CHAPTER SEVEN

         DEPRESSION - A CAUSE AND AN EFFECT OF SUICIDE

"CORY" 

By "Shirley"

        Our handsome, gifted son "Cory" was born March 23, 1965. He always had a curious mind, even teaching himself to read. He devoured books, was a good athlete, had a strong spirit of competition, and a fun sense of humor. He was always on the honor roll in junior high and high school. He served a mission to Central America. While at the MTC, he became so fluent in Spanish, he was sent to his mission early. He worked with many native companions. It was a challenging mission, but Cory's attitude throughout was positive. He served an honorable mission, and learned to love the humble poverty-stricken people.
        Cory returned from his mission in February 1986. He had no emotional problems on his mission, but in March we started to notice symptoms of depression and anxiety. He was experiencing sleepless nights and obsessive, self-devastating thoughts. It was Cory's first experience with severe depression. As my husband, Don, and I watched him become more agitated and disturbed, we obtained psychiatric help for him. Don is a social worker. I took him to the psychiatrist who had been following my case at a university mood disorders clinic. My worst fears were confirmed. The doctor suspected that Cory was a victim of the same mental illness I have-Bipolar Disorder. He immediately put Cory on medication. To be on medication for emotional problems was difficult for Cory, as it is for many people. He would say, "I don't want to be a druggie! I should be able to handle this myself!" When Cory became more agitated, he would hide his pills or not be consistent in taking them. This only made things worse as it is crucial to stay on consistent prescription dosages. 
        Cory was on a full academic scholarship at BYU. Even suffering from depression, he was still able to get A's in advanced calculus and advanced Spanish during spring semester, maintaining his 4.0 GPA. When I pointed this out, he retorted, "All I can be is a student! What good is that? I have no other talents!" He was constantly comparing himself with others-especially his brothers who were working. He felt their jobs were much more prestigious than his. Cory was a bagger at a local grocery store. He felt humiliated that he had not advanced to a checker. After all, he was "a returned missionary with over a year's college training" who was working as a bagger with high school students! He had some panic attacks at work. Finally he could not face going to work. He quit, which increased his negative feelings about himself.
        I experienced my first bout with depression when I was nineteen. Several years later I was diagnosed with Bipolar Disorder when I had my first manic attack. The disease often manifests itself in late adolescence and young adulthood. It is a biochemical, genetic illness I probably inherited from my paternal great-grandfather. He suffered "melancholia" (depression) and several descendants have taken their lives. 
        Just before Cory came home from his mission, I had been tormented with my ninth, four-month long severe depression. I did not want him to come home and find me in this agitated state. For me depression is like a smothering, all-encompassing darkness-being plunged into a bottomless abyss where blackness descends over my entire body, where no light penetrates. Almost miraculously, with a change in medication, the depression lifted just three days before his return. Now in my positive high, I was excited and delighted to welcome him home. Nothing had changed in my physical world. It was a shifting of chemicals in my brain, which to me defies understanding. When my depression lifts, it is like a rebirth for me. I have such a renewed appreciation for the Lord, life, my husband, my family and friends. My previously "black world" becomes beautiful again. I have increased energy, enthusiasm, and sometimes exaggerated euphoria. Then I must guard against the manic dimension of my illness. I must watch that I do not get too high emotionally, that I do not become manic-psychotic, a state which has twice required my hospitalization. In my first psychotic manic episode I was so bad the hospital personnel thought I had taken LSD. 
        I feel anguish knowing that I have attempted suicide. I know the distortion, the irrationality, and the feeling that my family and friends would be better off without me. On our fifth wedding anniversary, I asked "Don" for a divorce. I was certain he and our two young boys would be better off without me. Because he did not understand the illness as well at that time it was a terrifying, painful time for him. But it has been Don who has helped me the most to be able to "hang on." He would say, "We have been through this before; we will get through it again. I am here! There is nothing more important than the two of us, than our relationship." 
