The Fire and the Fall

Over the last couple of days, several Facebook friends posted links to a story about a young woman from our church community who had gone missing. Her friends and family were deeply worried. The police were involved, and the media. It was clear from the outpouring of support and concern that many people loved her, many people wanted to support her.

I read the news story about the search for her with a hard, cold clenched fist in my stomach, looking for the words I was afraid would be there. I found them. She "suffered from depression." I took some deep breaths, and went for a walk.

The worst fears of her parents, her friends, her community were bound up in those three words and what they implied. Those worst fears were realized, tragically, when police found her. She had taken her own life. She was 22. The story describing her mentioned that she had John 3:16 tattooed on her back: "For God so loved the world, that He gave His only begotten Son, that whoever believes in Him shall not perish, but have eternal life." It's a verse full of indescribable hope.

Suicide cuts a wide gulf across our society. It's a gulf between people who cannot conceive of why a bright, pretty young woman surrounded by supportive family and friends could kill herself, and those who can. The people who don't understand try, but fail, to think of circumstances so terrible that they'd kill themselves rather than face them. They don't grasp the way depression kills you — not by heaping burdens upon you, but by making you incapable of thinking rationally about the ones you already have, by making you certain you can never survive them and don't deserve to. People who don't understand often regard suicide as a hateful, selfish, unfeeling act. Perhaps it would be if they did it, because they are capable of believing that the world is better with them in it. They're able to believe that the people who love them will be better off if they stick around.

David Foster Wallace — a moody, wordy man — understood it, though not enough to save himself. In Infinite Jest he described it. It's not clear how many people knew then that he was talking about something he had felt:

The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.

An acquaintance commented on this passage to explain why the love and support of friends and family isn't always enough to save someone. Friends and family, she said, are on the other side of the flames. They may shout encouragement and promise rescue and yell at you to hang on. But the flames keep you apart. And the flames keep coming, higher and closer. And so you jump anyway.

When I wrote about severe depression earlier this year, I mentioned the mindset that saved me. It wasn't a belief that I could get better. I didn't believe, and couldn't hope. I couldn't think straight. The only thing that worked was surrendering and putting myself in the hands of others. I didn't believe in myself, but I knew that the people who cared would take care of me. And so they did, until I could hope and believe again.

I think people don't get help in crisis because they can't believe, can't hope. Going to a parent or a friend, calling a hotline, making an appointment with a doctor can feel futile if you can't believe that it will make things any better, if you can't see how things could possibly improve. But that's not what you have to believe. You only have to believe that there are people who care for you, whether they are loved ones or strangers dedicated to helping people like you. Depression lies. The leap of faith required is that the people who care about you know the truth. The leap of faith is that if you lay down your burden they will pick it up. They will.

If you're ever in crisis, call the National Suicide Prevention Lifeline. Just say "I need help." And say it to a loved one. You may not be able to imagine it now, but they will lead you out.

Edited to add: I'm doing well right now. Thanks for asking.

Last 5 posts by Ken White


  1. Aimee J says

    Sitting here with tears in my eyes. It's always simultaneously grief-inducing and terribly reassuring to just know that someone else has been there and understands. So sorry you've experienced it, but so grateful you endured. Thank you.

  2. Lisa Clews says

    This post from Hyperbole and a Half says it perfectly. "… I somehow managed to convince myself that everything was still under my control right up until I noticed myself wishing that nothing loved me so I wouldn't feel obligated to keep existing".

    When I've felt suicidal it's not because of despair or terror or any negative emotion. It's because I don't know if I can deal with another 50 years of the dreary nothingness that is the worst symptom of my depression.

    Imagine the most boring, pointless meeting or training session you have ever been condemned to attend. The one which starts off with the projector not working properly and goes downhill from there. Where the presenter simply reads the power point slides and mumbles at that. Where the only refreshment is cheap instant coffee in styrofoam cups, the airconditioner is set at exactly the wrong temperature and there's a weird smell in the room.

    We've all been there. Take a moment to recall your emotional journey. At first there was eye-rolling, then anger at how your time was being wasted. These soon wore off to leave resigned endurance. You zoned out as the speaker droned, you sipped the awful coffee and simply suffered and watched the clock until it finally freed you.

    That awful resignation? That's my experience of depression. And I have no clock to tell me when I'll be released. That's why people kill themselves; they see it as the only escape from the dreariness that has become unendurable.

  3. flip says

    I find Wallace's quote to be most apt and the most descriptive comment about how suicide is for myself and others.

  4. Sami says

    I had a dream, once. One of the most vivid I've ever had.

    In it, I killed myself, like I'd been thinking about doing. And the dream went on from there. I was dead, there was no physical pain, and the existential agony of my depression was lifted – but what followed hurt more than depression ever had, because instead the dream showed me everyone who loved me. My friends, my parents – and they were devastated. Living the agony of grief and loss and guilt and self-recrimination and simple, overwhelming pain that follows for the people who loved a suicide.

    Everyone I care about in pain because of something I did, and I couldn't change it, couldn't undo it, couldn't make it stop.

    I woke up sobbing, and disoriented. It took me a moment to work out that I was in my bed, in my bedroom, that I was, in fact, alive and that had all been a dream, and I'd gone to sleep thinking about ways I should maybe go about killing myself and I woke up so damn grateful to be alive that it took me about an hour to stop crying.

    Certain sects hold it as doctrine that suicides automatically go to Hell. I have never believed that, but I have come to think that maybe an afterlife like that comes kind of close. With the veil of depression lifted, you're left with the knowledge of the pain you've caused to people you'd choose to protect, if you could.

    I've never quite been truly suicidal since. That dream haunts me. There are people I love. I would give my life to protect them. If I have to *live* my life to protect them, I will endure this pain, because I can't hurt them like that.

    It was the most agonising, painful nightmare that, if I could, I would send to everyone who even thinks about suicide.

