Ironically, society’s demonization of suicide and suicidal people has negative consequences even from the standpoint of preventing suicide itself, as Chris points out:
I passionately hate that all of the mental health people are obligated by law to commit me to an asylum if they think I’m about to kill myself. They can’t be objective. You know, if they could talk to me without such stupid constraints, they might have prevented this very suicide
Does it overall cause more suicides than it prevents? I don’t know. However, speaking as someone who has a history of clinical depression, if I’m ever in circumstances where I am contemplating suicide, I want people to commit me. Because when I’m functional I’d consider suicide to be completely and utterly awful. So where is the line here? When do we decide that someone is rational enough to decide on their own to end their existence and when not? These are certainly difficult questions, but it does seem that the majority of people who attempt suicide and do not have terminal illnesses are being essentially irrational. On the other hand, preferences are hard to break down here, and if the technology doesn’t exist to cure someone then should they have a right to end it now rather than waiting years? Another thing to consider is that from a utilitarian perspective, committing suicide generally makes everyone around you absolutely miserable, and will then always cause pain for them. In that regard, committing suicide is either misguided or selfish.
from a utilitarian perspective, committing suicide generally makes everyone around you absolutely miserable, and will then always cause pain for them. In that regard, committing suicide is either misguided or selfish.
Not necessarily; it depends on whether the pain they will experience is enough to outweigh the pain that the suicidal person will experience by staying alive.
Not necessarily; it depends on whether the pain they will experience is enough to outweigh the pain that the suicidal person will experience by staying alive.
Sure. Hence my use of the term “generally”. When one is depressed, existence really sucks. But one also massively underestimates how much other people care and benefit from having one around.
My experience (as someone who worked on a psychiatric ward for two years, in the middle of the last decade) is that after a short time 100% of those who were involuntarily brought in for attempting suicide were grateful for it, or at least claimed to be.
Which is why I said ‘or at least claimed to be’. However, I have also met various ex-patients since I left that job, at a point where that power relationship was almost completely gone (of course there might be residues of it, but I had no actual power over them) and they’ve volunteered the same information. Also, I have several friends with psychiatric problems who’ve said the same kind of thing about their own experiences, and who haven’t ever been patients anywhere where I’ve worked.
(Also, in my experience, patients trusted me with confidences with which they didn’t trust the other staff members—I was better at building up trust relationships with patients than most staff were).
On the whole I think that even allowing for the strong motivation to lie, I think that a minimum of 75% of those who said they were grateful actually were grateful. And while I am in principle in favour of people being allowed to kill themselves, I think saving the lives of three people whose (if you like) CEV is actually that they don’t want to be dead is worth the temporary inconvenience to the fourth who really does want to be dead and who is not mentally ill. (I actually think the numbers are skewed far more towards those who don’t really want to die).
True, but it’s unlikely that someone would, for example, see me across the street (when I have obviously not noticed them), run across and thank me for all the help and tell me how much their life has improved unless it had, in fact, improved.
True, but it’s unlikely that someone would, for example, see me across the street (when I have obviously not noticed them), run across and thank me for all the help and tell me how much their life has improved unless it had, in fact, improved.
In many cases, you have to claim to be getting better or they don’t let you out. I’ve spoken with multiple people who’ve been committed and had to “fake a recovery” to be released. Personally, the first thing I would do after being released in such a situation would be to cut out of my life whoever it was that committed me, as legally and finally as possible, so that they could never do something like that again.
Agreed, and I’m confident enough in this belief that I actually make a point of telling people that even if I’m suicidal, they are to keep in mind that any stated preference to avoid being committed is endorsed by non-suicidal!me.
I find it quite plausible that this preference varies significantly from person to person, though.
Given the choice of present-me not existing, or 17-year-old-me spending that year in a mental institution—which could fairly easily have happened if I’d gotten unlucky with a psychiatrist or two—I would prefer the former.
I’m at significantly less risk of that kind of thing coming up now, but I expect future versions of me to agree with this assessment.
It’s probably notable that I’ve read several accounts of peoples’ experiences in institutions and also worked in a nursing home for four years—this is not an uninformed decision. Institutions suck.
Is there such a thing as “high-functioning depression”? Because the thoughts I have when feeling really bad seem just as reasonable when I’m not feeling bad.
First, look into http://en.wikipedia.org/wiki/Dysthymia .
Second, large parts of my family consider emself to be hardwired to be just not very happy, on the left side of the hard-wired-to-happyness-bellcurve. We pretty much resigned to it.
Third, are you sure, by written review of your mental states, that your thoughts are consistent? There can be really really subtle differences; when I review my mental state I need to use more criteria than reasonable/unreasonable.