        Paradoxically, with Cory in depression, I learned what it was like to be the well person-- the caregiver--trying to convince our depressed son of his self worth and not being able to do so. It had been so recent since my last depression that I still remembered the irrational, negative thoughts and self-comparisons. Admiration for my husband's long-term patience increased. I felt I would always be inferior, never be able to measure up to others. When friends or family pointed out my strengths, I wouldn't believe them. I felt I alone knew the "real truth" about myself. I felt I could not endure this hideous disease one more time. I felt abandoned. My sister wisely said. "You compare yourself with others at their best when you are at your worst." Prayers for help or comfort seemed unanswered. To escape the excruciating painful thoughts I would find refuge by staying in bed, by hiding. Then terrible guilt would follow because I had not accomplished anything! Don tried to help me understand what has become known as the Depressive Triad, described as the following distorted thinking: 1. I am basically defective. 2. I contaminate my environment and the people around me. 3. The negative will never change, and the way I feel now is the way I will feel forever. This is terminology used by professionals in treating depression.
        Cory had similar obsessive, self-negative thoughts. I would say to him, "Cory, these bad feelings will not last. What you are thinking is not true. Hang on! Your mood will change. You won't feel this way forever." Yet, in my heart, I knew the depressed person believes a depression will never end! He shot himself September 3, 1986, six months after his return from his mission. I was alone when I found him.
        Two days earlier Cory had made a suicide attempt by overdosing on medications. I wanted him hospitalized. Both the doctor and my husband, who is a social worker, felt that to admit Cory would only create more guilt. The day before he died, Cory had been very remorseful, distraught, and tearful. I took him to our family cabin, and we put a difficult puzzle together. I kept trying to keep him distracted. 
        That night our family had planned to attend a musical. He said he could not go! It was an effort for Cory but he came. The next morning, his mood had improved. He said, "You know, Mom, I think I could take a reduced load at school and still keep my scholarship." I had to remind him that we had withdrawn him from BYU two days before, at the doctor's advice. He looked at me with his penetrating gaze and a look that seemed to say, "So now, I can't even be a student." This was the last time I saw Cory alive. 
        I was doing household chores. After a time, I went downstairs to check on him. In an instant I saw the small revolver by his outstretched hand. He had shot himself in the right temple. I ran to the phone and dialed 911. An ambulance came quickly, followed by neighbors and friends. I think deep down I knew Cory was dead, but when the paramedics said he was gone, I started screaming hysterically, "No, no, my brilliant son is dead. I knew how sick he was, but no one would listen . . . no one would listen!"
        My husband had gone fishing early that morning and came home to find an ambulance and police cars in front of our home, and the house was filled with people. His first comment was, "What a waste!" Don's anguish was intense. When our friends saw us, it was Don for whom they were most concerned. I was definitely sustained that day. When people came to our home, I was often the one able to comfort them. 
        Later in the afternoon, I went back to Cory's bedroom. All reminders of what had happened had been removed. I knelt by his bed and pled to the Lord for comfort. I received a strong impression that when Cory's special but disturbed spirit left his body, he was received with forgiveness, love, and compassion into the arms of our Savior. The next few days we survived the funeral and the burial because we felt the presence of the Holy Ghost sustaining and comforting us. The love and compassion shown to our family were overwhelming. Perhaps this is what "suffering" is all about-people dropping barriers and trying to comfort, love, and help one another. More than ever before, gospel principles strengthened me. To believe in a life hereafter and a reunion with our loved ones was crucial to my faith. 
        I had to accept there was no way to change what had happened. I learned, when I got on my knees and would plead for His comfort, the Lord never failed me. During one long and excruciating period of depression a dear friend had told me, "You will not be able to believe me now. But when your depression lifts, you will have a greater compassion for the Savior and his atoning sacrifice in Gethsemane where he descended below all human suffering. He knows and understands your suffering!" 
        Suicide is a horrific tragedy for everyone. You find yourself saying, "what if" or "I should have" and think about "what might have been." It is so difficult for people who have not experienced severe depression themselves, or seen it in a family member or friend, to really understand how people can be so desperate that they would take their life.
        Several weeks after the funeral, a young woman who had fallen in love with Cory after his return, came to see me. She said she had seen Cory in a dream. He was dressed in white and he told her that he was "all right and he was with God." She wanted us to know that he was at peace. This was comforting to me, but I longed for him to appear to me in a dream. 
        At the funeral family and friends expressed their love and admiration for Cory, and their faith that he was with his Father in Heaven. In his sermon one of our dearest friends spoke these words of comfort and peace:

