The sad journey towards suicide – the painful reality of Depression

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The 2017 World Health Organisation (WHO) theme was Mental Health in the Workplace. This much needed focus on this silent killer went by without much attention because we, as friends, colleagues, line managers and family members of those who suffer from mental illness were not ready to engage in discussions that required such deep introspection, on a subject that is largely shunned or is taboo in some quarters. Even the tragedy of the much-publicised Life Esidimeni de-institutionalisation Gauteng Mental Marathon project did not jolt us into either a meaningful national conversation, nor concrete action plans about how we as a country must deal with Mental illness.. We therefore remained largely ignorant or in denial about this scourge that is attacking some of our finest sons and daughters. In the meantime, many of our colleagues, family members, loved ones and friends continued to suffer in painful silence.

It took the tragic news of the untimely death of Prof Bongani Mayosi, the Dean of the Faculty of Health Sciences at the University of Cape Town to spark the long overdue national conversation. Full credit must go to his beloved wife, children and broader family for a bold, far sighted and courageous decision to announce the exact cause of his death. The family statement informed a stunned nation that, “in the last two years he has battled with depression and on that day (Friday) took the desperate decision to end his life.”

This simple, yet profound statement sparked a huge debate with people asking themselves and others some painful and sometimes awkward questions such as:

  • How could such an A-Rated scientist take his own life?
  • How could one so young and so talented be so depressed as to take his own life?
  • What is this depression, how bad is it?
  • Did we fail Prof Mayosi?
  • Why could we not see the signs?
  • What actions or ommissions led to his death?
  • How could this not be treated, could this not have been avoided?
  • How could Prof Mayosi leave us, his family, his students, his country, his world of medicine, when we needed him so badly?
  • Could he not have fought harder?
  • Did our actions push him over the limit?
  • Could he not have asked for more help?
  • Did UCT not support him enough?
  • What was the final or most impactful trigger to this?

I fully understood these questions, not because I have suffered through mental illness myself, but it is through the painful lessons I have learnt from dear colleagues, friends and family members who have shared their mental illness journeys with me. These personal journeys, mostly shared in deep confidence because of the stigma, associated with Depression, enabled me to better support them in both their have helped me to better appreciate the daily struggles they go through and made me support them better in my personal and professional life. I also had to learn and understand the possible triggers of these painful episodes, relapses, and how one can support without judment.

What is Depression?

In the words of Prof Liz Rabe, who lost a son in the fourth year of medical studies, “ Depression is a biological disease caused by a chemical imbalance in the brain, and indeed, it can lead to a fatal malfunctioning of our most important organ. By acknowledging mental health issues and speaking openly – and normally – about them, you, as a young generation and community of students, can become a new generation to understand that illnesses above the neck should not be treated differently to those below the neck, and that they should also be diagnosed and treated by a specialist, as with other serious diseases.”

Depression or broader mental illness may result in loss of life through suicide. This was brought to the fore by a deep conversation I have had with a dear colleague, Julian Turner. Today I would like to help to share his story, in order to help those suffering from mental illness to find strength in his story, and those who are friends, colleagues and family members to find the knowledge they will need to help support those suffering from mental illness.

The remarkable story of Julian Turnerhis tragic journey towards failed suicide

On the 10th of February 2014, Julian Turner drove off on a long journey to take his life and to be with his God. As shocking as this may sound, Julian says that he had reached a point in his life where he felt he no longer had a purpose. He was working himself to death both at work and socially. Describing that fateful day, Julian says, “As I left work that day, I set off on a seven-hour journey to a beautiful setting called Kloof Gorge in Kwa Zulu Natal. I made up my mind that my purpose in life was waning and just felt a lack of appreciation for who I was and what I did. I felt alone in the burdens of the world. Depression had me in its grip of desperation and despair”.

Asking for mercy

Throughout his trip of death, Julian prayed to God to please take him into His Kingdom. He felt that he had done enough, had no desire to be on earth any longer and he begged God for Mercy before attempting to take his life.

Taking the leap

Julian describes those critical minutes before his jump:

 “With great courage and putting aside my vertigo, I walked along the edge of the cliff from left to right to pick my jumping spot. I then got back into my car and made my way to the shops to purchase a bottle of whisky to “take the edge off”. After having a swig, I sent off the necessary messages to loved ones from my cell phone.”

Julian continues, “Arriving at my final destination, I wound my windows down to allow the breeze and sunlight rays into the car as I wrote out my final note. Taking a couple more swigs of the whisky, I watched people come and go to take in the breath-taking view.

 Then a miracle of God started to take shape. This car arrived next to me with two young girls (18 and 19). They later told me that they had been planning to meet at the Gorge for the last three months, but kept putting it off. On that very day at 4pm, the one girl phoned the other and said that they had to meet that late afternoon – no excuses. They made their way down the hill to the cliff edge, but chose the right hand side, as opposed to my planned left, which had a clear drop to the bottom. God had called them there as part of His bigger plan.

 I carried on writing my note and after about twenty minutes I left the car and made my way down the hill, in some strange way drawn towards the girls, who looked like angels in the outlining light. I was very careful in not startling them, but the one saw the giveaway look on my face and knew that I planned to end my life.

