To Keep Him Here: Suicide and Mental Illness in 'Modern' America

“The next red line train to Alewife is now approaching.” I looked down the tracks to the right and saw the train pulling closer. The station was packed. All of the sudden, the man standing next to me screamed, ran, and jumped in front of the oncoming train. My eyes locked with his eyes. His face was gnarled in the purest expression of pain that I have ever seen. And then he was gone and everyone was stunned.
Mental health is a lot like physical health. Mental illnesses can run their course even if a person wants and tries to feel better. Yet people stigmatize them instead of treating them with the dignity and concern that physical illnesses receive. I knew this from experience, but still initially assumed that the man in the T station chose to kill himself. And maybe he did—maybe he had recently been diagnosed with a terminal illness, for instance. But maybe he had depression or some other mental illness that chose death for him.
People tend to think that others can choose when to ‘get over’ mental illnesses. After witnessing my dad’s accidental death, I resisted grief counseling. Even my nine-year-old self could perceive the stigmatization associated with mental counseling. I pretended to be fine and cried alone at night. I knew that people would allow me some small grace period but that soon they’d expect me to move on—as if I had a choice.
Little has changed over the past decade. “I think you should pick yourself up and brush yourself off,” one of my professors told me a few days after the incident in the T station. Several of my friends responded similarly. But I kept replaying that dreaded sequence of events over in my mind, and it disrupted my sleep, diet, concentration, and mood. Did so many people really not understand that I didn’t choose to be hurt any more than I chose to witness what happened that day at the T station? And why did they think that brushing it off was the best approach for everyone, anyway?
Although some responded with deep concern, I was swimming upstream against a larger tide of misconception about mental health. In a world that sees mental health as a choice, I felt trapped and alone.
Was that how he felt, too? I wondered as I struggled with my impulse to blame the man who took his own life four feet in front of me. Despite already knowing from experience that mental health isn’t a choice, I initially assumed that the man had rationally chosen suicide—so sticky is the popular impulse to consider mental health a choice. But as I processed the event, my own experience with grief and PTSD prompted me to wonder: did he choose suicide, or might depression have chosen it for him?
Maybe depression kills people like cancer does: against will, beyond control. Maybe some people who have cancer and some people who have depression survive and others don’t, and maybe they don’t get to choose which category they fall into. Writes therapist Aimee Le Zakrewski Clark, “When a person is feeling rational and in a good place they [sic] can decipher between perspective and reality. They can feel depressed but able to understand their mind is temporarily in a place of distress, versus permanent[ly]… Severely depressed and suicidal people cannot.” According to a different doctor of psychology, when a depressed person kills himself or herself, his depression undermines his ability to freely choose suicide.
If people discussed mental illness like they discuss physical illness—as though people with PTSD did not choose to not sleep or concentrate any more than people with diabetes choose to feel low, as though people with depression did not choose to kill themselves any more than people with coronary artery disease choose to have heart attacks—then they might give mental illnesses the respect and concern they deserve and work harder to heal them. So why do we treat mental health like a choice?
Walking near Harvard Square the afternoon after the incident in the T station, I noticed a man who looked like the man who died the day before. As he walked in the middle of the empty street, I saw empty tracks. As he turned around, I saw the man from the previous day turn his body to face me. As our eyes met, I remembered how my eyes had met another stranger’s 24 hours earlier.
The man before me aimed his camera at the stunning sunset filling the gaps between the snow-breached branches lining the street. The man in the T station missed that sunset. I wondered what would have kept him here to see it.
Image Credit: Wikimedia Commons, Steve Evans