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Health Healthcare THE FRONT ARCHIVES

Too Sad to Move: On the Paralysis of Depression

On my honeymoon we hiked a glacier at the border of Argentina and Chile, about as far south as you could go before hitting Antarctica. No organic life moved. Neon blue water faded to the shore into a milky hue due to particles of ice. The shore was rock, the redbrown of a lion. The glacier sliced in white sections shot with the same chemical blue as the waters. The guide said the blue came from the sun. When ice gets super cold and dense, light refracts off it differently; the color shows more intense. We slipped and climbed in our rented spiked shoes and caught panoramas of water and rock and air. It was like no sensory experience I’ve had, save staring into a canvas — pure color, something by Gerhard Richter, maybe. Occasionally we’d meet a blue sliver in the ice plunging more than a mile. The guide told us to beware; if we tumbled to the bottom we might not die, but we’d break every bone, lie in pain until they somehow got us out.

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A bedrock of pain linked us, so this caught our attention. By then we’d developed a game, my husband and I, that we called: “Should we just kill ourselves?” It involved saying the phrase, then pondering the question. (The rules were unstated but understood.) We played when faced with a task that felt insurmountable, some paralysis, due to career, or other people, or family. Paralysis was something I felt I would live with always. My first therapist couldn’t figure it out, met with silence my description of sitting on the couch unable to move, circles of thought moving me instead, arguments against living. I’d found her after calling my dad, after considering walking into traffic with a seriousness that was new. No one we knew from India or with roots there had a therapist, at least not openly; but my dad was a pragmatist, and we didn’t need more death. The smell of my mom’s cremation was still in my nose, every word still in my head from the letter I slipped under her bathroom door a few days before she fell from a stroke that came like a surprise wave — blaming her for the hands that touched me when only hers should have, for denying me when I asked for therapy years later.

Now she was dead and I worried she didn’t know that I also didn’t blame her, that I loved her. I went to an old escape fantasy, first shared at the office of my pediatrician in Texas, who laughed when I asked for a pill that could turn me back to a baby. Some darkness always lay in wait to get me and I felt I couldn’t stand it — kids laughing in the shadows, or grown-ups who hated me, or, always, hands. I imagined the whole world sharpened to a point against me, a vision helped along by the many times people would stare: when I walked into a classroom, the only brown kid; when we entered a gas station on a road trip. Some years later a girl around my age, seven or eight, shot herself with a gun in the bathroom of her fancy prep school nearby. I was transfixed by the story, couldn’t stop thinking of a girl my age being so decisive while I stayed wishy-washy. I contemplated the knives in our kitchen, asked my mom what she’d think of a girl my age going that way, covered my tracks by saying I’d heard of such a happening. She said she’d think the girl was sick. I didn’t want her to think badly of me, so that was that.

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I don’t know where the urge to kill oneself comes from, if some of us have it and some of us don’t. My mom didn’t seem to have it. She had no hair or ability to walk or talk, and still she raised her arms every day to exercise them, on the hope she would get strong enough to live through surgery to remove the tumors that caused the stroke, a cancer growing in hiding until it made itself known by wrecking her in a second. Watching her I felt awed, and confused. If it’s not a kitchen knife that gets you it’s a rotting hole in your belly from the feeding tube, physical pain if not emotional. At amusement parks, I’d get to the end of the line and turn around, bow out, push through all the people to exit the experiment. I knew I’d never fight as my mom had, given the chance to die. Why waste time along the way?

Biology tells me I’m programmed to want to live. So many sperm could have made their way to the egg. Clearly the one that did had will, a survival instinct, expressed years later in my dad insisting I live by securing outside help. That day on the ice, my husband and I considered dying, but only because the glacier was more beautiful than anywhere else we could go. Better to die there, we reasoned, than return to a place of paralysis. I’ve found it helps to physically move, the way stretching can stave off the stiffening of joints that comes with another sort of disease. But healthcare is expensive in this country, people too busy to talk on phones, therapy treated as a luxury good. I do not know what one does without a biological proxy for the survival instinct, engaging your will to live when it is lost to you, who calls the numbers, writes the checks, lifts your arms in exercises when you can’t move.