What does that even mean? If all you mean is “can check off enough boxes on DSM IV” then certainly it is possible but since that is baseline, the baseline performance measurements won’t tell you anything helpful. If the question is “could he have debilitating depression all the time” I guess we’d only know for sure if he experienced a remission and performance measures changed.
For some value of ‘thinking’, it can, though I suspect that most people can’t easily do the thing I have in mind.
During my last round of depression, about two and a half years ago, I had a brief period of suicidal ideation—the first time I’d experienced such a thing. I recognized it for what it was, assumed it would be temporary, and basically responded with variations on ‘so what?’ from there: Yes, I want to walk in front of this bus. So what? That’s not what I’m going to do, so it doesn’t matter that that’s the case. (This is very similar to how “even if killing babies is the right thing to do, it’s still the wrong thing to do”.)
I suspect that fighting with the part of my brain that was generating those thoughts—trying to get it to stop doing so—would have been counterproductive. Instead, I took it as a valuable communication that things really had reached emergency status, got myself out of the situation that was causing the problem (yes, I was lucky to be in a situation where that was a relatively easily implemented option), and was fine.
The elephant-and-rider metaphor is relevant here. Just because the elephant is panicking and trying to roll over or run away doesn’t mean that the best answer is to beat it.
It’s almost like having two consistent, rational versions of yourself and switching between them. (I say “almost” because it’s more like a gradient.) When you’re in the depressed state, you have no access to the functional state. When depressed I tend to feel hyper-rational and gravitate towards ideas that allow me to dismiss other aspects of my life as illusory.
What scientism said is congruent with my experiences. I tried one time while being on the strongly-irrational/strongly-depressed-side to fight the irrationality. I refused the negative emotions to be accurate and trained myself to flag and consciouly counter all irrational thoughts with the accurate, positive thoughts.
I described it then as a civil war inside my body. It was highly exhausting, my body and brain ached as if overworked, hands trembled, and I was highly agitated. I reported it then as a really good feeling, but the depression was lurking in the depths and attacking every few minutes or so with a “depressive” thought. It was like a two-day episode of being manic.
Since then I did not investigate its reproduceability, it was rather frightening, costed a lot of willpower and, luckily, I have not been so deep into depression again.
Does it overall cause more suicides than it prevents? I don’t know. However, speaking as someone who has a history of clinical depression, if I’m ever in circumstances where I am contemplating suicide, I want people to commit me. Because when I’m functional I’d consider suicide to be completely and utterly awful. So where is the line here? When do we decide that someone is rational enough to decide on their own to end their existence and when not? These are certainly difficult questions, but it does seem that the majority of people who attempt suicide and do not have terminal illnesses are being essentially irrational. On the other hand, preferences are hard to break down here, and if the technology doesn’t exist to cure someone then should they have a right to end it now rather than waiting years? Another thing to consider is that from a utilitarian perspective, committing suicide generally makes everyone around you absolutely miserable, and will then always cause pain for them. In that regard, committing suicide is either misguided or selfish.
Not necessarily; it depends on whether the pain they will experience is enough to outweigh the pain that the suicidal person will experience by staying alive.
Sure. Hence my use of the term “generally”. When one is depressed, existence really sucks. But one also massively underestimates how much other people care and benefit from having one around.
When I’m functional, I find the notion of being committed awful.
My experience (as someone who worked on a psychiatric ward for two years, in the middle of the last decade) is that after a short time 100% of those who were involuntarily brought in for attempting suicide were grateful for it, or at least claimed to be.
People in that situation would have every reason to lie to you, though, wouldn’t they?
Which is why I said ‘or at least claimed to be’. However, I have also met various ex-patients since I left that job, at a point where that power relationship was almost completely gone (of course there might be residues of it, but I had no actual power over them) and they’ve volunteered the same information. Also, I have several friends with psychiatric problems who’ve said the same kind of thing about their own experiences, and who haven’t ever been patients anywhere where I’ve worked.
(Also, in my experience, patients trusted me with confidences with which they didn’t trust the other staff members—I was better at building up trust relationships with patients than most staff were).
On the whole I think that even allowing for the strong motivation to lie, I think that a minimum of 75% of those who said they were grateful actually were grateful. And while I am in principle in favour of people being allowed to kill themselves, I think saving the lives of three people whose (if you like) CEV is actually that they don’t want to be dead is worth the temporary inconvenience to the fourth who really does want to be dead and who is not mentally ill. (I actually think the numbers are skewed far more towards those who don’t really want to die).
People tell lies just to make you feel better; even depressed people will do this.
