Depression and Suicide: Why don't we "just talk to someone"?

Why is it so difficult to talk to people about our problems?

Whenever suicide takes a life, there's a massed chorus on the internet to the tune of 'If only they had spoken to somebody!'. Sometimes, a celebrity suicide causes people to reach out to their loved ones, to check in on them. People tell their depressed friends: 'Call me anytime, day or night!' Maybe sometimes the depressed friend actually even reaches out to talk when it gets bad enough.

Mostly, they don't.

But why not?

I have been volunteering in mental health work for over a decade now. I fight for the acceptance and normalisation of a range of mental health issues -- including my own struggles with autism, depression, anxiety, and ADHD. I tell people all the time to get help, that it's okay to be vulnerable, to call a friend and just get it all out sometimes. I check in on people when I'm worried about them.

Even I don't talk.

The only thing keeping me from being actively suicidal right now is a sheer monumental existential rage at an existence and a brain conspiring against me to cause me to want to kill myself. I refuse to give this universe the satisfaction of getting me to snuff myself out before my time. Some days it's a close thing, though. This is not my story, but my credentials should be sufficiently established for now.

This is my life.

Despite all that, despite knowing all I know, I still struggle to talk about it.

Why do we battle with it so much? What is so gods-damned hard about talking to somebody who has already declared themselves emotionally available to you? Obviously, I can't know all the myriad reasons people have, or rationalise, for why they can't talk to someone. I do feel that I have identified a possibly fundamental underlying motivation, though.

I feel that there is a fundamental mismatch between what a mentally healthy and/or neurotypical person means when they say "Call me anytime you need to talk!", and what a mentally ill person hears. (I shall disregard the 99% of cases where this is not a genuine offer, and focus on the rest.)

To the healthy person, this feels like a genuine offer of support. They hope that the depressed person will reach out to them in their hour of need. From the privileged, blissfully ignorant position of mental wellness, they genuinely think that they're up to the task of providing a mentally ill person with emotional support.

They don't realise that mental illness rears its head at the most inconvenient of times, in every conceivable situation you can imagine. They aren't prepared for the emotional turmoil over a stupid meltdown in the shops because brain fog caused you to forget your bank card. For teary 3 a.m. calls where you're so drained from crying that you can hardly string two words together, but you don't want them to put the phone down because you need to know that one human being in the world still cares enough to listen to you breathe and cry. They are made uncomfortable by the visits to your unholy mess of a house where you're so depressed that you mostly just sit there like a stump not knowing what to say to them but not wanting to be alone either. The only emotion you can still feel is anxiety, and that's got you paranoid that they're only tolerating you out of guilt or obligation or common decency.

Their relatively charmed, mentally-healthy lives have not begun to prepare them for the sheer amount of emotional labour it takes to actually support a depressed person emotionally. They're unable to sustain the energy required to be emotionally supportive; because they haven't had to provide themselves or their loved ones with support on a daily or hourly basis, they have not developed the right mental "musculature" to deal with it. So after a while, you stop hearing from them. They stop responding to messages and don't take your calls.

Now, imagine for a moment that this might have happened to depression sufferers before. More than once. Imagine the effect on a vulnerable depressed person when somebody offers to support you and then, not long after, disappearing from your life. Imagine opening up your most vulnerable parts to people, again and again, only to have them drop you over and over like a bad habit.

Depression already has people believing that they're worthless, that nobody cares about them. Your well-intentioned offer of support could end up reinforcing the feelings of worthlessness and self-loathing in the very person you intended to help!

What does the depressed person hear? What have they learned from years of struggling with mental illness in a world that simply doesn't understand? They hear that you want to help them, sure, and that's admittedly nice to know someone cares in principle. So now we're stuck with a conundrum: Don't accept the offer, and give them the impression that you don't want to open up to them; or take them up on it, and accept that this will most likely cost you yet another friendship.

That's what it comes down to, in the end.

Why do we carry our burdens alone? Why do we carry on and keep going, shoring up our facade with humour and acting normal even as the cancer of depression hollows us out inside? Why do we keep out the people around us who want to help us?

Because we want to keep them around. Because historically, sharing our burdens means even greater loneliness as we alienate friend after friend with our fucked-up emotions. Because we would rather have people around at all than to let them in, only to lose them. Because this has happened to us over and over and over again.

This is not our first rodeo, people. We've been down that road. We know exactly where it ends, and we know that that's not where we want to be.

Why are we afraid to talk about our problems? Because we are afraid of losing our friends. Afraid of being back at Disconnection Town (pop. 1), only with an even bigger pile of depression, anger, self-loathing, abandonment issues, anxiety, and sadness to process than we started out with. I'm sure you can see how that would be an unsustainable long-term strategy for dealing with depression.

I don't know where to go from here, but I have an idea where to start. We need to change how we talk about depression and to depression sufferers. To paraphrase the Matrix, perhaps we've been asking the wrong questions all along.

Think about it. You say to someone "Talk to me anytime!" because to your mind, the question of "What does a depressed person need?" returned the answer "To talk to someone, of course!". Which often helps, and is better than not talking about it, but that's not the point. You're still asking the wrong person for advice on how to support a depressed person. You should be asking them. Next time you're speaking to someone struggling with depression, or someone confesses to you that they're thinking of committing suicide, don't simply give them the standard knee-jerk offer to let them talk to you. Let go of your assumptions, except to assume that they know more about their disorder than you do.

Instead, lead with a question. "What do you need?" or "How can I help?" or "What can I do?" should be a good start. When they answer you, listen. Internalise it. We spend most of our lives being talked over and told what to do to feel better. We have tried all the well-intentioned advice in the world. We're still depressed.

I think a lot of the burnout that leads to healthy people withdrawing from a depressed person's life has to do with a perception that if they do it right, we won't be depressed anymore. When their efforts fail to produce a mentally healthy friend, they give up... because if they expect their help to make us better, and that doesn't happen, they either feel like a failure or believe that the depressed person isn't even trying.

You don't need to fix us. It's pointless and it will drain you dry. We're not broken. We're disconnected. Help us feel like a part of humanity again.

Each day that we're still alive, every single fucking day that we choose to wait just one more day before ending it, is a victory. Every day that we choose to take care of ourselves instead of treating ourselves with abuse and neglect, is a victory. Every time that we feel we can reach out to you is a victory. Help us fight the small battles, win the small victories.

Connect with us. Help us reconnect with humanity.

It might be the last chance you get.




(NOTES: I admit to employing some broad generalisations in this piece in order to make a larger point. I am also not othering anyone with the they/us distinctions in the text; this is simply an attempt to illustrate certain differences and disconnects as clearly and simply as possible. Please bear in mind that I am autistic and struggle to express my feelings at the best of times; especially so when it's an emotional topic for me.)