If you or someone you love is in need of help, call the National Suicide Prevention Hotline at 1-800-273-8255. It is free, operates 24-7, and provides confidential support for people in crisis.

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Health Healthcare THE FRONT ARCHIVES

Who Are We Telling Depressed People to ‘Reach Out’ to, Anyway?

“Reach out,” they say. “Get help,” they say. “Go to therapy,” they say. They, of course, are seemingly every friend, celebrity, and politician offering well-meaning platitudes after the suicides of culinary force of nature Anthony Bourdain and iconic designer Kate Spade last week.

It is comforting to believe that all that stands between a beloved friend or family member and suicide is an active cry for help. Unfortunately, that banal chestnut too often doesn’t match the available treatment options for a vast number of Americans, especially when the Narcissist in Chief’s budget slashes funding for the National Institute of Mental Health by more than 30 percent in 2019.

In New York City, where major depressive disorder is the single greatest source of disability, according to a 2015 report by the mayor’s office, who exactly are we telling our friends and neighbors to reach out to? The report found that poverty, race and ethnicity, sexuality and gender identity, age, where a person lives, and whether or not they’ve been bullied all increase the likelihood that a New Yorker may experience mental health challenges or suicidal ideation — and yet those same factors make it harder to access treatment.

“At any given time over half a million adult New Yorkers are estimated to have depression, yet less than 40 percent report receiving care for it,” the 2015 report states. Eight percent of New York City public high school students report attempting suicide, a percentage that “doubles if a student has been bullied on school grounds, which 18 percent of students experience.” LGBTQ youth are twice as likely to attempt suicide, while elder citizens and Latina adolescents are both at elevated risk as well.

As a media critic, my journalism has almost never included personal memoir. But in light of the implicit shaming underneath all that stock advice to “reach out,” I want to share a story about how few resources are available for mental healthcare in our city, and why judging someone for “not getting help” is not just rude but dangerous.

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Ever since I was a teenager, I’ve considered myself lucky that I have never experienced suicidal ideation, beyond fleeting dark thoughts as a child and adolescent while living in an emotionally abusive home. But because of that upbringing, I’ve dealt with a kind of low-grade depression my whole life, an undercurrent that is always right under the surface, always, and which I work really hard to push through every day. (A coping strategy reflected in the Ani DiFranco lyric “Maybe you can keep me from ever being happy, but you’re not going to stop me from having fun,” which has resonated with me since 1997.) Most of the time I’ve been able to remain functional, but at times the depression has become much more acute.

In my mid twenties in the early 2000s, in the midst of a deep depression during which I stopped having the desire to see friends, take showers, or even write (the most alarming “tell”), I finally overcame my resistance and tried to find a therapist I could afford on a low-income activist writer’s budget. At the time, I was working completely unfunded as the founder and director of a small nonprofit feminist media justice group I was working to build, and I could not afford health insurance; I could barely afford rent and food. As I researched my options, nothing was affordable except for students in training, or group therapy, which — though often extremely useful — I determined wouldn’t be helpful for my specific challenges.

Activating my local network, I finally found one supposedly feminist therapist who I was told offered sliding-scale payment options. I called and asked the therapist if she was taking clients. She said she was. I told her I was living one bare step above poverty and did not have any savings or health insurance, but that I was suffering from a deep depression and I had finally accepted that I needed help. I asked what her rates were at the lowest end of the scale. I can’t remember if she said $75 or $100 per hour; I do remember the burning feeling of internalized shame rising up in my throat as I regretfully explained that I couldn’t afford that rate. Did she have any other options, or could she suggest other therapists with a lower scale? She replied, in a derisive tone I will never forget: “If you are unwilling to pay that little for therapy, you are not dedicated to improving your mental health.”