        A little four-year-old boy ran into his house one day and said, 'Dad, come outside and see what's out there!' The father went outside, looked down at a puddle of water, and the little boy said, 'Dad what is it?' The father said, 'It's just oil that dripped on the water.' The little boy, seeing all the glorious colors spreading out across the water, said, 'Oh . . . I thought it was a dead rainbow.'
        That story has sustained me through the years. It has become my metaphor to describe my relationship to my Father in Heaven. Given what the child knew about death and about rainbows, his answer made good sense. In the same way, with our limited understanding, we try to make sense of the things that happen to us in this world. Our answer, our explanation of things, would probably seem just as limited as the little boy's, if we had eternal perspective.
        But the little boy trusted his father's explanation even though he had no way to know for sure that it was right. That trust is the leap of faith we make in the same way when we trust that Father understands the things we do not.
        We should not use the word 'waste' when we speak of Cory's life. Who are we to judge the quality of a life by the length of it? Cory's life has been full of excellence, beauty, accomplishment, laughter, joy and goodness. He fulfilled a fine mission. And then-from my point of view-he got sick and died.
        We often wonder why such suffering must exist in this mortal life. But out of pain often comes a finer spirit. Some better self seems to rise up out of us. As we are touched by that fineness of spirit, we want to do what's right. We want to help others. We want to be tender and kind and loving. 
        Suffering moves us in another way. In Moroni 7:42-43, we read, 'Wherefore, if a man have faith, he must needs have hope, for without faith there cannot be any hope. And again, behold I say unto you, that he cannot have faith and hope, save he shall be meek and lowly of heart.' It is in our lowliness of spirit and meekness in times of grief, or in times of challenge--that we feel faith, and out of faith comes hope. Of course, that hope which we all share is hope that death is a temporary separation-and we start to get some perspective.
        Don and Shirley are celebrating their twenty-fifth wedding anniversary today, the day of their son's funeral. A cynic might call that a terrible, fatalistic irony. I find it poignant. Shirley's life has been one of the greatest examples of courage that I know. She never gives any indication of the pain and anguish of depression that she has had to live with most of her life. She does not view her life as tragic because she doesn't dwell on that. She loves people, cares about them and gives her whole life to people who never realize the pain she has suffered over, and over. 
        Don's life to me is one of the finest examples I have ever seen of unconditional love, and ironically, of patience-because Don is not a patient man. He has learned patience through some tough experiences. Because he is a rational man, it's been difficult for him to deal with the anguish and the irrationality that depression can bring upon a person. These are courageous people. They will go forward, passing their courage on to their children. Their suffering has brought them a refinement of spirit and a wellspring of charity, which they will graciously share with others. (Funeral sermon used by permission of survivor)

        In June of 1987, two men interviewed our family, one the producer of the PBS/BBC series "The Search for Mind." They were researching our family's bipolar history. In a follow-up letter they wrote:

"As a result of speaking with you, we have made sure that the danger of suicide among depressed people is made clear in the film. We interviewed a number of people who have attempted suicide and several doctors who discuss the pervasive nature of suicide among depressed people."

        April 2001 I emerged from my twenty-fifth painful bout with depression. As always, it was horrific, black, debilitating and irrational. As usual, I was convinced that "this time" the blackness would not leave-this time that depression would remain. But like a miracle in two months it finally lifted and once again my world is filled with beauty, light, and my beloved family and precious friends. When I am "well," I feel very willing to share our family's experiences. My hope is that my story-and Cory's-might help prevent other such tragedies and provide added insights and comfort to those who are struggling with the pain of suicide or severe depression.
        In Emily Dickinson's words (1830-1886)

Not In Vain
If I can stop one heart from breaking,
I shall not live in vain:
If I can ease one life the aching,
Or cool one pain
Or help one fainting robin
Unto his nest again,
I shall not live in vain

(101 Famous Poems, p. 30, Pub. Reilley & Lee Co. 1958)

What's the Point?

