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March 6, 2009
A heartbreaking work of staggering sadness
That's how I would characterize D.T. Max's long, riveting article in the latest issue of The New Yorker about David Foster Wallace's amazing journey through life, terminated by his suicide last September 12.
The piece is compelling reading, taking you as close as you can get — if you haven't been there — to what it's like to have your world collapse around you as clinical depression unfurls its talons and proceeds to slowly, inexorably squeeze the life out.
I cannot recommend Max's piece highly enough.
I believe it unfair to criticize or find any fault with either Wallace or those around him — Karen Green (his then-wife/now widow), friends, doctors, therapists, editors, publisher, agents, students — for not somehow preventing Wallace's suicide.
If a person is determined to take his or her life, it is almost impossible to stop them — they will find a way, because inevitably the guard lets down just a little bit and in that momentary window the decisive act transpires.
Having said that, I do believe that it is eminently possible for those who care for a suicidally depressed person to protect them from themselves long enough for the urge to pass.
The only way to make this happen with certainty, though, is with very, very heavy medication — to the point of rendering the afflicted individual nonfunctional.
This requires either psychiatric hospitalization or 24/7 observation at home.
A very difficult thing.
Nevertheless, doable.
March 6, 2009 at 10:01 AM | Permalink
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Comments
Hm. What? No suicide duck? Don't want to link back up to that nifty post? Either way, with regard to your commentary on suicide prevention, are you offering your opinion as a professional psychiatrist or merely as the world's most popular blogging anesthesiologist who just so happens to know everything about everything?
Posted by: S-Dogg | Mar 6, 2009 1:37:36 PM
I find it very sad that the main thrust of his treatment seemed to be purely medication. Of course, this is what western science sees as the savior as opposed to actually getting at the heart of the matter...and who knows what else was attempted, but in my own experience, people seem to go for the simple solutions.
That said, without treatment in something like cognitive behavioral therapy, you just aren't going to get better from medicine. There are a lot of smart people that believe chemical imbalances are the bodies attempt at homeostasis caught up in a feedback loop that is out of control constantly overcorrecting. The body does NOT like to be depressed as it goes against the biological imperative, so it ups or downs certain chemicals, in which the behavior and / or situation does not change, and thus requires the body to correct again...and again. For most of us, it is a short term problem that this feedback kicks our ass to get better, but sometimes it goes beyond this.
We are not depressed because of a chemical imbalance, we are chemically imbalanced for the most part because we are depressed.
This isn't to say that medication doesn't work...it does. But one NEEDS to get the hard, painful, do-not-want therapy and make changes while they are on this. And then, quickly get off the meds once there is any indication that the CBT or other treatment seems to be taking effect (sadly, few psychs use real assessments other than their 'good judgment' ignoring empirically based tools that do just this).
All of this is sad...I work with creative types all the time and for a time was considered one. They don't want to change because it might alter their outlook, and thus success. Behavior is not random, it is based around past failures and successes. We just choose to prioritize which failure or success is more important to our own model of understanding. To most of my friends, it was choosing happiness over the next platinum...and they weren't willing to do so. Me? I didn't see the point of winning the same award over and over in an industry I have disdain for and got out. Most of my colleagues didn't see the open doors in front of them, or didn't understand the importance of occasionally burning bridges behind them. As such, I've gone to too many funerals for too many creative types who either intentionally or unconsciously were the direct cause of the outcome.
Anyhoo....off to go soak up some sun south of the equator and try to disrupt my own recent bout of the blues...I just wish I could convince more friends to be proactive about their mental health (damn...my last comment for a week and I was completely sober!)
Posted by: clifyt | Mar 6, 2009 11:54:09 AM
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