When life itself kills people

THROUGH early morning fog I see, visions of the things to be, the pains that are withheld for me, I realise and I can see....

People from my generation will immediately recognise these opening lines from the iconic 1970s American TV series M*A*S*H theme song. They will also know what follows:

That suicide is painless, it brings on many changes and I can take or leave it if I please.

That’s why this song has been playing in my head ever since I heard of Anthony Bourdain’s death.

His passing on June 8 stunned the world, especially as it came just three days after the suicide of another famous person, fashion designer Kate Spade.

While I was also shocked by Spade’s death, I wasn’t as affected because I didn’t “know” her well.

With Bourdain, I felt I knew him better: I had read his books, watched his travel shows and was pleased he had visited Malaysia and praised our food. What a fabulous, exciting life he led, one that combined food and travelling which many of us dream of having. So how could he just give it all up?

Yes, Bourdain had been honest about his struggles with heroin addiction but on the outside, he seemed to have overcome it.

Now we know that wasn’t true. It was the same for Spade and other famous people who killed themselves, like South Korean singer Jonghyun who died on Dec 18 last year.

He was only 27 and seemed also to have lived a fabled life of success and adulation.

It is a terrible irony that people like Bourdain, Spade and Jonghyun who seemed to have it all were so desperately unhappy.

That is what makes depression so scary. Jonghyun had it from young, Spade struggled with it for many years and Bourdain’s illness was exacerbated by his drug addiction.

With so many high-profile suicides, depression has come to the forefront. It is described as a serious medical illness that leads to profound and constant feelings of sadness, hopelessness, helplessness and worthlessness.

The causes of depression are said to be stress, health and hormones. Drug and alcohol abuse can also play havoc on the brain’s chemistry and affect one’s mood and feeling of well-being.

Everyone experiences bad moments and feel sadness and despair and luckily, for most, these moments pass and we get on with life.

But for some, as the MASH song goes:

“The game of life is hard to play, I’m gonna lose it anyway, the losing card I’ll someday lay....

“The sword of time will pierce our skin, it doesn’t hurt when it begins, but as it works its way on in, the pain grows stronger, watch it grin....”

That is when it becomes a serious illness called clinical depression.

According to mayoclinic.org, depression requires long-term treatment and most patients get better with medication and psychotherapy.

Most but tragically not all. Jonghyun, Spade and Bourdain were being treated but somehow their grinning demons consumed them.

Yet, until they ended their lives, family and friends were not aware of how deep and debilitating their despair was.

That’s how good people can be at hiding their pain and putting up brave fronts. Who knows what was the tipping point for their suicide?

According to Victor Schwartz, chief medical officer of the Jed Foundation, a US suicide prevention group who is quoted by Andrew Solomon in The New Yorker, the decision to kill oneself is often impulsive and acted upon because they have the means to do so.

Even so, Solomon notes that while it helps to make it harder for people to kill themselves – which is why he advocates stringent gun control – the horrible truth is that modern life is driving suicide rates up.

He says a new Centres for Disease Control and Prevention report shows that more than 50% of American suicides did not have any previously known mental health issue.

What they were suffering from ranged from relationship failures to substance abuse to job and financial problems.

Suicide is one of the top 10 causes of death in America and one of the top three among teenagers.

The news is even more shocking in South Korea. Suicide is the number one cause of death among South Koreans aged 10 to 39.

The reason why Americans and Koreans are killing themselves are similar – stress from economic hardships and family problems.

American youths now start out as adults with more debt and less confidence about their future.

K-drama fans will know how competitive Korean society is and how their youths are under great pressure to perform in their school and work cultures which have been described as “lethally toxic”.

In Malaysia, we haven’t had celebrity suicides, at least not any that were reported, but we have had tragic cases of families dying together because of debt problems and more recently, a student who hanged herself after being accused of stealing a teacher’s handphone.

Officially, our suicide rate is very low, also probably because of under­-­reporting, at 1.3 per 100,000 (the global average is 16 per 100,000). It is also outdated as this figure was released in 2012.

By now, it would surely be higher, going by global trends.

There is no doubt our world has become more crowded and competitive. Technology has enabled and crippled us.

We are more connected as never before. Ironically, people have also become more isolated and lonely as never before.

As Solomon observes, people can be so alone that “they are effectively invisible to the rest of us”.

No wonder they feel their lives are so bleak and meaningless, they have suicidal thoughts.

There is no silver bullet in solving this growing epidemic but among the many possible ways is to redefine and destigmatise mental illness and strengthen support and treatment for it.

Our society can also be kinder and caring with less hate, intolerance and negativity which can feed the personal demons of vulnerable people.

If a person really wants to end their life, then it should be like how David Goodall did it.

The Australian scientist decided to die after living a long and productive life. He was 104 with no major illnesses. But after a fall that led to a deterioration of his quality of life, he sought euthanasia.

That is illegal in his country and he had to go to Switzerland where assisted voluntary death is legalised.

His death on May 10 was carefully planned and he made sure to say his goodbyes to his family and friends.

That is the kind of suicide that is really painless for all concerned.

Aunty was amazed that a 14-year-old boy wrote the MASH song lyrics and he wasn’t at all suicidal. Just Google to learn more of its quirky origins.