ERICA

By Bill

        It's been about four months since my daughter, Erica, hung herself. Let me tell you a little about her. My wife, Deann, and I had been married ten years before we were able to have children. Through the wonders of medicine and a lot of prayers we were able to have twins, Erica and her sister. Erica brought a lot of joy to our lives, although she had many challenges. She was born with a hearing impairment, scoliosis, and asthma. In her youth, she had an operation to restore her hearing, which accidentally severed the nerves in one side of her face. She felt very self-conscious because the paralysis took away half of her smile. In her younger pictures she had a very beautiful, full smile, but after the surgery people made fun of her and teased her.
        I miss Erica very much. We spent a lot of time together as a family. I didn't go out with the guys to do sports or hunting--I went out with my family. Erica played basketball and softball and I was her coach. She took piano lessons too. Music was hard for her because of her hearing impairment, but she did it and I went to her recitals. We took family vacations every year to give our daughters exposure to different places and people. Those were fun times. We tried to help our daughters know our Lord and Savior and understand that they are daughters of God. We went to church and prayed together. I had many talks with Erica during the weeks before her suicide. I knew something was wrong, but there was a lot I didn't understand.
        Prior to her death, I learned that she had been raped many times on dates. I found out about other problems she had also. She dealt with her problems in her own way and began making unsuitable life choices. Her attitude about the Savior and the Church changed and eventually she stopped going. When I talked  with her I could tell she was dealing with depression, hate, and discontent. As soon as we discovered these things she began therapy and was placed on medication.
        My wife and I loved Erica deeply. We tried to understand what she was going through and did everything we could think of to help her. I believe that she knew we loved her, but this didn't stop her from taking her life. 
        Erica hung herself with our dog, Buddy's, leash. She threw one end of the leash over a plank in the basement ceiling and placed the other end around her neck. Then she knelt on her bed and leaned onto the leash until she went unconscious. She died. I don't think it was painful. When my wife discovered her she was kneeling on the bed with Buddy's leash around her neck and Buddy, her dog was on the bed beside her. My wife called me after finding Erica. I told her to call 911. I immediately came home. I pulled in the driveway behind the police and paramedics. I had to remove Buddy while the paramedics worked on Erica. It has bothered me to think she could have sat up anytime and saved her life. She must have been in great emotional pain. We still have Buddy now. He helps us deal with Erica's death. Sometimes, he stares off into the room. We think he might see Erica.
        Erica died on the 21st of the month. Every month since then on the 21st I've relived driving into the driveway, going down the stairs, and seeing Erica hanging there.
        The first few days after her death we had many people comforting and helping us. The bishop gave me a priesthood blessing and together we blessed my wife and daughters. We received extra strength to deal with the viewing and the funeral. It got harder as time went on. The phone didn't ring as much and people stopped visiting. Then reality set in and I started feeling the grief and sorrow keenly. When it hit me I'd cry and take deep breaths to bring down my blood pressure and help me relax. I couldn't get what happened out of my mind. Church was especially difficult. I would sit with my eyes closed through the hymns and the talks. Sometimes I would just sob. If someone asked me if I were having a bad day, I'd say, "Every day is bad."
        Going back to work was good for me. When I first went back all I could see was Erica's face. When the paramedics carried her out of the house in a body bag I asked them to unzip it so that I could kiss her lifeless face. I couldn't get that picture out of my mind. I eventually brought a lot of pictures of her growing up and on vacations to work. I put them on my desk, on my wall, and in my day planner. I wanted to be reminded of the happy memories, not the last few moments of her life. It helped. People I work with have been very understanding and helpful. Some of them have acted as sounding boards. Since Erica died, they have been less critical of me and it's made my work less stressful.
        We haven't felt much guilt because we'd been very devoted to Erica and to helping her with her special needs. We have felt a tremendous amount of sorrow and grief, however. The last couple of months things have improved somewhat. At first I tried to figure out why it happened and I had many questions about Erica's death. A friend who lost his wife to suicide told me, "There is a plan that you're not aware of. Don't dwell on the whys. Look to the future and focus on the family left behind. Erica is in a better place. You'll kill yourself if you focus on the unanswered questions." I finally realized that some things are not meant for me to know. The unanswered questions don't bother me so much anymore.
        Since Erica's death, I've been trying to help my family. My wife is on antidepressant medication now. Her sister took her life and another sister tried to kill herself earlier. Depression and suicide run in her family. I try to listen to her and to spend a lot of time with her. I try not to lecture her. It's hard sometimes, but I love her. Our younger daughter, Jessica, was quite close to Erica. We recently learned that one of Jessica's friends was contemplating suicide. It was wearing Jessica down to have her friends coming to her with thoughts of dying. I listen to her and talk to her about her feelings. We've become a lot closer as a father and daughter. I try to do what I can to help my wife and daughters as well as to deal with my own pain. Sometimes I'm overwhelmed and I think, "What's the point?" I give priesthood blessings to my family. Sometimes I'm spiritually ready and sometimes I'm not, but I just do what I can and accept myself for that.
        Some things just aren't as important to me any more. Before Erica's death, I would think, "I need to do this or that "--like be to work on time and make more money for the family. Now I spend more time with my wife and girls. I'll wait up for my girls to come home and talk to them about how things went. The next morning I'll go into work late and make it up at another time. The job and other things are secondary now. I've learned that life is too short to worry about things that don't really matter.
        My wife and I have joined a support group of other families who have experienced suicide. It's very comforting to talk to them and we've become good friends. If I get emotional, then I get emotional. I can deal with tears and most of my friends can too. Tears are good. In the past two weeks there have been four more suicides in our community. We've been trying to help their families and it helps us too.
        Erica's suicide has been a wake-up call for me. Life is tentative. You can have someone one day and the next day you don't. It makes me realize that I have to do everything I can to fulfill my stewardship as a father and husband. I believe that the Church is true and that God speaks to our prophet. I believe that Joseph Smith was a prophet. I know this. I also know that there is a Satan and that he has a lot of tools. I've felt his presence. I rely on prayers and I know the Lord answers prayers. I don't believe I'll get all the answers about Erica's death in this life. I don't understand why some things happen or why I have to deal with them, but I have been comforted and strengthened to cope with my challenges. As painful as it has been, I think I'm learning "the point."

