Murdered by depression

Depression has the frightening ability to take away lives. It is not just feeling sad or blue. Depression takes away your happiness, your purpose in life, it takes away what you love and sometimes even makes you feel so numb towards everything and everyone. It sucks the life force from you. Whilst it can be managed so that recovery is possible and people can lead their lives, it is also one of the greatest serial killers, claiming many lives.

Suicidal people are in great psychological pain; they want to end this not take away their lives but they can't see any way of ending the torment without doing this. They may have exhausted their options, therefore depression drives them away from life.

For those clients that may have lost a loved one to depression, the grieving process is rendered complex. Suicide is seen as a taboo and is rarely openly talked about.

The client may even be afraid that we as counsellors may not be able to handle hearing such a deep and distressing topic and worry about our ability to deal with this. They may be aware that it may make us uncomfortable and that we may be unable to hear the horrors or pain of their story. As counsellors, we need to be confident that we can sit with clients pain whatever they may bring because clients can sense our discomfort and this will affect their ability to heal and talk things through. Trust and safety are therefore paramount to the client.

It is important that as counsellors we are okay with hearing this and can be strong and stay with the client to support them. It is also important we practise self-care and that we take this into supervision should it make us feel uncomfortable. Clients can sense our discomfort and this can prevent them from healing.

A client may also feel unease talking about this due to the existing, damaging myths that surround the victims that are seen as weak or selfish for doing what they did. They want to preserve the dignity of the person, they want to protect them from having their character scrutinised and protect their lost ones from harsh judgement. They may be conscious that the counsellor may believe in certain myths about suicide.

Depressed people do not kill themselves, rather they are killed by depression, at their own hands but forced and taken over by this host and illness that drives them to do something that, in a better state, might not be conceivable. The aim is not to take away their lives but to take away the pain of living.

Let the truth be known, suicidal people are not selfish, bad or weak, this is so untrue and inaccurate as well as hurtful and disrespectful. This detrimental and negative form of judgement and labelling is far from the truth; the truth is that victims have been strong for so long before suicide seems the only way. Suicide generally does not occur because of a precipitating event but because this event occurred in the context of a chain of numerous other negative events that are interpreted by the individual in despairing ways. Unhappy and traumatic events can push an individual further into depression or to feel suicidal but, generally, there is a build-up of many painful events and unresolved issues that the individual has been fighting for many years, and of which at times an event can be the trigger that leads to the fatal act.

Victims are not selfish, they feel like a burden and perceive that others would be better off without them. The paradox is they are wanting to prevent others from the pain of seeing them suffer yet the pain and suffering is left when the person that feels like a burden removes themselves forever.

Who are we to judge? To not allow choices when pain is too great? Suicide isn't a sin, it is an act of desperation to end unbearable psychological suffering.

It is fundamental that we challenge any prejudices and beliefs that we may hold about those who complete suicide and replace these with helpful and accurate ways that reflect the truth about suicide and those that have lost their lives to it through depression.

This is the reason that suicidologist Edwin Shneidman, coined suicide as 'Psychache'. He described it in the following terms: "unbearable psychological pain - hurt, anguish, soreness, and aching". His theory also suggested that suicide stems from thwarted or distorted psychological needs as every suicidal act reflects some specific, unfulfilled psychological need. Therefore, unresolved psychache results in suicidal behaviours. Fulfilment of being in the world is the antidote to psychache.

This would make perfect sense if we consider that our emotional needs are just as important as physical needs for survival such as food and drink and warmth. In fact, Maslow's Hierarchy of needs covers this important aspect. Unresolved needs in themselves create a lot of pain and inner conflict, and when the need becomes greater than the want then it makes us vulnerable to many things.

Suicidal people do not want to harm their loved ones, they just want to find the peace they crave. They are not bad people or criminals for taking their lives. There is nothing right or wrong. Our aim is to save people, but if a person decides to end their pain in this way, there is nothing anyone could have done if the individual makes that decision.

In the book Waking Up Alive, Dr Richard Heckler (1994) discusses additional causes of suicide, including the following:

• Penetrating hopelessness - the person's state of mind is such that feelings of hopelessness penetrate every or almost every aspect of his or her life
• Inner chaos - the person experiences so much ambivalence about so many aspects of himself or herself and feels so indecisive in matters large and small that he or she feels without identity and unable to relate to others
• Unbearable or unending pain - an emotional or physical condition of so much agony exists that death seems like the only remedy
• Acknowledgement - the person hopes to find in death the recognition and appreciation he or she did not receive in life
• A desire for peace and calm - the person has exhausted his or her ability to cope with stress and see's death as a means of obtaining love, peace, and relief from current exploitation and suffering.

We can start helping and preventing loss of life by encouraging a culture where expressing emotions is deemed as healthy and courageous, where the act of talking about emotions and feelings is supported. A place like counselling allows people to feel those darker or more negative emotions. By breaking societal gender roles that prevent men from being the natural emotional creatures they are, we can allow them their humanity and allow them to cry and not feel weak or shame at experiencing depression or painful emotions.

We need to eliminate all the detrimental myths that surround depression. It is the shame experienced by victims that can silence them, that can add further hurts and pressures to smile and act as if they are happy in order to mask depression.

Depression isn't always recognisable; functional depression can hide behind the greatest humour and smiles. These individuals find ways to function like any other person without depression, yet the inner turmoil means they are at great war within themselves. When this happens it can come as a greater shock that we never saw it coming or would never have known the extends of the raw pain and the depths of it that was living buried in the person we lost to suicide.

Loved ones often blame themselves, feel angry at the abandonment, find it hard to grieve when it is surrounded by such stigma, and have a sense of shame. Feelings are complex, and complex grieving is often experienced. Left unattended the consequences can be detrimental.

Clients will benefit from the person-centred approach offering the core conditions and resolving issues such as feeling rejected, feeling abandoned, blame and guilt, being unable to say goodbye, loss and grief, shock, shame and pain. Depression can form a multitude of emotions and feelings, engulfing them.

Some people may struggle to talk about suicide as it would seem that it is not always met with sympathy, empathy or the respect it deserves. This outlines how it's made to feel shameful as the person-centred approach will be ideal and recommended to combat this element of shame.

I think it is important to be open about talking around difficult issues such as suicide because silence is destructive and by not talking it leaves those left behind silenced in their pain feeling isolated and ostracised. It makes grieving harder if it is surrounded by shame, silence and stigma. In order to heal, we must feel able to talk about it, able to name our experiences for what they are and feel supported and safe in doing so.

By talking about it, we make suicidal people feel less alone, supported and able to ask for help. We set depression free from the stigma it carries. If we want to reduce the rates we need to offer support, understanding and show care and love.

Suicide doesn't just take away the life of the person who does it, it takes away a part of the lives of those left behind. Suffering is passed on. Depression is serious, it's not a matter of being lazy when you can't get out of bed. It's a constant dark cloud, swallowing your world. It takes away all you have and this can include your life. Depression is a killer and deserves as much attention as illnesses such as cancer.

As counsellors, many of our clients who feel depressed may be expressing suicidal thoughts or idealisation. It's okay to have these, it's assessing any plans made and any wishes expressed to act upon these thoughts that require immediate action to be taken to prevent this and confidentiality to be broken for the protection of clients well-being.

We can all make a difference not only to depressed people but in potentially saving lives.