September 10 is World Suicide Prevention Day. First launched in 2003 by the International Association for Suicide Prevention (IASP), World Suicide Prevention Day seeks to raise awareness across the world for suicide, suicidal ideation, and prevention. According to the IASP, almost 800,000 people die globally by suicide each year.
The threat of suicide is not new to journalist Anna Mehler Paperny; in fact, after a major suicide attempt in her early twenties, she resolved to put her reporter’s skills to use to get to know her real enemy: depression. In her book Hello I Want to Die Please Fix Me, Paperny charts her desire for knowledge about depression and suicide alongside her quest to get well. Hear from her on the process of writing the book, the state of depression treatment, and what the future might hold for those battling depression in this exclusive Q&A, and be sure to check out Hello I Want to Die Please Fix Me, available now.
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Q: You have struggled with depression and suicidal ideation. These are topics that many shy away from discussing publicly. What motivated you to include your personal experiences alongside your research?
Anna Mehler Paperny: I found a gap in the discourse that wasn’t addressed by redemption narratives, medical screeds, or antipsychiatry polemics, and felt the urge to fill it with my experiences and my quest for answers.
Q: The tone of the book is conversational, slightly irreverent, and often comic, though the topic is serious. What inspired you to write it in a relatively casual voice?
AMP: I wanted to craft a narrative that was easily accessible—one that drew the reader in, despite the seriousness of the topic at hand, and one that forced them to ask questions they might not otherwise have posed. Humor and irreverence allowed me to do that.
Q: When suicide is discussed in the media, the details are often glossed over. Why did you choose to go into such detail when discussing suicidality and suicide attempts?
AMP: For no other public health crisis would we pretend that ignoring it would make it go away—but somehow, for decades, that’s been received wisdom for depression and suicide. This has got to stop. I wanted to go into detail, to make the story real, to make the reader grapple with the reality of suicidality and suicide.
Q: Why do you think myths and simplifications—such as, “Depression is caused by a chemical imbalance”—are so difficult to dispel?
AMP: We like to think that problems of the brain are easily explained and easily willed away. The truth is far more complicated. We remain woefully ignorant of the workings of the brain and how to change what it does. The best we can do is still, so often, just fumbling—and that persistent ignorance is scary, which is why people turn to simpler explanations.
Q: If depression is the reason why many people take disability leave, why is our culture and medical system so bad at addressing it?
AMP: I’ve learned depression and suicidality lack urgency because they aren’t interpreted as being sexy enough to warrant attention—and they’re too ubiquitous for the spotlight. That’s execrable negligence and it has to change.
Q: Did you set out to write about inequality for people of color and other marginalized groups in mental health care, or did this emerge in your research?
AMP: I wanted to write about inequality, but I didn’t realize how bad it is in so many ways until I did my research. It taught me that we horribly worsen existing marginalizations when it comes to this disability.
Q: Suicide in teens is being discussed more in the media as frequency increases. Is the identification and treatment of depression and suicidal ideation in teens different than adults, and should it be?
AMP: Teens are in a vulnerable point in their lives in many ways and this is something we must watch out for, even if the signs and symptoms of depression and suicidality remain the same as they are in adults.
Q: You discuss several types of treatment in the book, and how one solution doesn’t work for everyone. This is somewhat unique in the medical field. You write: “We’d never accept choose-your-own-adventure approach to dental abscesses but we’re totally cool with that norm for the world’s leading cause of disability.” What was the main takeaway you want people to have about psychiatric care?
AMP: The psychiatric treatment you get depends entirely on who is providing you with care and what kind of interventions they want to try. There is wide variation in what that might be and whether it does any good. That variation is astounding when you think about the kind of precision we demand for any other field of medicine. We should demand interventions that work, that are backed by evidence—in psychiatry as much as any other field.
Q: Are you hopeful about the development of effective depression treatments, despite the closure of many psychiatric facilities?
AMP: I am hopeful. I have to be, or I couldn’t keep going. But I also think we need to continually demand better.
Q: What do you hope for in terms of reform in the psychiatric arena and healthcare system, or in public discourse about suicide and depression?
AMP: I hope we become much more open in talking about depression and suicide. I hope we treat it with interventions that are proven to work. I hope we demand evidence-based care for people in the grips of depression and suicidality. I hope we pursue and perfect interventions to the point where they work well—much better than they do now. I hope this becomes a malady that’s swiftly and easily dealt with, so that it doesn’t destroys anyone’s life.
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If you or someone you know is struggling with depression or suicidal ideation, help is out there. Please visit the below for more information:
- National Suicide Prevention Lifeline
- SAMHSA (Substance Abuse and Mental Health Services Administration)
- AFSP (American Foundation for Suicide Prevention)
Interview with Anna Mehler Paperny, author of Hello I Want to Die Please Fix Me: Depression in the First Person (The Experiment, March 2020)
theexperimentpublishing.com
