[Mz]

I get the impression that this is a long, polite way of saying Steve committed suicide.

The last time I was on HN and the topic of suicide came up, I wrote kind of a ranty piece that I am not up to editing it (to remove the rantiness) and reposting. The short version: If you know someone who is suicidal and you care about them, spend time with them. In person. Suicide is almost always committed when one is alone.

My credentials: I attempted suicide at 17 and have been hospitalized once or twice for being suicidal in my teens/twenties. In recent years, when medical issues make me mentally and emotionally unstable, my adult sons "babysit" me (in other words, I am not left alone when I might be genuinely suicidal and not just grumpy about life's stressors). I am 48 and I am okay these days in spite of serious medical problems which have somatopsychic impacts (it's a real word -- look it up). So I know it is a method that works.

[badclient]

If you know someone who is suicidal and you care about them, spend time with them. In person. Suicide is almost always committed when one is alone.

100%, although I wish we talked more about the challenge of determining that someone is suicidal.

Here's what I wrestle with the most about this. I fear that if I "misdiagnose" someone as suicidal, that I might have now given them the idea that there is such a thing as suicide and it may now become an option, completely backfiring against my goal of helping them.

I wonder if there is best practices although it seems a bit silly given we are basically trying to read someone's mind - something that even they(especially them) might not have clarity about.

[jdswain]

A while ago I had a problem with anxiety and basically panic attacks. Back then I didn't know how to deal with this, so eventually when it got too much I asked for help. I went to a doctor and the first thing they asked about was suicide. I thought, well, I hadn't really considered that, but now that you mention it, it's probably something I should think about. I wasn't suicidal, so I guess it didn't matter, but it sure does make you think about it when everyone is asking you. Overall though I think it is better to ask about it, because you really do need to know. I've heard though that a lot of people that do commit suicide are good at hiding things from people, even their family may not be aware that something is wrong, so even asking that question is not sufficient. When I hear about people committing suicide, I often think why didn't anyone help them. Often the truth is that nobody was aware, that's sad in it's own way, but it does show that a lot of people can keep these things to themselves.

The next thing I felt about the suicide question was that it was a way of categorising people. If they considered suicide, then they need immediate help, otherwise it's no so important, so offer them some pills, refer them to counselling (which was offered to me with a 4 month waiting list, that was not a lot of help). The pills weren't what I needed anyway, so I didn't really get a lot out of going to see the doctor. Talking to your family about it is a really important step though.

[john_fushi]

I dealt recently with a friend who was suicidal. Since I didn't know what to do I called Suicide Action to ask how to deal correctly with the situation and get some pointers on dos and donts.

Basically you WANT to talk explicitely about suicide. From what the lady on the phone said, most of the time the suicidal person wants to talk about it.

[badclient]

Interesting. How did you know he was suicidal? If I am convinced he is suicidal, it is easy to have a conversation. But I feel there is so much gray area and the last thing I want is to make someone who is just feeling a bit down in life from thinking about suicide.

[john_fushi]

She wasn't feeling her usual self and I had to ask explicitely(Do you consider suicide?). For someone who is just feeling down and not suicidal the question might be a bit of a shock, but in the end you are showing that you care and that you are present if things go really bad.

And then again, pretty much everyone knows the existence of suicide. If asking the question and trying to help drives someone to action, chances are something else would have.

[ghswa]

As somebody who's been there (on both sides) I don't believe that anybody who might act on suicidal ideation would not have already considered suicide as an option.

I'd say that, if you're worried, starting a conversation about it (in person) is just about the best thing you could do. A "missed diagnosis" is far worse than a "misdiagnosis".

Sorry for the pun.

[andrewflnr]

I haven't examined the statistics myself, but isn't it known that suicides go up when there are news stories about them, even in a preventive effor? This implies that suicides are, in fact, somewhat suggestible.

[ghswa]

Reading about suicide in the news is incomparable to the kind of direct intervention I'm talking about. As john_fushi commented[1], the best thing you can do is talk about it and his suggestion of calling your local suicide helpline for advice is an excellent one.

On a personal level, I've found that talking frankly about suicide greatly reduces my desire to act on any suicidal feelings. This effect is greatest when talking face to face with somebody I know and trust.

