Confessions from a patient with depression: For whom is my heart closed and opened?

Editor's Note

The sunny and cheerful singer Coco Lee committed suicide due to depression, which once again triggered three questions from the public after celebrity suicides: Why did she do it? Why did she do it? Why did she, who was so glamorous, end up with nowhere to go?

The interviewee in this article is as lively and cheerful as Coco Lee and has a successful career, but she is also suffering from depression. Luckier than Coco Lee, she was saved from suicide and has a happy family. She hopes to help more people with her real experience and her thoughts and feelings about depression.

This article is not based on academic research, and due to time and space limitations, it is unlikely to discuss depression in an exhaustive manner. However, I believe that this summary of personal experience should be able to provide a reference for a considerable number of patients with depression and their relatives and friends.

Special Contributor | Fang Xuanchang (popular science writer)

After seeing the news of Coco Lee's suicide, the first person I thought of for an article or interview was the interviewee of this article. She currently lives in the United States, is also a depressed patient who has attempted suicide, has a successful career, and looks as sunny and cheerful as Coco Lee. She even has several more "unlikely to suffer from depression" traits than Coco Lee: humor, love of sports, and profound attainments in the field of medicine. She may not have the same fame as Coco Lee, but she has achieved quite impressive and even world-class achievements in the academic field, especially in a certain amateur work that she is interested in.

But I didn't dare to speak up for a long time, of course because I was afraid that the interview would touch her pain points. Unexpectedly, after another friend of the author made an interview request on my behalf, she readily agreed - just as she said in the interview, she also hopes to help more people.

Sunny appearance vs. self-blame

Fanpu: As a reporter, I may ask some offensive questions, some of which may hurt you. If you are not comfortable or willing to answer the following questions, please skip them.

What was your first reaction or feeling when you heard the news of Coco Lee's suicide? Compared with the news of Leslie Cheung's death 19 years ago, how did the two have a different impact on you? What are the internal and external reasons that led to this difference?

Interviewee: I felt very sad. I was still very surprised, not because I couldn't imagine it, but because I felt that she had such good resources, how could she not control her illness? She was such a lively girl, daring to speak, act, sing and dance, but something still happened to her. I was very shocked and very sad. She was a much more successful person than me, but she still couldn't make it in the end.

Compared to when Leslie Cheung passed away, it does feel a little different. I always felt that Leslie Cheung was an unusual, deep person. He was a very successful actor, but he seemed to have a melancholic temperament. Although I was also shocked by his death, it still didn't seem to be as shocking as Coco Lee's death this time - maybe because Coco Lee is a girl, and she is indeed very sunny.

Fanpu: Coco Lee gave people the impression of being sunny and cheerful on stage, so her suicide surprised many fans. What kind of image do you have of Coco Lee? Can you see that she has a tendency to depression?

You also give people a very sunny impression, and because you always pay attention to exercise, you give people an impression that you are healthier and more sunny than Coco Lee, and even have a strong temperament. When I first heard you say that you have depression and have experienced suicide, I was very surprised. I really want to know if people around you who are familiar with you also find it difficult to understand your mental state. Do you talk about this issue with people around you? Or, are people around you more reluctant to discuss this issue with you?

Interviewee: Coco Lee has always been sunny and happy, and she seems very aggressive. But I don't know why, but I always feel that she seems to be acting a little deliberately. I don't mean to criticize her, but I just feel that she seems to have an inner impulse to overcome herself, so she appears to be too sunny.

Yes, I also look sunny and cheerful on the outside. Many people don't believe that I have tried to commit suicide, and it was the kind of suicide that I would not have survived without rescue. How can I explain it? The sunny appearance and the melancholy inside, the self-confidence and fortitude on the outside and the inferiority and weakness on the inside, can actually be unified in one person. I am such a complex individual.

What is my true self? It took me a long time to examine myself, and with the help of a psychologist, I finally understood my true nature. I am not even sure if I have a complete and accurate understanding of myself.

I rarely talk to others about my depression and the fact that I attempted suicide more than once. I only tell my doctor and never tell my friends and family. After psychotherapy, I will open my heart to two people. That is, if I lose control, I will talk to these two people. They are now my lifeline.