I lay my hands on each one’s shoulder as they sat and said my final prayer. I then handed my car keys over and let them know that suicide was the next step. The one girl got between me and the edge to try and stop me, but I got hold of her hands and swung her behind me to safety. I then took a run and silently flew into the air over the edge in swallow style. My journey towards God’s Kingdom had begun…or had it?”

The extended hand of God

By an amazing miracle, Julian was saved from certain death, he describes what happened: “I was later told by the rescue crew that on my 80m journey off the cliff, my body smashed into a protruding tree and was deflected sideways onto a cliff edge. I then rolled off down to the last remaining ledge where I was then laid to rest, before what would have been a final 55m drop to the ravine and almost certain death awaiting below. By the time I became conscious, darkness had fallen and sand was falling onto my face. I immediately came to the realization that this was not Heaven and thanked God for sparing my life. I no longer felt alone and was relieved of my burdens.”

Alive and filled with purpose

Julian was badly injured, his left leg was dislocated, the femur head was fractured, most of his ribs were broken from the tree impact and his left ear was cut. Miraculously there were no scratches on his face, no broken teeth, no skull, spinal or internal injuries, and no cuts on his arms or legs. The Lord had heard his prayer in the car, but decided that he was still needed on earth to live out his Life purpose.

The rescue

The rescue teams for Julian were amazing, overcoming challenge over challenge to get him safely to the top. Various teams mobilised on top to welcome him, including the SA Community Action Network, Crisis Centre, Rescue Tech, ER24, Police etc. The ride to the hospital in the ambulance was excruciating. Once at Hillcrest Hospital, the staff were remarkable, as certain death had been averted. Two operations and ten days later, and after a huge number of visitors and well wishes, Julian was released to Healing Hills Clinic in Inchanga for rehabilitation. It was a healing time for him, as he gave himself to the Lord and participated in the many group therapy sessions. On the day of his release from the clinic, the people there flocked to his car and tears flowed, leaving him deeply humbled by the impact he had on them.

Finding healing through Family

Julian describes the journey home and the reunion with his family, “The journey home was long but enjoyable, with my wife and I having many hours to discuss the path forward in our lives. On arriving home, the momentous time arrived for me to be reunited with my sons. The combination of hugs, tears and smiles made for an emotional return. I would over the coming week have discussions with Aston, Camryn and Rowan to try and get them to understand in some way why I did what I did.”

His recovery continued as his hip healed very well, but the excruciating pain on the common peroneal nerve feeding the lower part of the left leg had only just begun. The nerves were damaged to the extent that he could not lift his foot up, which needs to be supported by an AFO, a blade-type orthotic. Nerve tests were conducted during April 2014, where surgery was performed to release the trapped nerve. The neurosurgeon found that the peroneal nerve had been crushed as flat as paper and that it would require at least two years before any improvement could arise…a small price to pay for truly finding God. Julian walks today with a partially paralysed left leg. It took over four months for his rehabilitation process to place him into a position to be able to return to work. He prayed to the Lord to give him a new start in life – with a new job, a new team and in a new environment. His prayer was answered on all fronts! 

God has made it all good

This episode strengthened Julian’s relationship with God and his family, “I have to thank my wonderful wife Sheryl for being an absolute pillar of strength throughout this ordeal, from the time I sent her my goodbye message from the cliff to the time she collected me and took me home. God has given us all strength to unite together and move forward in a way that He wishes. It’s been a journey for many people. We never know what life holds for us, but “we know that in all things God works for the good of those who love Him, who have been called according to His purpose – Romans 8:28.”

Rethinking how we view suicide

No two stories are alike, no two impacts of mental illness are the same, but I hope Julian’s incredible story will go some way to give more answers to the questions being asked. Julian’s story may be unique, his motivation to take his life may differ from others, and his experiences with mental illness may not be similar to someone else, but there are a few lessons which his story highlights for all of us:

Firstly, let us not separate suicide from its causal illness – Prof Lizette Rabe argues that for ages, our societies – mostly as a result of religious and cultural dogma – have seen suicide in isolation of its causal illness because of ignorance about mental diseases, whereas modern science and research today sees suicide as the possible terminal phase of an often- fatal progessive biological disease.

Secondly, the suicide is aimed at ending the pain and misery, and not necessarily ending life –  As one listens to Julian’s account of his attempted suicide, it is clear that the primary goal of a suicide is not to end life, but to end pain, misery, nightmare and helplessness. Medical literature has constantly demonstrated that those who are in the grips of a suicidal depression are battling an emotional agony where living becomes objectionable. In Julian’s own words, “I immediately came to the realization that this was not Heaven and thanked God for sparing my life. I no longer felt alone and was relieved of my burdens.” This clearly shows that he wanted to remove the burdens more than remove a life, he could now live because the burdens had been removed.

