He was only in his 40s but his rheumatoid arthritis had gotten really bad over the last few years. He had an ankle replacement and picked up one of those horrible infections in the hospital that nearly killed him.

He was in constant pain. Unrelenting pain – non-stop fuel for depression. He didn’t bring it up unless you asked but you would see it in his face and the tightness of the muscles in his back and shoulders. He couldn’t work. He couldn’t do any of the activities he loved to do. My girlfriend, a saint, became the sole provider. It was hard on her. It was hard on him. Throughout it all there was the physical pain. He hated taking the pain medication but without it, the pain was too much.

I won’t go into the details but he was thoughtful to the end, leaving a note and doing “it” far from their home.

My friend is such a strong woman. She broke down a couple of times during our phone conversation. She said she wasn’t mad at him. She watched the pain wear him down. The rheumatoid arthritis was getting worse, fast. The pain was getting worse. The prognosis was not good.

“He just lost hope,” she said.

I completely understood.

Photo by Elward Photography, available under a Creative Commons attribution license.

But seriously, it really comes down to honestly answering one question: Is what I am doing right now bringing me closer or further from a depression and a drink?  Going to a sports bar and watching Michigan’s football team get clobbered by Penn State – again, is going to bring me closer to a drink. Not taking my meds is going to bring me closer to a depression. Listening to Sarah McLaughlin and pawing through old photos after I break up with a guy is going to bring me closer to both.

I don’t want any more responsibilities. I get ticked off sometimes that I have to be responsible for my alcoholism and depression. I’ve got enough responsibilities: my 83-year old house that needs a new roof; getting my daughter through college; my job; saving for retirement; bills; leaky faucets; pulling weeds; scrubbing the toilet and herding the dust bunnies roaming the floors of my 83-year-old house that needs a new roof.

Along with all these damn responsibilities come consequences. You can’t have a responsibility without a consequence. It’s like one of those laws of physics: For every action there is a equal and opposite reaction. If I don’t get a new roof on my house I’m going to have some serious damage, which is going to cost me a lot more in the long run. If I don’t work, I don’t eat. If I don’t save for retirement, there is no retirement. And on and on and on…

If I don’t take my anti-depressants, get enough sleep and exercise I will very likely get depressed. If I drink, I risk losing everything, including my freedom and my life. I have to remind myself – constantly – is that the responsibilities I have today are, for the most part, luxuries. I am a single mom and I have a great old house, a nice nest egg, a great job, devoted dog and lovely daughter. I wake up every morning without a hang-over and knowing exactly what I did the night before and with whom. I am happy. I don’t think about killing myself anymore.

And those are the consequences of being responsible.

Photo by Eggybird, available under a Creative Commons attribution license.

Florida lawmakers are considering a bill that would prohibit emergency room doctors, psychiatrists and pediatricians from asking patients  if they own or have access to a gun. Doctors would face stiff fines: $10,000 for the first offense; at least $25,000 for the second offense and up to $100,000 for the third offense.

I’m not making this up. In fact, on Tuesday the Florida Senate’s Criminal Justice Association voted 4-1 in favor of the bill. The initial draft of the bill made it a felony to quiz a patient about gun ownership and included fines of $5 million.

The bill is the byproduct of a controversial story about a pediatrician in central Florida who asked a patient’s mother if there were firearms in the home. When she refused to answer, he gave her 30 days to find a new pediatrician. The doctor says he routinely asks patients about risk factors, such as texting while driving and whether there is a pool at the home. Sounds like a good doctor to me.

I have a problem with this legislation. We have this thing called THE FIRST AMENDMENT and it  guarantees everyone – including doctors – free speech. As a journalist I take the First Amendment very seriously. It is utterly outrageous and embarrassing that a lawmaker would consider prohibiting  free speech. I mean, come on. If the First Amendment allows Dr. Dre to sing about bitches, hoes and tricks, shouldn’t it protect a doctor questioning a patient about risk factors for suicide?

The argument for censoring doctors sounds like this: “A growing political agenda is being carried out in examination rooms,” said Marion Hammer, a lobbyist for the National Rifle Association. “It has become about the politics of some medical doctors and it has to stop.”

In 2007, 34,598 people killed themselves, according to the National Vital Statistics Survey report. About half of them used guns. A 2008 article in the New England Journal of Medicine that reviewed studies on guns and suicide found “at least a dozen U.S. case–control studies in the peer-reviewed literature, all of which have found that a gun in the home is associated with an increased risk of suicide. The increase in risk is large, typically 2 to 10 times that in …”

Additionally, another study found that the higher risk of suicide in homes with firearms applies not only to the gun owner but also to the gun owner’s spouse and children. (Click here to see what’s happening in your state regarding firearm access.)