    People care about you. Just tell someone how you're feeling, let them take it from there. They will.

  5. Bob Niland says

    Was this person on (or had just quit) any meds?

    Suicide is a "side effect" of several common anti-depressants, such as Ambien CR, which claimed the life of one of our relatives. These "adverse events" are not "suicide", they are more often negligent homicide by MD. In the local case, despite clear black print in the Drug Facts fold-out that the family MUST be warned, there's no evidence it happened. There were other meds involved as well, unknown to me, so I can't even speculate on the further possibility of acute interactions.

    I can also think of a number of simple (if dissident) diet and lifestyle approaches to depression that are easily worth a try before spinning the cylinder on these Russian roulette psycho-actives.

  6. says

    Your words were very moving, thanks, Ken.

    The same thing saved me from depression: surrender to the forces I have no control over, and trust in the love of family and friends.

    It seems like that kind of surrender would be very hard for someone with no spiritual beliefs whatsoever. Not impossible, but just harder to say "There are great and powerful forces in the universe and I am just a little man."

    I don't personally believe the answers to life can be found in a single book, or any book for that matter. But when we talk about the beauty, grandeur and power of our universe, I believe it's just a question of semantics. We all feel the same sense of wonderment and helplessness.

    And if you believe that everything that has ever happened and ever will happen are the result of just this really huge sequence of events in a massive chain of cause and effect, then surrender should come easier. But surrender is not possible if you don't believe we have free will. So for whatever reason, atheists seem to have a harder time with depression, even for what I consider "proper" atheists. You have to take that leap of faith and know that someone or something will catch you.

  7. Me says

    If you're ever in crisis, call the National Suicide Prevention Lifeline. Just say "I need help." And say it to a loved one. You may not be able to imagine it now, but they will lead you out.

    How desperately I wish this were a universal truth. 15 years of doing everything short of standing on a crowded street and screaming for help never yielded me any results. The professionals I consulted dismissed and ignored me. I was told I needed more "me time." Those who love me just didn't know how to help, despite desperately wanting to.

    The main thing that kept me from suicide was a terrified certainty that I'd end up dead and still depressed, trapped in it forever. I could never manage to believe that death would end it. Then, one day, it just went away. Two decades of fear and pain just disappeared out of nowhere. Which is great, except I have no idea if or when it will suddenly come back, and if it does I still ddon't know how to fight it. I'm still helpless and trapped. Just on temporary reprieve.

  8. Maximilian says

    Thank you, Ken.

    I love the 1st Amendment posts and the general ranting, but I feel confident that these are the most valuable part of your writing.

    Am forwarding to some family and some friends.

  9. Dan Audy says

    Thanks for this. It is always comforting to hear someone else talk (much more articulately) with the things that I wish I knew how to express. I think it is so important that people who've suffered from soul destroying depression, especially people who are respected and successful, to speak out to help eliminate the stigma and help show that there is a way forward when it seems like nothing could ever get better.

    That sucks and I'm sorry you had to go through that. I think a lot of us suffer from having loved ones who wish they could help but don't know what to do. I spent so many years faking being ok and trying not to be a burden that I came across to the professionals as 'relatively ok'. Eventually in a moment of rational insanity I acted in a way that even I could cover up and literally carved the words I couldn't say into my flesh, which thankfully finally got me the help I so desperately needed.

    At one point the medication that helped me cope with my depression stopped working and I slid back into that place. While eventually we found me a different anti-depressant that worked (even better!) but I still have a small deeply buried fear that it will stop and I will go back to that intolerable place. My strategy for coping with that fear is simply to have faith that my ability to overcome it once will allow me to do so again if I should be unlucky enough to be in that situation.

  10. Richard says

    As someone who has both lost a parent to suicide and suffered from depression myself (though not to the point of seriously contemplating suicide):

    Thank you, Ken.

    It's a terrible thing to lose someone to suicide, and just as terrible as the loss itself is the feeling that someone is to blame: yourself, for not making them feel loved, their therapist, for not fixing them, the health insurance, for not covering their meds, their employer, for not offering better insurance… There's always someone to blame, and you never feel like you can blame the illness itself without blaming the person with the illness (and sometimes you do blame that person).

    I remember once, when I was very young, at the onset of my parent's depression, I asked my other parent: "Is depression contagious?" The sad answer was "Yes."

    I now understand depression a lot better than I did all those years ago, and I can see that, while it's not literally true, it really is the truth.

  11. Anonymous says

    Well, to read this here was certainly unexpected. Great thoughts on a bitter subject, though. Thank you so much for your article – if it only helps one person, it was worth the effort.

  12. says

    I have a friend who is frequently and commonly depressed, and when I tell him to call suicide hotlines, he just laughs bitterly. Checking the IM chat logs, I see him say things like

    wondering why i should live. and i know it is dangerous to call the suicide criss hotline, they have threatened me so many times…


    there is no where to go and eventually the cops will catch and execute me. that's what they do with psychiatric patients here in the US.

    if i had only read about it in the news that would be one thing, but i've had them come to my house twice for suicide 911 calls, and all they did was scream at me "who are you going to murder? where are the weapons you are going to murder people with? where are your plans to murder people?" and searched my house, screamed some more, and left with vague threats

    if it wasn't for it happened identically back-to-back 911 calls…

    there were no EMT's, offers of help, just threats.

    all i feel now is my life endangered when cops are around.

    I ask him to talk to his psychiatrist, and he says

    if i had $280

    and several weeks to get in

    earliest i could talk to therapist would be thursday IF I had $65. And not like either of them can help in the least. no professional EVER has been any help with these things.

    it is take drugs or go into a psyche ward, that is it.

    there is no other help nor assistance here in the US.