I hung up the phone and sobbed. I felt even more defeated, demoralized, and depressed than I had been before I reached out, and I quit the search for therapy right at that moment. It wasn’t just that I felt shamed; it was that my research had led me to a brick wall. It seemed as if there was no point in trying to seek additional resources.

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Now, many of us are familiar with the phrase “depression is a liar,” so perhaps if I had been in a better state of mental health I would have left her a scathing Yelp review and initiated another search, or returned to my network for additional recommendations. But the whole reason I was reaching out was that I wasn’t in that healthier state of mind, and so I fully believed there were no therapeutic options available for me.

It took a lot longer for me to get out of that period of depression than it should have, in part because of that therapist insisting that I was “choosing to not prioritize my mental health” just because I was unable to afford her fees. I’m in a much better place now (my low-grade depression is less of an urgent battle and more of an endurance race these days), and thankfully I now have the option for mental healthcare under my partner’s employment benefits if I find myself in need of help in the future. But I know that if I — a cis-gender white journalist adept at research who, while having no money, has significant social capital and a strong network of connected writers and advocates — was unable to secure adequate mental healthcare, it’s decidedly more of a struggle for New Yorkers with fewer racial and professional privileges.

The outpouring of grief, disbelief, and concern in the wake of beloved public figures’ suicides is certainly normal, as is the instinct to want to encourage those struggling with depression and suicidal ideation to seek lifesaving support. But blanketing social media with hollow statements about “reaching out” (exhibit A: senior White House adviser and first daughter Ivanka Trump) obscures the fact that, too often, the infrastructure for that aid is wholly inadequate. That is especially true under the despair-provoking darkness and myopic cruelty of the Trump administration, whose budget is making an already rickety ladder of support even more unstable, while triggering increased anxiety and depression.

If we truly want to help keep people alive and thriving, we need more than platitudes about calling friends or suicide hotlines in a moment of extreme crisis — we need ongoing, substantive, broad-based investment in mental healthcare. So instead of demanding that depressed people reach out to some random concept of help, how about every single person who isn’t struggling reach out to politicians who can fight for more effective mental healthcare policies and resources, and to philanthropic foundations and individuals who can help fund nonprofits that provide direct support to people who need it most. That’s the kind of outreach we should advocate for if we truly want to save lives.

If you or someone you love is in need of help, call the National Suicide Prevention Hotline at 1-800-273-8255. It is free, operates 24-7, and provides confidential support for people in crisis.

To learn more about the battles for funding of mental health services in the U.S., visit the Mental Health America website.

To contact your congressional representatives about mental health funding, visit Call My Congress.

 

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Health THE FRONT ARCHIVES Uncategorized

Fighting the Darkness That’s Always There

Each depressive episode is a battle in a war that will never end. Sometimes, you can see the enemy coming, its march toward you set up in straight lines like a British military exercise, and you have time to fortify yourself, to build up your habits and your friends and your resources to protect you. But sometimes, when everything seems fine, and the horizon looks clear, you face a guerrilla attack. Every episode, you must fight not for victory, or power, or glory, but simply to continue, to stay alive.

Here is a list of habits I have constructed to keep me here: I walk every day for more than an hour. I exercise three times a week. I do not have more than three drinks at a time. I try to eat vegetables every day. I see a therapist weekly for an hour. I get eight hours of sleep. I take two pills every morning. I go to museums and walk in nature and do things I like even when I cannot feel anything from them at all. I am fighting like hell, and I am so tired.

“What merely a few weeks ago had seemed beautiful to her, was no longer beautiful, it was nothing,” Karl Ove Knausgaard writes about his wife’s depression in his new book, Spring. “She hated it. There was nothing she wanted more than to free herself of it. It ruined her life, she often said. There was something other inside her that took her over.”

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That other, that creeping terror, that darkness is always there. It creeps around the edges of your vision even on the best days. If you get to the darkest part, and you are all alone, danger is there waiting for you. I’m a solid six out of ten.… I’m drawn to negatives in life, and I dwell on them, and they consume me.… If I get a couple of days a week at a seven, fuck, it’s great,” Scott Hutchison, the former frontman of Scottish indie rock band Frightened Rabbit, recently told Noisey.

