World Suicide Prevention Day: the euphemistic language of mental health
By Daniel J. McLaughlin
Mental health is, in many ways, the last taboo. The language surrounding mental health is both euphemistic and delivered in hushed tones. We are only just starting to discuss illness of the mind with a slight candour, but there is still a long way to do before mental health is treated the same way as physical health.
I would know, because I am a manic depressive. After years of manic highs and crippling lows, I was diagnosed with Bipolar Disorder Type II in January. Along the way, as I sought treatment at long last, I struggled to find ways to discuss my illness to family, friends and colleagues. Instead of dealing with the diagnosis head on, I used terminology that did not quite address the truth. I was "unwell", "not on top form", "under the weather" and simply "taking time off" for a short while.
In truth, I was exhausted, depressed, and suicidal. I had hit rock bottom, and I could not see beyond the bleakness.
When health websites, such as the NHS or Mind, the mental health charity, attempt to describe suicidal feelings, the checklists feel somewhat clinical. The lists of symptoms - hopelessness, tearful and overwhelmed by negative thoughts, cut off from your body or physically numb - do not do justice to overwhelming blackness and desperation.
I felt lethargic, which can be confused as lazy. I could not leave my bed, which can be confused as bone idle. I was at my lowest point, which can be confused as being merely sad. There is a difference between being sad and being depressed; one is logical, one is not.
When my condition comes up in conversation – you needn’t worry, my small talk does not consist of “Good evening, my name is Dan and I am a certified nutter” – with lexis aplenty in my arsenal, I struggle to choose the appropriate verb. I do not, even thought it can be particularly unpleasant, feel that I “suffer” from bipolar; nor do I remark that I “have” bipolar, as though it is a possession or an accessory. Instead, I have opted for “I am bipolar/I am a manic depressive”. In the same way I am white, five foot seven, right-handed, and – sobs – have a receding hairline, my manic depression is very much a matter of fact.
Let's talk about the 'S' word. Suicidal thoughts, and tragically actions, are a symptom of the condition. It is a bigger killer than cancer and heart disease for men; it is a silent epidemic that takes so many lives, but its lethality is not respected.
I treat my manic depression the same way the late, great and sorely missed Christopher Hitchens calmly and maturely observed his cancer: in all likelihood, it will not be the tumour that will kill him; he died of complications from cancer, rather than the cancer itself.
If, heaven forbid, my life is claimed, I will not die from manic depression, but complications from it. That may be suicide; that may be addiction; or it may be from old age; or getting hit by a bus. I am rather hoping that life gets to me before bipolar disorder does.
A final note on suicide (no pun intended, even with my gallows humour): when I and many others plummet to the depths of these dark thoughts, we are not obsessing over whether or not we want to die. Sometimes, we simply do not want to live. In the depths, I look forward to sleep and when I awaken, I greet the morning with a resigned, “Oh, you again.”
There is a debate over the language we use to describe suicide in the press. The common phrase equipped to discuss the tragic act is that someone has "committed suicide". On World Suicide Prevention Day, a group of campaigners, celebrities, and politicians have called for this phrase to be ditched. You can understand why.
To commit something is to suggest that it is a criminal act. And it was in the UK until 1961 when the Suicide Act decriminalised attempted suicide and suicide (voluntary euthanasia, however, still remains a crime). As the Samaritans suggest to reporters in their coverage of suicide, the word ‘commit’ in the context of suicide is "factually incorrect because it is no longer illegal".
What are the alternatives? A person either took or ended their life, or they died by suicide. It is straight to the point and honest, without the connotations of a crime or a sin.
It can be utterly distressing to be experiencing suicidal thoughts, and it can feel like there is no other way out. As someone who has been through the darkness, I can honestly say that there is light. In Stephen Fry's 2006 documentary about bipolar disorder, The Secret Life of the Manic Depressive, the actor and comedian likens depression to the weather. It is like the rain - it is horrible, it feels never-ending, but it will eventually pass.
You, of course, can combat the horrible weather, finding the medical equivalent of an umbrella or raincoat. If you are feeling suicidal, seek help immediately. Go to a hospital A&E department. That's what I did, and it was the best decision I made. I have a support network around me, medication that is working, and I can honestly say, with hand on heart, I have never felt better. The rain clouds have, finally, dissipated. They may return, but at least I am prepared this time, armed with a brolly, a big coat and sensible shoes.
If you need some support right now, but don't want to go to A&E, here are some other options for you to try:
contact the Samaritans on freephone 116 123, they're open 24 hours and are there to listen
contact your GP for an emergency appointment or the out of hours team
call NHS 111 (England) or NHS Direct 0845 46 47 (Wales)
contact your local crisis team
In the United States, you can call the National Suicide Prevention Lifeline on 1-800-273-8255. You can also contact TrevorLifeline, a suicide prevention counselling service for the LGBTQ community, on 1-866-488-7386. You can also text HOME to 741741 to have a confidential text conversation with a trained crisis counsellor from Crisis Text Line, and they are available 24/7.