In 1998 I was a 27 year old, Magna Cum Laude graduate of the University of Notre Dame who had recently become the youngest Principal consultant in American Management Systems Manhattan office. Shortly after receiving a 7% off-cycle salary increase due to exemplary job performance, I was found unconscious inside of a running rental car in a parking lot of a warehouse in Secaucus, New Jersey. I had transformed the car into a makeshift carbon monoxide gas chamber the night before. After losing consciousness in the rental car and prior to waking up in the hospital, I had what is commonly referred to as a near death experience, and if I had not survived, the cause of my death would have been listed as suicide via acute carbon monoxide poisoning. As accurate as that description would have been, I’m compelled to share about how my lack of experience with the thoughts and feelings I had leading up to my suicide attempt, and my fears about what other people would think about me, if I had revealed the struggle I was embroiled in, dissuaded me from getting the help that I so desperately needed. As a suicide attempt survivor fortunate enough to have a second chance at life, I hope others suffering as I did will benefit from the lessons I’ve learned over the last eighteen years.
In late 1997 while on a challenging work assignment in Toronto I began to experience insomnia for the first time in my life. My mental health deteriorated quickly over the next few months as my five closest friends all coincidentally moved away from New York City, and I began to ruminate over what I was doing with my life. Up until when I began to have suicidal ideations, I would have described myself as very confident with respect to my intellectual abilities, but the personal crisis I became involved in, stemming from difficulties encountered on the project in Toronto, shattered my self confidence and stripped away my self esteem. In their place was an overwhelming sense of self doubt followed eventually by self loathing. Hope and excitement for the future were replaced by fear and apprehension. Night after night of getting between zero to three hours of sleep at most, and the relentless barrage of dark, automatic thoughts bombarding my consciousness ate away at my sanity, and over the course of only a few months I was lost in a seemingly inescapable, abysmal black hole of simultaneously self-defeating and self-fulfilling thoughts.
I wasn’t familiar with the diagnostic criteria of major depressive disorder at the time, but I learned after the fact, that I was a textbook case. I had persistent feelings of emptiness, hopelessness and worthlessness. I lost interest in activities that I normally enjoyed, and my appetite all but vanished. It was challenging to concentrate and to make decisions, even simple, inconsequential ones. Not surprisingly given how little I was sleeping, I was perpetually tired and lacked energy. Recurrent thoughts about dying, the first was imagining that my Friday afternoon flight home from Toronto to New York City would crash, eventually evolved into persistent thoughts about intentionally ending my own life. The long, sleepless or nearly sleepless nights took the greatest toll on me. I was unable to quiet my sleep deprived, addled mind from producing a non-stop stream of negative, hyper-critical thoughts, as overpowering feelings of shame, guilt and embarrassment consumed me. I was ashamed that I needed help to deal with how I was feeling. I felt guilty that I was having suicidal thoughts considering my life of relative privilege and my knowledge of the depth and breadth of suffering experienced by countless others in the world. I was embarrassed that I had ever considered myself intelligent and capable of attaining any goal I set my sights on achieving. I was ashamed that I was considering suicide out of a fear that I would become completely incapable of doing my job. I felt guilty that I hadn’t achieved more in life considering my talents as well as the advantages and opportunities afforded me. I was embarrassed to be in a position where I obviously needed help and was mortally afraid to admit that fact to anyone. I viewed my deteriorating mental health as a character flaw, because I believed that other people would see it the same way, and I believed that asking for help to deal with what was going on in my head was a sign of a personal weakness. Thoughts and beliefs like these lie at the heart of the stigma surrounding mental illness, and explain why many people suffering like I was back then never seek help.
According to the National Institute of Mental Health, in 2013 an estimated 15.7 million, or 6.7% of all U.S. adults, had at least one major depressive episode in the preceding year, making it the leading cause of disability in this country. Sadly it is estimated that only about half of Americans suffering from depression ever receive treatment for the disorder. Over 90% of Americans lost to suicide each year suffer from depression or some other behavioral health condition. In 2014 alone, 42,773 Americans, or about 117 a day, died by suicide according to statistics from the Centers for Disease Control. The tragic reality behind these statistics is that a great majority of people suffering from depression could be helped by one or a number of different treatments that help people return to living full, productive lives.
Immediately after my suicide attempt, I began taking the antidepressant medication Paxil, and seeing a psychologist twice a week, and within about three months, I was well again. I lived with my parents during that time period, and my mother had bought me a small stack of paperback books to read while I convalesced. While most of the books were novels, she had also bought me a copy of David Burns best selling book Feeling Good: The New Mood Therapy. It was the last book I read out of the stack, and although I was still too depressed when I read it the first time to appreciate the significance of the ideas it contains, over a decade and a half later, it’s clear that what this book taught me about cognitive behavioral therapy (CBT) comprises some of the most valuable lessons I’ve learned during my eighteen plus year journey as a consumer of mental healthcare services. In the book, Beck summarizes what he refers to as, “the powerful principle at the heart of cognitive therapy,” by writing “your feelings result from the messages you give yourself. In fact, your thoughts often have much more to do with how you feel than what is actually happening in your life.” A few years later, my psychologist introduced me to a related idea called mindfulness – the practice of being aware of the present moment and your thoughts and feelings in a non-judgmental way. Both CBT and the practice of mindfulness helped me to be more reflective about my thoughts and feelings as I was experiencing them, helping me to consciously respond to them in a more discerning and intentional way instead of impulsively reacting to them. I have never taken an antidepressant medication since the time immediately following my suicide attempt, nor have I ever had a recurrence of a depressive episode as severe as the one that I had in 1998. By no means do I believe that I am “depression-proof”; no one knows what tribulations may befall them in the future, but it’s clear to me that years of reflective introspection and personal growth have equipped me with valuable insights, habits and tools that help to safeguard me against the self-defeating thought patterns that led up to my depression and suicide attempt over eighteen years ago. I have developed other habits over the years that have also helped me to remain well in a sustainable way. I transformed my diet to consist mostly of plant based foods full of fresh fruits and vegetables, and I became an avid distance runner. I worked to cultivate a habit of unconditional self-acceptance as well as the practice of consciously acknowledging things in my life that I am grateful for on a daily basis. Recognizing the dangers inherent in becoming isolated, I committed myself to remaining connected and communicative with my family and close friends. Maybe most importantly, I have promised myself and those I love that I will never hesitate to ask for help from them or a professional caregiver if I need it.
Unlike when my silence about my suicidal crisis over eighteen years ago almost led to my demise, now I view the act of asking for help as a sign of courage and strength. This belief led me to join the Speakers Bureau of the Philadelphia chapter of the American Foundation for Suicide Prevention where I deliver talks at area high schools and colleges about the warning signs of suicide with the aims of reducing the stigma surrounding mental illness and lowering the suicide rate. I see making myself vulnerable to the potentially negative judgments of others by publicly sharing about my past as a powerful way to offer hope to people who are suffering, and to encourage them to seek help.