Fanpu: You once said, "Many patients with depression blame themselves more than usual, so they can't blame others, let alone trouble others, and always show happiness and tolerance to others" (Author's note: This is what the interviewee said during a previous online chat) . Is this your own feeling or your observation of other patients? Do you think this can explain Coco Lee's daily behavior?

Interviewee: This is my own evaluation, plus other examples. I can't say there is any scientific evidence, because I haven't read any papers on this issue. I don't know why, but I never look for papers on depression and suicide. I'm a scientist, and it's my habit to look for papers and dig up data, and I do it almost every day. But I haven't looked for papers on depression and suicide. It may be a deliberate or unintentional avoidance.

A family member of a good friend of mine has been struggling with depression and self-harming. Although he has not yet taken suicidal actions, he has been hospitalized for treatment many times because of the fear that he will really take action. Every time he wakes up, he will say things like "I'm so sorry", "I couldn't control myself again", "I've caused you trouble again", etc. He also always says "I seem to be a really useless person in this world."

I lost a friend a few years ago. We were classmates in different departments in college. He was courting my roommate, so we often joked with him. After coming to the United States, we often chatted on WeChat. Many people said that he was an extremely humorous person, and his articles were also very interesting to read. He had a successful career overseas, a beautiful and capable wife, two children, and excellent academic performance, but he still chose to pass away due to depression.

From our conversations, I always felt that he was always praising his wife, children, and even his classic car, but he was silent when it came to himself. I wonder if it was a sign of self-blame. We had never discussed depression. I guess he didn't know I was depressed, and I didn't know he was depressed. We just joked with each other and talked about other people's things, never knowing that we both actually had the same disease.

I often see people trying to persuade suicidal people like this: Think about your parents, how can you let them die young? Think about your children, think about your husband or wife, etc. I think this method of persuasion is useless, if not adding fuel to the fire.

I hope everyone can understand how difficult it is for people with depression to stop themselves from taking this path, and how much effort they have made. We have tried hard to consider our parents, our brothers and sisters, and we can't let go of our lovers and children. If we don't consider others, many people may have taken this path earlier. So this kind of persuasion is very difficult to accept. Not only did it fail to help me solve the problem, it was equivalent to blaming me for not thinking of these people, which can only make our self-blame further deepen (Author's note: Because Coco Lee left behind an elderly mother after her death, there have been comments online accusing her of suicide as irresponsible behavior).

"Suicide is just one of many solutions"

Fanpu: What is the main factor that led to your depression? Under what circumstances did you first discover or realize that you had depression? Was it a gradual process or a sudden process?

Interviewee: I can only say that I don’t know why I am depressed, why I am depressed to the point of committing suicide, I don’t have an answer. The psychologist helped me analyze it, because there were many contradictions in my growth process. My parents had high hopes for me, but I felt that my parents’ expectations of me and what I wanted to do were almost completely inconsistent.

It was not until my first suicide attempt that I was diagnosed with severe depression and suicidal impulses. Before that, I had no idea that I had depression, and no one had ever told me that I had symptoms related to depression, such as "looking depressed."

Fanpu: What was the background of your first suicidal thoughts? What was the background of your actual suicide? What was the psychological and physiological process?

Interviewee: The first time I attempted suicide was when I actually put it into practice. At that time, I was in the painful process of divorce, but I never thought that divorce was the reason for my suicide. I can only say that the hurt caused by the divorce process may have played a small role in promoting my suicide, but it was not the fundamental reason.

After I woke up, I only admitted to my friend who saved me and my boss that I committed suicide. I refused to admit it to the doctor. Why? Because I found that after I was rescued in the emergency room and could speak, a psychologist and social worker came to evaluate me immediately. If I admitted that it was suicide, they would send me to hospital for monitoring. I felt that the matter would be out of control. This was still due to self-blame.

Outsiders may not understand, as if I didn’t seek help when I needed it the most, but blamed myself. But at that time, I would only think: I didn’t handle my own affairs well, and so many people were busy running around, why should I cause so much trouble to others? Self-blame can be said to be my main theme.

I remember it very clearly. After I woke up, the doctor wanted to know what medicine I had taken. I didn’t know what it was made of. I only knew it was a sleeping pill. It was not bought from a pharmacy, but a sample from my ex-husband’s pharmaceutical factory. Then the doctor told my boss to call him immediately to ask what the medicine was made of and what the dosage was. They were right next to my bed at the time, and my boss took the phone and called. I was very embarrassed: it was all my fault, and it caused trouble for both my boss and my ex-husband. It can be said that I blamed myself to the extreme.

