Dr. Keith: Beautiful, Smart People Are Depressed Too
The suicides of two stunningly successful individuals in two days should be enough to do away with the notion that great beauty or professional achievement or a treasured family and good friends can immunize anyone from the potential ravages of desperation and major depression.
On June 28, supermodel Ruslana Korshunova plunged nine floors to her death from her apartment in Manhattan's financial district.She had just come back from a modeling gig in Paris.A friend said she was "on top of the world."
On June 30, Dr. Douglas Meyer, an esteemed physician at Manhattan's Beth Israel Medical Center, described by a co-worker as "full of life," leapt 17 stories to his death.
As a practicing psychiatrist for 15 years, I can tell you that these tragedies were a long time in the making.The complete wearing away of self-esteem or shutting down of the ability to see any future other than darkness is more like a curtain slowly closing than a door swinging shut.Indeed, the fragile sense of self that can give way to a free fall may be decades in the making.
Why did no one see it happening in these two cases?Or why, if someone intuited that it could, was it not prevented?
One reason is that we don't like to think of ourselves-whether as associates or friends or family members-as parts of personal dramas that could be so dark.We deploy a kind of denial about the lives of others that suggests things will "turn out alright," that terrible tragedies of the kind that have visited the families of Korshunova and Meyer happen to otherfamilies, that the light in the lives of our loved ones could never be extinguished.
Another reason is that we mistake the ability to do one's work in this world, and do it well, for well-being.I have treated executives and politicians and health care providers who went to work on time and performed admirably, even brilliantly, while battling major depression and even delusional (psychotic) thinking.
And yet another reason is that we may fear that opening up a discussion about whether someone is actually "on the edge," or "unsure of whether he or she can go on" will put us in a kind of psychological no-man's land where we will be lost, over our heads, not knowing what to say or do.
Here are a few things you can do:
Be alert for major depression in people you care about.The symptoms include low moods and tearfulness, but they also include trouble concentrating, trouble sleeping, changes in appetite, low self-esteem and dwelling on personal losses, even ones that took place in the distant past.And, remember, major depression affects people of both genders, every age and every socioeconomic group, without exception.
Listen a little like a psychiatrist.That means if someone says something about life being "too hard" or the future not being "worth it," it's okay to pause and ask a nonjudgmental follow-up question.No one will hold it against you."Are you saying you don't see any sense in living?""Are you telling me you've thought about hurting yourself?"
Listen even more for the person's answer.Your patience and openness can literally be a lifeline.
If someone opens up about feeling desperate, you can offer to take a walk over to an ER, to make a call for an appointment with a psychiatrist who comes highly recommended or to schedule a "right now" appointment with the person's internist or family physician.
Remind the person that he or she cannot judge, while depressed or desperate, where he or she will be, or how that person will feel, just a few weeks or a few months from then.Depression is, arguably, the most treatable condition in all of psychiatry.The vast, vast majority of patients get completely well-which is why it is so important to keep them safe when they can't keep themselves safe.
Share your own frailties.Depressed or desperate people often feel completely alone.They won't be dragged further down by you speaking to times you've felt like all was lost, or like hiding or like you really needed help; they'll be sustained by your openness.
Don't feel like you have to keep quiet about what feels like an impending crisis.Call the person's family or physician or both.You'll be forgiven, because you'll be acting in good faith, trying to do what's right.
Being a supermodel doesn't make you too beautiful to hate yourself, and being a great doctor doesn't make you stronger or smarter than mental illness.No one is immune.These couple of days reminds us of that, as they cost us two great talents and two good, vulnerable people.
Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement. Check out Dr. Ablow's website at livingthetruth.com