Sunday, November 08, 2009

Depression and Suicide

Once again the subject of mental illness comes up.

This time it hits us squarely in the pit of our collective stomachs as we read of a Chasan married just 48 hours earlier jumps to his death. Of course no one actually saw him jump. But the circumstantial evidence is overwhelming that it was a suicide. Or murder. I shudder to think if it was the latter and I highly doubt it was. The story in the New York Post reports that the Kallah was asleep, awoken by hotel staff and informed of what happened.

My brain will not allow me to even recognize the kind of pain this family must be suffering. I have a mental block to it. My heart nonetheless goes out to them. This young man’s death must not be in vain.

As the New York Post reports it - this is a story of a very happy young man who was the picture of joy at his wedding. And yet he committed suicide. Who really knows what went on inside his brain as he leaped to his death from the 7th floor of a hotel in Boro Park where he and his bride were staying.

But this kind of scenario - where a depressed personality seems fine to everyone around them - is unfortunately all too typical of the illness of depression. Suicide is one of the greatest dangers of the clinically depressed. And this is not the first instance of suicide in the religious community. People often just don’t know that an individual - even a close friend can be clinically depressed. This insidious illness is often never apparent to people who come in contact with them in their daily lives. They hide it. And they hide it well.

But the depression is there. And it’s real. Usually it is only the very closest to them that are anywhere near being aware of it. But those that are - indeed are acutely aware of it. In fact when an individual suffers from clinical depression – it is almost always the case that their ‘significant other’ suffers too. Not from depression. But from coping with a loved one who is depressed.

If this young man suffered from depression his wife probably was not aware of it. I’m sure he hid it from her during their probably very brief courtship. And I’m equally sure that at some level he was hoping to have a great future with his new wife. That marriage would change his depressed state. But if he was clinically depressed - what probably happened is that he felt as depressed as ever 48 hours afterwards and thought that there was no hope.

If I had to guess, I would say that he probably erroneously concluded that if getting married didn’t change his depression - nothing could. He would be miserable the rest of his life with each passing day getting worse - deeper and deeper into the abyss with no way out. This is a typical thought pattern of clinically depressed people. That makes them even more depressed.

Now I don’t know the actual circumstances here, but the picture I painted is unfortunately not all that uncommon. As any competent psychiatrist will tell you. There are treatment options for people like this that they are not aware of. That may have been the case here. Too often the feeling among religious Jews is that going to professionals will ‘hurt the Shiddach’. Parents might feel that this ‘Narishkeit’ is all psychological and that getting married would ‘shake him out of it’.

That is obviously not what happened here. It isn’t always just a psychological problem. In fact most of the time it is a bio-chemical problem. The chemistry in the brain is defective and that causes depression. It is a physiological disorder – not a psychological disorder. It takes medication to treat it, just like many other physiological disorders. There have been tremendous advances made in this field in recent years. Many different medications or combination of medications are available that clinically depressed people can take and lead completely normal lives – free of depression.

Unfortunately this is still not well known or at least not so well accepted by the general public and in particular the religious Jewish public. There is still strong resistance to medications. They are seen as crutches. There are still some mental health professionals that believe in psychotherapy only. Stay away from these quacks.

I’m not saying therapy is never warranted. Sometimes it is. But most of the time it is medication that works best. Therapy should be used in conjunction with that. It is rare that depression can be ‘cured’ without the properly prescribed medications. And that should be done by psychiatrists who are experienced with them and have a good track record.

I am not the only one to say this, but it is no less true. If you think you suffer from any form of clinical depression, get help. It is available and you do not have to live your life that way. If you are afraid of the stigma attached to seeing a psychiatrist – think about what happened here. Don’t think it can’t happen to you or your child. It can.

One final note. Halachicly I don’t think there should is a problem declaring this death a natural one and not a suicide. There is no ‘proof’ that it was a suicide. That should offer some comfort to the bereaved. But if it is the case that thier son suffered from depression - and they ignored it... it will not diminish the pain of knowing something was terribly wrong and hiding it from the world, from the Kallah, her family, and most importantly - from themselves.

Updated: 7:35 PM CST