However, worrying about whether or not somebody trusts you should NOT stop you from intervening. If somebody shows a desire to listen and help my in such a situation I'll have a much greater level of trust in them than I did before, even if they were previously a complete stranger or somebody I dislike.

[1] https://news.ycombinator.com/item?id=7228997

[Mz]

I am not shy. I tell my kids when I am suicidal. They still live with me and monitor my medical issues closely, so they know when I am being really, really wonky and not just bitching, if that makes sense.

It helps that I have an especially close relationship to them. Also, they were raised by me, so are well educated in certain social paradigms.

[badclient]

Good for you! You make your kids' life so much easier You and your kids are both lucky!

[DanBC]

Do these child carers have access to a support network?

[Mz]

100%, although I wish we talked more about the challenge of determining that someone is suicidal.

I will add that most people who are suicidal will "tell" you. They often talk about suicide, though they may then claim it is a joke. It usually is not. If someone frequently says things like "I wish I were dead", you should take that seriously, basically.

[EMRo]

He did. Thank you for sharing your story. I wish I had been there for him when he needed me like your sons can be there for you.

[Mz]

((HUGS))

[mailshanx]

My deepest condolences. Hearing about your brother makes me very sad.

[wavefunction]

The best actors in the world are the depressed. No one who knows me knows how many times I have almost died. I say this in the hopes that it helps with the hurt a bit, though losing your brother never goes away. I lost mine to a motorcycle accident when a driver got impatient with traffic.

[einhverfr]

Something occurs to me when reading what you wrote here. I have heard folks who have struggled with depression (and not just suicidal depression) talk a lot about how important in person time was to recovering generally. I wonder how much depression is a social as opposed to a purely mental/neurological illness.

We humans need social contact and this has been known since at least the time of Aristotle (and probably time immemorial).

Perhaps you could answer this question: when your adult sons come over and care for you (this is a really great thing btw, and something we have lost as a society), is that in itself theraputic? Or is it just a stop-gap?

If it is theraputic, then we are missing a key piece of the discussion in the discourse of mental health.

[Mz]

My sons still live with me. They are both ASD and not very touchy-feely people. But they are very loyal to me. I have a deadly medical condition. Doctors told me "people like you don't get well" and washed their hands of responsibility. Since I have defective genes, it won't hurt their professional reputation if I die while under their care. That feels pretty awful to be on the receiving end of.

My sons are taking care of me so I can get well, physically. Part of that is dealing with the brain chemistry fall out as I fight the infections that overran my system, etc. Yes, over time, their devoted care is convincing me someone actually cares about me even though neither of them is the gushy type. They do the important stuff. They provide the care I need.

I was a homemaker and full time mom for many years. I took devoted care of them. The three of us are getting physically well together, but I was the sickest. So the care I gave them is coming back to me. That is a first for my life. For the most part, my emotional generosity has gotten me burned by other people.

tldr: It wouldn't be inaccurate to say that it is therapeutic.

[camus2]

My brother committed suicide. He died for nothing,and nobody in the family even knows why he died. 10 years later, I feel like I dont care he died anymore, I just cant feel sorry for people committing suicide, it accomplishes nothing,except destroying a family ,making relatives feel guilty all their life.

Suicide is the most selfish thing one can do, that's my opinion.

[mikeash]

Would you be saying that if he died of cancer instead of mental illness?

People have this bizarre idea that mental illness somehow doesn't "count". That you have to fight it, and that if you lose, it's your own fault.

You are, right here, blaming the victim of the disease. Your brother died from a mental illness. It killed him, just as surely as cancer or a heart attack might have killed him. You'd never, ever, ever say that someone who's killed by a heart attack is "selfish", so don't do it for mental illnesses either.

[billyjobob]

I agree it is not useful to blame suicide victims, but this issue cuts to heart of free will and personal responsibility and is not clearly resolved. I wish depression was the same as a physical illness, because then I could simply go to a doctor and be given a cure. But the only effective cure for depression is therapy, and no-one else can do it for you - therapist can only assist you to cure yourself. So without taking personal responsibility there is no hope of recovery.

Perhaps we should should recognise an ill person cannot be held to the same standard expected of a well person, but can still be considered to have some degree of agency in their actions.

It's especially problematic because mental illness is a fault in your thoughts, and not in, say, your arms or legs. But you don't have thoughts in the way you have arms and legs - you actually are your thoughts.

