Night Falls Fast Read online

  His letter to the coroner addressed the inquest he expected would take place after his death and left even less doubt about his mental state:

  On the one hand, you will have the solemn assurance that I am the Son of God—the Lamb slain from the foundation of the world, and on the other the oppressive, fearful fact, that I died by my own hand. You will hardly dare bring in a verdict of temporary insanity, because of the deliberation, forethought, and predetermination in which it was accomplished, and because my resurrection from the dead at the end of three days and three nights would manifest such verdict to be an infamous libel and blasphemy.

  Few suicide notes are so overtly peculiar or psychotic; in fact, most reveal little or no evidence of incoherent or delusional thinking. Yet, as we will see, the overwhelming majority of suicides are linked to psychiatric illnesses, so it is not surprising that most of the notes and records left behind reflect the misery, cumulative despair, and hopelessness of these conditions.

  Acute mental illness brings pains and dangers, and there is a chronic distress that comes from living with it and dreading its return. The anguish of depression, manic-depression, schizophrenia, and the other major psychiatric disorders cannot be overstated. Suffering, hopelessness, agitation, and shame mix together with a painful awareness of the often irreversible damage done by the illness to friends, family, and careers. It is a lethal mix. One woman wrote in her suicide note about her unsuccessful struggle with mental illness:

  I wish I could explain it so someone could understand it. I’m afraid it’s something I can’t put into words.

  There’s just this heavy, overwhelming despair—dreading everything. Dreading life. Empty inside, to the point of numbness. It’s like there’s something already dead inside. My whole being has been pulling back into that void for months.

  Everyone has been so good to me—has tried so hard. I truly wish that I could be different, for the sake of my family. Hurting my family is the worst of it, and that guilt has been wrestling with the part of me that wanted only to disappear.

  But there’s some core-level spark of life that just isn’t there. Despite what’s been said about my having “gotten better” lately—the voice in my head that’s driving me crazy is louder than ever. It’s way beyond being reached by anyone or anything, it seems. I can’t bear it any more. I think there’s something psychologically-twisted—reversed that has taken over, that I can’t fight any more. I wish that I could disappear without hurting anyone. I’m sorry.

  A forty-two-year-old woman who shot herself left a long note defending her character and pleading with the press not to sensationalize her death. She was, as are many with mental illness, concerned about the effects of her illness on others, in this case on her mother: “I will be of no use to her much longer with these crazy nerves. No one who has not experienced the utter discouragement of a nervous collapse is any judge whatever and cannot realize that that alone can make one wish to die.”

  Nineteenth-century British painter Benjamin Haydon turned to Shakespeare for some of his last words. Agitated and sleepless, with a history of violent manic-depression, Haydon slashed his throat and then put a bullet through his head. His journal was left open to the final entry:

  21st.—Slept horribly. Prayed in sorrow, and got up in agitation.

  22nd.—God forgive me. Amen.

  Finis

  of

  B. R. Haydon

  Stretch me no longer on this rough world.—Lear.

  “Nerves,” agitation, and discouragement with prolonged mental suffering are common themes of suicide notes. Japanese writer Ryuunosuke Akutagawa, paranoid and delusional (believing, among other things, that maggots were in his food), took an overdose of sleeping pills when he was thirty-five. “The world I am living in now,” he wrote, “is the icily transparent universe of sickly nerves.… Of course, I do not want to die, but it is suffering to live.”

  James Whale, director of The Invisible Man, Journey’s End, and the classic Frankenstein films, also spoke of nerves and suffering in his suicide note. Addressed to ALL I LOVE, he wrote:

  Do not grieve for me. My nerves are all shot and for the last year I have been in agony day and night—except when I sleep with sleeping pills—and any peace I have by day is when I am drugged by pills.

  I have had a wonderful life but it is over and my nerves get worse and I am afraid they will have to take me away. [He had been hospitalized for a nervous breakdown and received shock therapy.] So please forgive me, all those I love and may God forgive me too, but I cannot bear the agony and it [is] best for everyone this way.…

  No one is to blame—I have wonderful friends and they do all they can for me.… I’ve tried very hard all I know for a year and it gets worse inside, so please take comfort in knowing I will not suffer anymore.

  Morbidly afraid of water, he then drowned himself in his swimming pool. Not too far away, consistent with a lifetime of dark humor, he left out a copy of the book Don’t Go Near the Water.

  The awareness of the damage done by severe mental illness—to the individual himself and to others—and fears that it may return again play a decisive role in many suicides. Those patients with schizophrenia who are more intelligent and better educated, for example, who perform better on measures of abstract reasoning, and who demonstrate greater insight into the nature of their illness, are more likely to kill themselves. Patients who do well socially and academically when young and who then are hit by devastating illnesses such as schizophrenia or manic-depression seem particularly vulnerable to the spectre of their own mental disintegration and the terror of becoming a chronic patient. For them and many others there is a terrible loss of dreams and inescapable damage to friends, family, and self—Randall Jarrell, in describing to his wife the cumulative effects of his manic-depression, said, “It was so queer … as if the fairies had stolen me away and left a log in my place”—a sense of being only a shadow or husk of one’s former self; an unshakable hopelessness; a feeling of failure and shame; and a terrible anxiety that the illness will return. For others, the fact that the illness has come back is in itself unendurable; its recurrence intolerable, one time too many.

