Jamison on suicide: the truth of illness

October 10, 1999|By Diana K. Sugg | Diana K. Sugg,Sun Staff

"Night Falls Fast," by Kay Redfield Jamison. Knopf. 432 pages. $25.

So many people throughout time have died from suicide, written about it, tried to make sense of it. In this new book, Kay Redfield Jamison attacks this complex, emotionally charged topic without fear. She has created a single, fresh text that answers the question so many have agonized over for so long: Why?

In a sweeping, authoritative look at suicide, laced with the compelling tales of those who died or nearly died at their own hands, including herself, Dr. Jamison exposes the truth: Suicide is not one isolated moment of madness for otherwise rational people, but mostly an impulsive act of a patient trying to end the awful pain of a psychiatric illness.

The numbers are shocking, especially among the young, in which suicide has tripled in the last 45 years. Worldwide, among people 15 to 44, suicide is the second-leading cause of death for women, and the fourth-leading cause of death for men. For every suicide, there are 10 to 25 attempts.

Jamison's excellent book is essential reading for all health care providers, for patients and families of those suffering from mental illnesses and for anyone trying to comprehend a relative's or friend's suicide. With nearly 100 pages of sources and footnotes, the author has investigated suicide on the scientific and human level, digging through studies of genetics, neurobiology and psychopathology, as well as conducting extensive interviews with patients, families, doctors and researchers.

But she weaves haunting, personal tales of some lost to suicide through this mammoth reporting effort. With her wonderful writing and the excerpts of poets and writers plagued by these conditions, Jamison takes the reader by the hand and simply tells us the story of suicide.

A psychiatry professor at Johns Hopkins University School of Medicine who herself suffers from severe manic depression, Jamison reveals her perspective in the book's first pages.

As a high school senior, she suffered a bout of depression so fierce that she searched out tall buildings and learned to load her father's gun.

Years later, she made a pact with a friend who also suffered from manic depressive illness that if either grew suicidal, the other would pull her or him back from the edge. What Jamison explains on a human level, as well as a scientific one, is that by the time a patient with a mental illness is this ill, he often can't call a friend, hash it out, cry and let the suicidal moment pass.

Ultimately, at age 28, after a seige of mania and depression, she swallowed a massive overdose of lithium pills and nearly died. Her experience brings passion to every page of the book. She deconstructs suicide, piece by piece, revealing a massive and mostly unrecognized public health problem. She also proposes steps society can take for prevention.

By the end of the book, Jamison's vivid writing and extensive reporting have convinced the reader that there can be no illness more horrible than schizophrenia, bipolar disorder or depression. These health conditions, she argues, are like heart disease and cancer, but they are often undiagnosed, undertreated, and stigmatized.

Even though many historical traditions such as burying suicide victims at night, at the crossroads -- so as to keep the spirit from finding its way home -- have faded from our culture, people still ask the relatives of suicide victims, "How could that person have been so selfish?"

The book's victory is showing these people aren't selfish. They are sick.

Diana K. Sugg, a staff writer at The Sun, has covered health and medicine for six years, winning three national prizes and several state and local awards.

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