03.27.2015 07:37 AM

Harm, self-harm and depression

Quote:

Investigators are focusing on whether a “personal life crisis” led a Germanwings pilot to intentionally crash a plane into the French Alps on Tuesday, Bild Zeitung reported, citing unidentified security officials.

Authorities are trying to determine whether Andreas Lubitz’s relationship difficulties with his girlfriend played a role in his apparent decision to initiate the descent into the mountainside, taking 149 passengers and crew to their deaths on Germanwings Flight 9525, the newspaper reported.

The first officer, who had a history of mental illness, had to repeat some stages of flight school because of depression and was occasionally listed as “unfit to fly” during his training in Arizona, Bild said.

Over the years, I’ve had too many friends whose depression spiralled downward into suicide and self-harm. At Bishop Carroll, two artistic, sensitive members of our 531 Club killed themselves in 1977. Periodically, I Google their names, hoping to find some evidence that the world remembers them in some way.

And, in the intervening years, I’ve had other friends and colleagues who did self-harm. In the punk scene, in fact, it was pretty common to see evidence of people burning cigarettes into their arms, or slashing themselves with razor blades. I figured most of that was for shock value – the Germs elevated it to a trend with Circle One – but maybe I was wrong about that.

I’m no expert in depression, but I had always assumed that people suffering from it mostly harmed themselves, not others. If the early reports about Andreas Lubitz are true, however, that assumption is plainly wrong. Lubitz’s apparent act of suicide was also an act of homicide, on a massive scale.

Can anyone refer the rest of us to writings on this issue? It’s important, I think, because it may help answer the “why” that lingers over then tragedy of Flight 9525. It’s also important because I suspect we are going to now see measures to exclude people with depression from certain roles in society – like airline pilots.

And, comments are open, as always. Tread lightly, please.

26 Comments

  1. ABlanas says:

    The why is fairly simple: An opportunity presented itself, and he acted with self-destructive impulse.

    He could not have planned it with deliberation for this particular time, because for short flights it is rare for a pilot to leave the flight deck. The opportunity simply came upon him, and he seized it.

    I am thinking that the better way for the captain to handle things might have been to stop banging on the door, and calmly discuss the situation with him (I know, easy to say in retrospect)… but there might have been a way to wedge open the suicidal pilot’s mind to a resolution through calm discussion. Instead, each slam of the door with the fist or with an axe caused him to withdraw even deeper.

  2. doconnor says:

    “I had always assumed that people suffering from it mostly harmed themselves, not others.”

    They mostly do, but there are always exceptions. It’s not unusual to read about people who kill their family and then themselves. This probably happens a couple times a year in Canada.

  3. Mark Roseman says:

    In general, people with mental illness are far more likely to suffer harm (at their own hand or that of others) than cause others harm. This is true of depression as well. But like everything, there are exceptions. And while it’s hard enough to accurately diagnose people when they’re with you and you have enough time, doing it retrospectively is a fool’s errand. Yet, it’s also very common for people to have more than one mental health diagnosis, including certain personality disorders that tend to devalue the lives of others. Depression is too often used as a shorthand for something far more complex that may or may not be fully understood.

    Ultimately, you can’t prevent a single person causing harm to people, or you’d need to ban individual doctors and other health care providers, crane operators, amusement park ride operators. And then if you have two people working together who have a suicide pact…

  4. Joe says:

    I am no expert on depression either but I have lost family and friends to suicide and to be honest I don’t know that suicide is always depression related. In the case of my son he had no symptoms of depression and in the light of evidence it was almost like he was looking for a ‘reset’ button. In the bits we were able to find it seemed that he was looking to start over not end it all.

    None of which explains the actions of the copilot.

  5. MC says:

    On the question, but not on point. http://www.officer.com/article/10744560/murder-suicide-when-killing-yourself-isnt-enough; http://www.jaapl.org/content/37/3/371.full; http://theviewfromhell.blogspot.ca/2009/03/murder-suicide-and-murder-suicide.html.

    Seems most stuff deals with the narrower case of murder-suicide amongst intimates. But I didn’t read those articles in detail – perhaps they go further.

    This one on suicide bombers is not likely strictly relevant to this case either. https://www.psychologytoday.com/blog/insight-therapy/201009/understanding-the-suicide-bomber

    Fact is, we might never get to the bottom of what went on in this guy’s mind.