Look, firearm access is a risk factor for suicide. Personally, I want my physician to assess any and all of my risk factors – whether for heart disease, diabetes or suicide.

This debate pits two of the most politically powerful special interest groups in the U.S. against each other. The National Rifle Association and the American Medical Association. Advocates for victims of domestic and child abuse will also join the fray. It will be an epic smack down.

Maybe what we need are some Miranda rights for patients. Rights that a doctor must read to patients before asking any questions – whether about fried food, stress, exercise, alcohol consumption or guns.

“You have the right to remain silent. Anything you say can and will be used to prevent, treat or heal any disease or injury you may have. You have the right to speak freely. If you cannot or will not answer my questions, I may not be able to help you. Do you understand these rights as they have been read to you?”

“What is the point?” the woman asked me in a text message.

Instantly a drum-roll of trite responses popped into my head: “You’re so smart and help so many people.” “With all you’ve been through you are such an inspiration to others.” “You have so much to live for.”

True, but those responses are monkey dung, all of them.  The point is, I don’t know what “the point” is for this woman. What I do know is that it is okay to not know  ”the point.” The lack of “a point”  does not mean there is no point. It simply means you don’t know what “the point” is right now. And that is okay. I don’t need to know everything all the time. 

This epiphany came to me in the produce aisle at the grocery store. I looked at the cantaloupe and realized that on a good day, my brain is no bigger than a cantaloupe. Pretty arrogant of me to think that a blob of flesh no bigger than a cantaloupe in my head could figure out the really important things in life, such as: Is there a God? What happens after we die? Why do the Kardashians have a TV show? and What’s the Point?

Faith is the point. I need faith to get through the pointless hours of depression. I need faith that it will not always be this way and  that there will be a point. I believe in a higher power. I call my higher power God but you can call your higher power whatever you want. She doesn’t care. I have faith that my God has a point for me and faith that it will be revealed. Until then, I hang on…for dear life.

Some people have “issues” with the higher power/God thing. But when you are at the bottom of a black hole, the God-thing becomes very, very real. Without faith in something or someone, you could be down there for awhile. I look at it this way: I ended up in a depression despite my very best efforts to stay healthy. If my best efforts are not enough to keep me from falling into my black hole, I sure as hell need some faith in something or someone to get me out.

The woman who sent me the text message got an answer a few days later. She went to visit family for the holiday. Her young niece was in a crisis and needed someone safe and understanding to listen and hang out with – like a really good Aunt who will take you out for a manicure and pedicure and play Wii and even try to dance hip-hop.

That’s the point.

I am on vacation. I am back home – a home where I have not lived for decades. Still, it feels more like home than any other place I have ever lived. It’s in southwest Michigan, about 30 minutes from “The Big Lake” – Lake Michigan.

There are memories here. Some good. Some very bad. Many, many memories – I am sure. I am trying very hard to remember. For some reason – and my therapist has many – I have very, very little memory of my childhood. Many of the memories I still have stir up “icky” feelings. That’s the best way to describe them. Icky.

I am traveling with a dear friend. We grew up a block from each other, went to school together and graduated in the same class. He has an amazing memory and he remembers so many good times. Names of teachers I had long forgotten. Donut runs to the bakery. Make-up spots around the lake. Water skiing. Bonfires. Football games. Great stuff I DO remember.

“Oh my God, I had totally forgotten about that,” I say, over and over.

We hung out with friends last night and watched the moon rise over the lake and talked and talked of who married, divorced, moved away, stayed in town, had kids and illnesses. Who died, who is rich, who ended up in rehab or behind bars.

I remember now.

I drove by the house I grew up in this morning. We sold it six years ago after my parents died. They both had cancer. Dad went first, mom 16 months later. My dad was an alcoholic. Before we sold the house I cleaned out his bar, poured every drop of every bottle down the drain. I was alone in the house – six years sober myself. It felt good.

My parents owned the house for nearly 40 years. I tried to kill myself twice in that house. I wrote my first journals. I listed to The Who’s Quadrophenia, over and over, alone in the basement. I lied to my mom here about where I had been, who with and what we had done. I stole booze from my dad’s bar and watched my parents fight without words.

But there were good times, snuggled up by the fireplace with our dog. Ernie Harwell calling the plays of some ballgame as my dad listened on the back porch, with the crickets signing. A glass of wine beside him and the newspaper on his lap.