[mikeash]

"I wish depression was the same as a physical illness, because then I could simply go to a doctor and be given a cure."

That makes no sense. There are plenty of physical diseases where that doesn't apply, and many where the only cure requires lots of work on your own part.

[lutusp]

> I wish depression was the same as a physical illness, because then I could simply go to a doctor and be given a cure.

1. In point of fact, much scientific evidence shows that depression is a physical illness, not a mental illness.

2. The only reason treatments are not available for the physical illness of depression is because of the primitive state of neuroscience.

3. But neuroscience research is moving apace, and is very promising. Read this: http://www.nytimes.com/2006/04/02/magazine/02depression.html...

4. A quote from the above-linked article: '"So we turn it on," Mayberg told me later, "and all of a sudden she says to me, 'It's very strange,' she says, 'I know you've been with me in the operating room this whole time. I know you care about me. But it's not that. I don't know what you just did. But I'm looking at you, and it's like I just feel suddenly more connected to you.' '

"Mayberg, stunned, signaled with her hand to the others, out of Deanna's view, to turn the stimulator off."

'"And they turn it off," Mayberg said, "and she goes: 'God, it's just so odd. You just went away again. I guess it wasn't really anything.'"'

5. Psychiatrists and psychologists, of course, insist that depression is a mental illness and is treatable with therapy and drugs. But there is no reliable scientific evidence for this view.

6. President Obama recently announced a major "brain initiative", meant to speed up the pace of neuroscience research. More here: http://www.whitehouse.gov/the-press-office/2013/04/02/fact-s...

7. Notice that the initiative is not called the "mind initiative". The reason? Psychology had its chance and failed. It's time for a new approach.

> It's especially problematic because mental illness is a fault in your thoughts, and not in, say, your arms or legs.

That's what psychiatrists and psychologists would like you to think, but it's false. Some day this way of describing mental illness will be judged to have been criminally false.

[illuminate]

"1. In point of fact, much scientific evidence shows that depression is a physical illness, not a mental illness."

A false dichotomy there.

"Psychiatrists and psychologists, of course, insist that depression is a mental illness and is treatable with therapy and drugs. But there is no reliable scientific evidence for this view."

Stated without actual evidence, naturally. On a scale of One to Clear, how much do you love L Ron Hubbard?

[lutusp]

>> "1. In point of fact, much scientific evidence shows that depression is a physical illness, not a mental illness."

> A false dichotomy there.

Dichotomy, yes. False, no. The evidence is copious. I posted evidence, you posted opinion. Which part of the evidentiary links that I provided caused you the greatest amount of emotional upset?

Which part of "drugs and therapy do not work, but neuroscientific treatments do work" didn't you understand?

> "Psychiatrists and psychologists, of course, insist that depression is a mental illness and is treatable with therapy and drugs. But there is no reliable scientific evidence for this view."

> Stated without actual evidence, naturally.

I said there is no evidence for the belief that psychiatrists and psychologists can treat depression. Your reply? Where's my evidence that there's no evidence? You are clearly unaware of (a) the impossibility of proving a negative, (b) of the role played by the null hypothesis in scientific thinking, and (c) who has the burden of evidence to provide positive evidence for a claim.

Link: http://en.wikipedia.org/wiki/Russell's_teapot

Quote: "Russell's teapot, sometimes called the celestial teapot or cosmic teapot, is an analogy first coined by the philosopher Bertrand Russell (1872–1970) to illustrate that the philosophic burden of proof lies upon a person making scientifically unfalsifiable claims rather than shifting the burden of proof to others ..."

In other words, you are a scientific ignoramus.

Psychiatrists claim to be able to treat depression, the claim is formally unfalsifiable, there is no evidence for this claim and copious counterevidence, and the burden of evidence belongs to psychiatrists and psychologists.

Nevertheless, in spite of the fact that the burden belongs to those making the claim:

Title: "Treating depression with the evidence-based psychotherapies: a critique of the evidence"

Link: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.2007....

Quote: "... the specificity of CBT and IPT treatments for depression has yet to be demonstrated."

Title: "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration"

Link: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

Quote: "Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance."

Title "The Emperor's New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration"

Link: http://alphachoices.com/repository/assets/pdf/EmperorsNewDru... (PDF)

Quote: "If drug and placebo effects are additive, the pharmacological effects of antidepressants are clinically negligible. If they are not additive, alternative experimental designs are needed for the evaluation of antidepressants."

