ON COMMITTING SUICIDE

Victor Bloom MD

The recent suicide of Admiral Jeremy (Mike) Boorda hit the headlines with great impact. It was said he was a great man, one who rose from the ranks and was greatly loved and respected. Many who knew him spoke of his great personal qualities and how much he was admired. He was in a position to raise the morale and the reputation of the United State Navy, the most powerful in the world. He had a position of great responsibility and great stress, as the scandal of Tailhook died hard and Navy planes were crashing.

In recent memory the suicide of Vincent Foster shocked the nation. He was counsel to the president of the United States and a former law partner of the first lady. At the first hint of scandal, he killed himself. He allegedly wrote a note to the effect that the Washington press pillaried innocent and unsuspecting victims for sport. It was learned that he was depressed and was not under treatment.

These two examples illustrate the unfortunate tendency for persons on the ladder of success to avoid treatment for mental conditions because of the certainty that they would not be considered fully competent to function in a high stress and responsible position. These suicides, unfortunately, give validation to their fears and the stigma of mental illness.

On the other hand, when a person who is intelligent and competent, but carries the history and genes of depression, who is adequately and appropriately treated, that person will probably remain stable and highly functional. It is a pity that successful and highly achieving individuals avoid getting the medical treatment they need.

The common misperception is that the person committed suicide because of the fear of embarrassment or scandal. There are many examples of prominent figures who have survived greater embarrassments, such as Ted Kennedy and Richard Nixon. This is not Japan. This is not a culture where suicide is expected in the event of losing face. We are a very forgiving and compassionate society.

All the more reason to think that Mike Boorda and Vince Foster committed suicide because of the chronic anguish and despair of untreated depression. People who are depressed may function at a very high level, and may have a keen sense of humor. People cannot believe they are unhappy, because they have learned to hide their feelings very well. People say, "he had so much to live for." Little do they know that day after day, they feel at the end of their rope, that they will never be out of the woods.

Little do they know that they are grimly hanging on to life and are looking for an excuse to end it all. For Vince Foster it was the threat of scandal. Earlier that year in the commencement address to his alma mater, the Law School at the University of Arkansas, he emphasized that man's most precious possession is his reputation, that he should guard it daily with the greatest of care. Would he really rather be six feet under than bear the slightest hint of some disreputable act?

Would Admiral Boorda think that killing himself spares the Navy some stigma because he might have been wearing two medals he didn't earn? If either man had been able to think about it, he would know that his suicide is more condemning than anything he might have done in the past. But depression clouds thought and logic, depression is a psychic pain so deep and seemingly constant and unbearable, that death seems to be the only surcease.

It is terrible to contemplate that in this day and age, when the vast majority of even the most serious depressions are treatable, that intelligent and sophisticated men would end their life rather than visit a psychiatrist. I have spent thousands of hours in a psychiatrist's office, and I can tell you from first hand experience, that although it is no picnic, it is much better than nothingness. Millions of people can attest to the fact that psychiatric treatment can lead to a new lease on life.

Would that all those reading this and suffering in silence, contemplating the last straw, would avail themselves of psychiatric care!