  Virginia Woolf, who suffered through psychotic manias and depressions, wrote in the first of two suicide notes to her husband, “I feel certain that I am going mad again: I feel we can’t go through another of those terrible times. And I shan’t recover this time. I begin to hear voices, and can’t concentrate. So I am doing what seems the best thing to do.” Several days later, she wrote again, and again she blamed her madness for her death:

  Dearest,

  I want to tell you that you have given me complete happiness. No one could have done more than you have done. Please believe that.

  But I know that I shall never get over this: and I am wasting your life. It is this madness. Nothing anyone says can persuade me. You can work, and you will be much better without me. You see I can’t write this even, which shows I am right. All I want to say is that until this disease came on we were perfectly happy. It was all due to you. No one could have been so good as you have been, from the very first day till now. Everyone knows that.

  V.

  Will you destroy all my papers?

  Woolf then loaded her pockets with heavy stones and walked into the river.

  It is tempting when looking at the life of anyone who has committed suicide to read into the decision to die a vastly complex web of reasons; and, of course, such complexity is warranted. No one illness or event causes suicide; and certainly no one knows all, or perhaps even most, of the motivations behind the killing of the self. But psychopathology is almost always there, and its deadliness is fierce. Love, success, and friendship are not always enough to counter the pain and destructiveness of severe mental illness. American artist Ralph Barton tried to explain this in his suicide note:

  Everyone who has known me and who hears of this will have a different hypothesis to offer to explain why I did it. Practically all of the
se hypotheses will be dramatic—and completely wrong. Any sane doctor knows that the reasons for suicide are invariably psychopathological. Difficulties in life merely precipitate the event—and the true suicide type manufactures his own difficulties. I have had few real difficulties. I have had, on the contrary, an exceptionally glamorous life—as lives go. And I have had more than my share of affection and appreciation. The most charming, intelligent, and important people I have known have liked me—and the list of my enemies is very flattering to me. I have always had excellent health. But, since my early childhood, I have suffered with a melancholia which, in the past five years, has begun to show definite symptoms of manic-depressive insanity. It has prevented my getting anything like the full value out of my talents, and, for the past three years, has made work a torture to do at all. It has made it impossible for me to enjoy the simple pleasures of life that seem to get other people through. I have run from wife to wife, from house to house, and from country to country, in a ridiculous effort to escape from myself. In doing so, I am very much afraid that I have spread a good deal of unhappiness among the people who have loved me.

  Barton put on his pajamas and a silk dressing gown, got into bed, opened up his copy of Gray’s Anatomy to an illustration of the human heart, and shot himself in the head.

  DIFFICULTIES IN life merely precipitate a suicide, wrote Barton; they do not cause it. There is much evidence to support his belief. But which difficulties are most precipitous? And why? The reversals of fortune, the deaths or divorces that may be blamed for a suicide are the same disasters and disappointments that attend us all. Yet few of us kill ourselves in response.

  A. Alvarez describes better than anyone the highly personal interpretation given to events by those who are suicidal: “A suicide’s excuses are mostly casual. At best they assuage the guilt of the survivors, soothe the tidy-minded and encourage the sociologists in their endless search for convincing categories and theories. They are like a trivial border incident which triggers off a major war. The real motives which impel a man to take his own life are elsewhere; they belong to the internal world, devious, contradictory, labyrinthine, and mostly out of sight.”

  Each culture has stressed its own motivations for suicide. In classical antiquity, according to scholar Anton van Hooff, shame, grief, and despair were the primary reasons for suicide in young Romans. By the nineteenth century, Bierre de Boismont had classified the causes of nearly five thousand French suicides and concluded that insanity and alcoholism were the most important, followed by incurable disease, “sorrow or disappointment,” and “disappointed love.” Enrico Morselli, surveying European statistics in the last century, noted that most suicides were attributable to madness; next in order of importance were “weariness of life,” “passions,” and “vices.” Further down the list, but compellingly human in its language, was “despair—unknown and diverse.”

  The twentieth century has added specificity, although perhaps not eloquence, to the debate about why people kill themselves. In recent years, psychologists and psychiatrists have looked at the relationship between “life events”—an oddly bloodless phrase for catastrophe and heartbreak—and the onset of psychiatric illnesses such as depression, mania, and schizophrenia. Although life events may, of course, be positive (for example, getting married or getting promoted at work), most investigators have focused on adverse events such as medical illness, divorce or separation, death or illness in the family, family discord, and financial or job problems.