I read somewhere that the brains of people with depression cop to  negative memories. It’s like an instinct. When we remember, the first thing we remember is a bad memory – not a good one.

Do this long enough – for decades – and the good memories get buried so deep that you forget they are still there.

But they are.

There are about 18,000 homicides in the United States every year.

Now, ask yourself this: If there are nearly twice as many suicides than homicides, how come I don’t hear about more suicides in the news?

Because the media doesn’t think it’s appropriate to cover suicides. We don’t want to cause any more anguish to the friends and family of people who kill themselves. (Imagine that, the media is concerned about causing anguish!)

That’s the unspoken rule in newsrooms across the land – suicide is personal and private and covering it would cause more pain. Unless the person who killed herself is famous, there is no news value. But homicide is fair game. Doesn’t matter how obscure you are. If you’re dead and somebody killed you – it’s news.

Which is why the cover story in the New York Times’ Sunday Styles section yesterday, the Mysteries of Tobias Wong, is such a big deal. It is about the suicide of Tobias Wong, a brilliant young designer in New York city.

This is a thoughtful, carefully written story that balances the man with his suicide. For those of us who live in the realm of Rooms-to-Go, the author, Alex Williams explains why Wong’s work was important. Wong was “deeply influenced by subversive art…and went on to produce an acclaimed and influential body of work that questioned concepts like luxury and consumerism in a business that was about promoting them.”

Wong hanged himself. Most authors would have left it at that. Like so many men who kill themselves, no one saw it coming: “This was no tortured artist locked in a downward spiral…he had no history of mental illness, no health problems and no substance abuse issues…unlike many Manhattanites, he wasn’t even seeing a therapist.”

The second half of this lengthy story delves into the pathology of Wong’s suicide. “Mr. Wong was, clinically speaking, asleep. For years, he had suffered from a variety of sleep disorders known as parasomnias: in layman’s terms, he was a serious, chronic sleepwaker.”

We then learn about the bizarre world of sleepwalkers, night terrors and the odd behavior that fill the hours that should be spent in deep sleep. Wong’s own episodes and his battle to conquer his sleep disorder are punctuated with comments from experts about the disorder.

“Given this history, many people who were close to him believe that his death was not an act of will, but, like other sleepwalking episodes, a bizarre out-of-character act that ended tragically.”

Why is this article a big deal? Because the New York Times has published no less than four other articles about suicide in the last month: “In Midlife boomers are happy and suicidal” on June 11; “New leader of DDB must bring luster back” on June 10; “After suicide, scrutiny of China’s grim factories” on June 6; and “Rise of suicides in middled aged is continuing” also on June 6.

Countless newspapers around the world subscribe to the New York Times wire service. Subscribers are allowed to reprint articles in their own newspapers. At a time when newspaper staffs around the country have been slashed, the wires play an even more important role, providing readers with feature stories and editorials that might not have been picked up in the days when newspapers had the staff to write their own stories, features and editorials.

This is how the stigma of suicide will be eliminated: One article at a time. Talking about suicide is not enough. Much of the talk is either gossip or too touchy for an in-depth conversation. But when a newspapers such as The New York Times decides that suicide is “fit to print,” then it becomes news.

And God knows we can’t seem to get enough news.

I have been thinking a lot about my trip to Venice…Louisiana.

I went to Louisiana with a photographer about six weeks ago to cover the oil spill. We heard the action was in Venice. We bought a map and asked for directions because even with a map I had managed to get us hopelessly lost a day earlier in a small town called Houma.

“When you get to Belle Chase you take 23 and go straight,” we were told. “When the road ends, that’s Venice.”

Venice is in Plaquemines Parish, a 70-mile long peninsula that hangs off the toe of Lousiana. The first 30 miles or so seemed pleasant enough. Nice brick houses, convenience stores, churches, schools – the usual small town stuff. Then things started getting…interesting.

On August 29, 2005 Hurricane Katrina made landfall about 15 miles north of Venice in a tiny town called Buras. It was the third time in 40 years that a hurricane and completely obliterated the town and everything to the south, including Venice.

One fisherman I spoke with said that a month after Katrina- while still displaced in Mississippi- he went on Google Earth to check on his mobile home. He could see the roof of his trailer under a foot of water.

When the Census numbers come out next year we will know how many of the 2,200 people that were in the southern half of Plaquemines Parish never came back after Katrina. Judging from the debris still on the side of the road – boats, overturned mobile homes and abandoned shells of buildings – it looks like a lot of folks did not come back. Many of those who did now live in mobile homes.