    I ask him to see if maybe they could put him in touch with some kind of service that could help him, and he replies,

    ahahahahahaah, what services do you think exist? ahahahaahah, five years of this, trust me, there are no "services" but being committed to a psyche ward. ahahahahahahahahahahaha… i've asked for help hundreds of times. MHMRA, suciide criss hotlines, 911, case workers for mental services… ahahahahahaha… take drugs take drugs take drugs aren't you ashamed of being a cancer on society! ahahahahahahaha… that is all that is offered!

    no help, no one to talk with.. therapists, professionals, psychiatrists, do not talk wot you unless you go in and PAY.

    People always say to call the suicide crisis hotlines like it's a panacea, but then I talk to people who try that and find that it doesn't work for them.

    What am I supposed to tell someone like that? I'd really like to know, because I end up feeling helpless every time he tells me about how depressed he is, and every time it happens I wonder if one of these days there won't be a "next time" I hear from him.

  13. Kalgash says

    Kratoklastes, I am a convinced, belligerent atheist. I am also disgusted by your comment, and by the possibility of being lumped together with people like you.

  14. svs says

    Kratoklastes –

    I really wish you would work much, much, harder at hiding your inner heartless bastard. I'm not at all sure that it's actually inner, come to think of it.

  15. Jordan says

    Sorry, but my inner heartless bastard emerges when soi-disant 'believers' claim that a fellow-traveller's death is somehow bad.

    I too am sorry that you somehow found it appropriate and necessary to pollute an otherwise fine thread with your own brand of bigotry and fundamentalism. From one atheist to another: your evangelism is no less annoying than that of "religiotards".

  16. Toastrider says

    I remember a quote I read once: that suicide is murder, and it makes all your friends and family unwilling co-conspirators, because they will spend the rest of their lives wondering what they missed, what they could have done to prevent it.

    Allie Brosh's description of depression is chillingly spot on. Thankfully I've never been trapped in that kind of nihilistic hell (too egotistical, I suppose). But the image is enough to make me understand why someone would desperately want out, even to the point of taking their own life.

  17. Dan says

    This brought a tear to my eye. No it didn't. OK maybe a little. Ken, I love reading your writing so much. Please never stop.

  18. PACW says

    Thank you. I had not heard the fire/fall analogy before. Although I am not immune to despair I have a difficult time forgiving suicide, and appreciate the opportunity to adjust my mindset a little bit.

    Tim is absolutely correct that the bloggess is a great place.

  19. Paige says

    Thank you for posting this, Ken. It is a powerful message that we all need to be reminded of from time to time, and you write eloquently. I've learned on my journey that people WILL help, and sometimes not only the ones you think are "supposed to". If you let people know you are hurting, eventually you will find someone whose support lifts you up and doesn't feel like a condemnation.

    What I wish the people who haven't been there knew would be most helpful to say is "I don't understand what you are going through. It isn't a feeling I have felt. However, I can see that it is hurting you, and I want you to know that I am here to listen and to help you in any way I can, even if that means helping you find someone else who can help more. Please tell me what you need right now."

    As a postscript…I don't think depression and atheism are related. I think knowing you need to reach out for help is tough for many people, and that atheists (like me) might be more likely to ask a tangible person for help, which I personally think is a good thing. For me, I could never do Alcoholics Anonymous, because the whole thing would feel like a lie. That doesn't mean I couldn't ask for help…just that I'd ask a person. Just my 2 cents.

  20. Merissa says

    I'm currently 32. I started having my first suicidal feelings at 14. Therapy, medication, and other measures (I was even desperate enough to try homeopathy; not proud) have been unsuccessful. After using LSD, I had a very enjoyable three-month vacation from my depression – no matter what happens now, at least I can say there was a respite.

    I keep going by telling myself I'll die eventually either way, and that good things might even happen if I wait for it to happen rather than taking the initiative. It's so, so tempting on a daily basis, and I know eventually I run a chance of just being too tired to go on. But I've survived this long, and that's worth something.

  21. JHanley says

    I can't write about this the way Ken does, or Wallace, or Styron. So I deeply appreciate them carrying the load of doing so.

  22. says

    Thank you for writing on this, Ken.

    Mrs. Grifter has been struggling her whole life; we've been seeing someone, but the meds aren't helping and I worry constantly. Hearing from someone who can articulate what she can't helps me at least try to get a better understanding.

    I just wish I knew what to do.

  23. Beverly says

    What an excellent article, sir. It immediately made me think of a young woman in her early 20s who earlier this year took her own life. At least I'm fairly certain that is what happened, but I don't know her family well enough to ask. The young woman was someone that my son had known since early elementary school, although their lives took different directions after high school. For whatever reason, she and several other of my son's classmates had friended me on Facebook many years ago. Perhaps it was because I was a cool Mom, but I think part of the reason was that I was more involved in school activities than their parents were, so they were comfortable with me. Anyway, the young woman's last post on Facebook was, "Just when you think things are getting better…" Those words will always haunt me because although they sound like something that anyone would say if something bad happened, no one responded even if just to say, "Hey, what's up?" It was the very next day that one of her close relatives posted something about how much he loved her and would miss her. No one ever said exactly what happened, but a few comments were made that made it sound pretty certain that she had taken her own life. Her Facebook page is still there, and her friends and family still "talk" to her.

    But then the strangest thing just happened. I finished reading your article and returned to Facebook, and the very next post was from one of the young woman's friends saying how much she missed having adventures and talking for hours with her, and then the very next post after that was from a friend of my son's reaffirming her belief in Jesus Christ. That just totally weirded me out.

    Anyway, thank you for a well-written and meaningful article.

  24. Brandon says

    What I've found from people who have never suffered from depression is the lack of understanding of how constant a struggle depression is to deal with, even at times where you are not feeling it. There is a constant worry in the back of your mind about what will trigger it again, how long it will last this time, who you might alienate because of it, or if it will overwhelm you at last. It's especially worrisome when you've seen how it affects those closest to you on days when you can feel clearer, especially if you have children.

