As someone who (mostly) earns a living by writing about mental health, it is heartening to see the steadily increasing national conversation around issues of mental illness, particularly during months dedicated to mental health advocacy.
But as Suicide Prevention Awareness Month comes to a close, I challenge us all to do better. We have to talk about suicide, and work to prevent it, during the whole year. We can’t just talk about it nationally during September or in the weeks following another high-profile suicide.
It is estimated that 6.7 percent of American adults struggle with major depressive disorder, and 1.5 percent of American adults are affected by persistent depressive disorder, formerly known as dysthymia, and for the LGBTQ community, rates of depression, substance misuse and suicide are even higher. That means 16.1 million and 3.3 million adults deal with major depressive disorder and persistent depressive disorder, respectively. Clinical estimates place a similar percentage of people in the United States as being addicted to alcohol and drugs. There is certainly a great deal of overlap between these trends, whose statistical prevalence – I would venture to guess – is already grossly underestimated.
For every suicide, there are 25 suicide attempts – and somewhere around 44,193 people die of suicide in the United States each year. That is twice as many killed as by homicide, yet dialogue around suicide, and even depression, is underwhelming and scarce – except during specific advocacy pushes or during the weeks following another celebrity’s suicide.
Mental health remains a taboo topic in the U.S., and people who struggle with it still fear the stigmatization that accompanies addiction and such mental illnesses as depression. When someone commits suicide, the person is deemed crazy and selfish. There is often a lack of perspective on what could lead people to feel so utterly hopeless and alone that they would go to the ultimate extreme of taking their own lives.
Similarly, there is far too much of a cultural attitude that anyone confronting such issues as addiction, clinical depression or eating disorders – all of which fuel the suicide rates – needs to “toughen up” or just “be happy.” People with depression are perceived as being whiney and dramatic, while addicts are seen as reckless and self-indulgent.
For those who have not endured the situation, it is difficult to understand the all-consuming nature of these diseases. Denial is prevalent in a culture that, overall, is growing increasingly cold and less sympathetic. Even those who are aware of their own conditions, and truly want to get better, still face many challenges.
The mental health field in the United States is flawed. Public mental health facilities and services are underfunded by the government. There are not enough psychologists in schools. It is challenging for people without much money to find quality mental health care in a field where leading providers charge upward of $100 per hour and often do not accept insurance. Even those who do can be difficult to locate. The combination of a weak mental health system with a cultural stigmatization of mental illness leaves people who suffer incredibly vulnerable.
Addiction and such mental illnesses as depression are now better understood clinically as real diseases, rather than character flaws or signs of weakness. Yet there is still a sense of cultural shame and secrecy that surrounds these conditions.
I can speak on this shame from personal experience. Both sides of my family have several generations with a prevalence of depression and addiction. Both of these genetic diseases were passed on to me.
For as long as I can remember, I have suffered from depression. I went to a therapist as a relatively young child, and soon began taking antidepressants. In 7th grade, I attempted to overdose on that same medication, all of which I also kept a secret from my friends.
In ninth grade, I was hospitalized for alcohol poisoning. By the time I graduated college, I had been hospitalized three more times for alcohol and drug-related overdoses, and should have been on several other occasions. I had completed inpatient and outpatient rehab programs and still continued to drink, use drugs and struggle with depression.
Through all of these events, I was embarrassed and in denial. I kept convincing myself that I would eventually gain control of my alcohol intake and my impulsive and erratic behaviors. This never happened. After an especially traumatic blackout spell in which I ran into oncoming traffic in New York, I stopped drinking because – if not – I knew I was eventually going to kill myself.
Even since becoming sober, I’ve had to confront the underlying depression that remains.
Through these struggles I often felt alone, and this is not surprising: Depression and addiction are diseases that make you feel isolated. They blind you, compounding this sense of isolation.
I did not know that many people were suffering in the same way, even many people of my own age. Like me, they were probably ashamed or scared of being labeled “crazy” and thus chose to keep their stories to themselves.
As I began sharing my story, I cannot tell you the number of people who started confiding their own stories of attempted suicide, mental illnesses or addiction. Even if you don’t realize it, people all around you are dealing with these struggles, every day.
I hope that even after this week, as Suicide Prevention Awareness Month concludes and the topic fades from the media, suicide and mental illness remain topics of conversation for people across the United States.
If we really want to make a difference, then we must fight to improve and increase affordable (if not free) mental health care, just as we must constantly increase efforts to de-stigmatize mental illness in the United States - and to help those who are suffering to understand:
They are not alone.
Seamus Kirst is the author of the memoir, Shitfaced: Musings of a Former Drunk.