True, but it’s unlikely that someone would, for example, see me across the street (when I have obviously not noticed them), run across and thank me for all the help and tell me how much their life has improved unless it had, in fact, improved.
I’m not convinced of this. Some form of self-deception could be in play. There’s some evidence that in some aspects depressed people are more realistic and rational about their surrounding world. A person who is no longer depressed might simply have convinced themselves otherwise. I consider this to be unlikely but it is worth considering in this context.
In many cases, you have to claim to be getting better or they don’t let you out. I’ve spoken with multiple people who’ve been committed and had to “fake a recovery” to be released. Personally, the first thing I would do after being released in such a situation would be to cut out of my life whoever it was that committed me, as legally and finally as possible, so that they could never do something like that again.
Agreed, and I’m confident enough in this belief that I actually make a point of telling people that even if I’m suicidal, they are to keep in mind that any stated preference to avoid being committed is endorsed by non-suicidal!me.
I find it quite plausible that this preference varies significantly from person to person, though.
I would definitely prefer it to being dead!
Given the choice of present-me not existing, or 17-year-old-me spending that year in a mental institution—which could fairly easily have happened if I’d gotten unlucky with a psychiatrist or two—I would prefer the former.
I’m at significantly less risk of that kind of thing coming up now, but I expect future versions of me to agree with this assessment.
It’s probably notable that I’ve read several accounts of peoples’ experiences in institutions and also worked in a nursing home for four years—this is not an uninformed decision. Institutions suck.
This is my experience too. There may be circumstances where it is rational to commit suicide but I don’t think major depression is one of them.
Is there such a thing as “high-functioning depression”? Because the thoughts I have when feeling really bad seem just as reasonable when I’m not feeling bad.
As far as I can tell, misery and inertia/paralysis are semi-independent factors.
First, look into http://en.wikipedia.org/wiki/Dysthymia . Second, large parts of my family consider emself to be hardwired to be just not very happy, on the left side of the hard-wired-to-happyness-bellcurve. We pretty much resigned to it. Third, are you sure, by written review of your mental states, that your thoughts are consistent? There can be really really subtle differences; when I review my mental state I need to use more criteria than reasonable/unreasonable.
Have you considered that you might be partially depressed all the time?
What does that even mean? If all you mean is “can check off enough boxes on DSM IV” then certainly it is possible but since that is baseline, the baseline performance measurements won’t tell you anything helpful. If the question is “could he have debilitating depression all the time” I guess we’d only know for sure if he experienced a remission and performance measures changed.
Does being aware that your depressed self is irrational change your thinking while being in a depressed state? It should! But I suspect it doesn’t.
For some value of ‘thinking’, it can, though I suspect that most people can’t easily do the thing I have in mind.
During my last round of depression, about two and a half years ago, I had a brief period of suicidal ideation—the first time I’d experienced such a thing. I recognized it for what it was, assumed it would be temporary, and basically responded with variations on ‘so what?’ from there: Yes, I want to walk in front of this bus. So what? That’s not what I’m going to do, so it doesn’t matter that that’s the case. (This is very similar to how “even if killing babies is the right thing to do, it’s still the wrong thing to do”.)
I suspect that fighting with the part of my brain that was generating those thoughts—trying to get it to stop doing so—would have been counterproductive. Instead, I took it as a valuable communication that things really had reached emergency status, got myself out of the situation that was causing the problem (yes, I was lucky to be in a situation where that was a relatively easily implemented option), and was fine.
The elephant-and-rider metaphor is relevant here. Just because the elephant is panicking and trying to roll over or run away doesn’t mean that the best answer is to beat it.
It’s almost like having two consistent, rational versions of yourself and switching between them. (I say “almost” because it’s more like a gradient.) When you’re in the depressed state, you have no access to the functional state. When depressed I tend to feel hyper-rational and gravitate towards ideas that allow me to dismiss other aspects of my life as illusory.
Sometimes I call that “an attack of the bleaks”.
What scientism said is congruent with my experiences. I tried one time while being on the strongly-irrational/strongly-depressed-side to fight the irrationality. I refused the negative emotions to be accurate and trained myself to flag and consciouly counter all irrational thoughts with the accurate, positive thoughts. I described it then as a civil war inside my body. It was highly exhausting, my body and brain ached as if overworked, hands trembled, and I was highly agitated. I reported it then as a really good feeling, but the depression was lurking in the depths and attacking every few minutes or so with a “depressive” thought. It was like a two-day episode of being manic.
Since then I did not investigate its reproduceability, it was rather frightening, costed a lot of willpower and, luckily, I have not been so deep into depression again.