  25. lagaya1 says

    You write beautifully on this subject (as on all subjects, it seems), but I'm always a little worried that this is your way of saying goodbye. I worry about that a lot.

  26. says

    @Bob: Yes, people on anti-depressants sometimes commit suicide. And people undergoing chemotherapy sometimes die of cancer.

    Therefore, chemotherapy is just a Big Pharma scheme to murder people for money, and people with cancer ought to drink homeopathic tea and have their auras recalibrated via harmonic waves, right?

    If you recommend to someone who has been correctly diagnosed with clinical depression that they just "change their diet" instead of taking the medications recommended for them by a qualified psychiatrist, you might as well save some time and just hand them some razor blades and instructions to "slit up the wrist, not across".

    One of the reasons for suicide when taking antidepressants is because they DO work. If someone is in serious depression, they may have only not killed themselves because it's just too much bother. (And if you think I'm joking, you've probably never had, or lived with someone who has, truly severe depression.) During the early stages of treatment, the medication can give a person just enough energy and drive to go through with it, before it's done enough to remove the urge. That's why medical supervision is a Really Good Idea when starting or switching meds.

    I know how difficult and frustrating medication roulette is. My wife went through, literally, everything from Abilify to Zoloft, as well as trying ECT (which worked but wore off too quickly), until we found MAOIs. Thanks to Nardil, she's been out of the hospital for four years now… double her previous record, and far better than the usual 3 to 6 month cycle of going inpatient. And I've seen how effective proper medication is for other people I know well enough to judge.

    No, it doesn't work for everyone — there's pretty much no treatment that does. That's reality. An extremely tiny percentage of children have adverse reactions (though not autism)to some vaccines. The danger of NOT being vaccinated greatly outweighs that risk. If the only acceptable standard of treatment is a 100% perfect cure, all the time, you're asking for the impossible.

  27. albert says

    This is some of the best writing on the subject that I've seen. It goes straight to the heart. Only someone who's 'been there' (and I know about 'being there') can possibly reach people who haven't. Well done!

    . .. . .. _ _ _ ….

  28. mcinsand says


    Old MacDonald fan? I noticed the signature line and, no, I didn't have to look it up. I enjoy using code, historically in the lower HF bands. With changes in locations, though, I may have to start looking at life above 10 MHz.

    As for the topic, all I can say is that Ken did a painfully good job with the article.

  29. albert says


    Congrats! You are the first to mention it, after hundreds of postings on a dozen or so blogs, including all of my emails. S.F.B.M. gone, but not (yet) forgotten.
    . .. . .. _ _ _ ….

  30. Danger Actual says

    Thanks for writing about this, Ken. My first comment was seized by the server squirrels and published before I was done. Please feel free to delete it. I'm not able to write coherently right now.

  31. mcinsand says


    Thank you. FWIW, when I took my tests, the 5 WPM was easy, but I had to work to get to 13. Back then, there was SuperMorse to use as a trainer. I had the PC to take text files, start slow, and then increase speed as the translation went. I kept the cassettes (yes, that long ago) in the car and listened on the way to and from work. As for the text files, of course they were collections of dirty jokes. What else would you use?

  32. SirWired says

    @Bob Niland

    For starters, Ambien-CR isn't an anti-depressant at all, it's a sleeping pill. (In medical parlance, a sedative-hypnotic.) And it has no such Black Box warning. (It has one for the exact things you would expect a sleeping pill to warn you about; suicide isn't one of them.)

    Second, there are no "simple" solutions to depression. Yes, lifestyle changes MAY have an effect, and I could conceive of dietary changes of some sorts that could have an effect also. Different treatments work for different patients. Sometimes the proverbial fog can be lifted with therapy, etc., and sometimes it just takes drugs. Trying to treat a case that requires drugs without using them is no less dangerous.

    It is certainly well beyond hyperbole to call SSRI induced suicide ideation "negligent homicide". A summary of the Black-Box warning is on a sticker on the bottle, and included in the leaflet the pharmacy hands you when picking up a prescription for an SSRI. That's not to say it's impossible to incorrectly treat depression, just that you are casting a pretty wide net here…

  33. Ron says


    Thank you for posting this. Sometimes I think I'm the only one who gets that way, and it feels good to know that others have gone through it too, and still came out the other side in one piece.

    To anyone who feels that suicide is the only answer, get help. Please.

  34. Sami says

    For what it's worth, if anyone is having particular difficulty with insomnia: most sleeping pills are unbelievably bad news, one way or another. A surprisingly under-recommended option is melatonin pills. I believe they're over-the-counter in the US.

    People mostly use them for quicker recovery from jet lag, but they're also amazing for insomnia. Melatonin is the hormone that creates sleepiness. The pills just help you fall asleep.

    Unlike other sleeping pills, there are no side-effects I'm aware of. If something happens and you find you need to stay awake after all, you can – they only make you fall asleep if you co-operate by lying down in the dark with your eyes closed. They don't make you drowsy the next day.

    And they're not going to kill you if you overdose, so they're not a temptation if you suffer from depression, either.

    I am chronically insomniac to the point where I once literally could not sleep, at all, for the best part of a week. (This also had me on 24-hour suicide watch. It was not a fun time.) With melatonin pills, I sleep, every night. The times when insomnia would have me not sleeping, at all, the worst it gets is "not sleeping very well" or "waking up earlier than usual".

