Alex Tang
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Medical Students /Paediatric notes
Down and Out and Suicidal
by Dr Alex Tang
At 4.30pm, April 1st 2003, Leslie Cheung, one of Hong Kong’s most popular singer and actor, took an elevator to a private gym on the 24th floor of the Mandarin Oriental Hotel in Hong Kong. There he wrote a suicide note and leapt off the balcony and fell to his death. His suicide shocked Asia and displaced SARS and the Gulf War as headlines in the Hong Kong’s newspapers. The question, which everyone asked, was why. Why would a man who have everything: money, fame, friends and am an icon of the Chinese pop culture with thousands of adoring fans who called him ‘Gorgor’ killed himself? Leslie himself provided the answer in his suicide note. “Depression,” he wrote, “I have not done one single bad thing in life, why is it like that?”
One of his closest friend, singer and actress, Anita Mui said that she was not aware of Leslie’s ‘ill demon’. In one of his songs ‘Who Would Be There to Understand’ his loneliness and pain showed through. Translated from Cantonese by Pin Yin (www.goodbyeleslie.com), the lyrics are:
“As the wind whirls and purify the air
Only to realize that life is uncertain and changes
But I still could not grasp the meaning of my bitter-smile
I don’t believe in life
I only believe in my pair of hands to conquer
Yet I feel powerless to cease the feeling of confusion
Who Will Know?
My Heart is full of depression
As the night deepens into stillness
Who Would Be There To Understand”
Normal Depression
All of us would have felt depressed at some time in our lives. Many of us would have identified with the lyrics in Leslie Cheung’s song. We would have shared his feeling of confusion, being lost in an uncertain and increasing insecure world. When our ordered world collapsed, when we are faced with a life changing event like illnesses, death, divorce or loss of our jobs, we would feel depressed. Some people when approaching midlife become depressed. This is a normal reaction. Doctors named this ‘reactive depression.’ Reactive depression is temporary and will disappear when our life event changes.
Depressive Disorder
The disease called depressive disorder or commonly, depression, affects us irrespective of our life events. A person who suffers from the disease, like Leslie Cheung, may be at the peak of his profession yet was depressed. This disease affects people of all age groups, even children. It affects the body, mood and thoughts. The person who is suffering from depression may have a persistent sad, anxious or ‘empty mood’. There will be feelings of hopelessness, helplessness and worthlessness. Some may even have tremendous feelings of guilt. He or she may lose interest in things they once enjoy, feel ‘tired’ all the time, have trouble sleeping and have difficulty in concentrating on the simplest task. Some have no appetite and loses weight while others overeat and become overweight.
Women experience depression twice as often as men do. This may be due to hormonal factors such as menstrual cycle changes, pregnancy, post delivery ‘blues’ or miscarriages. Also the constant stress of responsibilities at home and/or at work, caring for children or aged parents and sometimes single parenthood may contribute to the triggering off of the disease. Depression in men is difficult to detect because it is often masked by alcohol, drugs or the socially acceptable habit of working long hours.
Depression and Christians
Depression also affects Christians. Notable Christians who suffers from depression are Martin Luther and Charles Spurgeon. A pastor of a mega-church who had depression described his experience as “ like being in an emotional black hole. All my emotions are sucked into an abyss until there is nothing left. No laughter, no joy, no happiness. I felt so empty and worthless. God seems to be absent and is not hearing my prayers for help. I also felt tremendous guilt because I am a Christian leader and am not supposed to feel like this. I cannot concentrate. I cannot sleep at night and just getting through each day is a constant struggle. And I have to preach, counsel people and run the church!”
Depression and Suicide
There is a strong link between depression and suicide. Although men are less likely to suffer from depression, their successful suicide rate is four times that of women though more women attempted suicide. Teenage suicide is on the increase in certain countries like Japan and the United States. Most of these who committed suicides also suffer from depression. People with depression who are likely to commit suicide have an unhealthy fascination with death – talking about death, asking questions about death, listening to music about death or watching videos related to death and dying. They may be giving away their possessions, writing their wills, are often fatigued and sometimes taking dangerous risks such as driving recklessly. Spouses, family members and friends of someone with depression must always be on the lookout for these signs of a depressed person being suicidal.
Helping People with Depression
Depression, with its accompanying risk of suicide can be treated. There are four modalities of treatments, which should be given concurrently. Firstly, is prayer. Following the advice of James, the person with depression should be prayed with and be prayed for. As Christians, we can draw upon the love and resources of a mighty God who cares for us and heals us. Secondly, is godly counsel. The depressed persons must take an active role in their treatment even though their natural tendency is to give in to these negative emotions and give up. Godly counsel reminds them of who they are in Christ, evaluate their situation in a realistic way and to focus on the positive emotions. Thirdly, is the support of spouses, family and friends. The natural tendency of depressed persons is to withdraw into themselves and shun other people. Loneliness worsens their depression. And fourthly, medications prescribed by psychiatrists. There are now new generations of antidepressant medications, which are very effective with minimal side effects.
Conclusion
With prayer, godly counsel, support and medications, depression can be treated and cured. It took the pastor mentioned earlier six months to come out of his depression and back to his normal lifestyle. However, we need to be vigilant when we are dealing with people with depression because of its strong link with suicide.
Soli Deo Gloria