UNDERSTANDING THE HEALING PROCESS: DEPRESSION AND LONELINESS

        Most suicidal people and survivors of suicide experience sadness and depression. Depression is said to be the "common cold" of modern life. It ranks second, after heart disease as the most disabling ailment in the Western countries. 
        Depression can range from a temporary feeling of sadness to a very serious chemical imbalance in the brain. The more serious types of depression are considered a mental illness. Depression can occur because of a variety of factors, including substance abuse, mental illness, conflicting lifestyles, or the death of a loved one. The bad news is that depression is common; the good news is that people often respond well to treatment, both biological and psychological. Depression left untreated can be devastating and even fatal. 
        When suicide survivors realize that bargaining has not worked and the struggle to ward off reality has not been effective, an overwhelming depression can take over. This is commonly when the full force of the loss is experienced and is accompanied by crying and intense emotional pain. The more serious types of depression are characterized by the following feelings:

¨ You may feel lost, empty, alone, reclusive and restless. 

¨ You may feel mentally and physically drained with nothing to give. 

¨ You may feel helpless and powerless. You may feel emotionally paralyzed and inept.

¨ Your sleeping and eating patterns may change drastically.

¨ You may have thoughts of: "Why bother? Things will never get better or be the same." This may prevent you from performing even routine tasks. You may not want to go out in public.

¨ You may feel like a failure, and experience self-pity, despair, and a loss of hope. 

¨ You may have a desire to die. You may also feel that you can't make it on your own. 

¨ You may begin self destructive or self-defeating behaviors.

¨ You may feel consumed with grief and so overwhelmed that you struggle to make decisions. 

