Dr. Thomas Lane Butts: On Depression and Suicide

Several years ago Larry King did a program on depression, and reported that 20 million Americans suffer depression serious enough to require treatment. It seems this illness has almost reached epidemic proportions in this country. Very few families are free of the impact of depression. We all know depressed people - and we may be a depressed person.

As a pastoral counselor, if there is one word that I hear more often than the word ‘lonely', it is ‘depressed'. The two words are often inter-changeable. One is almost always accompanied to some degree by the other. Since I am a ‘general practitioner' (not a specialist), some of the people who come through my door suffer a kind or degree of depression that is above my pay-grade, and if they are able to afford the cost, I send them to a more highly trained specialist.

There are multiple causes and consequences of depression. Depression can erode important relationships at home and in the work place. It can cause many problems and much unhappiness to the depressed person and to the people who live and work with them. Situational depression can be resolved with time and some outside help, and sometimes with short-term drug therapy. But there is a species of depression that is more than situational. It is deeper, darker and less amenable to the usual means of treatment. Unfortunately, such in-depth depression is not always initially detectable; and unfortunately, those who have such in-depth depression are often resistant to treatment either due to embarrassment, pride or despair. If you are depressed over a long period of time, it is important to consult someone who can help you determine the depth of your condition and keep you from falling into an even deeper, darker hole. Even the darkest of depressions can be treated

One of the most serious outcomes of severe depression is suicide. Not all suicides are the result of depression, but I would estimate that 95% of them are. Last year more than 30,000 people in this country died by suicide.

There is nothing of which I know that is more emotionally devastating than the death of a family member or friend by suicide. Death under any circumstance is an upsetting experience, but death by suicide leaves so many unanswered questions, even when some note of explanation is left. "What were they thinking? What could I have done? Why? Why?" The mental and emotional machinations of a suicide are almost always lost in mystery.

I decided to write this column after reading an article on death by violence in The Chicago Tribune. The World Health Organization, using research from 160 experts in 170 countries, reported that 1.6 million people (world-wide) died violently in the year 2000. One person commits suicide about every 40 seconds, one is murdered every 60 seconds, and one dies in armed conflict every 100 seconds. The report estimated that almost 1 million people took their own lives in the year 2000, making suicide the number 13 cause of death world-wide. 550,000 people were murdered, and that does not count the unlawful deaths disguised as accidents or natural causes. About 60,000 young children died from abuse.

You may rightly be wondering in what way I intend to find a word of encouragement for anyone given the above-mentioned statistics. Encouragement takes many forms. Sometimes it comes in the form of comfort. Sometimes it comes by logically seeing an individual tragedy in the context of its larger social setting. Sometimes it comes simply by knowing that you are not alone in your struggle to understand a mystifying tragedy.

There are things that happen to us, and to those we love, which are beyond our power to understand or fix. Such things may come in the plain brown wrapper of every day life, or be wrapped in life-altering and soul-ripping tragedy A friend once told me of an ordinary day in his family in which it seemed that everything that could go wrong went wrong. At the end of a uniquely stressful and complicated day, his wife was preparing the evening meal to the tune of two children crying. Suddenly something boiled over on the stove and she threw up her hands and began to cry. The husband asked: "What can I do?" She said: "There is nothing you can do, just comfort me." Things happen in life about which no one can do anything. If all you can do is comfort someone, that is enough.

When tragedy strikes we often feel alone. While it is cold comfort to be told that the same thing happened to 999,999 other families, objectively, we at least know we are not alone, and we have a statistical reality which in time may help to put the matter into perspective. At the moment in which suicide happens, nothing else seems to matter except that one isolated death, but with time the margins will expand so as to allow the tragedy to be put into some perspective

If you have experienced several months of unrelieved depression, and you cannot identify a reason for your depression, ask your primary physician for help. If you have a friend or loved-one who has symptoms of serious depression, use your powers of persuasion in a spirit of love to persuade them to seek help. Help is available

While there are often warning signs that a person is suicidal, you must never blame yourself for the decision of a person to commit suicide. Get help if you see signs of suicide in yourself or others. After a suicide, get professional and spiritual counseling to help you come to terms with the fact that someone you know and/or love chose a permanent solution to a temporary problem.