The doctors were very responsible at the time. Seeing that I didn't admit it and that someone else was with me, they guessed that I was too embarrassed to say it, or couldn't say it, so they took me to another room and asked me if I could tell them truthfully whether I was planning to commit suicide. I insisted that I didn't commit suicide, but because I couldn't sleep and forgot to take the medicine when I took it, it was just an accident. This would avoid sending me to the hospital.

Fanpu: After Coco Lee committed suicide, many members of the public could not understand how she could have ended up like this given her good conditions.

Interviewee: When I hear someone commits suicide or hurts themselves, I think the first question many people ask is why he/she becomes depressed or commits suicide? The second question is why did he/she commit suicide?

For the first question, as a person who has experienced it, I can say that I don't know. I really don't know. Was he sick? No one is completely healthy. Everyone has a little illness. Was he short of money? No, I thought I had plenty of money at the time. Was he afraid of losing his job and not being able to find a good job in the future? No, I was doing well, and I had just been transferred from a postdoctoral fellow to a research assistant, and my salary had increased by several thousand yuan.

Of course, it's not that I don't have anxiety in my life. I was going through a divorce at the time, and the process hurt me a lot, but I'm not the kind of person who would cry, make a scene, or even hang himself, and I always look down on people like that. So I really can't answer why I hurt myself. The only thing I can say is that divorce is indeed a trigger, but I don't think it's the main reason.

Let's talk about the second question, why him/her? Others will be surprised to see me take that path. Why is it her? She looks very outstanding. People who know me will say that she is the youngest child of a professor, very spoiled, always ranked first in high school, went to a very good university, went to graduate school after college, and found a job immediately. How can such a successful child, the one that everyone talks about, be so depressed?

I have some understanding of my own situation. In general, I am a very contradictory person. On the surface, I must be the funniest person in the crowd. I remember when I was in college for military training, within two days, all the girls in the class gathered around me to listen to my jokes, saying, "This guy is really funny." If there is something, I want to say it positively and make a good joke to make everyone happy; but if I want to criticize someone, I will become very sarcastic, and make people think it is quite humorous. From the outside, I have a good family background, I am not ugly, and my grades are good. What is there to be unhappy about?

I think the years of meeting with the psychologist were very soul-touching. The psychologist helped me analyze my family environment, my upbringing, and the things I had experienced. What touched me the most, what surprised me the most, and what I even wanted to deny, was the influence of my family on me.

As I mentioned before, I am the daughter of a professor. Both my parents are professors. They received the highest education in China at that time. When most people did not even have the opportunity to go to college, both of them graduated from graduate school. Many people describe my parents as one is elegant and the other is lively, beautiful and versatile. At home, I think my parents are very good to me. However, after so many years, I have dug back and found many negative factors with the help of a psychologist that I did not think were important before, but actually had some influence on my growth and the formation of my personality, as well as how I look at things and solve problems.

For example, I am the youngest child in the family. In other people’s eyes, the youngest child must be the apple of their parents’ eye. The reality is that my parents told me from a very young age that they didn’t want me, and they had no concerns when they said it. When I grew up and understood more, they also told me that as soon as they found out that they were pregnant with me, my father immediately went for sterilization. This action showed that they really didn’t want me. My mother had an abortion when she was pregnant with me. At that time, there was no one-child policy, and the doctor refused to give her an abortion. I was saved by the obstetrician and gynecologist. Later, my mother had to be pregnant with me, but she tried every means to give birth to me as soon as possible. After all the trouble, I came into this world a month earlier. My grandmother told me that when my father saw me for the first time, he said, "Oh, why is this little girl so ugly?"

They often joke with me at home, saying that you are so dark, you are not our child, you were wandering on the street and we picked you up; sometimes my family members say to me, do you know where we picked you up? We picked you up under the chimney, that's why you are so dark.

When my psychiatrist heard about these things, he asked me how could they talk to me like that? At that time, I was unwilling to admit that such an environment would have any impact on me. I even thought that the psychiatrist was making a big deal out of nothing. Of course, I no longer think so now.

