativity myself once upon a time - it just doesn't work. Sooner or later you have to recognize that the way you are isn't working and take steps to change that.
I have to commend Tim Ferris for speaking out about this. He's worked his brand to the point of steel- making it sometimes hard to see him as a normal human being. I am a fan of his tip and tricks, but I really appreciate that he was vulnerable here in order to start this discussion.
One specific thing you can do, that is rather unlikely to counterintuitively backfire like many ideas, is to simply make plans with some to meet and talk/eat/play with no pressure.
Having something planned -- an easy commitment, but not a heavy intimidating responsibility -- gives people a sense of purpose to move foward through their day/week/month, buying time for luck and expert assistance to come together.
This in addition to steering toward professional help.
It should be a liberating thought - that you've got nothing to lose, go try something exciting like
white water kayaking,
hike the Pacific Crest Trail,
sail across the ocean,
challenge yourself at a sport, biking, swimming, climbing?
take a safe amount of MDMA and go to a music festival?
listen to some alan watts [1]
try fresh cannabis [ideally from Washington/Colorado/California], and music
When my brain is functioning properly (according to third parties), this sounds like great advice, and I can even intend to head it next time I sink.
However, once my brain was processing my every action as futile, I was often too depressed and incapacitated to shower, or even to get up and make food when I was hungry. In that state of mind, things like kayaking and hiking were functionally impossible. Music remained, but my brain retreated to the comfort of Radiohead's "Street Spirit" or "Creep" (etc).
My point is that it's almost like being a different person. Reality is persecution, logic is warped, and intentions from good days do not always carry over.
I was fortunate to have understanding and patient friends who helped me work on this during my good days. Kayaking is still unobtainable, but now I am able to turn to, e.g., "Katamari on the Rocks"[0] for music, and Alan Watts as well. The Zen Habits reminder to breathe [1] is a permanently open tab in my "distractions" group.
As the quote from Infinite Jest says[2], the flames become terrifying. I can only speak for my own terror, but the help and support I've received have made it easier to face and combat. Long talks with friends, smiles from strangers... it has all been important. Thank you.
> include wording like “impossible situation,” which was reflective of my thinking at the time, not objective reality.
Distorted thinking tells you that the only way to escape the impossible situation is death. If distorted thinking told people to go whitewater rafting we wouldn't have 112 Americans dying by suicide each day.
Major depression turns life into quicksand. It seems like anything you do makes it worse so you choose to do nothing. Eventually it gets unbearable and suicide starts creeping in.
That's the beauty of MDMA actually: there's little that suicidal ideations can do in the face of a massive flood of serotonin. It's like an antidepressant that works within an hour and lasts for about three.
It can lead to insight that produces lasting change.
Please heed this last part: if you choose to treat suicidal urges in this way, tell someone what's going on so you can have support for the following week. The crash can be dangerous to someone in an unstable place.
I was not feeling suicidal when I first took MDMA but I had been struggling with depression for years, and the experience was a key step on the way out. It was such a clear demonstration of the degree to which my perception of the world around me, and my estimation of the beauty and worth to be found there, are driven by the chemical state of my brain. I had thought that I was depressed because I lived in a crappy world; that first MDMA experience showed me that I had causality backward, and that I thought the world was crappy because I was depressed. Insight that produces lasting change indeed.
This is really a very important reason to do drugs in the first place, especially psychedelics. They show you how much of your reality/perception is based on a temporary chemical/biological state, not what you previously thought of as 'reality.' It also teaches you to 'ride it out' in the event of a bad trip (also a valuable experience). Ironically to some, doing drugs like this can make you more sane.
Not necessarily impossible. I've been completely "distracted" out of the depths of depression, at least temporarily. Depression is a cognitive feedback loop, sometimes a major change of scenery or activity can effectively disrupt it, if you can somehow bring yourself to do it.
I know you mean well, but this is classic terrible advice, based on an incorrect understanding of depression. It's not boredom (cured by white water kayaking). It's not a lack of endorphins (stimulated by biking, etc). It's not stress (-> cannabis). It's not that one just forgot that there's good things in life, and some Alan Watts will snap you out of it.
Stagnation, lack of exercise, and lots of oily/sugar/processed foods - all have a direct impact on everyone's baseline well being.
Cutting out fast food / snacks / soda (substitute fizzy mineral water), and making the effort to do fresh stir fry veggies with some ginger, spice, and coconut oil has been life changing. I no longer feel tired all the time, or get drowsiness after I eat.
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Going for a hike, or cautiously ingesting a small amount of cannabis has done as more to reinvigorate life and eradicate dismal states of despair and bleakness as I could ever imagine.
These are all wonderful things, truly. Highly recommended.
But they're of little use to someone with severe depression planning out their suicide. In fact, "empowerment" can trigger the opposite reaction: it emboldens the person to finally carry out their plans. For this reason, activities that would usually be good signs (e.g., someone starts hitting the gym vigorously after starting new meds) can in fact be warning signs that another suicide attempt is on the horizon.
