Suicide and My Sister

May is Mental Health Awareness Month, for which a recent Pew report offers some alarming statistics. In 2020 almost 46,000 Americans died by suicide, and over the last two decades the suicide rate has increased by 33%. Some 629,000 adolescents attempted suicide, and—according to the N.Y. Times—hundreds of these teens spend extended times in hospital emergency rooms because of the lack of  psychiatric inpatient facilities. Among active-duty military over one soldier or sailor a day died by their own hand—a fact which Friends may take as proof of the dehumanizing effect of military service.  

Research indicates that 90% of completed suicides involved mental health conditions, usually mood disorders and/or substance abuse disorders. Surprisingly, suicide is not inextricably linked to mental health disabilities. Some people seemingly conclude that their lives are just not interesting enough to continue living. Of course, these persons might be suffering from a hidden, “high functioning” depression, but—in any case—successfully treating mental health disorders would potentially result in a dramatic decrease in the number of suicides in this country.

One problem in treatment is that anti-depressants can take weeks or even months to take effect, and a minority of depressive people are “treatment-resistant.” In such cases, electroconvulsive therapy (shock treatment) can bring relief in a short time period but with the possible side effect of memory loss, usually transient but sometimes permanent. Lately, thankfully, the administration of a common anesthetic, ketamine, can alleviate even treatment-resistant depression in a matter of hours or days. Moreover, ketamine appears to have the separate effect of stopping suicidal ideation even if depressive symptoms don’t disappear.   

Up until four years ago, my sister had suffered from an intense, treatment- resistant depression for much of her adult life. When she would phone me to seek some kind of relief from the pain, Gail would invariably talk about the possibility of committing suicide. The following paragraphs are her own (edited) words.

I have suffered greatly from depression for many years.  When I started being seen at the Veteran’s Administration Clinic in Ft. Collins, I was severely depressed. At times I was not even able to get out of bed.  I cried whenever I was awake. I even went to the emergency room 3 times (at the recommendation of mental health workers) because I couldn’t stop crying. Over many years, I have tried many antidepressants and cognitive interventions.  Some didn’t work at all, some for only a time.

On May 21, 2018, I began ketamine infusions in Westminster, CO. It was a MIRACLE!  For me, a couple of hours after the infusion, my depression began to lift.  My suicidal ideation vanished.  I no longer had painful memories from the past, and I didn’t cry all the time.  I became more active.  I was once hesitant to even go out to my car.  Now, I go to (a recreation center) 6 days/week (for) strength training and aquarobics. As of 9/06/2019, I had lost 109 lbs. 

Immediately after the first infusion, my friends would ask me (even on the phone) what had I done?   Even my voice and the way I sounded was different to them. When I talked, I made sense.  I didn’t cry.  I believe I was and am in remission. I wasn’t high and didn’t feel medicated.  I don’t take antidepressants or antipsychotics.  I know some people do and that’s fine; but I don’t need them.  What a wonderful life and I feel so grateful!
 
Gail’s experience indicates to me that when suicidal patients arrive at an emergency room, ketamine infusions should be the first line of therapy. Many lives would be saved in the ER, not to mention lives of people who are prescribed ketamine by their regular doctor or psychiatrist. Of course, this drug is not a one-time intervention. To maintain patients depression-free, ketamine has to be administered every four to six weeks at a sub-anesthetic dose. And sometimes it doesn’t work. Ketamine is “only” effective about 60 to 70% of the time with treatment-resistant patients. If we’re talking about the entire depressed population, I can imagine an effectiveness of 90%.

But how is all this relevant to Quakers? Well, we may have the Inner Light; but Friends, like other people, suffer from depression, bipolar illness, and drug addiction. George Fox himself may have been a manic-depressive. That would explain the episodes in which he kept to himself away from human company as well as the mystical, hallucinatory visions that he experienced. 

If a Friend in your meeting is afflicted with depression or post traumatic syndrome, someone in the meeting could tell them about ketamine, which is still a novel treatment usually not covered by health insurance. Nevertheless, the psychological benefits of the drug are now known. Ketamine “resets” the brain and—in the case of Quakers—allows a dimmed Inner Light to shine brightly once again.

~ Richard Russell