The scientific consensus? Depression drugs and therapy don't work.

[sdegutis]

As someone who struggles with mental illness daily, I agree with the sentiment that the world should really treat this kind of disease with a lot more compassion and support, rather than a blaming and negative attitude. It really is a constant uphill battle, and the cards are stacked against us.

At the same time, at some level it really comes down to a personal choice to either keep fighting against it, or just give up. The nature of despair and depression can make it less appealing choose to keep fighting, but it's still a choice.

But that doesn't change the fact that people should be supportive and compassionate toward people struggling in these ways. It's never ever ever good or healthy or productive to condemn someone who's made some kind of mistake, because mistakes are usually the result of an internal struggle of some kind. Condemning or blaming someone only makes it harder for them to win the fight against whatever they're battling internally, and ultimately we just want everyone to win these internal fights.

[dreamdu5t]

People disagree with that perspective because it implies that the brain is entirely deterministic biologically and has no plasticity. That you have no mental control over your physiology. That you don't have control over your attitude and outlook, etc.

[mikeash]

Attitude is proven to have an effect on cancer remission rates. Yet we still call it a disease and say that it killed you, not that you selfishly killed yourself due to not getting better.

You have some control. Far less than the "suicide is selfish" idiocy assumes.

[dreamdu5t]

So you're claiming suicide is caused by a biological mechanism? That once we identify that mechanism, we could prevent suicide?

Great, maybe that's the case. However, there's no more evidence for that than the assertion that suicide is a choice.

[Mz]

There is some evidence that brain chemistry is influenced by diet and dietary changes can help with depression. For example: http://www.mayoclinic.org/diseases-conditions/depression/exp...

That fits with my experience. I have to be very careful with peanut oil, for example. It does terrible things to me.

So, in short, it is possible that depression and other mental illness has biological roots. There are also social factors and other factors, but in some sense mental illness may well be a medical illness.

[grahamburger]

Actually I might say about someone who had a heart attack or cancer. A father whose doctor and family begged him to change his diet and exercise habits for years before his fatal heart attack, or a mother who continued smoking even after the cancer set in, for example. Yes, mental illness is very much like any other illness, and like any other illness it can often be prevented and managed through lifestyle changes under a doctor's direction. I'm with GP - with a few rare exceptions suicide is a purely selfish and preventable act.

[mikeash]

Refusing to take preventive measures could potentially be called selfish. (Although it's much less clear with mental illness where the disease itself hinders such action.) The death itself is not, especially since these things can still kill you even if you do everything right.

Would you mind giving me the name of your practice so I can make sure that nobody I care about ever, ever goes there?

[illuminate]

"Refusing to take preventive measures could potentially be called selfish"

The problem isn't just the illness clouding the need for them but also that there are sometimes more significant side-effects as well.

[duney]

It isn't selfish of someone to have had a mental illness that drove them to commit suicide. I'm sorry for your loss, but I disagree with your assessment of suicide being a selfish act.

[vacri]

Most (not all) people who commit suicide aren't in their right minds and aren't thinking clearly. Denigrating it as being selfish misses the point of what's going on for the person.

it accomplishes nothing

It accomplishes nothing for you. For the person committing suicide, it frees them from significant pain of some sort. That might be psychological pain due to a disturbed mental state, but it's still pain.

Guilt is a hard one and you have to learn to deal with it and move on, but blaming the victim isn't going to help there.

[justzisguyuknow]

I used to think the same thing. I have never been suicidal so I don't know from personal experience, but I recall reading something that helped me understand suicide as something more than self-absorption. That the pain of deep depression is so real and intense that it can be compared to physical pain, and when it gets strong enough, simply ending it becomes its own imperative. That suicide is like jumping from a burning building - it's hardly even a choice, the pain compels the body to do it.

Some additional reading material that might help inspire some compassion, also both good and entertaining reads in their own right:

http://hyperboleandahalf.blogspot.com/2011/10/adventures-in-...

http://www.newyorker.com/fiction/features/2010/12/20/101220f...

[VolatileVoid]

Depression isn't just /like/ physical pain. It can cause real, physical pain. Pain, for which you go to doctors who say "oh, you're fine." Pain for which you go to dentists only to hear "oh, you're fine."