  There are many reasons to believe that stressful events might bring on or worsen a psychiatric illness. If the underlying psychiatric illness or biological predisposition is severe enough, such events may well play a role in suicide as well. We know that stress has a profound effect not only on the body’s immune system and the production of powerful stress hormones but also on the sleep-wake cycle (which, in turn, plays a critical role in the pathophysiology of mania and depression). Tom Wehr and his colleagues at the National Institute of Mental Health, for instance, have demonstrated that psychological stress, certain medications and illnesses, and significant changes in light and temperature can interfere with circadian rhythms; these disturbances can, in turn, trigger mania or depression in genetically vulnerable individuals.

  The relationship between the events of life, stress, and psychiatric illness is not a straightforward one, however. People, when manic or depressed, not only are influenced by the events in their lives, they also have a strong reciprocal influence on the world and people around them: they often alienate others with their anger, withdrawal, or violence; act in such ways as to cause divorce; or get themselves fired from work. What looks like the cause of a relapse may in fact be brought about by the illness itself. (There is, for example, no consistent strong relationship between unemployment and suicide. It is clear, however, that heavy drinking, mental illness, and personality disorders all contribute to unemployment.) The causal arrows move both ways, further compounded by the fact that individuals, when depressed or psychotic, react to stress in very different ways from those who are not mentally ill. Accordingly, many researchers have narrowed their study of life events to the so-called independent life events, such as a death or serious illness in a family. Unlike “events” such as divorce or financial problems, which are more likely to be affected by mental illness, these independent events are more genuinely random.

  Most research finds a significant increase in life events prior to the onset of both manic and schizophrenic episodes, although the influence of psychosocial stress appears to be less important in later stages of manic-depressive illness (by which time the illness has often established a rhythm of its own). Patients with mood disorders seem, for the most part, to be more affected by stressful life events then those who suffer from schizophrenia. Psychologist Sherry Johnson and her colleagues at Brown University found that negative life events not only increase the rate of relapse in patients with manic-depression, they also increase the length of time it takes for patients to recover from their episodes of depression or mania. Without significant causes of stress, patients take about four months to recover. If, on the other hand, significant negative life events precede the relapse, it takes, on average, almost eleven months before they are well again. This nearly threefold increase in recovery time is not only a highly painful time for patients and their families, it is also an extended period of vulnerability for suicide.

  Sudden heartbreak or catastrophe is often known to have occurred before a suicide, but the nature and extent of the crisis it causes is unclear. Almost certainly, most of the danger of the event lies in its incendiary effect on the underlying mental condition. But the ultimate impact of psychological stress is different in each individual, depending on his or her own life experiences, ease of access to a means of death, extent of hopelessness, and type and severity of the mental illness. Difficulties and conflicts in personal relationships or imminent threats of arrest or criminal prosecution tend to occur more frequently before the suicides of alcoholics and substance abusers, for instance, than before the suicides of individuals with depression. (Sometimes the reasons for desperation are beyond fathoming. One six-year-old girl who tried to throw herself out of a moving car said simply, when brought into a psychiatric clinic, “I am very hungry. I bite people and try to eat them up. I am a bad girl, and I should die.”)

  Gender also matters. In a large Finnish study, the partners of those who had killed themselves were asked what they thought was the reason for suicide. Severe mental illness was rated as the most important cause of suicide in the women, whereas medical illness was seen as a more important reason for suicide in the men. For both men and women, intense interpersonal discord was also perceived as an important contributing factor.

  Differences in gender exist at a younger age as well. Young or adolescent boys, for instance, are much more likely than girls to have experienced a crisis event in the twenty-four hours prior to suicide. Particularly common are breakups with girlfriends
, disciplinary or legal crises (such as suspension from school or a pending appearance in juvenile court), and humiliating events, such as public failure or rejection. David Shaffer, a child psychiatrist at Columbia University in New York, finds that many male adolescents who kill themselves are not only depressed but aggressive, quick-tempered, and impulsive; they also tend to drink heavily, use drugs, and have difficulties in their relationships with others. Most other clinicians and researchers agree. Depressive illnesses in conjunction with substance abuse are common in these adolescents, providing a combustible fusion when triggered by an adverse or painful event. The fact that most parents are unaware of depression and suicidal thinking in their adolescent children only makes the potential for disaster worse. Recent research shows that adolescents who suffer from depression are much more likely than those with no psychiatric illness to commit suicide when they reach adulthood.

  A different but not uncommon profile of an adolescent suicide is that of a high-achieving, anxious, or depressed perfectionist. Setbacks or failures, either real or imagined, can sometimes precipitate suicide. It may be difficult to determine the extent of such a child’s psychopathology and mental suffering, due to the tendency to try to appear normal, to please others, not to call attention to oneself. The real reasons for suicide remain fugitive.

  One fifteen-year-old boy wrote this poem two years before he killed himself: