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FIRST PERSON: Dying of Depression - Words Are Not Enough

My friend died of depression just before Christmas 2012.

It’s fine if that sounds blunt or unusual, but after two years of grappling with phrasing, I just don’t know how else to put it.

Whenever you run into someone you haven’t seen for years, the topic often comes up, and you clumsily dance around the euphemisms, desperately trying to explain what happened in a sensitive but – for want of a better word – accurate way.

Once the sheer visceral shock of a friend’s suicide sinks in, explaining it to other people is one of the hardest things.

Many other bereaved folk don’t have the same problem. "He died of cancer." "He had a heart attack." Simple and to the point. People get it, no questions asked, but suicide is different. I feel that there’s an added layer – a stigma – that makes talking about it different.

There are many familiar phrases we use when talking about suicide. You know them, you’ve probably used them, I’m sure you don’t like them:

"He committed suicide"
"He killed himself"
"He ended it"
"He took his own life"

Without getting too bogged down in semantics, none of these feel right to me. None of them capture the experience or the impact or the legacy.

Suicide is no longer a crime – even though it’s laughable that it was ever considered such – so ‘commit’ definitely doesn’t work. In fact it feeds into the stigma attached to suicide more than any other terms associated with it. Let’s all agree to never use this term again please.

As for the others, well, there is just an overwhelming sense of selfishness in each of these – that suicide is somehow a well-thought-out act; a rational process taken without any consideration to those left behind. I’m not ok with that, and neither should you be. I feel that these terms totally misunderstand and misrepresent the reality of what may lead to someone dying in this way.

I’m positive, though, that over the last two years I have used all of these phrases in various contexts to various people. Partly because I haven’t been thinking straight, but mainly because I’m struggling for an alternative. And that’s something that I feel will only materialise when people get a better sense of the cause of so many tragic suicides. That’s why, for me, saying someone “died of depression” is the closest I can get.

I imagine a world in the hopefully-not-too-distant-future where depression is taken as seriously as cancer. A world where it's treated like a real, physical disease. A world where – yes – it's valid to say "unfortunately he died of depression" and people just get it.

Because that was the cause. It was as much an exterior affectation as cancer or diabetes or heart disease. He didn't decide to take action to end his life. He was as much a victim of something outside of his control as anyone else. Since control seems to be such a recurring theme in suicide, it’s interesting to view depression this way.

You would never hear someone say: "He died of cancer? But how could be leave his wife and child behind?” or “Pneumonia, you say? I think he just needs to pull himself together.” So it speaks again to the lack of knowledge and understanding still prevalent that often you might hear this reaction to depression: "Cheer up mate, it might never happen!” or “Man up and get on with it, son.” Somehow it's easier for people to deal with a physical – rather than mental – condition, but just because you can’t see depression, doesn’t make it any less life-threatening.

Of course, anyone can feel a bit down or tired for a day or two – stress at work, late nights, whatever – but that isn’t clinical depression. You can ‘snap out’ of a rubbish afternoon where you’ve accidentally deleted that urgent 10-page report you’ve been working on for a week. You can’t ‘snap out’ of clinical depression; the kind of hopelessness that builds up inside and can feel like an expanding black hole. Depression is not about being happy or sad. In fact it has almost nothing to do with happiness, or lack of it. It is about hopelessness and despair. A very different prospect to feeling ‘a bit sad.’

There can be old-fashioned steadfastness that still treats anything emotional or mental as a general weakness in some way, particularly in men. Depression can be filed away in the same category as ‘not going to the pub to watch the football because it’s your wife’s birthday,’ and that’s why for so many men it’s just easier to internalise it and let it build up silently inside.

But the tide is changing. Increasingly more so, people are noticing both the mental and also the physical manifestations of the myriad conditions and complications that we group under the broad heading of ‘depression.’ Scientific research even suggests that there might be a link between depression and physical illnesses like rheumatoid arthritis. That’s easier to understand isn’t it? You know where you stand with RA, right? Sorry, poor choice of words, but you know what I mean.

Somehow that ability to focus on the physical cause makes empathy so much easier. All of a sudden, personal responsibility is shed in some way; a person who’s depressed can no longer just ‘liven up a bit,’ because there’s something causing it. Something that could strike anyone at any time.

It would help if men were honest about it too. It needn’t be tough or embarrassing to say that you’re feeling down, or that such-and-such has really upset you. A guy will always mention – always – if he’s got a bit of a cold, so why not that he’s been feeling depressed for a week now and hasn’t been able to shake it?

Accepting that depression is a real part of everyday life is a big victory, and recognising that it could affect any of us at some point in our lives is another. With that in mind, hopefully Society (capital ‘S’) will continue to understand that suicide isn’t a crime, or a cop-out, or a weakness, or a joke; it’s the all-too-real result of depression run rampant. The tragic end to what can be a chronic, but ultimately treatable, illness.

For many years I lived with my friend without realising he was dying; slowly but surely, day after day. Now I believe I truly understand that he died of depression, not by his own hand.