Over the course of a lifetime, major depression
will strike twenty percent of the population, numbers
comparable to cancer and heart disease.
We are talking
battlefield odds. Those with major depression have an 85
percent survival rate, but the prospect of finding
ourselves in the lucky majority brings us only small
relief. The experience has exposed us to our worst
vulnerabilities, and deep inside we no longer trust what
tomorrow may bring. We may still be walking and breathing,
but we have been as close inside death as this side of
life permits, and our minds will never let us forget it.
We ponder the fates
of the unlucky minority, and sometimes we say a prayer.
contemplate the tortures their brains exposed them to, and
know for a fact that no God would ever hold judgment
against them. For the time being we are the lucky ones,
but tomorrow that may change.
Still, we do have a
certain amount of control in managing tomorrow. We who
have survived know what we are up against, and can plan
accordingly. Following are some common sense guidelines:
THE LONG TERM
friends or family members you can call on should you find
yourself in crisis.
If you have no friends or family you can trust, then seek
out a support group, live or on line.
posting your cry for help on the Internet: Choose your
site or mailing list very carefully.
If you are new and posting to a very busy list, your
appeal may be lost in the shuffle. At the opposite end,
your message may go completely unread on bulletin boards
with little or no traffic. It may take a few weeks before
you establish a presence on a particular list or board.
then, you will probably be on email or ICQ terms with some
of the members.
up the numbers of various local suicide hotlines and keep
them where you can find them.
Familiarize yourself with the Internet crisis and suicide
sites and bookmark the ones you like. (See the list of
links on this page.)
a close relationship with your doctor or psychiatrist.
Ask yourself: is this someone you can call on in the
middle of the night? Or, if not, will someone be there to
respond to your call?
all guns and rifles from your home.
According to the Centers for Disease Control, 60 percent
of all suicides are committed with a firearm. This is not
an anti-NRA message. We're just being sensible, that's
same principle that applies to firearms applies in part to
The tricyclic and tetracyclic antidepressants can be fatal
in overdose. You may want to switch to a different
antidepressant if you don't trust yourself. If you must
keep certain medicines in the house, it may be advisable
to turn them over to a loved one.
your thoughts and feelings very carefully.
You may be able to pick up subtle signals in your mind,
before a full-scale crisis overwhelms you. Actually
visualizing the act should set off every warning bell.
AN ACTUAL CRISIS
All too often, a
suicidal depression catches us alone and off-guard. Notwithstanding all we have to live for and all those who
care for us, the brain in crisis has a perverse way of
having us think the very opposite. To those of you who are
in this state right now:
yourself another 24 hours.
call a trusted friend or loved one or a crisis hotline.
Remember, there is no shame in reaching out.
take comfort in the fact that help is on the way.
Your brain at the moment may not allow you to think
hopeful thoughts. But it cannot keep out the knowledge
that others are hoping on your behalf. This may be that
precious one inch of life you can hold onto at the moment,
the one that can eventually lead you to a tomorrow worth
percent of all those who commit suicide indicate their
deep despair beforehand."
the teen-age girl who's driving you nuts. And you, over
there! The one with the co-worker who's been acting a bit
strange lately. You, too, with the husband who's just made
out his will for no good reason. Yeah, and you with the
aging parent who's just come back from the doctor.
Have I got
everyone? Wait, you over there, the guy who keeps telling
his wife to snap out of it.
You, all of you -
listen up good.
Sure, you may never have suffered from major depressive
illness yourself, but chances are it will strike at
someone close to you. Should that happen, the odds are
heavily in favor of your friend or loved one making it
through, but how you respond can greatly increase or
decrease those chances.
Following is some
common sense advice:
studies, 75 percent of all those who commit suicide
indicate their deep despair beforehand. All but maybe ten
percent are sane people who might have responded to help.
very seriously any possible signs of major depressive
These may include fatigue, weight gain or loss, and
feelings of hopelessness and worthlessness. A child or
teen-ager may feel more hyper or agitated than usual.
in mind that any number of situational events can bring on
thoughts of suicide, with or without major depression,
events such as: marriage breakup, death in the family,
difficult birthdays or anniversaries or holidays, or loss
out for sudden changes in behavior.
These may include:
In your child,
declining performance in school.
declining interest in previously enjoyed activities,
neglect of personal welfare, deteriorating physical
In the elderly,
self-starvation, dietary mismanagement, disobeying
very seriously any signs of suicidal behavior.
These may include: explicit statements about suicide,
acting-out behavior such as rehearsals or mini-attempts,
self-inflicted injuries, reckless behavior, making out a
will, giving away possessions, inappropriately saying
goodbye, and odd verbal behavior (such as "you won't
have to worry about me, anymore").
TO SAY AND NOT SAY
Five things to say
to a severely depressed or possibly suicidal person:
you like me to get help?"
to say to a severely depressed or possibly suicidal
snap out of it."
just a phase."
being so selfish."
just trying to get attention."
gotta pick yourself up by your own bootstraps."
is excellent prevention. Read articles on what a depressed person can do, and think
what you can do to help that person. If your friend or
companion needs someone to call on in a crisis you can be
that someone. If you are living at home with a depressed
person, you can cooperate in making the house as safe as
AN ACTUAL CRISIS
Do not be judgmental. Allow the person to vent his or her
anger or frustration.
if he or she is planning to commit suicide, or has a plan.
This gives the person another chance to vent his or her
concerns and allows you to gauge the nature of his or her
intentions. This question is a fairly standard one, and
apparently will not trigger an actual attempt.
not leave the person alone, once you have determined he or
she is suicidal.
to convince the person to seek help.
The fact that he or she is talking to you is a start.
Offer to make the necessary arrangements if you think that
will get the ball rolling.
the person, if necessary, that seeking help for depression
no longer carries the stigma it once did,
that going for help is not a sign of weakness, and that
the chances for recovery are excellent.
Keep in mind, one
day it could be me.
For access to
counseling, visit Suicidal.com.
For several good
articles, visit If
you are thinking ....
For a directory of
local hotlines, visit About.com.
John McManamy is a
journalist and writer who has obtained his expertise in
depression in a most unwanted manner - that of battling
the beast most of his life. He was born in Connecticut,
obtained a law degree in New Zealand, worked as a business
editor on a number of newspapers and magazines, then moved
to Australia, where he published three books on business
and finance. In early 1999, following a series of
crippling depressions, he was diagnosed as bipolar. Soon
after, he began writing on depression for Suite 101 as a
means of coming to terms with his diagnosis, and not long
after that launched the net's only independent weekly
depression and bipolar newsletter.