The last question is, when many people hear someone commit suicide, they will wonder, is he really desperate? Why would he choose to end his life to solve this problem?

At least in my case, **I didn't choose the solution to the problem because I had exhausted all other ways and had no other options. For me, suicide is just one of many solutions. I don't even see suicide as any different from other methods, or at least not particularly different. **More than 20 years have passed, and I still have suicidal thoughts. I did another psychological evaluation this year, and the conclusion was that I still have mild depression and suicidal tendencies, but the doctor thinks that the control methods I have mastered seem to be effective and feasible.

Suicide has never been my last resort, but like all my other options, it pops up from time to time, and sometimes it is even the first thought that pops up, just die. This is very strange to others, as if death should always be the last resort. However, for me, a patient with depression, suicide may not be the last resort, but one of many solutions. As for the ranking of various solutions to the problem, where suicide should be ranked is different for each person.

Seeking help: "I am not a burden to others"

Fanpu: When did you develop the habit of exercising? Does exercise help you control your condition? Did you later (try to) actively correct your tendency to blame yourself?

Interviewer: I have always been a great athlete. From elementary school to middle school, I could always get first place in three events in every campus sports meet. After entering college, I could even get second place in the school sports meet.

I personally think that physical exercise is helpful in controlling the disease. Whether it is running alone or playing ball with good friends, every exercise is very pleasant during and after exercise.

The psychologist helped me make great progress and realized that it was wrong to blame myself in many cases. My self-blame did not make my family or friends feel relieved, but actually put them in a dilemma. If I stopped blaming myself and asked them for help instead, I could not only free myself, but also free others.

Fanpu: You once said, "My current teammates have contributed the most to my survival." Can you elaborate on this? What roles have the care of your family and the help of society played in your life?

Interviewee: It is hard to say what role social help plays. After all, I haven’t told many people about my situation, and I called a suicide hotline once but didn’t get any help. So I personally think that the help I received from society is negligible.

The ones who helped me directly were basically my doctors, psychologists and psychotherapists, who were all great. I saw psychologists and therapists for three years, and they really gave me a lot of different perspectives on the world and my own life. They taught me how to deal with emotional fluctuations, and the most effective way for me was to seek help from family and friends in a timely manner, and seek help from the people closest to me.

My current teammate is a very kind person. Sometimes I even think he is too kind. How should I put it? We have the same hobbies but have different ways of dealing with things. I am a person who strives for perfection and speed, while he is a person who is more relaxed and willing to find happiness. He is the first person I will ask for help. If I am not in a good mood, the idea of ​​suicide comes up again, or the idea of ​​suicide flashes a little too frequently, he is the first person I will ask for help. I will tell him that something seems wrong. Do we have time to talk or do something? He will take action immediately and change his original plan to see what is best for me. Most importantly, he will listen and participate.

My condition is not so serious that I will take immediate action. If I have some bad thoughts occasionally, I can talk to him or go out for a walk, or even take my favorite self-driving tour, and many things will disappear. So it is very reassuring to have such a person around. During the psychological evaluation this year, I told the psychologist that I am confident with him and can manage myself well.

The second person I could turn to for help is my best friend. We grew up together and now understand each other very well. Last time, after I was rescued, the hospital sent me to her home. I can be free at her home. I trust her without reservation, and she will help me without reservation.

So, these two people are my lifeline.

Fanpu: There are reports that Coco Lee's marriage and family have had a series of problems for a long time (her husband cheated on her, and there are reports that they were facing divorce in January this year). Based on your understanding of depression, is it possible for Coco Lee to save herself under such circumstances? If you allow time to go back, what advice would you give to her and her family (such as her mother) a few months ago?

Interviewee: This is too difficult. To be honest, I don't know what advice I can give her or her family. I did go through this myself. Although my suicide cannot be attributed to the breakdown of my marriage, that was also a factor.

Feelings are hard to explain. Sometimes letting go is the wisest choice. Although it seems that letting go gives the other person more freedom to be promiscuous, in fact, isn’t it giving freedom back to your soul, which should be free? How wonderful! In fact, looking back after the divorce, I feel that my persistence at that time was meaningless. My growth process after the divorce can be said to have broken free from the shackles and lived a free and comfortable life.

Fanpu: You said that suicide hotlines are ineffective. Can you explain why? Long waiting times may be one of the reasons. Are there other reasons?

"Finding someone to talk to/help as soon as possible" is very important for all people with depression. Do you think it is possible for society to establish a better mechanism than a hotline? Or can we only remind people with depression to take protective measures in advance so that they can find someone to talk to at any time?

Interviewee: When I called the suicide hotline, I used the old phone number, not the current 988 (Editor's note: 988 is the suicide intervention hotline designated by the Federal Communications Commission of the United States) shortcut format. When people want to call this hotline for help, they still have to dial a number of digits, which is a very inconvenient and unfriendly setting. I think the current 988 is very good. I don't know how long the waiting time is now. When I called, I waited for more than 40 minutes and still didn't get a call.

I recommend that all patients with depression must see a psychologist and psychotherapist. In the United States, they are really professional. Some people may say that it is not worth it to spend so much money to talk to someone. In fact, it is not. You will find that it is worth it. They will analyze you and work with you to find a coping method that suits you. For example, at the beginning they wanted me to do regular group therapy, but I was determined not to participate; later they learned that I had an inexplicable pride that made it impossible for me to confide my inner thoughts to strangers, and I only trusted a few of the closest people. Based on this, the two doctors and I found the most suitable method for me at present, which is to set the two people I trust most as the first people I ask for help.

After three years of psychotherapy, on the day of "graduation", the psychotherapist gave me a book called Wherever you go, there you are. I didn't really read the book, but the title of the book seemed to have inspired me to focus on everything I have already obtained and the achievements I have made.

After three years of psychotherapy, the biggest gain I got was a clear understanding of myself, and I was ready to overturn my understanding of myself and the people around me. The most important thing is not to blame yourself. You have your own reasons for where you are, as well as your family and social factors. **The biggest burden the doctor asked me to let go of is that I am not a burden to others, and I should not blame myself for what I did or did not do. **If I encounter difficulties, I should know how to ask for help, and know that many people around you are willing to help you. This is an effective way I use now to control the idea of ​​self-harm and suicide.

When suicidal thoughts come, I will evaluate myself. Is it a flash of thought or a real idea? If it is just a flash of thought, I will just ignore it; if it is a little more serious, I will see if I can suppress it. If I feel that suicide or suicidal thoughts are a bit serious, or appear more frequently than usual, then I will seek help immediately.

Fanpu: You are now living and working in the United States. From your observation, what are the differences in the views of depression patients in China and the United States? Do people with depression have different social views on this disease in the two countries? For example, is it more taboo to talk about your illness in China? I noticed that you don't seem to deliberately avoid your depression?

Interviewee: In my impression, most Chinese people still think that depression is a matter of being too stubborn, too fussy, or just acting out. So in this environment, people with depression are definitely more reluctant to talk about their condition, and even telling others that they have depression seems to be a very shameful thing.

In the United States, people are not shy about talking about depression or other mental illnesses. I was a little surprised when I first heard a colleague say that he had anxiety disorder, but I became more relaxed after seeing it more often. A colleague who was newly hired last year also said that he couldn't make an appointment with a psychologist after moving to this city because he needed regular evaluations; another colleague said that he had an appointment with a psychologist for a remote consultation and had to use the empty house next door. It can be seen that they talk about their mental problems and see a psychologist, just like I tell everyone that I will go for breast cancer screening tomorrow, and they are very calm.

Fanpu: Are you still afraid of your suicidal tendencies? Do you usually avoid recalling the past? Is accepting this interview a painful process for you?

Interviewee: I still have a slight fear of my suicidal tendencies, but I know that they are currently controllable, and I have methods to control them, so I am very confident about this. But if one day I find that this control method is no longer effective, I will definitely see a psychologist as soon as possible.

I still try to avoid recalling painful past events, sometimes not intentionally. I rarely think of the person who brought me the most pain. He rarely appears in my memories over the years and I rarely dream about him. This may be my own way of avoiding hurt.

It wasn't very painful to do this interview, it was okay.

Fanpu: Among all the questions I asked, which ones showed that I had misunderstandings or even prejudices against people with depression?

Interviewee: I feel okay. Some of the questions are a bit direct. No one has asked me such direct questions in many years, except my doctor. But it doesn’t matter. I also hope to help others.

Produced by: Science Popularization China