This is not an essay I wanted to write, but, after the recent tragic loss of the author and celebrity chef Anthony Bourdain to suicide, I now feel compelled to explain what it’s like to be stuck in the depths of a debilitating depression, utterly convinced you are beyond help, to the extent of contemplating taking your own life. Whether or not it was depression that induced Bourdain to kill himself is still unclear but, whatever its origin, mental affliction so severe that it exhausts your resources for coping often leads a person to take drastic measures to end his suffering. Though I am unable to proffer a solution to depression, I can, from personal experience, give you a unique insight into what it feels like and why, even after years of torment, I am still deeply averse to the idea of suicide and its catastrophic consequences.
It’s important to establish from the outset that depression is not merely a case of the blues. It is a life-denying, soul-crushing condition, which is often very hard to describe to those who haven’t experienced it. I usually compare it to a vortex of despair from which you desperately struggle to escape but can’t, or to a plague of inner demons mercilessly tearing away at the very fabric of your being. Even these evocative descriptions fail to do justice to just how painful chronic depression can be. Andrew Solomon, author of the bestselling The Noonday Demon, very accurately described it as a loss not of happiness but of vitality.
In a state of depression, you often become socially isolated, disinterested in once enjoyable activities, listless, lethargic, and desensitized to the outside world. While some sufferers are merely sad and irritable, others withdraw from life altogether. During a time spent working abroad, for reasons I’ve yet to discern, a switch went off in my head and my brain short-circuited. I could no longer get out of bed, let alone go out to work and earn money. I lost contact with friends and acquaintances and, after several months confined within four walls, which had become a festering landfill site of potato chips and cola bottles, some filled with urine from when I couldn’t even drag myself to the bathroom, I took myself to a nearby psychiatric hospital. I checked in and was as a voluntary inpatient for eight weeks, during which time I was put on antidepressants.
Antidepressants work by boosting neurogenesis in the hippocampus, the part of the brain which helps regulate emotions, and generally start to take effect after a couple of weeks. Though not a panacea, they can provide a respite from the worst feelings, which may be enough to enable someone to begin CBT or Cognitive Behavioral Therapy. Unfortunately for me, it took several years of running the gamut of medications until I found a drug that agreed with me. Citalopram, the first one I tried, gave me yellow diarrhea. The second, Prozac, submerged me in the dreaded “brain fog,” which left me struggling to think, plan, or even initiate conversation, while Remeron gave me an appetite so voracious I would eat incessantly, leading at one point to obesity. It wasn’t until I started taking Venlafaxine, a drug that increases the neurotransmitters serotonin and norepinephrine, that I finally felt better. Muscles in my body began to relax, while my mind returned to a state of clarity. Though depression still lingered somewhat precariously at the back of my mind, at least now I was able to function again and to return to work after a very long absence.
Depressed people are used to hearing facile advice—such as “exercise more”—and platitudes like “time to talk” and “it’s okay not to be okay.” Once they have opened up, both to their families and to their therapists, many depressives are all talked out, while others, who have become a burden to those closest to them, have become painfully aware that in fact it’s not okay not to be okay. Depression affects everyone around you, diminishing their quality of life as well as yours. When compassion fatigue sets in, common depressive behaviors such as withdrawal and non-participation draw accusations of selfishness, breed enmity among family members, and sometimes lead to the complete breakdown of relationships.
In some cases, especially where a person has become intractably depressed, suicide can seem like the only rational option. However, suicide is so utterly devastating that bearing the burden of depression, in spite of the hell it entails, is still the better option. My mission in life is just to stay afloat. I take each day as it comes and limit my time frame. I’ve also developed coping strategies for when suicidal ideation creeps into my consciousness, such as drawing up lists of things I can do, however banal, to improve my immediate environment. The famous Jordan Peterson maxim “clean your room” works well here. When I feel overwhelmed by rumination and complexity, I set myself a difficult task requiring maximum concentration, such as completing a Sudoku puzzle or preparing a complex meal from a lengthy recipe, perhaps written in another language just to make the task more involved. Anything to stave off those darker impulses which I have conditioned myself to recoil from ever more viscerally, because deep down I know that they are simply unacceptable.
Many people have posited theories as to the causes of depression, but it may not have a singular cause. In his new book, Lost Connections, Johann Hari attributes the rise in instances of the condition to the atomizing effects of neoliberal capitalism, a claim of which I’m very skeptical. A slew of wellness experts, on the other hand, have discussed the gut-brain axis and suggested that improving the diversity of gut flora helps restore mental well-being. Maybe there’s a kernel of truth in such claims, but reducing such a complex condition to a single cause seems ill advised.
Unconventional solutions, such as psychedelics like LSD and magic mushrooms, have become the subject of renewed interest, as conventional mental healthcare has proven increasingly ineffectual at stemming the tide of the West’s depression epidemic. Though the mechanisms of these mind-altering, hallucinogenic drugs remain a mystery to science, the numinous experiences they often elicit are frequently reported to liberate mentally ill people from the maladaptive cognitive and behavioral patterns that had previously held them psychological prisoners, and, through the temporary dissolution of the ego, enabled them to map new pathways and alter their perspectives on life. For the past few years, Dr. Carhart-Harris of Imperial College, London has been conducting clinical trials into the therapeutic effects of psilocybin, the psychoactive ingredient in Amanita muscaria mushrooms, with some success. Some patients report feeling as if they had been psychologically rebooted, after receiving the mystical vision. Some of those involved in the trial, however—perhaps owing to their mental and emotional fragility—experienced hellish visions, or bad trips, which left them in an even more anxious, neurotic state than before. The therapeutic benefits of these highly potent and unpredictable drugs are therefore not guaranteed. In any case, they are contraindicated for the most sensitive subjects, who, by nature, are also the most susceptible to illnesses like depression.
