Last spring my younger sister Kathy jumped off a freeway bridge in Phoenix. For better or worse, she lived. Kathy made her first suicide gesture in high school, when she took a handful of –I think—aspirin in reaction to a bad haircut. At the time, she was already, obviously, mentally ill. In middle school, anorexia had drawn her down to a skeletal thirty-eight pounds. Her hair fell out. Her sunken face took on a plastic texture from fat soluble vitamins that her body couldn’t process. Force-feeding brought her back from the brink but couldn’t heal her. In the years since, even during three pregnancies, she has never topped a hundred pounds, nor has she ever been free of compulsions, body-loathing, or debilitating bouts of depression.
Since that first handful of analgesics, Kathy has made an effort to die somewhere between twelve and fifteen times: prescription pills, threatened jumps from an apartment balcony and a communications tower, an attempt at drowning, a car set on fire. Kathy is alive because even in the heart of Arizona’s Wild West no one will sell her a gun, a fact that she finds immensely frustrating at times that her bipolar illness takes her into another trough of despair.
For three days, Seattle has been reeling, grieving a wave of senseless violence that left five dead, including a shooter who was, from his family’s description, bipolar like my sister. Mentally ill women are most likely to exit this world alone or try to take their children with them. Some men prefer to go out in a blaze of rage and blood. Either way, access to a gun makes the impulse more lethal. Firearms are two and a half times more effective than the next method of suicide, suffocation. According to Centers for Disease Control statistics for 2003-2007, gunshots represented only three percent of suicide attempts but almost half of fatalities. So far this year over 40,000 people in the U.S. have been shot. By December 31, we can expect to bury about 9500, each dead at the hands of someone pulling a trigger. Guns were designed to be effective, efficient killing machines, and they work very well.
When someone kills – we ask why? It’s a worthy question. A part of the answer that haunts me (because it seems so preventable) is the way we choose as a society to prioritize our resources. We build for-profit prisons across the country, with lock up room for minor drug offenders. But while prisons are growing, prevention and treatment services are disappearing.
As a psychologist, I used to have an outpatient mental health practice in Seattle. By the time I quit, it was almost impossible to get public mental health services for a person who hadn’t been diagnosed with a chronic mental illness or acute intent to harm. I told one desperate and suicidal young woman with no health insurance that she could get inpatient treatment if she was willing to go in front of a judge and swear that she intended to hurt herself or someone else. She disappeared, and I didn’t know for weeks if she was still alive. Relentless cuts in funding and services over the last twenty years mean that psychiatrists, psychologists and caseworkers frequently offer a lower level of care than they believe is actually needed, and they are under constant pressure to pretend someone is more intact than they actually are.
The state of Arizona spent close to a million dollars last year putting Kathy back together after she fell forty nine feet. By contrast, they spent a pittance, a few thousand, on follow-up mental health assessment and treatment. Kathy’s car-on-fire incident a few years back was triggered by her SSI and Medicare being cut off because she had earned a couple hundred extra dollars working at Target over the holidays. Desperate to cut costs, the Social Security administrators decided that she wasn’t actually disabled–this is despite the fact that she has repeatedly ended up in restraints at state and county hospitals.
But even the best mental health treatment in the world won’t prevent some people from just losing it. There are going to be people who want to die. There are going to be people who want to kill. Most of the time the impulse passes. Whether someone dies before it does depends largely on the tools at hand. I once traveled with a handful of young adventurers and a couple of fishermen in an open skiff from southern Belize to Honduras. Constant salt spray meant we were chilled to the bone, and in the middle of the night we stopped on a small offshore island for hot drinks. There we were greeted by a wiry black man in his sixties. A deep scar ran across his face, from cheekbone to chin. Another deformed one arm. He was missing digits. He told us that as a young man he had been assaulted with a machete. I was fascinated and horrified by his graphic story, and one thought imbedded itself permanently in my mind: It takes a lot of effort to kill someone with a machete.
With a gun, it takes very little.
Valerie Tarico is a psychologist and writer in Seattle, Washington. She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org. Her articles can be found at Awaypoint.Wordpress.com.
AwayPoint 
That was painful to read. I feel for you. I was married for six years to a woman with a schizo-affective disorder, so I understand a little bit, although Marie generally did better than Kathy apparently does. Wouldn’t it be great if we’d get past this idea that these are “spiritual” (moral) problems and recognize that they’re really brain disorders that could probably be fixed if we’d devote the time and resources to figuring them out?
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That would be wonderful. We couldn’t stop all of the suffering, but certainly some of it.
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The bad part is that soon further cuts will be made to try and reduce the deficit. The sad part to me is that the people who need psychological help the most are the ones who refuse treatment because they think nothing is wrong with them.