There are no movies, malls or main streets down here. No Starbucks, no grocery store and no wifi. There is a fair amount of drinking and a lot of fried food and mosquitoes. These are hearty, honest, hard-working people. Until the oil spill, these communities had some of the lowest unemployment rates in the country.

These fishermen and oystermen are not wed to these waters. They are  a part of the ecosystem itself. They and their ancestors have fished these waters for so long that they have become a link in the delicate circle of life here. The ecosystem here expects their annual harvest. This year, as the oil approached, the state opened the shrimp season early to help the shrimpers get what they could before the oil hit. Didn’t matter. The shrimp weren’t ready yet, the shrimpers said.

How will these people survive – mentally – if they cannot fish these waters? At least after Katrina they knew the shrimp and oysters and fish would eventually come back – and they did. Not this time. No one knows when – or if – anything will grow back or swim again in these waters. If just one species or plant does not come or grow back, the entire ecosystem could collapse. These people know that. They lose sleep over that.

People are going to die. They are going to kill themselves. For now it’s animals and plants that are dying. Soon, there will be people dying. A charter boat captain in Alabama killed himself yesterday. His fishing charters dried up when the government closed down the fishing grounds because of the oil. A couple of weeks ago he took a job with BP – the company that put him out of business. His crew found him in the wheelhouse of his boat, shot in the head.

There will be more suicides and there will be even more collateral suicides – the folks who drink themselves to death and overdose. Wives will be abused and kids and dogs will be beaten. Some folks will stop eating and others won’t be able to stop. Some will start smoking or smoke more. Hypertension and heart attacks will kill some. Drunken driving and homicides will kill others.

This is not only an ecological nightmare, it is a mental health holocaust. At least the fishermen in Prince William Sound knew that there was only a finite amount of oil in the Exxon Valdez and when the tanker had purged itself, the  oil would stop spilling. And those fishermen hadn’t lost their homes and everything they owned to a hurricane a few years before the Valdez ran aground.

There are limits to damn near everything in life. Credit cards, speed and hopefully the oil spewing from the Deepwater Horizon disaster. I am afraid that many people will hit their limit and die because of this oil spill. Unlike the running tallies on dead turtles and birds, no one will keep track of how many people this oil spill will kill.

We will never know.

Four years and four days ago was the last time the lights went out.

That was my last major clinical depression: Four years and four days ago.

I got up at about 4:30 am. I didn’t wake up because I wasn’t actually asleep. I got up – meaning I got out of bed. Took my dog to the dog park and sat on a picnic table. Tears rolled down my cheeks. I wasn’t exactly crying because crying takes emotional exertion and I had run out of that. It was more like just water dripping from the corner of each eye.

I am a clean & sober recovering alcoholic/addict but I made one last desperate attempt to make myself feel better. I went to spin class at the gym. Exercise is one of my addictions. I love the endorphins. But that morning there were no endorphins. I pedaled so hard that my lips flapped and foam gathered in the corner of the mouth. Nothing. No endorphins. My legs quivered. Nothing.

I showered and went to work. As I walked by the security guard I felt like I wasn’t in my body. I walked into the newsroom, sat at my desk and looked out the window. Then the lights went out.

I left. I went home and did an excruciating free-fall into my black hole.

That was four years and four days ago.

The day the lights went out.

I look back and think how blessed I am to have had that day and to be here to honor it. That day marks the end of my old life. Something died in me that day and it was a horrible, slow death. It was months before I could see the light and breathe again.

I drove to the Florida Keys last weekend. It was late Saturday afternoon when I crossed the peak of the Card Sound Bridge — a huge, arching bridge the connects the mainland to the northern tip of Key Largo. It is holy spot – where you cross from your old life of trudging the road to happy destiny to your new life of wild, uncharted beauty. At the top of the bridge I rolled down my windows. In that delicious yellow, pink light of later afternoon I looked around. I was surrounded by an endless horizon of blue water dotted with uninhabited mangrove islands.

I asked myself, “How could you have ever wanted to kill yourself?”

That was four years and four days ago.

We don’t know much about the bullying Phoebe endured at South Hadley High School in the months before her death, and we know almost nothing about the nine teens charged with a smorgasbord of shocking crimes against her.

We all want those details. But I want more. I want to know how those nine teens reacted to their arrests. I want to know if they feel a shred of regret and remorse. If the teens made statement to detectives, I want to hear their recollection of what happened. I want to hear the tone of their voices. I want to see their body language.