        Crying is a good way to express sorrow. It relieves some of the emotional pain, washes away sadness, and heals. Tears and funerals allow you to be sad and reach some closure. Crying is a sign of strength when used as part of the grieving process, but if prolonged, crying can become a chronic behavior that does not effectively promote grieving. Accept that it is okay to feel sad and tearful at times and to talk about those feelings. It is part of the healing process.
        Elder Jeffrey R. Holland emphasized the healing power of tears in speaking to the widow and family at the funeral of a close friend, Karl, who took his life: 

        I ask us not to hide our grief, especially you, Susie, and the children and the grandchildren when they come to hear this story. There is no pretense here that this is all wonderful, that there is no sorrow or disappointment. Tears are appropriate. What anger you feel, get that out, let it go and send it on its way. These emotions are real and we won't do each other any service if we pretend there is no pain in this. Tears are appropriate.
        "Thou shalt live together in love, insomuch that thou shalt weep for the loss of them that die." (Doctrine & Covenants 42:45)
        The only thing worse than losing Karl now and in this way - unexpectedly and without our preparation - would be not to care, to act like it didn't even matter. Tears are the price we pay for love in this world. You shed them as you need to and you'll be healing sooner and feeling God's strength more with His love upon you. Karl made a mistake but it is not our role to pass judgment.
        "I, the Lord, will forgive whom I will forgive, but of you (and of me), it is required to forgive all men." (Elder Jeffrey R. Holland, funeral service remarks, used by permission) 

        When a loved one dies, part of us dies too. Because that person cannot be replaced, loneliness in separation is the price we pay for loving. Loneliness may last a lifetime when an anniversary, a place, a song, or a flower brings back the aching painful memories. You will feel the disappointment of not having that special person there to share in the family's activities, events, joys and sorrows. However, by accepting the loneliness and realizing the depths of your love, you can learn to become more sensitive to others in their losses. By reaching out to others and placing your hurt, your sensitivity, and your compassion at the service of others, you will discover a way to help yourself as related in the story of "Lisa", whose mother made it her mission to minister to those in depression. 
        It takes courage to place your sensitivity and compassion at the service of others, but it is part of the key to helping yourself. Use your pain to reach out to others. It will become a creative and transforming love. As the Savior said: "If any man will come after me, let him deny himself, and take up his cross daily, and follow me. For whosoever will save his life shall lose it: but whosoever will lose his life for my sake, the same shall save it." (Luke 9:23-24) King Benjamin in Mosiah 2:17 made the definitive statement about service: "And behold, I tell you these things that ye may learn wisdom; that ye may learn that when ye are in the service of your fellow beings ye are only in the service of your God." 
        Depression and loneliness may reoccur in the months and years after a suicide. Survivors have found serving others helps them heal. You can come to know the Savior and feel of His love for you by seeking out someone you can minister to who is hurting. Pray to find someone to help. Listen to them and be their friend. You can enlist your family's help in service projects, which will help each member heal. Service to others will help you forget your own sadness and loneliness. Elder Neal A. Maxwell spoke of the importance of service:

        We, more than others, should carry jumper and tow cables not only in our cars, but also in our hearts, by which means we can send the needed boost or charge of encouragement or added momentum to mortal neighbors. (The Neal A. Maxwell Quote Book, "Service," p. 312)
        To withdraw into our private sanctuaries not only deprives others of our love, our talents, and our service, but it also deprives us of chances to serve, to love and to be loved. (The Neal A. Maxwell Quote Book, "Service," p. 314)

HELPS FOR HEALING

        The path of healing in this stage will be in taking small steps each day to return to normal activities of daily living and in finding something positive that is happening in your family. Many survivors have found the following tasks to be helpful: 

¨ Do your best to take care of yourself. 

¨ Try to get sufficient sleep and eat regular well-balanced meals. 

¨ Exercise regularly. 

¨ Find the listening ear of a good friend. Get a priesthood blessing. Caring friends and extended family can provide emotional support and help in the healing process. 

¨ Find others you can serve.

¨ Develop resources and a support system that encourage the positive changes in you and in your life. These may be ecclesiastical leaders, close friends, survivors of suicide support groups, and mental health groups.

        However, if the symptoms of depression continue for several weeks and interfere with daily living activities, you may need professional help, which could include temporary medication and/or counseling from a mental health professional.