I had a wife many years ago who was afflicted with paranoia and schizophrenia. When she went to a mental hospital she was able to fool the medical staff into thinking there was nothing wrong with her and it was my fault. I now have a daughter and son who have inherited their mother’s afflictions but refuse to accept help because they think there’s nothing wrong with them and it is someone else’s fault. That’s sad to me that they won’t accept help. Another one of my daughters tried to help the sick one and the sick one drove her off because of her wild mood swings. She was sucidal and tried to kill herself and was admitted to a mental hospital and they were forced to let her out after about two weeks because she wouldn’t stay. I’m sorry, but I think those kinds of people should not be let out until they have been evaluated and given some kind of medication.
Thank goodness there have been no guns yet involved with these three.
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It’s so hard to be in a position to see what is happening to people you love–and at the same time be helpless to fix it.
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They could give her meds, but it is up to her to stay med compliant. Most do not stay med compliant and end up on what I call “The Revolving Door Plan”. My younger son is on a similar plan, but he self-medicates, in a bad way, which causes him more problems. He does the “I don’t have a problem. Everyone else does” thing too.
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I’m wondering how the girl in the picture managed to sit that way? I mean, when I had anorexia that bad, maybe even worse, it hurt to sit on the hard floor, it hurt to sit against the back of the pew at church, and sometimes it even hurt to walk. It was like the my tail bone when I sat down or even my feet when I walked would shoot pain right up my spinal cord when I came in contact with something hard. I lost count how many times they wanted to hospitalize me as a teen, when I had it really bad. I wasn’t for a variety of reasons, including religious. Ironically, religion was one of the things that contributed to it, beside the other crap I went through. At 4′ 11″ I didn’t top 100 lbs either until recent years, but I’m not telling my current weight. I’m not overweight or underweight, and most of the time, I feel better than I ever did, but I also got help for all my issues too. Now I only have joint pain when I’m cold or it’s cold, but the JA that I developed in my teens will never go away. My joint problems, due to JA/Osteoarthritis, will be about the only thing, from my eating disorder, that will never go away. It has improved, but it won’t go away. I’ll always have some joint issues. I surmise, most women, and even some men too, who have anorexia severely for several years (I include relapses as ongoing anorexia), but yet survive to recover from it, probably do have some residual physical problems from it. It think it is physically one of the cruellest and harshest mental illness- it either kills you or you end up with some sort of physical reminder of just how serious you had it.
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And part of the cruelty is the depression and anxiety — rarely getting to feel good no matter how many of those weight loss goals you meet . . .
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This is true. The mirror always shows you as fat, no matter how thin you are. You are never thin enough and never burn enough calories, even though you eat no more than 500 calories a day and do aerobic exercise for at least 4 hours a day… The mental and physical whirlwind never stops, until your body forces you to fall asleep and when you wake up, you do it all over again. And then… the church encourages fasting, not realizing that those with eating disorders take it as permission to not eat at all, despite what everyone else says and while Fundamngelicals take the Bile literally, they will try to tell the one with the eating disorder, who pulls Bile verses out about food and/or fasting out of the Bile, they are taking it too literally, that’s not what that meant, only to cause more anger and defiance in the person with the eating disorder, etc etc. It become a vicious merry-go-round until they finally get the help they really need, treating all the issues and not just some or one.
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Thank you. I drive on the 145th bridge over I5 every morning, and have a vivid reminder of the need for more support. I have no bright ideas, but I’m glad you have shared your insights. They are needed… and humanizing people is needed, too. About 5 years ago, I had a message from a God, Hermes. He told me to meet their eyes… the homeless on the street, and acknowledge their being there. I get thumbs up from a lot of my “regulars” these days as I go past. I don’t know if it helps them, but it helps remind me that there are people sliding into the cracks.
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Very sorry about your sister. I hope she is still with us and at least maintaining. Your story was wrenching for me to read. My sister has severe Down syndrome and my brother is debilitated with adolescent onset schizophrenia, so I understand your heartache. Because they cannot function at all, my brother and sister are well taken care of. Unfortunately, with other mentally ill individuals who have some capacity such as your sister, Arizona’s polices in particular can be incredibly self-defeating.
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Thank you, Tom. She is still with us — back in the hospital as of last night in fact. It sounds like your family got hit very hard. I can only imagine the effect on the rest of you.
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It is outrageous that most human services agencies in our country do not recognize mental illness as a common, chronic, and often treatable disorder that requires monitoring and compassion. Equally reprehensible that political leaders do not adequately fund the assessment, treatment and monitoring necessary.