If the parents of these teens made statements to detectives, I want to hear — in their own voices — what they knew about their child’s relationship with Phoebe and behavior toward her. I don’t want to read transcripts of these statements, I want to hear and see how the parents feel. You see, when a child is accused of horrific behavior we cannot grasp the explanation or find the reason why by reading words on paper.

We need to see and feel how these children and their parents feel about what has happened. Bullying is extraordinarily hurtful. Being bullied when you are a teenage girl, new to a school, with a developing body and raging hormones is devastating.

I know. It happened to me. I transferred from a Catholic school to a public school in seventh grade. I had been wearing uniforms, some threadbare with hems made of masking tape, and found myself surrounded by young girls in monogrammed sweaters. Let’s just say I was well and early endowed and seeing as how I was a gifted competitive swimmer, I spent a lot of time in a bathing suit and received a lot of attention and comments from the boys.

My depression was just beginning to kick in. I drank and smoked pot to feel comfortable in my own skin. I was so unhappy and felt so not-a-part-of that I had a breast reduction when I was 19 — which, back in those days, was extremely painful and left me disabled for weeks. In the years that followed, I had two suicide attempts.

Some girls, like me, are so fragile at that age. We have no emotional stamina. A sideways glance, a crude remark and damning accusation and we can crumble and melt like a sandcastle in high tide. Add depression, problems at home that we tell no one about, and the stress of making good grades and it is no wonder that some girls — like me — want to end it.

I don’t know if Phoebe had depression. I don’t know her family dynamics. I don’t know what he-said, she-said or they-said. I only know the pain — and danger — of being reminded every day that you do not fit in and you are not good enough.

God bless Phoebe.

These newsroom debates are passionate and I have been at the center of many. For years, I argued that omitting details of sex crimes because “some readers might be not want to read about that over their Cheerios” misrepresented the true level of brutality against women in America.

I mean, come on, the music industry turned misogyny into entertainment a long time ago. Why not throw in a little reality for balance? I am not arguing for gratuitous details. However, very often the word “rape” does not capture the true horror of many of these crimes.

The same is true for media coverage of suicide. There is an unspoken rule among editors throughout the land that covering a suicide — especially details of a suicide — is morally wrong. It unnecessarily inflicts  more pain upon the loved ones left behind. They argue that suicide is not newsworthy unless a celebrity kills himself or the suicide affects the public — for instance, when  tortured soul jumps off an overpass during rush hour and brings traffic to a halt.

I disagree.

We, the media, misrepresent the true level of mental illness — especially depression — in society when we ignore all but celebrity and gawker suicides. We saw this on display during the last week with the suicides of Michael Blosil, Marie Osmond’s 18-year-old son, and Andrew Koenig, star of Growing Pains. According to media reports, both had suffered with depression. End of story.

There are nearly twice as many suicides as homicides every year in the United States. Of these  33,000 suicides, how many did you hear about last year? Then think about how many murders the local media covered in your community last year. I am not — NOT — in favor of publishing the details of every suicide. As with rape victims, we do not need to publish the names or any identifying information about those who commit suicide. We do not need to publish gratuitous detail or romanticize these deaths. We should not use sensational headlines “Girl, 13, kills herself after failing to make the cheerleading team.” We should not play up these stories on the front page. But we could publish something like this:

A 17-year-old Podunk youth died Friday of a self-inflicted gunshot, according to police. The youth had a history of depression and had recently become despondent, according to the police report. The suicide is the xxx reported in Podunk county this year and the xx by a teen.

I am firmly against publishing how-to details of a suicide. Several years ago, the editors of the student newspaper at New York University struggled with their coverage of a spate of suicides and whether to identify the exact location of where several students had jumped to their deaths. Copycat suicides also are a serious concern as seen in Palo Alto, California, where a spate of teens have killed or attempted to kill themselves on a particular stretch of railroad track.

The American Foundation for Suicide Prevention has published recommendations for media covering suicide. But I have never heard these recommendations mentioned during suicide debates in the newsroom. I did not even know these recommendations existed until I started covering mental health several years ago.

I have learned over the years that writing anything about any death — by homicide, suicide, accident or natural causes — often angers someone. I do not want to add to the grief  of those devastated by a suicide. But I ask myself, are we, the media, feeding the stigma of suicide and mental illness by ignoring it? Are we hiding our own disdain for mental illness with feigned, self-righteous compassion?

You tell me.