By Dr David Laing Dawson
We are Borgs, if you will pardon the Sci Fi reference.
At our best we carry in our heads a sense of the thoughts and feelings and wellness of others as well as our own. I am not talking about empathy here but rather that a piece of our consciousness is devoted to the existence of others; that an awareness of others, even when they are not present, is an important part of consciousness.
This ability allows us to experience empathy but it is wider than that. When conscious, at our best, we are aware of not just what we see and hear and of ourselves, but of the people in our lives and our connections to them. And that circle of people can include a few family members or stretch to the refugees of South Sudan.
At our best.
In a psychotic illness that awareness can become strangely distorted, with one or many of these relationships over interpreted, imbued with magical power or ominous threat. This is easy to observe, from a stated conclusion that the people on television talk to me or the police are watching me and putting drugs in my orange juice.
What is not so easy to observe is the effect of clinical depression. But depression, the illness depression, diminishes and eventually eliminates that social form of consciousness; the awareness of others, our connections to them, the presence they maintain in our minds, is lost in depression. Consciousness, in depression, is reduced to simply the self, and the self in depression is a malfunctioning body of limited worth and a sense of dread. Others are gone from our shrinking cloud of consciousness.
Anthony Bourdain killed himself in a hotel room in Paris and I watched CNN last night. He left grieving friends, colleagues, fans, and an eleven year-old daughter. Oddly, with what I have written above, Anthony made a career out of connecting with, engaging with others and sharing their lives and cuisines.
Apart from remembering, paying tribute to Anthony Bourdain last night, much of the focus was on suicide. The number of a suicide hot line was displayed throughout. But we have had these help lines available for 30 years and, as CNN reported, the suicide rate continues to climb. And as I recounted in a previous blog, the numbers of people brought to emergency rooms for assessment of “suicide ideation” has been growing by 14 percent year after year. Yet actual numbers of completed suicides persist and grow.
The focus on suicide itself is wrong. This focus, this de-stigmatization and “talk about it” approach obviously has not helped and may even be a contributing factor.
Suicide is the product of despair, dread, pain, anxiety coupled with the cognitive impairment of depression I have described above. It is this cognitive impairment that allows the severely depressed person to not realize the damage his death by suicide will do to his daughter or son, sister, brother.
We are often bewildered by seemingly successful people with loving partners and family who kill themselves. But depression, the illness depression, renders success hollow, and gradually eliminates loved ones from consciousness. In depression one’s sphere of consciousness has deflated to the agony of self. And at that point we seldom call a hot line or seek out help.
For prevention of suicide we need to focus on depression. The recognition of depression and the cognitive deficit that develops with depression, and the treatment of depression.