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This article brings up many difficult issues. The most salient one is that help for the mentally ill is woefully inadequate. No other group falls through the cracks as predictably as the mentally ill. Many end up living on the streets or in prison. It is shortsighted of society to cut medical and social programs for the mentally ill. We end up paying for it in other more traumatic ways.
In regard to suicide, we naturally fear our loved ones committing suicide. Nothing seems worse or more unimaginable. But we also need to consider that it may be viable, even logical, choice for some who are burdened beyond their ability to cope by the cards they have been dealt. Just as we shouldn’t attach a moral stigma to mental illness, we also shouldn’t attach a moral stigma to suicide. Having said that, we certainly need to prevent the impulsive actions that lead to many suicides by keeping lethal weapons out of the hands of the mentally ill.
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https://c4ss.org/content/39669 a nice article to post in response to something that makes me too infuriated to give a civil reply.
How about you stop blaming us for every problem in existence? Last I looked it was you ‘normal’ folk who are generally in positions of power and look at the bloody mess you’ve made of it.
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Hi BlackCatMagic – I hear your frustration, but what makes you think I’m normal (I don’t feel neurotypical) or that I blame mentally ill people for most of society’s problems (I don’t). I don’t like it when people stigmatize the mentally ill or assume mental illness cancels out other good qualities and rich lived experiences. From where I sit, though, I get mad about people treating suffering like that of my sister and other family members as either socially constructed or simply another benign variant. Depression, anxiety disorders, and bipolar disorder suck.
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” I hear your frustration, but what makes you think I’m normal (I don’t feel neurotypical) ”
Cool, what’s your diagnosis? Self or ‘professional’, I’d accept either as valid; mine differ in the two regards in that my ‘professional’ diagnosis is schizoaffective bipolar and, while I can’t argue with the bipolar I disagree with the idea of me being psychotic and also think based on my history(which involves the school constantly telling my mother to take me a psychiatrist and her refusing.. one of the good things the woman who made me eat my own feces did regarding me. Heh) but… I suppose that’s neither here nor there. Good luck dealing with a world that hates you if you have an alternate neurology though, it sucks sometimes.
” or that I blame mentally ill people for most of society’s problems (I don’t).”
Perhaps you don’t blame us for all problems of society, but based on the rhetoric I hear some people do. You do seem to blame us for all mass gun violence though, which is both in error and contributes to the stigmitization that you later say you don’t like.
“I don’t like it when people stigmatize the mentally ill”
Such as, say… by declaring us legally second class citizens with limited rights, such as limitations on the right to not be detained without due cause or to own arms?
” or assume mental illness cancels out other good qualities and rich lived experiences”
While I do believe in the existence of the soul(not in a conventional religious sense, but as part of my psi training) as we currently live our neurology has a large impact on our sense of identity and everything we consider ourselves. You can’t separate a persons alternate neurology/’disorder’ from other qualities about them because the person with good qualities and rich lived experiences is running at least in large part on that ‘hardware’.
“From where I sit, though, I get mad about people treating suffering like that of my sister and other family members as either socially constructed or simply another benign variant.”
From where I sit your descriptions of what your sister has gone through are things I can relate to(history of suicide attempts starting at 11 and repeating a great deal over the years) and I STILL say I am glad to be who I am, ‘disorder’ and all, and that the way I am is indeed just another natural part of human diversity.
The definition for mental illness IS socially constructed, also; it’s basically the list of mental traits and experiences that a minority experience that make it difficult to function in the majority society. If the majority were autistic, the positions would be reversed and if the majority were bipolar people might be encouraged to take drugs to be able to participate in socially accepted altered states like ‘mania’ if they were unable to experience them naturally… and it’s likely neither society would be more dysfunctional than this one in any ‘objective’ way.
“Depression, anxiety disorders, and bipolar disorder suck.”
Depression sucks as an experience while you’re in it, it can be one of the worst things a person can go through(having gone through depressive periods and also having had flaming hot oil thrown on me, I would rather have the hot oil than a repeat of one of my more severe depressive periods). It can also teach you a lot if you’re willing to take the proper perspective on it and integrate the experience into your life.
Anxiety sucks, having social anxiety bad enough I can’t really go outside to anywhere with people without engaging in coping methods like repetitively hitting myself I can attest to that. The underlying neurology that makes someone prone to anxiety may have benefits though; http://www.livescience.com/36259-anxiety-linked-high-iq.html
Bipolar is something you need to deal with in some way to cope with or it will destroy you. It can also bring you to heights of experience that are beautiful beyond description. If it were accepted as a natural variant of human functioning I think we would have better ways of coping with and functioning with it than we currently do.
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