The recent loss of Anthony Bourdain has many talking and thinking of suicide and depression. As a regular viewer and fan of his work (including his CNN series Parts Unknown; No Reservations on the Travel Chanel, A Cooks Tour on the Food Network, and the many other series he has had a hand in, including one of my favorites, Mind of a Chef on PBS) the news of his death feels personal to me. I always appreciated Bourdain’s gritty perspective, his willingness to be real, his desire to help us all see things a little differently, and his comradery with his peers. He seemed to enjoy the things of life that I most frequently enjoy: good food, good drink and good company.
Many are asking themselves, how does someone who seemed to be living so well end it all? Some of the risk factors experts say people commit suicide include feelings of hopelessness, and impulsivity, believing the world would be a better place without you, relationship issues, financial issues, problems with work, a history of drug abuse, and history of suicidal thoughts or actions. Only Anthony Bourdain knows the reasons behind his actions; but as a mental health professional I can only answer, probably depression.
That’s the thing about depression…. It can appear to be vague, difficult to pinpoint and difficult to make concrete. It’s often described as a subtle feeling, that for many of us is just beneath the surface of our every day experience. Some describe it as an ever-present mist that kind of dulls the senses, or a fog that prevents one from thinking or seeing clearly, or as a numbness that dampens their experience. So commonplace is this feeling that many of us just take it for granted as a part of life and accept it as a given. Clinically, depression is defined as the presence of multiple factors including pervasive depressed mood, a loss of interest in things that used to interest you, disturbances in sleep or appetite, feelings of worthlessness or guilt, diminished ability to think clearly, and persistent thoughts of death.
Short bouts of sadness or even depression are normal and can be expected with the experience of trauma, or loss, or an undesirable change, or just a sudden change in mood that can’t be explained. The problem can come when this feeling stays. Depression can be very benign at fist; meaning it doesn’t impede your functioning in any meaningful way. You continue to go to work, have relationships, and perform the daily tasks of life. If it goes unchecked, it can evolve to where it starts to impede your functioning in some areas of life, maybe interpersonal relationships, maybe your health, maybe your work, etc. If further unchecked, it impacts more and more areas of your life until it has completely taken over; tainting your entire experience to where its hard for you to find satisfaction in anything and it seems like there is no hope of it getting better. That is one of the hallmarks of the person who is suicidal; a complete lack of hope that things can get better.
This is why it is so important to take action in the early stages of depression or even to just address the benign sadness that we all sometimes feel. By the time the ball of depression gets rolling, if it’s gone too far it can be very hard to stop. At that point, the depressed person has collected too much evidence as to how things probably won’t get better, because they’ve experienced it only get worse.
In her Psychology Today article, author of Struck by Living, Julie K. Hersh, who herself survived three suicide attempts and changed the course of her depression, addresses her frustration with the typical conversation around depression. She was writing shortly after the suicide of incredibly talented actor and comedian Robin Williams: “Very rarely do I hear mental illness discussed as a possibility for anyone with enough stress, lack of sleep, and lack of proper support systems. [The conversation is often] experts and family members pointing at the ‘mentality ill’, as though mental illness is only for the very few who are genetically stunted. Almost never do people discuss how all of us are susceptible and how we can protect our brains.”
This is why it’s so important that each of us individually are committed to enjoying life and to feeling good. Life is supposed to feel good. This doesn’t mean that we will never experience sadness. A full range of emotions is normal, not different than it is normal to experience changes in weather. Clouds, rain, and storms come and go. It is when the storms come to stay that there is a problem.
So what can you do? As a therapist helping my clients with depression, one of my first tasks is helping clients become aware of their feelings and help them be ready to start to identify the parts of their lives that feel good to them. For some, the gateway can be deep breathing. Diaphragmatic breathing, when done correctly, can bring immediate relief. With regular practice it can begin to provide a window to the idea that things can be better. In addition to talk therapy, medication management support from a licensed psychiatrist or acupuncture from a licensed acupuncturist can be helpful. Additionally, exercise, spending time with loved ones, going for walks in nature, a meditation practice, or anything that helps the endorphins going again can be helpful. The goal is to find a tool that can help the fog lift enough that you can start to feel a little bit better and create a space for hope.
If you think you or a loved one might be depressed, talk to your doctor and seek a referral to a licensed therapist in your area. I am one of them and you can contact me by contacting Third Space Wellness. For those of you in a rural area there are web based psychotherapist offering services through telemedicine. If you or a loved one are at risk of suicide call 911 go to your local emergency room or call the National Suicide Prevention Lifeline at 800-273-8255.
The most important thing to remember is no matter where you are in the continuum of depression, it can be better.