I say “former” because last month, Scott Hutchison lost the war. Designer Kate Spade lost last Tuesday; celebrity chef Anthony Bourdain on Friday.

In the past year, four beloved musicians got stuck in the dark space and couldn’t find their way out. Chester Bennington of Linkin Park lost his war last July. Chris Cornell lost last June. Tim Bergling, the Swedish DJ-producer who performed as Aviciilost in April. I know how all these men died. I shouldn’t, but I do. I know how Kate Spade and Anthony Bourdain died. I know if they left notes. I know what method they used. There are guidelines to reporting on suicides that are perfectly clear: Don’t describe it. Sharing these details, we know, is statistically dangerous.

Among the depressed — those on the front lines — war stories are allowed, encouraged. The more people who know you’re scared and tired, in theory, the more people you have on your team. Rarely do those stories leave the safety of like-minded people with the same fears. And so we all — those of us with the brains that lie to us, who can see the vignette of depression always just there — know plenty of people struggling with our same fears. But depression manifests itself differently in different people. Its symptoms are both weight gain and weight loss, sleeping all the time and not at all. It is a loss of pleasure, a slowing of the brain and the body, an absolute conviction that those around you would be better off without you. And it is hard as hell to talk about. In the wake of these deaths, more people have been writing about this struggle, talking about it, opening up. Robin Pecknold of Fleet Foxes admitted Saturday in an Instagram post to once having been “dangerously and actively suicidal,” and that “suicide has been an at-many-times daily part of my psychic reality.”

I’m a high-functioning depressed person, and I am not brave. For years, I hid those thoughts from everyone, kept them tucked away from even those closest to me. They were too damning to share, I felt, too terrifying. I could hide the darkness — not from myself, but from everyone else — behind good grades and hard work and productivity. It feels easier, safer, to be more like Kate Spade, to tell no one how extreme your feelings are. But it isn’t actually. In a statement, Spade’s husband said that she struggled with both anxiety and depression, took pills, saw doctors, fought. But still he was blindsided; her death was a “complete shock.” 

Mental health remains stigmatized: To take an antidepressant is still, in some perceptions, an undeniable weakness; to see a therapist means that you must be broken. We are getting better at admitting that people have depression; we are even trying as a society to talk more about it. But suicide? Suicide seems, in the court of public opinion, like another level of mental illness, something beyond depression. But it’s not. The darkness can arrive at any moment. Ready or not.

These deaths are devastating. They are not romantic. They are brutal and terrible and so, so sad. Suicide is no one’s first choice. Suicide is an act a person commits because they feel they have no other option, because they feel — as David Foster Wallace so eloquently put it — like a person who jumps from the window of a burning building: “It’s not desiring the fall; it’s the terror of the flames. And yet nobody down on the sidewalk looking up yelling, ‘Don’t!’ and ‘Hang on!’ can understand the jump. Not really.” Suicidal thoughts only make sense if you’ve at one point opened the front door of your consciousness to find them on the doorstep already pushing their way in.

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As Chris Gethard says in his HBO comedy special Career Suicideabout his lifelong battle with clinical mental illness, “Sometimes people just break.” It seems like more and more people are breaking, and not only artists or famous people or the rich. Depression does not discriminate. The National Alliance on Mental Illness says that one of the action steps in preventing suicide is simply to talk openly and honestly about it. Not to debate its ethics, but to check in on people you love, even if they seem fine, explicitly about suicidal thoughts.

The hardest part for me about Scott Hutchinson’s loss, about Kate Spade’s loss, and Anthony Bourdain’s loss, is that we know they were fighting. Hutchison was even brave enough to talk about it publicly. He knew he was depressed, and he told us. He was vulnerable, and open, and he still failed. He found art that could mend him, and friends who could support him. He made mistakes, of course, but he was relatable. He lost a battle so many people are fighting. What happens if you fight like hell and still lose? You can know everything, be doing everything, and it might not be enough.