  35. Karen Robinson says

    One quick warning about melatonin – it can cause hallucinations, at least for some people. My mother took it once, when she had trouble sleeping after she broke her arm. She hallucinated on and off for two days. (I say hallucinate, but I'm not certain that's the right word. She basically lost the boundary between sleeping and awake, seeing and hearing dream figures and acting out dream events while awake, in addition to interacting with actual reality. It was surreal.) I did a bit of Googling and found a group of idiots on reddit (but I repeat myself) who recommended taking melatonin with lots of high-caffeine drinks, because that would induce hallucinations, and that's such a blast, don't you know. My mother had taken her melatonin pill with coffee. I don't say don't take melatonin; many many people take it without the slightest harm. But maybe don't take it in high doses to start with, and don't wash it down with a caffeinated drink.

    On the post topic – thank you for writing this, Ken. I have had clinical depression for over forty years now. Between the fire and the fall is exactly right. I made one suicide attempt when I was much younger. I was stunned that my family was upset; I assumed their attitude would be more 'good riddance', but they were distraught. When the depression flares up now, I make myself remember that. Despite what the depression whispers in my brain, the people I love also love me back, even if I don't really believe it at the time.

  36. Peter Gerdes says

    I'm a little bothered by your claim that "depression kills you — not by heaping burdens upon you, but by making you incapable of thinking rationally"

    No, depression doesn't just make you *think* things are worse. It actively makes life less enjoyable. In anhedonic depression you really just don't experience significant pleasure or happiness from the things that other people enjoy. This is sad, but it doesn't make you irrational it just makes you less happy. Depression isn't being a negative nelly who just always focuses on how things can go wrong it is about being genuinely less happy than others in the same situations.

    Indeed, I will go much further and say that even suicide as a result of depression isn't always an irrational act. Often it is, there are treatments (but simple time is the most effective) that can help one get better and being sad can easily make you unreasonably pessimistic about how things will turn out. However, I've had friends who have suffered from treatment resistant depression for many many years (and doctors, perhaps because of liability, won't treat even serious depression with potentially dangerous drugs the way they would heart disease or paralysis) and lacking any other plausible options I can't say their choice to end their life was an irrational one.

    People need to recognize that suicide isn't the (primary) problem…the fact the person was that unhappy was the problem. There is something disgustingly selfish about getting all worked up when someone kills themself (so it affects you) but not getting worked up about the person being depressed during the long period before. Maybe if people treated being depressed as the problem effective but high risk treatments like adderall might be more common.

    (Yes, I can find cites showing the strong anti-depressant properties of stimulants like adderall. Unsurprisingly, the drugs that tend to work most strongly to improve mood for depressed people improve everyone's mood…but that makes them drugs of abuse and risky to prescribe so they aren't. I'm not claiming this is some magical solution but I believe if attitudes changed to allow this kind of treatment other, hopefully safer, alternatives would be found as well).

  37. Dan Audy says


    I'm not Ken, who is more capable than I to defend his phrasing, but as someone who has suffered with depression all my life that sounds reasonably accurate. When I am not in the midst of a mental health issue the thinking that I was having during those times is incomprehensible to me. While irrational thinking is often conflated with erratic behaviour but at its core it is simply thinking that doesn't make sense.

    When I suffered more fear for being judged by a stranger because I was embarassed by my wife being loud in a library than when I was getting mugged that was my anxiety disorder causing irrational thinking. When I don't enjoy good food, spending time with my family, sex, or my hobbies – all things that I normally enjoy, that is my depression causing irrational thinking. Believing that no one can love you when there are people telling you that they love you is irrational. Anytime you believe things that are unreasonable or not supported by reality it is irrational thinking.

    Suicide may be a rational response to the irrational beliefs that typically prompt suicidal ideation but that doesn't make the thinking that leads to it solid, reality based thinking. I do agree that focusing on suicide rather than what leads people to wanting to commit suicide is less than productive.

  38. Grey Ghost says

    I remember talking about this with a (non-depressed) friend once. I told her that suicide, ultimately, is a "rational act" – that is, the suicidal person sees ending her life as the best (most rational) option at the time. Ken's metaphor – you fear the flame more than the fall – is a very clear way to describe this.

    The fact that the individual doesn't see all of the options available – that their window of perceived solutions has narrowed radically – doesn't change that fact. You can't choose what you can't see.

  39. JimboTheFuzzy says

    I found this while I was unable to sleep prior to a doctor's appointment (thus there are probably spelling errors and more), and I can sympathize. My case is a little different, but I've seen a lot of this.

    In my case, I have epilepsy, with really bad seizures. The "I've broken two desks and have a bunch of scars from stuff I've done during seizures" kind. And I spent my childhood on a bunch of medications that caused depression-like symptoms. And even then, I knew that I had the choice between dealing with it, or probably having a seizure that would do some brain damage and then stick me with an IV that would force the meds into me anyway.

    That lasted until I found a medication (Lamictal) that had the sole side effect of making me sensitive to light. If you have to choose between wearing sunglasses under "normal" room lighting conditions, or facing that soul-crushing depression, it's no choice. And that worked for a bit over a decade.

    Earlier this year, I got hit with this condition known as Status Epilepticus, and pure chance wound me up in the ICU instead of the morgue (there was about a 15 minute window). Unfortunately, that means the meds that made life so good are probably not enough to deal with things alone. Since the nature of my seizures makes surgery not an option, and I've tried every medication I don't have an allergy or some other issue with that makes them a non-starter, I'm down to 5 choices for medications.

    1. Depression
    2. Depression
    3. Depression
    4. Violent aggression and lack of self-control
    5. Sleeping 2/3 of the day and hallucinating the rest of it.

    Maybe, MAYBE there's something. MAYBE I can convince them to try getting me off this. MAYBE there's some other way, even if it involves pushing that one good med past the max dose. Because I'm just thinking about the other night, when I had a plate full of my favorite pizza sitting right in front of me. And I couldn't bring myself to take a bite. When things were good, I would fight my siblings for that pizza. 6 months ago, I would have savored every bite of every slice. Now I can't even pick up a piece to eat it when my stomach is rumbling at me to eat.