    This one (http://www.psychcentral.com/library/depression_general.htm) lightly comments: “The most serious complication of depression is suicide. About 15 percent of patients with untreated depression will kill themselves. … In some cases, depressed patients may think about harming others.”

    As for the better way to handle it thought (ABlanas above): yes, maybe. But perhaps being in a plane heading straight into the side of a mountain creates a minor sense of urgency.

    • Patrice Boivin says:

      re. the suicide bombers, I read that (some) suicide bombers do it because they were promised their family would be given money in exchange.

    • Mark says:

      As an aside, often in the cases where very depressed people kill themselves and their family, the thought process involves not wanting their family members to suffer any further in an inherently bad world, or in other words, they are doing what they perceive as best for their family members who they love very much. That isn’t relevant in this situation where it’s a plane load of strangers of course.

  6. Russ says:

    I have been told that the average length of time between someone deciding to commit suicide and acting on the thought is 10 minutes. I don’t know how you protect against that. We don’t, as a society, deal well with mental illness in any of its myriad forms. That is something we can address. All it takes is a willingness to confront those demons.

  7. edward nuff says:

    please read “the noonday demon” An Atlas of Depresson by Andrew Solomon or better yet beg borrow or steal the audiobook as read by the author. It was a pulitzer prize finalist for him. I’ve never heard the subject so passionately described. The insights were staggering and a reminder of how much so many of us go through.

    http://andrewsolomon.com/books/the-noonday-demon/

  8. edward nuff says:

    further to Andrew Solomon. Here is a brilliant piece he wrote for the New Yorker before he wrote the book.
    Lastly, Wilhelm Reich famously said
    “Depression is the collapse of illusion in the face of reality.

    Much will be written and guessed at in the days to come about this vicious disease for which there is no cure. It will afflict 1 in 5 and the drugs can help and therapy works sort of if you are rich enough to afford it otherwise you’re pretty much on your own. I urge no=one listen to the usual wingnuts who will come out of the woodwork who have no idea of what it feels like to suffer this disease that gets worse every time it reoccurs.

  9. Craig C-E says:

    Went on a bit of a ramble with my thoughts; rather than clutter the comment section, I put them here: http://cce-wakata.blogspot.ca/2015/03/kinsella-depression-and-why-mental.html

    What I had to say boils down to these points, though:

    – a focus on isolating people suffering depression is like quarantining people who’ve caught a cold. It doesn’t solve the problem. Education, hygiene and environmental design are crucial factors to consider if we’re serious about addressing this.

    – depression creates a mental shroud around the person afflicted, effectively removing them from the world around them. Sociopathy and narcissism do the same thing, except they rise to the top while people weighed down by mental illness sink to the bottom. If we’re going to exclude people at one end of the spectrum because they may crash a plane as a result of their condition, what should we do at the other end to those who drop bombs or defund essential services as a consequence of theirs?

    Not trying to be polemic; I think it’s a necessary conversation that is long overdue. http://www.ted.com/talks/dan_ariely_on_our_buggy_moral_code?language=en

  10. kre8tv says:

    To me, it comes down to a matter of balance between rights and responsibilities. All people have the right to not be prejudged by a medical condition as a barrier to employment. On the other hand, when that job involves the care of others, people do have a responsibility to disclose information that could hinder one’s ability to perform their duties reliably.

    There is, of course, another angle on this terrible story. The very same measures that were put in place post 9/11 to protect passengers–locking the cockpit–contributed to this senseless tragedy. It underlines a lesson we as a society seem bent on ignoring: that every measure we adopt in the name of safety carries with it an infinite number of consequences that we never imagine form the outset.

    Mental illness did not bring down this plane, but it was a factor. Same point stands for design decisions.

  11. Dr Bukhanovsky says:

    Mass Homicide As A Societal Norm

    “We committed revolutionary suicide protesting the conditions of an inhumane world.” – Jim Jones final sermon to the 918 doomed souls of Jonestown.