Perhaps the most important, most constructive thing we can do is continue to speak openly and honestly about the battles we are fighting; to listen, as Scott did, to each others’ stories and fears. Depression did not deserve to take any of these people. And it does not deserve to take you.

 

If you or someone you love is in need of help, call the National Suicide Prevention Hotline at 1-800-273-8255. It is free, operates 24-7, and provides confidential support for people in crisis.

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FOOD ARCHIVES NEW YORK CITY ARCHIVES NYC ARCHIVES

Remembering Anthony Bourdain, 1956–2018

Tony Bourdain died and there’s no silver lining or lesson to learn or pithy takeaway from it. Just, for me and I’m sure the thousands of people who knew him personally and the millions of other people who saw him on television, a tremendous amount of sadness that turns this sunny New York day somber.

I first came into contact with Tony in 2007, when I was an editor at Gridskipper, Gawker’s defunct travel website. We had sold a bunch of pre- and post-roll ads for his Travel Channel show, No Reservations, attached to a silly video series of neighborhood guides I hosted. After the first one went live, I got an email from a strange AOL address. It was Tony, saying he’d enjoyed them. Anthony Motherfucking Bourdain emailed me and signed his name “Tony.” I was in heaven. I’ve received and sent hundreds of thousands of emails since then. That one sticks forever in my inbox. There was no reason for him to send it except that, as everyone knows, what Tony thinks he says.

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Evidently not. Over the years, I’ve interviewed Tony a handful of times, run into him at events and parties and whatnot. We weren’t friends, but we were friendly, and in ways big and small he always offered a helping hand. A single tweet from Bourdain could — and did — make a huge difference professionally. But more than that, to me, Tony was this towering, loping beacon in whose wake I could trail. Through his television shows and books and the never-depleted feast of often profane, often profound sound bites he proffered, he made the transition from talking about food to talking about people, about what we eat to who we are. From the time I was first introduced to the angry bad boy in Kitchen Confidential, I watched as Tony became a father and an athlete, digging into his insatiable curiosity to find a deeply human and humane heart. There was still anger there, but it turned into the sharp sword of righteous outrage. He didn’t take bullshit, called it as he saw it, and, because he never stopped traveling, saw a lot of the world, the good and the bad. The last time I saw Tony, his cookbook Appetites, about cooking at home with his family, had just come out.

When we spoke, Tony was talking about the joy of cooking for his family, how he wanted to make things ahead of time and things that were easy. “You want to be at your own party,” he said.  I stood in awe of how effortlessly, or rather fearlessly, he had shed the chrysalis of anger and emerged as something new, someone healthier. But, I suppose we know now, he kept some parts unknown, too.

Death is coming fast and heavy now, I fear. I can’t help but lasso together the loss of Tony and that of Kate Spade, just a few days ago. I hope I’m not out of line to suppose that Tony probably wouldn’t have had many nice words to say about the chirpy, cheery world created by Kate Spade. It was so antithetical to his rough rock ’n’ roll personality. But if he had known Kate, glimpsed just a bit of the back alleys of her mind, he would have been kind to her, because Tony was kind, and because Tony had them too. To me, they’re together in the bardo, and my heart breaks for them that they felt so hopeless that they took their own lives. I pray for Kate and I pray for Tony, that somehow I can decrease their suffering wherever they are. But I don’t think Tony would want sacred thoughts or noble feelings. So I offer instead a very Bourdainian prayer:

Fuck. Fuck. Fuck. Fuck. Fuck. Fuck. Fuck. Fuck. Love. Love. Love. But fuck.

 

If you or someone you know might be at risk for suicide, call the Suicidal Prevention Hotline at 1-800-273-8255. It provides free and confidential support 24 hours a day, seven days a week, for people in suicidal crisis or distress. Those who feel less comfortable speaking on the phone can text HOME to 741741 in the United States to reach the Crisis Text Hotline. For crisis support in Spanish, call 1-888-628-9454.