    On the one hand, I feel like I'm diverting the topic or uselessly rambling or something. On the other, I don't know of any better spot to say this. I'd have some sappy comment about how everyone here is nice and stuff, but I can't think of the best words to use.

  40. Maximillian says


    On the one hand, I feel like I’m diverting the topic or uselessly rambling or something. On the other, I don’t know of any better spot to say this. I’d have some sappy comment about how everyone here is nice and stuff, but I can’t think of the best words to use.

    Well *I'm* not very nice, but your post is still entirely on topic and not out-of-order.

    As some others, you make it clear that serious depression isn't a matter of having a bad day, or year, but the inability to feel contentment, let alone happiness.

    Huh- I just googled SE, wasn't familiar with it. Note that your depression sounds as if it might be affective, meaning that you have perfectly reasonable and rational reasons for feeling very unhappy. Still, talk to your medical providers and find a counselor/therapist/etc if they haven't referred you yet. Good luck.

  41. sorrykb says

    As a P.S. to my earlier thank-you: I've been dealing with depression for some time now. (Or, rather, attempting to deal with it, and I wasn't sure it even was depression, because I'd never talked to anyone about it.) I'd thought about seeking help before, and on a few occasions got as far as scheduling an appointment with a psychiatrist… but I always cancelled. I figured I'd handled problems on my own before, and everyone knows I'm the one who always keeps it together even when everyone else is falling apart (It might not be the most honest part of my brain telling me this.), and besides how could talking to someone possibly help…

    A few weeks ago I decided to give it another try and I scheduled a new appointment, for today.

    It was this post that stopped me from cancelling that appointment, and got me to that doctor's office today. Not sure where it's gonna go from here, but it's a beginning.

  42. ::scott:: says

    Ken – thank you for writing this. It helps me understand a little bit more about things that are hard to understand. I'm glad you're doing better.


  43. Mich says

    Thanks for posting this. Every time I read stories like this it's a wrench because of the constant realization of not just "That could have been me," but that it WAS almost me. Sometimes I think it's a miracle I made it out of that time; I didn't have any friends, no one to talk to, and my mother's first words when I told her I'd tried to kill myself was "No you didn't." It's hard enough when you do have people who care about you; personally I think what's even worse than feeling like no one cares is being around people who should care and just don't.

  44. Juliet Harris says

    Maybe it helps to lack physical courage. There have been many times, in my 60+ decades, when what kept me alive was the recurring thought that if I could find the courage to kill myself, I could find the courage to keep living. But I know EXACTLY the feeling you describe so well — it's a great analogy.

  45. Peter says

    Ken, thanks for your words here. For some, nothing will help them deal with the disaster that is a loved one taking their own life. For others maybe they can at least have some understanding; both from your post and the thoughtful comments of others here.

  46. says

    “I have epilepsy, with really bad seizures. … MAYBE there's something.”

    Since you didn't mention it, have you looked into ketogenic diet (KD) for that? I would have thought that due to the work of the Charlie Foundation, and since one can hardly search the web on epilepsy without getting KD hits, that people with conditions susceptible to some relief via diet would know about KD, but maybe not. My understanding is that KD used to be the go-to treatment for epilepsy back before the modern drugs became available.

    KD is an extremely low carb diet. If you try it, make sure none of those carbs are any of the gluten-bearing grains (wheat, rye, barley), as they are suspect in several neurological ailments, and not just because they are high glycemic. I'd suggest a grain elimination trial even if you don't try KD.

    See Perlmutter (Brain Maker) or Davis (Wheat Belly Total Health) for what's afoot with grains (both advocate no-grain low carb – but not KD routinely). Wheat exorphins are psychoactive. Provocation of zonulin by wheat gliadin opens at least the tight junctions of the gut, allowing adverse substances into the blood. Perlmutter argues that it opens the blood-brain-barrier as well, which if true would explain a lot of ailments.

    Both advocate a variety of other adjustments to compensate for deficiencies and hazards common in modern diet, several of which strike me as possibly beneficial in epilepsy.

  47. says


    «For starters, Ambien-CR isn't an anti-depressant at all, it's a sleeping pill.»

    I'm relying on information from the family on why it was prescribed. The main problem was depression. The CR may well have been specifically for sleep. There were apparently two other meds prescribed, not known to me, so adverse interaction is another possibility, and one the family was evidently also not warned about.

    «And it has no such Black Box warning. (It has one for the exact things you would expect a sleeping pill to warn you about; suicide isn't one of them.)»

    I didn't say it had a Black Box warning. Here's what the prescribing information on the sanofi-aventis site presently says (which differs a bit from what I found at the time at a different site):
    5.5: Suicidal tendencies may be present in such patients and protective measures may be required.
    17. Suicide: Tell patients to immediately report any suicidal thoughts

    Drug companies don't put things like that on prescribing information and patient information documents because they think it will increase sales. As reported to me, no protective measures were taken, and the immediate family had no warning about the risk.

    «Second, there are no "simple" solutions to depression.»

    Except when there are. I contribute to a health blog where relief from depression is commonly reported as an unexpected side effect of following the advice for other reasons (usually weight loss or intractable intestinal maliase). Anecdotes? Sure, but when it's one person's personal anecdote, confirmed on demand by challenge testing, it suffices.

    «…I could conceive of dietary changes of some sorts that could have an effect also.»

    The diet and lifestyle changes I would suggest for depression are the same that I'd suggest for everyone, even those with no apparent ailments. This includes things that would have specific bearing on depression (and this is my list, and not the official posture of the blog I work at):
    ◊ very low net carb diet (including zero grains and demin added sugar)
    ◊ remediate gut biome (probiotic course & daily prebiotic fiber)
    ◊ minimize modern n6 PUFA grain and seed oils (inflammatory)
    ◊ attend to specific micronutrients (DHA, EPA, Mg, Vit.D, Vit.K, some others)
    ◊ get a real thyroid check, and competent treatment if hypo (not easy)
    ◊ take a serious look at adverse meds (like statins, which are disastrously over-prescribed)
    ◊ eliminate circadian disruptors (long list)
    ◊ get a one-time genetic test looking for adverse polymorphisms with potential psychological impact (MTHFR is one)

    «Sometimes the proverbial fog can be lifted with therapy, etc., and sometimes it just takes drugs.»

    Agreed, but what I'm suggesting is safe and relatively easy to do before spending money on psychotherapy, and in particular getting on meds. The rise in ASD, for example, is not due to Ritalin deficiency. Something else has changed in the last half century, and is gaining on us. Throwing meds at symptoms is not a cure.

    «It is certainly well beyond hyperbole to call SSRI induced suicide ideation "negligent homicide".»

    Maybe. To the extent that many cases currently getting SSRIs could be resolved by what is admittedly a dissident diet, the problem isn't so much carelessness on the part of the prescribing MD, but that the nutrition training they get is nil (<20 hours), and almost all of it is incorrect, if not actively adverse, in terms of what humans really need to be eating.

  48. perlhaqr says

    Yeah… As someone who has suffered from depression for a long while, and has lost friends to suicide, I have definitely heard the "suicide is selfish" line quite a few times.

    But is suicide any more selfish than the folks who are saying "I'll be sad if you jump!" while you're trapped in the flames, burning, and without even the solace of the knowledge that eventually it will kill you and therefore at least end?

    Is it more selfish than all of the people saying "Please keep suffering, because I'll be sad if you leave"?

    The analogy of the fire and the fall is good. But where the limits of the analogy show through are that at least an actual fire will kill you. With depression… you can be trapped in that fire for years. Decades. Burning. And still have people tell you that it would be selfish to jump. "Just stay in the flames another 30-40 years! We'll try and put the fire out eventually!"

  49. perlhaqr says

    Perhaps that's too cruel, in my last comment. I don't mean that the people telling you not to jump want you to suffer, and they'd surely put out the flames if they could. But they can't.

  50. Me says

    "But is suicide any more selfish than the folks who are saying "I'll be sad if you jump!" while you're trapped in the flames, burning, and without even the solace of the knowledge that eventually it will kill you and therefore at least end?"

    I don't know. But this reminds me of a feeling I often had, which was that if I was dying, if I was in physical pain, it would at least be POSSIBLE for me to be happy anyway. It would be possible to find peace, to come to terms, to be okay in spite of my circumstances. Depression takes that away. It robs you of all peace, joy, happiness, so you can't choose to enjoy what you have, even if you have perfect health, people who love you, everything.

  51. Canonical says

    I appreciated you sharing your fight with depression and this story. For those of us on the outside, not knowing how to help, not know what to do, it gives us a tiny peephole into what those we love are going through.

    Thank you for your bravery in sharing something like that with all of us.

  52. Lilliana says

    Thank you for your courage and your compassion in writing this piece and I wish you all the best in recovery.

    You are right, help is out there, even when it feels inaccessible, pointless or nonexistent and I have felt all those things in my 24 year struggle with depression. Recovery is a process, and a support system is essential. Not everyone has an extensive network of friends and family, especially if they have been sick for a long time and tend to isolate, but no one has to be alone in this. I don't know if this will help anyone but in addition to the suicide hotline my local mental health hospital long ago referred me to both the national association of mental illness (NAMI) which has free support groups and classes all across the country (for people with mental illness and their loved ones) and the depression and bipolar health support alliance dbhsa). There are 12 step programs for depression, I believe the depression 12 step is called Emotions. And many, many people at AA and NA have a dual diagnosis of mental illness and substance abuse. Anyone with access to the Internet can get info on these resources and others, including online support groups.

    And thank you so much for quoting the late David Foster Wallace, who was, in my opinion, the best writer of his generation and another victim of depression gone way too soon.

  53. Bookman says

    Ken makes valid points, but let's bear in mind that depression isn't a monolith. That's a mistake that many make, as evidenced by how many well-meaning folks offer advice along the lines of "Well, I've been depressed a time or two, but I kept on smiling, and in a day or two, it was cured" variety. In that sense, Ken doesn't speak for me on the point of 'give up and let your friends and family come to your aid. They will', or however he phrased it.

    I feel the chill fingers winding their way into my soul again, and it doesn't even help when I'm at a (relatively-speaking) "normal" level for me. I know that if I don't struggle to maintain contact so that I can pretend they care, /they won't contact me on their own!/

    When I try and reach out for help, I get a "What can I do to help?", and it comes off to me as almost an accusation, because for one thing, I cannot say "If you care about me, then show it, don't wait for me to call for help", because by then I'm convinced that they would forget, they'd be occupied by more important things, and really, all they want is a quick fix to get me off the4ir back without them feeling bad about it, so they can get back to the important things in their life. If I were one of those things, after all, /I wouldn't have been in that grey hell/, now would I?

    I also agree with those that laugh at the suggestion that I contact "the pros". Even the ones manning some hotline or other don't really care about me – they can't, they don't even know me. What they care about is preventing suicide. Yay. That makes me feel so, so wonderful. My depression is now cured. And contacting anything official. Due to a misunderstanding involving my wife and a very close friend, I finally agreed to go down to the VA, and ask for help. From there, I could voluntarily allow them to lock me up, or they would do it by whatever means necessary, and I wouldn't be released until /they/ decided that it was ok to let me go. Some choice.

    So off i went, and while I was feeling alone and helpless and worthless, what happened? They locked me up in a psych ward, far from home, to ensure that I had no contact with friends or family, to be positive that I felt isolated and helpless and powerless and therefore worthless to any purpose.