You seem to be thinking about having "nothing to lose" as being like having a magical credit card that you never have to pay back. Since it never has to be paid back, one is now "free" to buy whatever they want. This could indeed be a liberating experience.
However, depression can manifest in feeling like the only thing that is available for purchase is nothingness. If you "know" that whatever you buy will turn out to be an box full of nothingness then having a magical credit card isn't very exciting.
The point is to seek out life, maybe you'll find something exciting if you try - rather than quit and throw all the untapped potentiality of your future away.
Depression is an incredibly broad umbrella label for a mental condition that is nothing like rabies or traditional diseases.
Depression is a state of mind, often (but not always) induced by circumstantial situations, financial, existential, diet, stagnation/exercise... the cause of Depression for many can be resolved, with effort - and it takes a significant amount of effort for someone with depression to do things as simple and necessary and normally enjoable as eating a meal or taking a shower.
The point is, if you're going to do something as extreme as quit life, you might as well try to see if your depression may just be caused by a lack of exercise or "tunnel vision" of your perception of the world that could be drastically contrasted through experiencing therapeutic mild doses of MDMA [1][2] or cannabis or pharmaceuticals.
If you are experiencing suicidal thoughts to the point where those thoughts have become intrusive and difficult to dispel, and/or to the point where you've begun formulating a plan, please seek professional help as soon as possible. If you know someone in that situation, please do not recommend therapeutic mild doses of any drug; rather, calmly and urgently vector that person to professional medical help.
Can confirm. I got to the point where I stopped shower for multiple days because I thought it would take to long. I know that it should take twenty minutes top but in my mind my time estimate was closer to an hour. I literally did nothing but smoke weed and watch Netflix, nothing else was interesting enough for me to bother.
That being said, avoid weed on depression, and find dissociatives. The third person perspective on your life they provide can be a life saver. Just be careful as you can get quite intoxicated by this effect.
Some guy on Reddit swore by playing a horror game (e.g. Amnesia: The dark descent) when he's feeling down. I tried it with mixed results, but it certainly is a powerful way of feeling something strong and different. Similarly for movies, there are some powerful ones too (for example from Studio Ghibli).
But most importantly: Be with others. Family, friends, random guy in a bar, whatever. Even if it doesn't sound appealing (nothing does when you're depressed) just do it, talk to them.
When you're going trough hell, don't stop walking.
I understand the sentiment but I disagree with it.
I'd stay away from the drugs, except in a monitored therapeutic context (which is probably still illegal, but may be helpful). Depression can be secondary to anxiety, and drugs can cause panic attacks. A bad trip is essentially a panic attack boosted by persistent altered consciousness. I'm not anti-drug but there are people who shouldn't use them (I'm one of them; I don't even get drunk).
Severe depression also makes it hard to do any of these things. But people don't usually commit suicide in the thick of a depression; they do it in the period of emotional volatility that tends to happen at the end of a depression. They're exhausted by having been depressed, but not depressed at the time of the event.
Anyone who is having suicidal thoughts, even if he's pretty sure he'd never act on them, should see a professional first and foremost and get the depression and, if they exist, panic issues treated. Then taking up the sports (which aren't especially dangerous; even scuba diving is safer than inactivity per minute) is a great call. Developing a meditation discipline is also a great idea.
This article does a great job of highlighting why I can't stand Tim Ferris. Even when talking about such an important, sensitive and terrible subject he can't stop himself from constantly hyping himself up. Every other sentence is still about how great he is, about how he's constantly talking to celebrities, etc. Awful.
So what... Better he not be happy about who he is and his accomplishments? I don't think that this suicide post was a big humble brag... it was to address to his own readership a serious issue in his own light. The more role models that follow this line of thinking to their own audiences the less suicides and more awareness there might be as a whole.
> In a tragically comic way, this was a depressing realization when I was considering blowing my head off or getting run over. Damnation! No guarantees. Death and taxes, yes, but not a breezy afterlife.
Well if the afterlife is terrible, you're going to end up there at some point anyway. So unless your religion says that suicides are punished, I don't quite see the argument.
Pascal's Wager can be used as an argument against any practice that some religion frowns upon, for that matter. If you accept his argument (I stopped doing that many years ago).
EDIT: and though we, in this realm, have no definite knowledge of what the Afterlife (if any) is, there is no guarantee in the Afterlife. So maybe you'll end up betting on Pascal's Wager through all such realities, indefinitely. And who's to say that, even if you have a wider and "higher" perspective, that you can ever be sure of the true nature of reality, and that there is nothing "above"?
Let me rephrase that: an afterlife is not guaranteed; therefore a breezy afterlife cannot be guaranteed.
None of us know what is going to happen when we die. There are many beliefs, but no guarantees.
The original statement was a reminder to think twice if you are contemplating suicide because whatever you think is going to happen after you die might not actually happen.
> None of us know what is going to happen when we die.
If you know the basics of the human body such as the brain, hormones, etc, I think it's pretty clear what will happen when you die. It's the same thing what happens to a computer when you shut it down. Do you know Occam's razor?
Anyone can believe what they want of course, but it won't impact reality.