Relatively new methods, such as Transcranial Magnetic Stimulation or TMS, a non-invasive procedure for treating mental illness that targets specific parts of the brain using a magnetic coil to stimulate neural growth, offer hope to sufferers. Though still not fully developed into a mainstream depression treatment, it holds a lot of promise. Behind closed doors, Electroconvulsive Therapy or ECT, a procedure made infamous by its depiction in One Flew Over the Cuckoo’s Nest, is a last-resort treatment for the most stubborn and prolonged cases of depression. Though it has to be carried out discreetly and is rarely advertised by health professionals, it’s effective, albeit brutal. Patients who’ve received ECT often report immediate relief from depressive symptoms: but also memory loss, sometimes to the extent where important life events, such as marriage and college graduation, have been entirely erased.
Depression is a terrible thing which, if left untreated, can devastate a person’s life. Suicide may seem like a quick and tempting relief from the unbearable suffering it entails, but its consequences are far, far worse than those of the depression itself. At a recent talk in Indianapolis, when the psychologist Jordan Peterson was asked by a suicidal audience member why they ought to go on living, he responded, “Don’t be so sure that your life is yours to take.” It was a pithy, yet compassionate answer, which immediately resonated with me. Though not everyone can be saved from suicidal depression, people can sustain even the most abominable suffering and override their darkest urges humbly and nobly if they know that they’re doing the right thing—not only for themselves, but for those who love and cherish their presence here on Earth the most. A courageous, almost superhuman effort to stay alive can teach you just how great a capacity you have for withstanding pain and how meaningful life can be, even if you have to bear a cross that is heavier than most.
Between the ages of thirty-eight and forty-three, Carl Jung underwent what he termed a “state of disorientation,” during which he experienced cognitive dysfunction, an inability to think clearly, emotional withdrawal, and overall psychic malaise. Such symptoms are now recognizable as depression but, ever the creative visionary, Jung took an experience that would have caused many to cave in and re-conceptualized it as an opportunity for transformation and renewal. He compared this profound state of confusion to the initiations undergone by shamans and mystics, during which you voluntarily descend into depths of hellfire in order to harvest insights about yourself, and then rise again and return to earth anew. The same theme of descent and return can be found in Dante’s Inferno, Virgil’s Aeneid, and the epic of Gilgamesh.
While those of a less romantic temperament might be tempted to dismiss Jung’s framing of what is for many merely a source of unnecessary pain rather than a time to engage in deep introspection, he may just have been on to something. Only in voluntarily facing his suffering, without giving in to thoughts of suicide, was he able to transcend despair, and subsequently develop a more mature relationship with the outside world. Prior to his illness, Jung had been a deeply introverted, cold, and priggish intellectual. This temporary breakdown in his thinking allowed him to harvest crucial insights about himself. He discovered a need to become kindlier and more empathetic to those around him, thereby removing much of the burden of being his previously complex, overwrought self.
In Western psychology, altruism is rarely seen as an important aspect of mental health, but in the Buddhist tradition, for example, it’s absolutely fundamental. Much of our culture feeds into the excessive sense of self we in the West have cultivated, often to our psychic detriment. Meditation, by contrast, is designed to dissolve the ego and the oppressive constraints it can place upon us. After reading about the Tibetan monk Matthieu Ricard, a long-term practitioner of loving-kindness meditation who, according to neuroscience, is reputed to be the happiest man on earth, I began to see the merits of a less self-centered attitude to life. Ricard’s book Happiness inspired me to spend short bursts of time in meditation, contemplating the suffering of others rather than my own, a discipline which temporarily frees me from the self-harming effects of the ego, awakening me to a more universal perspective. It’s a short-lived yet remarkable transformation, but it requires regular practice and attention to cultivate fully. The more you consider the suffering of others, the more you feel inclined to help them. Engaging in altruistic acts as simple as preparing a meal for your family or making tea for grandma can cause suicidal ideations to subside and new, better possibilities to emerge in your mind.
Perhaps the cruelest lasting effect of suicide, aside from the grief it inflicts, is the number of unanswered questions it leaves open. Family members will ask “What could I have said or done to stop them?,” “Why wasn’t I nicer to them?,” and “Is this all my fault?” These unresolved questions can eat away at close relatives, and excessive time spent ruminating and agonizing over them can cause illness. In some cases, it can even leave the family members vulnerable to suicide themselves. If you are thinking about taking your own life, first ask yourself, “Can I really put the people I love through a lifetime of mental anguish? Or do I owe it to them as much as to myself to do everything in my power to get better or at least to stay alive?” If you can’t sit in meditation or do even the most basic of chores to keep yourself occupied, take yourself to a hospital. Tell someone how you’re feeling, admit yourself to a ward if necessary. Don’t refuse any life raft thrown to you and, if you check out of the clinic and the same feelings of despair return, go back in. Try a new antidepressant, engage fully in group therapy, do anything, however mundane, to keep going. Set aside your cynicism, define your main objective as survival, and bear in mind that the world will be a lesser place without your presence.