02/06/2014 12:37 pm ET Updated Apr 08, 2014

Depression, A Kitchen Knife, And Phil Hoffman

Right around the time that actor Philip Seymour Hoffman was collapsing on the floor of his fourth-story Manhattan apartment with a syringe of what police suspect to be heroin in his arm, a woman I know was thousands of miles away swallowing about 120 pain pills, 30 Ambien capsules and grabbing the biggest kitchen knife she could find to stab in her stomach. Later, with her lips black and the narcotics pumped from her stomach, she told a visitor that pulling out the knife hurt so bad that she just couldn't muster the courage to thrust it in again. Instead, she called 911.

The woman, in her 50s, is the sister of one of my best friends. My friend flew to be by her sister's side -- as she does every time something like this happens -- and knows something about a topic that I suspect Hoffman's story is first shedding light on. Drug addiction isn't just about the pleasure of getting high. It is also the story of untreated depression and mental illness. Through his career, Hoffman battled doubts and depression.

Actress Jamie Lee Curtis, marking the 15th anniversary of her own sobriety on the occasion of Hoffman's death, wrote in The Huffington Post "Depression and other mental health illnesses are also a pathway to seeking relief through pharmaceuticals. It feels like the time has come to redouble our dialogue about mental health care, talk therapy, group therapy, drug courts rather than prison."

My friend's sister's life started to unravel just a few short years ago. She worked as a teacher, was divorced from a guy who worked in law enforcement, and was raising her son largely alone in a small town. She owned her own home, dated frequently, worked out at the gym regularly. And then the weird stuff began happening. People were "following" her at school, she said, trying to get her fired. She saw conspiracies, plots against her, became suspicious of people who challenged her stories. She worried incessantly about losing her job and talked about filing harassment complaints. It was a back injury of unknown origins that got her her first prescription for Hydrocodone. Hydrocodone, HC for short, is a slightly weaker first cousin to Oxycodone, according to You're probably most familiar with it by its better-known brand names: Vicodin and Lortab.

In what almost felt like a self-fulfilling prophesy, my friend's sister did lose her job in the height of the recession -- the real circumstances of which were never quite clear to my friend. All she knew is that her now-unemployed sister almost immediately began to shut down. She spent less time with friends and more curled up on the couch. She put no effort into finding work. When my friend called, sometimes the phone would be answered mid-day by a slurring, sleepy voice. It was the back pain and the medicine she took for it, was the explanation. Several of her sister's local friends called to report "strange" things, like the mail piling up in the mailbox, or a house that was atypically unkempt. My friend managed the situation as best she could from afar and began flying in to visit more frequently.

She didn't like what she saw. She offered to help but was frequently pushed away. There were several failed attempts at rehab. In one place, the sister left after a day because she didn't like the color of the wall paint. "I'm not a drug addict like these people," she said.

Things seemed to peak about two years ago when the bank threatened to foreclose on my friend's sister's house. My friend made a last-ditch effort to stop her sister and nephew from becoming homeless. She used money from her own retirement funds and paid all the back-owed charges to stave off what she knew in her heart would be the ultimate outcome. Her sister lost the house less than a year later. Her son moved in with his Dad.

What followed was a spiral downward marked by a DUI charge, brief stints in rehab that accomplished nothing, menial jobs found and promptly lost, friends' patience tested by lies and half-truths, intentional pill overdoses that landed her in the hospital. And then came this most recent suicide attempt which escalated what's been occurring: "A kitchen knife changes everything, doesn't it?" my friend asked me when we spoke that night.

Well, yes and no. It certainly does seem to up the ante of the situation to realize that someone is willing to inflict such pain and violence on themselves. But even the death of a popular and well-loved actor has barely scratched the surface of discussion about how we ignore the underlying depression and mental illness of addiction. I'm with Jamie Lee Curtis in hoping it does before it's too late for my friend's sister.