In many (most? all?) people depression has a physical manifestation. It hurts. It aches. It's not a "hole in your heart," it's like having the flu. All the time. It's not like a toothache. It is a toothache. This distinction has to be made because it's important: the pain is real - even if it is just created by brain chemistry.

[dfraser992]

Suicide, ingestion of drugs (incl. alcohol), addiction, religious fervor - all of these can be thought of as ways to escape the weight of "the self". A more abstract theory than "neurotransmitters being out of balance", but more useful perhaps in understanding what compels a person to act in those ways. People who commit suicide out of the blue, surprising friends and family, probably felt they were living a lie in some way, and couldn't see any way to get out of that other than escaping it entirely. If someone says "but they seemed to have it all under control" then ... how does anyone know what goes on in the head of another person?

I'm surprised I see no mention of the poem "Richard Cory" whenever this topic arises

http://www.poemhunter.com/poem/richard-cory/

[primitivesuave]

My best friend from childhood threw himself in front of a train almost exactly 1 year ago (Feb 18th). He had just got his college degree, had an amazing family and all the support in the world.

When he took his own life, I had an initial period of unanswerable questions and great sorrow, followed by deep resentment. He had so many people he could have reached out to and so many people reaching out to him, and he just decided to take an easier way out. It was selfish to leave his family hanging like that with so many questions, and the worst part is how difficult it was for them to move on.

[downandout]

I feel like I don't care he died anymore

I hope you are just angry that he committed suicide, and don't actually mean that. If you do mean that, you shouldn't be surprised that he killed himself. Suicidal people tend to look frantically for any reason they can find to not carry through with it. This kind of cold, judgmental attitude shown by a loved one at the wrong time can be the final straw.

[btmorex]

I'm sorry you cannot feel compassion or empathy for your brother. From personal experience, it makes it much easier if not understandable.

[pyrrhotech]

I get the point but there are definitely more selfish things one can do. Blow up buildings, serial kill, rape people, etc. While suicide clearly affects others, on some level we and only we should have a say over what we do with our own lives.

[marquis]

I'm sorry for your loss.

[pasbesoin]

Mz,

I continue to appreciate your honest and forthright approach to addressing issues such as this.

[Mz]

(hugs) old friend.

[sdegutis]

Someone who's depressed enough to consider suicide probably also experiences a crippling loss of hope which prevents them from taking the steps necessary to make local friends in the first place whom they would be able to reach out to. At least that's been my experience.

[rmc]

The short version: If you know someone who is suicidal and you care about them, spend time with them. In person. Suicide is almost always committed when one is alone.

I read an article about a sports person here who was going to commit suicide, they had it all planned out, and planned the day. But on the day he planned to do it, his mother stayed home instead of going to Mass. Saved his life.

[blueskin_]

In person isn't always possible - I'd expect the assumption any friends you know that closely are local from people in most communities, but not here. I've spent time talking to people who I've never met in person who I know consider me a close friend as do I them.

[Mz]

I have also given and gotten support online and by phone. That can also make a difference. But in person, just your presence can prevent someone from acting without having to be confrontational or whatever.

[xenophanes]

So your credentials consist of personal anecdotes? Maybe it's time to start taking the issue more seriously. I think it's a serious issue deserving a more serious approach.

For example, you might try reading literature with multiple different perspectives on the issue. Then try to figure out which ideas are right and why. (If you've already done this, forgive me, and please please inform me why Szasz is mistaken, I would love to learn something.)

[saalweachter]

I don't give two shits what Thomas Szasz thought about mental illness, because he wasn't a scientist or even a doctor, he was a goddamn libertarian philosopher. He found mental illness philosophically inconvenient because he couldn't see a way around the State being morally justified in providing coercive treatment to the mentally ill, so he just decided they didn't exist.

He was an asshole who spent sixty years shitting over real science to promote his politics, and you're an asshole for trying to promote his politics at a digital wake.

