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  3. David L. Conroy
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The depressed and the suicidal are often lonely and inhibited. Discussions of inhibition in this context usually emphasize fear of rejection.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
fear lonely suicide depression rejection suicidal inhibition

If someone suffers enough pain and abuse, his volitional capacities will diminish to nothing.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
pain suffering abuse volition

To be subjected to pain that threatens to exceed coping resources is not something that people choose.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
pain suicide depression coping resources involuntarism

The circles of shame are vicious. Painful feelings of shame help cause people to be depressed and suicidal, these in turn become shameful aspects of the self. Being angry does not necessarily cause more anger, being envious does not necessarily cause more envy (though once we envy, we can also envy someone's lack of envy), but, in our culture at least, shame (and envy and self-pity) are things to be ashamed about. The two common feelings of suicide are hopelessness and powerlessness; each is shameful, and this additional experience of shame adds pain on pain. A man who despairs because he feels his prospects of having a family are hopeless also feels he will never lose the feeling of shame over being wifeless and childless. To be powerless to change one's life in ways that others can is cause to feel ashamed of one's powerlessness.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
family suicide shame envy anger depression hopelessness suicidal depressed infertility self-pity powerlessness

Even if we accept the view that biochemical imbalances may contribute to depression and suicide, it is a mistake to assume that the biochemical aspect of the problem is entirely within the victim. It is also partly within the physiological makeup of the people around the suicide.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
society suicide depression antidepressants medication biochemical-imbalance physiological-chemistry

If the social stress is physical, sexual, or emotional abuse, the way to treat the depression is to stop the abuse. Unfortunately, advocates of the biochemical treatment of depression have gone along with the view of academic theory and popular culture that the problem is entirely within the skull of the victim. Enthusiasm for biochemical treatment and research is partly due to the fact that it helps perpetuate the myth that suicide and depression should be treated by changing the victim, not by changing ourselves. As long as we have a narrow view of the causes of biochemical imbalance, such as limiting it to innate genetic defects, we can practice denial on the social complicity in the causation of suicide. The narrow view does nothing to help reduce pain and increase resources for the millions of people whose problems do not respond to medications. It also deprives us of an opportunity for progress in a much broader area for social reform. The dynamics behind the oppression of the suicidal is similar to the dynamics of other forms of injustice; progress in one area can support progress in other areas.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
stress society suicide depression denial mental-illness medication biochemical-treatment social-complicity

Suicidal pain includes the feeling that one has lost all capacity to effect emotional change. The agony is excruciating and looks as if it will never end. There is the feeling of having been beaten down for a very long time. There are feelings of agitation, emptiness, and incoherence. 'Snap out of it and get on with your life,' sounds like a demand to high jump ten feet.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suffering suicide emptiness depression hopelessness agitation incoherence snap-out-of-it suicidal-pain

Do human beings have an infinite amount of energy with which to resist death? It is kinder and more accurate to say that they fought until they had no more fight left in them.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suicide depression involuntarism

Both the suicidal and non-suicidal are often angry with others. One way to discharge this anger is to fantasize about violent revenge. The insults of daily life often cause fantasies of revenge to flare up and quickly subside. The people with these fantasies usually do not act on them; they are not motives or goals. They are involuntary responses to perceived insult—ways of coping with rage. The suicidal, whether or not they attempt, suffer tremendous and persistent pain and anger. That this pain should find its way into their fantasies and dreams is no surprise. This ideation is not a motive for action; it is an alternative to action. Fantasizing about suicide is an effort to delay or avoid suicide, not the activity of formulating a motive, goal, or intention. Fantasies doubtlessly succeed in preventing many attempts.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suicide anger depression rage suicidal-ideation ideation involuntarism fantasize

Despair, grief, and depression are not things that people can simply stop, any more than someone can will an end to a toothache or the pain of withdrawal. Acutely suicidal people have lost all sense of having power over their pain. To tell them to magically acquire will power is like asking a crippled person to race against a champion. It does not help them do the thing in question; it just makes them feel worse.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
despair grief suicide depression will-power

The suicidal lead shame-drenched lives.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suicide shame depression suicidal

Suicidal pain includes the feeling that one has lost all capacity to effect emotional change. The agony is excruciating and looks as if it will never end. There is the feeling of having been beaten down for a very long time. There are feelings of agitation, emptiness, and incoherence. "Snap out of it and get on with your life," sounds like a demand to high jump ten feet.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suicide emptiness depression agitation incoherence snap-out-of-it

When we criticize the suicidal for being selfish, we are actually criticizing them for not enduring their pain with grace and good manners. These are nice qualities; we may be correct to reproach average citizens for not having them. But to expect everyone in pain to have them is unrealistic. Bearing pain quietly is what moralists call a supererogatory act--an act that is above the call of duty. Expecting everyone to who is suicidal to behave in a way that is morally above average is simply abusive.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suicide selfish depression criticism stigma

Snap out it' is abusive. It kicks people when they are down. It makes people in pain feel more hopeless, more powerless, more frustrated, more estranged from humanity. It says, 'I don't want to be bothered with your pain any longer.' For people not in great pain, "Snap out of it" may be helpful advice if they have trouble getting going in the morning. For the despairing, however, it has no positive and many negative consequences. None of the conditions associated with suicide can be snapped out of.

in Out of the Nightmare: Recovery from Depression and Suicidal Pain
suicide
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