Pascal's Wager would also imply you may as well invent as many religions as you please each requiring the thing you want to do as its dogma. Since each such religion has an equal probability of being right in his formula, in this way you can quickly overcome any inconvenience an established religion presents to what it was you wanted to do.
It's pretty obvious why they have to: "Don't worry about your shitty life now, if you believe in my religion, you will live in paradise for eternity when you die". And then the loophole: "So if I die now, I'll be in a better place? I'm going to kill myself". "No, in that case, you will go to hell for eternity"
No, but there are hell realms in Buddhist mythology, which can be the result of 'bad karma'. They're not eternal, but they don't sound particularly pleasant either.
Buddhists bet their horse in one particular lifetime on eventually escaping suffering by following Buddhist teaching/philosophy. Some suicidal people bet their horse on escaping a more immediate suffering. Other than the immediacy of the suffering, their both existential "bets" from the perspective of the author, and so I don't see a great distinction between either strategy.
> Buddhists bet their horse in one particular lifetime on eventually escaping suffering by following Buddhist teaching/philosophy.
Not actually true, otherwise all Buddhists would become monastics, which they don't.
Buddhists believe that positive karma is accumulated over many lifetimes, and negative karma is extinguished after periods of suffering.
In Buddhist thought, it's often enough to simply live a reasonably 'good' life, then you'll be reincarnated into a heavenly realm, or possibly another human body, etc... There are degrees of everything, and very few Buddhists (if any) believe they're going to achieve liberation after only a single lifetime. Even the Buddha was thought to have lived hundreds of lives, eventually culminating with his miraculous (by traditional accounts) life 2500 years ago...
Is any of that supposed to contradict any of what I said? I don't see it.
Though what you've written here doesn't contradict my current mental model of Buddhism, I might have been wrong in assessing Buddhist's motivation as universally being about eventually ending suffering. Maybe some are content with a good, pleasurable existence, and not necessarily Nirvana? Though the fact that not all Buddhists are monastic doesn't in itself imply that - even if being monastic leads to more quickly achieving Nirvana, maybe some Buddhists don't feel that they are in such a rush, at least in their particular lifetime?
> There are degrees of everything, and very few Buddhists (if any) believe they're going to achieve liberation after only a single lifetime.
That's why I wrote """eventually escaping suffering"""!! I said nothing about escaping suffering in the span of one lifetime. Only that they choose to devote their life to the goal of eventually achieving this "escape". Note that I contrasted this goal with people who commit suicide; people who commit suicide - because of depression and suicidal thoughts - do it to escape suffering in one particular lifetime. Hence, why I contrasted this with Buddhism as "a more immediate suffering". I thought my choice of words, to deliberately contrast these two kinds of sufferings, would be enough to get the point across to someone who understands Buddhism (probably better than me). But I guess you were in a lecturing mood. Good for you, buddy; we've all got to have hobbies. And web forums are as good a place as any to do that.
When you reincarnate, it's your karma that determines the form you take. If you have bad karma, you can come back as a tapeworm or worse (some Buddhists believe in hell realms-- which are not eternal, but still quite awful-- and some don't).
Buddhism doesn't categorically outlaw suicide but it's against violent or angry suicide and it definitely proscribes suicide as a way out. The bad karma you were trying to escape, plus possibly more, will be waiting for you on the other side. The self-immolating monk, Thích Quảng Đức, might turn out OK if he had compassionate intentions; but in general, suicide is still very bad.
What on Earth is your point? You agree with my point that punishment is not eternal in Buddhism, and then go on to write about how karma works. Is your assumption that I don't know any of this, and that I need to know in this context?
The people that I mostly have in mind are people that bet on Pascal's Wager. People that are not necessarily Buddhists, or even religious to begin with. From their standpoint, it might not be that crucial to bet on Buddhism, since it they're wrong they won't have to pay for it for ever and ever.
(Gotta say that I was surprised to see M. O'Church talking about Buddism, btw.)
I was trying to de-trivialize "bad karma". It's true that Buddhism doesn't have an eternal hell. It's not accurate to say that there aren't severe, terrifying consequences of living a bad life that are considered possible in the afterlife.
At any rate, I don't think humans are capable of comprehending eternity, so I'm not sure how meaningful Pascal's Wager really is. While there's objectively a huge difference between 10^14 years of torment and an eternity of it, I can't say that I can begin to fathom either one.
Motto had a patient who committed suicide from the Golden Gate in 1963, but the jump that affected him most occurred in the seventies. “I went to this guy’s apartment afterward with the assistant medical examiner,” he told me. “The guy was in his thirties, lived alone, pretty bare apartment. He’d written a note and left it on his bureau. It said, ‘I’m going to walk to the bridge. If one person smiles at me on the way, I will not jump.’”
He jumped. And ever since I read that, I've made it a personal mission to smile at everyone I pass on the sidewalk every day. Not only does suicide have unknowable impacts on all of the people around you, but even your most insignificant actions could have an enormous impact on the people around you. Be good to others -- you never know how much it might mean to them.
[1] http://www.newyorker.com/magazine/2003/10/13/jumpers