[einhverfr]

At the same time, I think it is inescapable, when studying how different cultures look at mental health and mental illness to see this as something which culturally constructed. Personality disorders for example, or ODD, or the like can only be thought of as disorders of inconvenient personality traits and therefore the way mental illness has always been used, and in the historical context, there is a very dark side to coerced therapy (which btw is no less dark when we convince parents to give their kids antipsychotic drugs because their kids are defiant).

my problem with Szasz though is different. He seems to accept the basic assumptions of mental illness that our society does, and therefore never frees himself from the problems of those assumptions. There is no scientific basis for these assumptions, as they form, effectively, the threshold questions under which one can try to make neurochemical inquiry into mental health. These assumptions are:

1. Mental illness, to the extent it exists, is objective and quantifiable.

2. Social context is irrelevant to mental health.

3. Therefore mental health is an individual issue.

Of course a libertarian will accept these assumptions because they are based on the assumptions of personhood behind that movement. But what if both of the first two are wrong? What if mental health is very much subjective and what if social context is an important factor in mental health? If so, then, not only is the science based on bad assumptions but so is Szasz's rebuttal to it, and mental health becomes more an art than a science.

None of this reaches the question of coercive therapy. The fundamental questions are who, when, and how (both regarding the coercion and the therapy). Obviously there are times when this is needed. But we should not ignore the dark side this has had throughout history.

[xenophanes]

> 1. Mental illness, to the extent it exists, is objective and quantifiable.

> 2. Social context is irrelevant to mental health.

> 3. Therefore mental health is an individual issue.

None of those are positions Szasz holds. The first two are just kind or ridiculous – he said contrary things, a lot. They are pretty opposite to his actual positions. For the third, he is pro-individualist but the "therefore" is wrong, and also the topic "mental health" includes things like the insanity defense which aren't just an individual issue.

Your supposed anti-libertarian insights are basically correct – but Szasz already knew them and wrote about them.

Of course what is labelled "mentally ill" depends on the social context, rather than being objective. That was a major point Szasz made. Have you read his books?

> Obviously there are times when this is needed.

Here, where you advocate coercion, you have an actual disagreement with me and Szasz. This, not your points 1-3, is your basic disagreement with Szasz. It's the standard disagreement most people have: they favor coercion, he and I do not.

[JustinCEO]

http://en.wikipedia.org/wiki/Thomas_Szasz

> In 1938, Szasz moved to the United States, where he attended the University of Cincinnati for his Bachelor of Science in medicine, and received his M.D. from the same university in 1944.[7]

[saalweachter]

Fine, he was a morally bankrupt doctor. I agree I should not have claimed otherwise in my initial invective and apologize for my error, but let me reiterate: his stance on mental illness did not originate from his medical or scientific observations, but from his philosophy. And despite living through fifty years of startling advances in medicine, where huge swaths of mental illness were found to have biological origins in the brain, he never recanted. So fuck him, he was an asshole.

[doktrin]

> And despite living through fifty years of startling advances in medicine, where huge swaths of mental illness were found to have biological origins in the brain

Pretty much this. Having just heard about him today, it's clear his [Szasz] statements reflect technological limitations of yesteryear combined with intense personal bias.

Why anyone would still espouse the concepts this guy put forward is beyond me.

[prestadige]

If science had found biological origins or symptoms for mental illness in the brain, don't you think these would be used for diagnostic purposes?

Szasz was indeed a deeply unpopular man, but progress often depends upon such people.

For instance, did you know that he was the first psychiatrist to claim publicly that homosexuality is not a disease? (In 'Sexual Inversion: The Multiple Roots of Homosexuality', ed. by Judd Marmor, Basic Books, 1965)

[vonmoltke]

> If science had found biological origins or symptoms for mental illness in the brain, don't you think these would be used for diagnostic purposes?

Science has found biological symptoms for Alzheimer's and rabies. Unfortunately, these can only be firmly identified post-mortem and are thus not useful for diagnostic purposes. Just two examples if diseases with biological markers that are not useful.

> For instance, did you know that he was the first psychiatrist to claim publicly that homosexuality is not a disease? (In 'Sexual Inversion: The Multiple Roots of Homosexuality', ed. by Judd Marmor, Basic Books, 1965)

A broken clock is right twice a day. When you claim mental illness doesn't exist in toto, then of course you will be "right" about bullshit mental illnesses like homosexuality.

[gruseom]

I like Szasz too, as well as his hippie counterpart R.D. Laing (whom you might check out if you're interested), but please, don't play intellectual hardball in this thread. The OP just lost his brother.

[mynameishere]

How is he playing hardball? He's being dickish crank. BTW, dickish crank, your hour-old xenophanes2 account seems to have already been hell-banned.