    Fortunately, since I "volunteered"(!), the next day I was able to check myself out into her care. But that changed me. It scarred me in ways that I will never fully heal from. They didn't mean it, so I can't tell them, but I still feel betrayed. In fact, I dare not, lest I be left alone, helpless, and worthless. Perhaps you can see how that makes asking for help again makes asking for help from anyone just a little difficult. Because I'll do anything to avoid that happening again, that sort of emotional torment. So even asking for help represents a massive risk to my well-being, to the point where I can see that, despite having sworn off for over 25 years, I can see that the point might eventually come up to where I either have it finally demonstrated to me that my emotional needs are meaningless, or opt for the eternal solution. As Ken so aptly put it, it's the fire or the fall.

    But, in an attempt to close, I will offer this much advice to those who want to help: Think this over. If a friend reaches out to you because they are depressed, do not, and I repeat DO NOT ask them what you can do to help. Odds are, you've already missed the easy opportunities to help, so by asking them at that time, you are taking the depressed person with figuring out how to help them – while they are in the grip of depression! That's either callously lazy, or insultingly disrespectful. Don't you think if that person knew what would help them, they wouldn't have asked for that, specifically? Or do you just think that the burden of figuring that out is best left with the depressed person?

    The same goes in spades, but squared and cubed, for the "You just need to" solutions that are trite quick fixes. It may not always work, but the best rule of thumb I can work out is, before trotting out your trite "cure", or anything else, pause to consider this "Would I say this sort of thing to someone who had recently lost a loved one?". Sure, grief and depression aren't the same thing, but would you seriously say to someone who had lost their best friend, "Well, cheer up, lots of people out there have it worse than you, just think about how much better off you are". If you're the sort of person who would say that to someone at a funeral, then you need counseling worse than I do, I'll tell you that much. But people think nothing of saying that to someone in the grip of depression. Why don't you just say "take sadistic joy in the suffering of others, that will cheer you up!"?

    And if you are thinking to yourself "But that's not how I meant it", or "that doesn't make sense!", stop and think. Pretty much everyone who thinks a minute or two about it /knows/ that the logic of depression doesn't make sense – even those in the grip of depression. Those statements are you putting the burden on them again, to try to make you understand, to work to earn your caring. Seriously?

    Final comment: While the comment that "Suicide selfishly disregards the feelings of those you care about", that's not the only truth. For some people, death as an escape from the sufferings of depression in'st them selfishly disregarding your feelings, it might just be because they have come to believe that you no longer care, and neither does anyone else. Why suffer through it any more, if nobody makes you feel cared about? Just because it doesn't make sense to YOU, doesn't mean that it doesn't make sense to THEM, even if they know that sense is twisted and distorted. At the time, it may be the only sense available to them, in existence that has gone mad. Horribly, horribly mad.

    If anyone takes this and reposts elsewhere, I'd ask the courtesy that you strip the names out. I, for one, don't want any sort of "credit", it would just make me feel guilty.

  54. GK says


    My wife and I are currently on the outside dealing with my son and his depression.

    He was always an upbeat kid all through High School and his first year at college. That all changed about a month into his second year when his girlfriend went through a period of indecision about their relationship and finally ended it after a month or more of "Let's give it another week". After she finally called it quits he became very depressed until the night we were driving home from a family Christmas party and he looked at my wife and said "Mom, don't let me kill myself". We immediately took him to the emergency room.

    Unfortunately our local psych services are not that efficient and we would not be able to get him in to see someone for more than a month. We had a little better luck with the University, unfortunately when talking to the counselor there, it was determined that he needed to be admitted to an institution for a short time. He spent almost a week at a hospital associated with the university and was put on mood drugs that never seemed to really work for him.

    When we talk to him about his accomplishments at his age and what they cold imply for his future, he can't see the joy that he should because of the depression. I would consider his accomplishments to be incredible even before the depression set in. His education has suffered slightly but we never pushed him in that area, as long as he is able to complete his degrees.

    It's been almost a year since he uttered that phrase and he has accomplished so much within that year. He quit his medication cold turkey while doing an internship in California, a very dangerous decision on his part. He is scheduled to be included as an et. al. in at least three different research papers to be published within the next year, and will be giving a presentation on his summer research at a scientific conference in January. He is also a constant contributor to a music review site.

    My wife has been in constant contact with him every day and he always says he is only having an OK day and not many good days. She is constantly recommending different devices, ( yoga, full spectrum light sources, meditation ), to try and refocus his thoughts away from his depression with very little luck. He never really wants to make the effort to try anything for more than a short while.

    Whenever you write about this subject I will always forward him the link hoping he will see that he is not alone in this situation. Maybe he can pick something out of your experience that can help him.


  55. Bob Niland says

    @JimboTheFuzzy: again

    re: my comment "…have you looked into ketogenic diet (KD) for that?" [epilepsy]

    Short of a full KD, exogenous ketones are another possibility. A recent (2015-07) paper is:
    Anticonvulsant properties of an oral ketone ester in a pentylenetetrazole-model of seizure.
    The fulltext appears to be paywalled, so I haven't read it.

    Although D'Agostino is probably using custom-formulated ketone esters in his work, there is at least one commercial product available from time to time (KetoForce).

    Ignore "raspberry ketones", however.

  56. Mike Easter says

    I know this is an older and don't expect anyone to respond, but I'm posting anyway.

    For me it's more… apathy. I don't care enough about anything to change. I can spend an hour staring at the wall just because I won't take the time to move. I don't trust anyone in the psycho field (no reason for it; I recognize they do important work and help a lot of people, I just panic at the thought of talking to one). I DON'T trust my family to help me.

    I wish that I had some answers for people, too. Unfortunately, all I've got is my own situation. I just… take some action when I recognize I'm in deep: take a walk, make dinner, clean a room; something productive. And I keep on doing it, forcing myself to do things I don't want to do until I DO want to do them.