Friday, September 27, 2013
What We Don't Know Hurts Us
I finally had the guts to start reading Iris Bolton’s classic suicide loss memoir, My Son . . . My Son. . . (Even the title makes me cry.) Bolton became a suicidologist and a founder of the suicide survivor support movement. So far, halfway into her 1983 book, she does not insist that suicide is caused by mental illness, like so much of the literature today. Rather, she says it’s complicated with many contributing factors.
This rings true. Because at the same time that the literature claims that more than 90% of suicides can be traced to mental illness, it also notes that the vast majority of people with mental illness do not take their lives. So there must be more to the story.
Lately I am convinced that in addition to the effects of untreated mental illness, N died from fear, shame, and ignorance. Fear of failure at college and at making his way in the adult world. Fear of another debilitating anxiety attack. Fear that he was losing his mind and would lose control of his life if he went the route of doctors, medications, and hospitals. Shame at the prospect of being mentally ill and needing medication. Shame that he was unable to “man up” to his problem and that others (“everybody at college”) knew something was wrong with him.
The ignorance belongs to all of us. To N about the possibilities of managing depression and anxiety and riding the ups and downs of young adulthood. To us his family about the nature of major depression, the severity of N’s despair, and the warning signs for suicide risk. To some of his friends who, like him, believed they could handle psychological crisis on their own without involving parents or professionals. To professionals, who—like family and friends-- only saw one small part of the elephant that was consuming N and did not consider him a suicide risk. To the fields of psychology, psychiatry and public health that still know so little about suicide and how to prevent it.
I know now that my own ignorance arose from fear of what I might learn. Why else would I start looking up bipolar disorder and psychosis online, only to stop after 30 minutes when it became too scary and confusing? Why wouldn’t it even occur to me to look up suicide risk? My ignorance also came from assuming too much and seeing my son through the cloud of those assumptions. I assumed that I knew enough about depression and mental health. I assumed that, like me, N could experience depression and still function in the world with his life force intact. I assumed that, like me, being exposed to suicide at an early age would make him stronger and more determined to live a good life. (I lost my father to suicide when I was 26; N lost a close friend to suicide when he was 19. More on this in future posts.) I didn’t know that major depression could be a terminal disease or that losing a loved one to suicide elevates one’s own risk for suicidal thoughts and acts.
And the most profound and troubling ignorance for a parent: I didn’t know about my child’s inner feelings and psychiatric history—the many things he didn’t tell us that we only learned in our desperate investigations after his death. And even more things we still don’t know and will never know about what he was thinking and feeling.
My therapist says you can only know what you know at the time; you cannot read your child’s mind, especially when they are a rebellious young adult; we are none of us all-knowing. Yes, I know this in some corner of my mind. But what we don’t know hurts us, even destroys us.
The other day I went to a lecture on depression sponsored by the local chapter of NAMI (National Alliance on Mental Illness). I learned how much I didn’t know and how determined I am now to know more and ensure that others know more. If I had been sitting there at NAMI a year ago, would it have made a difference? In my behavior and understanding, I hope, yes. In N’s behavior, we can hope but never know.