    The phrase “revolutionary suicide” was derived from Huey P. Newton, Maoist and leader of the Black Panthers. The intersection between death cults and elites has deep precedents. For example, there was a long standing symbiosis between various progressive political machines and Jim Jones. Seven months before the mass-murder in the jungle compound, Harvey Milk wrote to Jimmy Carter: “Rev. Jones is widely known in the minority communities here and elsewhere as a man of the highest character, who has undertaken constructive remedies for social problems which have been amazing in their scope and effectiveness.” Milk’s intent was to assist Jone’s abduction of a six-year-old boy: “Not only is the life of a child at stake, who currently has loving and protective parents in the Rev. and Mrs. Jones, but our official relations with Guyana could stand to be jeopardized, to the potentially great embarrassment of our State Department.” The boy perished.

    Jones was also a Maoist who envisioned something akin to the Cultural Revolution. Marceline Jones admitted in a 1977 New York Times interview that Jones was trying to promote Marxism in the United States by mobilizing people against religion via front groups citing Mao Zedong as his inspiration: “Jim used religion to try to get some people out of the opiate of religion” and had slammed the Bible on the table yelling “I’ve got to destroy this paper idol! You’re gonna help yourself, or you’ll get no help! There’s only one hope of glory; that’s within you! Nobody’s gonna come out of the sky! There’s no heaven up there! We’ll have to make heaven down here!”

  12. Steve T says:

    If indeed the pilot crashed the airplane due to mental illness, it presents an interesting conundrum with regard to medical privacy versus public safety. From the information released so far (which admittedly is sketchy), the co-pilot deliberately withheld information about his medical condition, and ignored his doctor’s orders to stay home from work.

    I don’t know about the laws in France and Germany, but here in Canada it would be illegal for the doctor to notify the airline about the co-pilot’s condition. Is that appropriate, or should there be some jobs where the safety of the public outweighs the individual’s right to medical privacy? Might there be 149 innocent people alive today, had the co-pilot’s mental state been disclosed?

    This is especially worth discussing in the context of Lufthansa’s liability. How is it fair to hold the airline legally liable for something that the co-pilot deliberately withheld?

    Warren, you have a legal background. What are your thoughts?

    • Telmea Story says:

      Here in Manitoba, a doctor can recommend that my driver’s license be suspended if I do not submit to a medical examination for a variety of conditions. I assume the same would apply to a pilot’s license.

  13. mississaugapeter says:

    http://en.wikipedia.org/wiki/Federal_Express_Flight_705

    Depression comes in all kinds of states. And yes, almost all endure it internally. Unfortunately, not all. Even more unfortunate, that anyone has to endure depression at all.

    http://news.aviation-safety.net/2013/12/22/list-of-aircraft-accidents-caused-by-pilot-suicide/

    Way too may murder-suicides to list.

  14. Peter says:

    I’m skeptical that this can be explained by such a nebulous, all-purpose concept as depression. Depression is very real, but the term covers a wide range of chronic and situational conditions with highly imperfect understandings of its causes and treatments. There are people in the throes of the disease who are awash in suicidal thoughts and can’t function or even get out of bed in the morning, but they don’t do anything like this or resemble this guy. Many recover, some don’t. Some treatments work, except when they don’t.

    In the old days, this kind of inexplicable evil would have been seen as the work of the Devil. Today we scorn the very word evil and are desperate to find a “rational” explanation. There will be no shortage of journalists and sages in the caring professions assuring a public comprised of amateur shrinks (we’re all Freudians now) that we can “learn” from studying him in order to detect the “signs” of such conditions and “prevent” future outrages. Look at how many people are almost desperate to believe ISIS followers have mental or emotional dysfunctions and that Islamicist terrorism can be fought therapeutically. As this impulse gets more and more traction, there will be serious repercussions for such things as employment, insurance, security clearances, etc. People afflicted will be fools to seek treatment. Type B personalities will need not bother applying to flight schools. Young people will be well-advised to present the public personas of those gregarious party animals in beer commercials. Say what you will about the Devil, at least He provided room for incomprehensible one-offs.

    • Joe says:

      As my old seminary prof once opined – The devil’s greatest success was conning modern mankind into believing he doesn’t exist. I’m not psychiatrist enough to put any kind of a psychiatric label on the copilot’s mental state but while reading what his ex girlfriend had to say about him, the label evil sprang immediately to mind.

  15. socks clinton says:

    I’m surprised in Germany medical doctors are not required by law to break patient/doctor confidentiality and alert authorities if their patient may become a danger to themselves or the public. It’s certainly the law in Canada and the United States and there’s caselaw to back it up.

    • Ian Howard says:

      That’s the law.
      The reality is that it is very rare and very difficult. With space at a premium in our hospital’s there is a great reluctance to hold someone for mental health reasons. Also the standard for harm is a nebulous concept. Like most people we all know someone who has acting in a troubling fashion. I watched a friend’s life unravel and at one point near the end he was taken by the police to an emergency room incoherent and obviously very troubled. He was released, overdosed, and died on his prescribed anti depressants days after.
      We may have a greater understanding of mental health issues than we did twenty years ago but the truth is that our health care system is overwhelmed already and the likelihood of us allocating greater resources to deal with mental health seems slim.

  16. MississaugaPeter says:

    Speaking about Bishop Carroll, Danielle Smith makes it second self-destructing alum in 2 years. The water was never good in those fountains.

  17. Daisee says:

    It’s called Psychotic Depression, it exists.

  18. King Prick says:

    I’m going to offer an opinion and while I come off as a king prick, i also have suffered—wrong word—endured depression.

    Depression is bullshit. It sneaks up on you like a bad night at the track or like well… A hapless conservative government out to ruin your country, for that matter. One day, you feel like you and then slowly, things change. You feel different. Food tastes different. The air doesn’t smell right. You can’t explain it but you just know that something ain’t right. For someone like me, it started with dark humour and cynicism.

    I’ve always been dark humoured. Nothing has ever been taboo and there’s never been a joke told too soon. Thing is; the humour wasn’t making me laugh anymore. I was just dropping jokes on facebook. (which to me was a major factor in my depression–I’ll explain in a bit) Some people laughed and others attacked. One day, I posted an update on my FB page. A relative noticed it and contacted an uncle to give me a call. Had the person that saw this not felt something was amiss, I may never have realised what was happening.

    After the call, I started to take account of myself and my idea of comedy. I was saying things (seemingly in jest) like: “Oh Christ, I give up. Maybe I should kill myself and get it over with.” It wasn’t what I was saying that surprised me, it was how often I was saying it. The words flowed from my lips more and more easily. I started to think about how I felt in my chest… I was feeling worthless. I was out of a job, had been screwed over by an employer, I was broke and going through a breakup. (Thank god for the breakup because she was more crackers than box of Saltines. So glad I avoided wading in that gene pool.)

    Anyway, I just felt worthless. Everyday. I couldn’t fall asleep and some days, I’d wake up at 6am and before I knew it, I’d look at my watch and it would be 4pm before I rose from bed. I had no idea where the time went. It was around one of those “days in bed” when I woke up, called a friend and completely broke down on the phone. I mean, whammo! A blubbering, sobbing fool. I cracked. I broke. I lost it. The next day I made an appointment with my GP and filled him in on everything. Every thought, every worry, every joke I’d made.

    I enlisted the help of a therapist who requested I go on meds so she could at least work with me. (I couldn’t stop crying. It was the oddest thing. I could be watching Pawn Stars and start blubbering over the subject matter.) Anyway, I tried the meds and they helped, but mine was a mild case. (And if mine was mild, I’d hate to know what severe depression is like.)

    I’m no barometer for those with depression but I will say this: The bile and venom spewed on social media for instance, isn’t helping. Today, people are so wrapped up with being heard and being seen that those that really need to be heard and seen are getting lost in the white noise of nothing more than egos, assholes, idiots and c**ts. I was lucky, someone who knew me and cared, saw me turn into one of those egos, assholes idiots and c**ts and called me on it. It was enough to get me to think introspectively. To face my own self.

    Today, I’m still feeling rather lame but I’m not telling people that I should “go kill myself” either. Believe it or not, that’s huge. I can recognise when I’m on the brink of feeling “not so right” and when I do, I call my GP, set up for an appointment and we have a chat. Sometimes, that’s all it takes.

    So, keep a couple of things in mind. 1) Depression is a Halloween costume. You never know who’s behind the mask. 2) Social media like FB and Twitter, for all it’s positives is, to my mind, an incubator for the most vulnerable. 3) Get over yourself if you don’t think it can happen to you because it can and very well may.

    Finally, this site helped me to unload and educate myself. http://www.depressionforums.org/forums/

    Cheers! (I really mean it!)

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