Thirdly, mental illness reduces the capacity for rational thought and decision making – In the words of Dr Deborah Serane, most people with mental illness who die by suicide have a significant depression narrowing their problem solving skills. Dr Serane concludes “Corrosive thinking reduces optimism, the hope of possibility and increases feelings of helplessness. The depressive illness itself makes it virtually impossible to hold onto any semblance of pain going away. While some may sargue that a person who dies by suicide has done so by their own choice, I argue that serious mental illness, in fact, limits choice”.

Fourthly, we must change the stigma about depression and mental illness – In the words of Prof Lizzette Rabe, Another way to help break the stigma around depression is in the way we speak about the disease. Language evolves, and to break the taboo and stigma, we need to rethink the words we use. We can begin to speak about depression in the same way we speak about any other disease. The same applies to those who have lost their lives to depression: to refer to them with the same respect and dignity that we use for those who have lost their lives to any other disease. In that way we can contribute to break the silence and the stigma around the illness and encourage others to be open about it.” 

Lastly, we must acknowledge the illness that may cause death and the pain of its victims – Prof Rabe argues strongly, in a way that supports her son’s story, Julian Turner’s experience and probably the unspoken words of Prof Mayosi, and many others who lost their lives due to depression, “ It is argued that the verb should not be to “commit” suicide, because that indicates a willful, rational act, while suicide as a result of depression, a clinical illness, cannot be a willful act, but the result of a terminally ill, irrational brain because of the absence of life-giving neuro-transmitters”.

 She concludes, “The preferred phrase should be that someone has died of suicide, as we now know that in the majority of suicides, more than 90%, the cause is a chemical imbalance in the brain, causing a fatal depression episode. Only a rational, healthy brain can “commit” something. However, the most humane phrase is to say the person has died of depression. In that way the illness that has caused the death is acknowledged, as well as the victim’s indescribable suffering.”

Conclusion

Dr Fundile Nyati, Chief Executive, Proactive Health Solutions, argues that contrary to prevailing prejudices or ignorance out there, when one suffers from depression, it is not a sign of weakness, and those who suffer from depression cannot just simply snap out of it. He points out that anybody can be affected by depression and those who suffer from depression may sometimes feel as if life is no longer worth living.

Julian reached this stage in his life, but as Prof De Vos counsels us, Julian did not make a decision to kill himself, if he had succeeded in his suicidal jump, he would have been a victim of humanity’s cruelest disease. Julian had an opportunity to fully explain everything that happened to him, his family was able to accept him as the Julian they always knew as a beloved husband, father, colleague and friend. I was inspired to listen to Prof Mayosi’s family, friends and colleagues at his funeral, they too spoke about him in the manner he lived his life, as a loving husband, a doting father, a brilliant scientist, a prolific researcher, a conscientious teacher, a consummate professional and and a world class cardiologist. They did not allow the manner of his death to be his defining character and enduring memory. May other families take the Mayosi and De Vos examples and have no anger towards those who left them through suicide, but reserve their anger towards this dreaded diseae.

At the best of times, we are the most beautiful country in the world, with some of the most amazingly warm and caring people. On our best day, we step on any world stage and compete at the same level with the very best in various fields. As Prof Mayosi did at Oxford and Harvard, at Groote Schuur and the University of cape Town and St john’s and Natal Medical School –we can be the epitome of excellence.

We however have another side – a more menacing side . At our darkest hour, we show an evil and cruel side, a side of a nation in pain, a society in turmoil, and a community in need of healing. During this dark hour -we tear each other apart in bitter contests over scarce resources, we dehuminize one another in fierce ideological battles, we use our dominant positions to maintain wealth and privilege, we are involved in titanic battles for positions in different spheres of life and use violence and abuse against women and children. When this is evil and cruelty is overlayed with bigotry, prejudice, mignomy, patriachy, racism, you then have potent cocktail. In such circumstances, those who may be vulnerable to or may be suffering from depression or mental illness may be pushed over the limit. They suffer silently in our private and public sector organisations, in our marriages and relationships, in our academic and research institutes and in our communities and neighbourhoods.

We all need to play our individual and collective parts in creating a much more caring, safer, equitable, tolerant, respectful, diverse and sensitive society. Such a society would

  • create a “safer” space for those with mental illness to declare their status to families, friends and colleagues without any fears of the current stigma;
  • have a deeper awareness of mental illness and have the same empathy for those who suffer from mental illness in the same manner we have empathy for those who suffer from physical ailments;
  • create an environment in which relationships and marriages are free from abuse;
  • accelerate transformation our institutions so that they reflect the beautiful diversity of our people;
  • have passionate, robust and challenging discourse without resorting to violence, threats, intimidation and insults;
  • create a supportive environment in which those who suffer from mental illness would thrive in their personal and professional lives;
  • accept the true diversity of our society in terms of religion, culture, race, sexual orientation and place of origin –we must be a society where people can be themselves;
  • empower girls and women to reach their personal, entrepreuneriaal and  professional goals without discrimination, and
  • teach its young about mental illness and ensure that they are supported from an early age.

Julian has been able to turn his life around, he is now the Chairperson of our Diversity and Inclusion Forum and inspires others by telling his story at Standardbank and at other organisations. I hope that this conversation may help to break the fall of others who are suffering like Julian. I also hope that those who lost their loved ones, may be champions against this disease.