The classic understanding of suicide casts it as reactionary measure against a particular event or outcome, but Kay Redfield Jamison argues that it is typically the result of the prolonged pain that comes with mental illness.
Question: What’s the most common misconception about suicide?
Kay Redfield Jamison: I think people don't understand how intimately tied suicide is to mental illness, particularly to depressive illness and bipolar illness. I think that there is a tendency to see suicide as a reaction to a bad event in ones life and you read the papers and you see that somebody had a financial reversal or broke up with somebody or didn't get into graduate school or whatever it is, and that is presented as the explanation and nowhere it is mentioned what shows up on the psychological autopsy is a person who had depression from the time he or she was 13, they used alcohol, they were impulsive. All the things that we know go in to suicide.
Question: Why is suicide so prevalent among college-aged students?
Kay Redfield Jamison: Well, it's partly prevalent because there are relatively few things that kill people that are that young other than car accidents and suicide. It's also—there is a very interesting relationship between age and suicide and bipolar illness, for example, that under the age of 30 you're just much more likely to kill yourself. A lot of people with bipolar illness who were over the age of 30 unfortunately killed themselves as well, but you're much more likely—and some of it is the protuberance itself may be a little bit more variant. People are more impulsive and they get slightly less impulsive as they get older and the impulsiveness interacting with the depression is particularly devastating and lethal, potentially lethal. But it's also the case that these often kids who haven't been accurately diagnosed, haven't been medicated properly, aren't in psychotherapy, so they—or if they are, they've stopped taken their medication because medication non-compliance is more likely to occur earlier on in the illness.
So you have all these terrible things that conspire against young people.
Question: Are there policy changes that might help people to cope with suicide?
Kay Redfield Jamison: Well, I think that—I mean, until recently, of course, there was no parody, there was no pretense of insurance coverage or treatment. So in a way you could get up and you can talk until the cows come home and you say, "These are the symptoms of depression. Get a second opinion. Do all the things you know that are..." But if people can't afford it, it's meaningless at some fundamental level and I think actually the current administration is very dedicated to doing something about coverage of mental illness and I think they are also very aware of how costly it is to society at a human level and at an economic level. I think they are very intelligent about that. I think Internists and GPs are much more aware of the relationship between depression and cardiovascular disease, for example. So depression is being taken much, much more seriously than it was. For a long period of time, psychiatry as a field didn't have much credibility and a lot of that was brought on my psychiatry. Now, there is so much more science, there is so much more credibility to our understanding of the brain and treatments.
So, I think things are changing. At the college level, a lot of the same things. A lot of kids don't have the insurance or the insurance runs out very quickly, they don't have enough sessions. I spent a lot of time talking to college administrators and students about this and it is very frustrating, or they are sent on medical leaves which really means in many instances don't come back until you've proven that you're well. It's a real catch-22. So it's a devastating time and I think that people just need to be more informed. It's a treatable illness. You have no excuse for not getting treated and you have no excuse for not putting your wing out and showing compassion and understanding.
Recorded On: September 30, 2009