Sunset is an angel weeping
Holding out a bloody sword
No matter how I squint I cannot
Make out what it’s pointing toward
Sometimes you feel like you’ve lived too long
Days drip slowly on the page
You catch yourself
Pacing the cage – Pacing the Cage by Bruce Cockburn
In a recent Breakpoint commentary, Eric Metaxas and Stan Guthrie addressed the question of suicide. Taking their cue from Joni Erickson Tada’s new book, “When is it Right to Die?,” they made several important points, chief among them that “suicide is everyone’s business.”
By “everyone,” they primarily meant the Church. Quoting Tada, they told listeners that “the sick and the well are inextricably connected in community. Those on the margins—the depressed, the ill, and the dying—need us.”
They rightly insisted that “we can share one another’s burdens and sufferings—depression, terminal illness, bereavement, job loss, mental illness, or whatever.”
It’s difficult to take issue with this but I’m afraid I am going to have to. Not because I disagree with a single word – I don’t – that was said but because something more is needed: knowledge of what the suffering and the Church are up against.
According to the Centers for Disease Control, between 1999 and 2014, “the age-adjusted suicide rate in the United States increased 24%, from 10.5 to 13.0 per 100,000 population.” In 2016, the American Foundation for Suicide Prevention it had risen to 13.4 per 100,000. That’s about 45,000 suicides a year.
While it’s impossible to know with any certainty, it’s estimated that for every “successful” suicide attempt there are another twenty-five attempts. That’s more than one-million a year. At least another nine million Americans considered killing themselves.
The peak age for suicide is between 45 and 54, followed closely by people over the age of 85. Suicide rates are highest among whites – white men account for 70 percent of all suicides – and lowest among African Americans, whose rate is only about a third that of whites.
According to the CDC’s Youth Risk Behavior Survey for 2015, “ 8.6 percent of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months.” These results were confirmed in a recent study published in the Journal Pediatrics, which found that “hospitalizations for suicidal ideation and suicidal encounters” doubled between 2008 and 2015.”
It doesn’t get better after they graduate from high school: “The suicide rate among young adults, ages 15-24, has tripled since the 1950s and suicide is currently the second most common cause of death [after accidents] among college students.”
That’s the “what?” of American suicide. The “why?” is even more important, and, to be honest, not especially mysterious. In “Night Falls Fast: Understanding Suicide,” Kay Redfield Jamison of Johns Hopkins wrote, “While no one illness or set of circumstances can predict suicide, certain vulnerabilities, illnesses and events make certain individuals far more likely than others to kill themselves.”
Chief among these is mental illness, such as schizophrenia and “mood disorders” such as clinical depression and manic-depressive illness, also known as bi-polar disorder. As Jamieson notes, the presence of a mood disorder not only makes it more likely that a person will attempt suicide, but also will incline them towards more “serious” efforts in that direction — that is, efforts that exhibit more forethought and planning.
It bears repeating that clinical depression is not the same thing as feeling sad. In “The Noonday Demon: An Atlas of Depression,” Andrew Solomon writes that “Grief is depression in proportion to circumstance; depression is grief out of proportion to circumstance. It is tumbleweed distress that thrives on thin air, growing despite its detachment from the nourishing earth . . . Grief is a humble angel who leaves you with strong, clear thoughts and a sense of your own depth. Depression is a demon who leaves you appalled.”
Understanding what depression is and isn’t matters because between two and seven percent of adults with major depressive disorder will die by suicide and about sixty percent of all people who commit suicide had depression or another mood disorder at the time of their death.
The numbers are even grimmer for schizophrenia: between 10 and 15 percent of people with the disease will commit suicide. (If you want you to understand schizophrenia better, I highly recommend “Nobody Cares About Crazy People” by Ron Powers.)
As the stories of James Dungy, Matthew Warren, and last December, Pastor Bill Lenz remind us, Christians aren’t exempt from any of this. We suffer from depression like other people. There’s no good reason to believe that we aren’t represented among the estimated 3 million (one percent of the population) Americans who have schizophrenia.
We are among the nine million who consider suicide.
The problem isn’t our beliefs or lack of them. For the vast majority of people who commit suicide or have what are called “suicidal ideations,” the road to self-slaughter isn’t paved with propositions – it’s paved with pain.
Writer Ann Voskamp has written about what can be called the “fire of depression” that can make suicide seem to be the least-bad option:
“We could tell you what we know.
That — depression is like a room engulfed in flames and you can’t breathe for the sooty smoke smothering you limp — and suicide is deciding there is no way but to jump straight out of the burning building.
That when the unseen scorch on the inside finally sears intolerably hot – you think a desperate lunge from the flames and the land of the living seems the lesser of two unbearables . . .
I had planned mine for a Friday.
That come that Friday the flames would be licking right up the strain of my throat. You don’t try to kill yourself because death’s appealing — but because life’s agonizing. We don’t want to die. But we can’t stand to be devoured.”
Ed Stetzer has many other examples of well-known Christians who despite believing all the correct things, and being surrounded by people who love them, understood that there are times that, as one of them put it, “the fear of the what was coming was greater than the fear of anything else.”
“The fear of what was coming” refers to the cyclical nature of depression. There are good times followed by bad times. You feel pretty good for a while, but you know that, chances are, it won’t last. And when the Noonday Demon returns, he may be accompanied by seven of his friends.
It’s why writer Virginia Woolf filled her overcoat with stones, waded into the River Ouse and drowned herself. As she wrote her husband, “I feel certain I am going mad again. I feel we can’t go through another of those terrible times. And I shan’t recover this time.”
If you’re expecting some great insight about to make this all better, I’m afraid I have to disappoint you. I don’t know any of the people quoted by Stetzer, but I strongly suspect that their battle against the Noonday Demon is a lot like mine.
We take our meds, notwithstanding the side effects, which are real. We remind ourselves that just because we think something doesn’t make it true. We struggle to remember that these thoughts may not originate with us, much less God, but with the Father of Lies.
We practice, or at least try to practice, what therapists call “self-care.” We try to get enough sleep, eat well, exercise regularly, avoid Gillian Flynn novels, and, odd as it may seem, make our beds first thing in the morning.
We try to do things for the sheer enjoyment of them, which is harder than it sounds since one of the defining characteristics of serious depression is anhedonia, “the loss of interest in previously rewarding or enjoyable activities.”
Spiritually, we pray. Sometimes a lot. We pray despite the fact that, especially during a major depressive episode, it feels like no one is listening.
We remind ourselves that we are loved “with an everlasting love,” and that, despite our feelings and circumstances, God has continues his faithfulness towards us. We can even cite specific examples of that faithfulness.
We are told by our friends and family how much we are loved and how much we mean to them. Sometimes we even believe it.
If this sounds less than stirring, keep this in mind: the vast majority of people with major depression and other serious mood disorders don’t take their lives. By the grace of God they limp victoriously to the finish line, like a marathoner who, having “hit the wall” at the twenty-mile mark keeps on going no matter how unsightly his stride appears.
Helping us to bear our burdens is a lifetime commitment. The disease – and that’s what it is, a disease – can be frustrating to those who are trying to love us, in part, because for the most vulnerable, it isn’t a transient phenomenon. As one of the people quoted by Stetzer said, “I have prayed for God to take this away. I have fasted for God to heal me of this. And guess what. I still have it.”
That’s what we’re up against. We welcome the company. Just don’t ask “are we there yet?”
Sometimes the best map will not guide you
You can’t see what’s round the bend
Sometimes the road leads through dark places
Sometimes the darkness is your friend
Today these eyes scan bleached-out land
For the coming of the outbound stage
Pacing the cage
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