[xenophanes]

People are spreading very bad, destructive ideas that will result in more dead brothers. I think that's more important than being "nice".

Also, Szasz and Laing are closer to opposites than counterparts. See for example:

http://www.amazon.com/Antipsychiatry-Quackery-Squared-Thomas...

Quote from the book, by Szasz:

> In the late 1960s, a group of psychiatrists, led by David Cooper (1931-86) and Ronald D. Laing (1927-89), began to criticize conventional psychiatry, especially so-called somatic treatments. But instead of advocating the abolition of Institutional Psychiatry, they sought to replace it with their own brand, which they called "Anti-psychiatry." By means of this dramatic misnomer, they attracted attention to themselves and deflected attention from what they did, which continued to include coercions and excuses based on psychiatric authority and power. Thus, antipsychiatry is a type of psychiatry. The psychiatrist qua health-care professional is a fraud, and so too is the antipsychiatrist. In Psychiatry.The Science of Lies, I showed that psychiatry-an imitation of medicine-is a form of quackery. In this volume, I show that antipsychiatry-a form of alternative psychiatry-is quackery squared.

> For more than a half century, I have consistently asserted two simple but fundamental propositions: mental illnesses do not exist, and coercions justified by them are wrong. Anyone who seeks to help others must eschew the use of force. Not a single antipsychiatrist has ever agreed with these principles or abided by these practices. Subsuming my work under the rubric of antipsychiatry betrays and negates it just as effectively and surely as subsuming it under the rubric of psychiatry. My writings form no part of either psychiatry or antipsychiatry and belong to neither. They belong to conceptual analysis, social-political criticism, and common sense. This is why I rejected, and continue to reject, psychiatry and antipsychiatry with equal vigor.

[ChrisClark]

So, what you are saying is that if I notice that a friend of mine is suicidal, I should not try to spend time with him in person?

Am I still allowed to talk to him on the phone? Email? Can I be within a kilometer of his house? Is it like a restraining order?

All the comment you replied to is saying is that if you notice a friend in trouble, spend time with him. You seriously think that is an awful thing?

[scott_s]

What did Mz say that you are objecting to? Everything she said aligns with what I have read and heard about suicide.

[doktrin]

If I understand the parent correctly, he agrees with a certain Thomas Szasz' [1] opinions on psychiatry. Central among his opinions is the assertion that mental illness is a "myth" due to the lack of observable changes at the cellular level (or at autopsy), and that mental illness patients are "malingerers".

My opinion : the dude sounds like an ass and his opinions are eye-rolling.

[1] http://en.wikipedia.org/wiki/Thomas_Szasz

[einhverfr]

Mental illness is a really tough thing to discuss in an objective way. See the debates about the DSM-5. I personally think mental health and mental illness are socially constructed.

This being said, the experiences relating to mental illness are very real. The larger question is how we make sense of them as a society. For something like depression how much of the illness is cognitive? How much is biological? How much is social? Somehow that last question never gets asked.

[doktrin]

> I personally think mental health and mental illness are socially constructed.

> This being said, the experiences relating to mental illness are very real.

What's the logical basis for this pair of assertions? How can the "experience" be real while the illness is not?

[einhverfr]

> What's the logical basis for this pair of assertions? How can the "experience" be real while the illness is not?

What is the difference in value between a $5 bill and a $20 bill? Is this difference not both real and socially constructed?

I.e. why do you assume that what is socially constructed can't be real?

The question is, really, what goes into the experience and what are the limits to the current science. If it is socially constructed, the science is limited to the current cultural context.

[Mz]

That last is very hard to ask because the vast majority of people are raised with either a guilt or shame model, thus asking it comes across as finger pointing.

Anyway, I need to go so cannot elaborate.

[einhverfr]

It's not a question of finger pointing so much as asking what social structures we have that make this harder.

You mentioned your kids live with you. How hard would it be if they didn't? Does the fact that we stigmatize adults living with their parents and make mental illness into an individual problem contribute to it?

[Mz]

FYI: I have done lots of reading. I spent time in therapy. Etc. And, for a time, I essentially had an unpaid "consultancy" where parents who had super difficult kids who had been failed by all the experts would get given my email address and talk with me a bit and a year or so later I would hear back that their "impossible" kid was getting their act together. So I strongly suspect that I know what I am talking about, better than most so-called experts.