Suicide

Documentary filmmaker Liisa Hyvarinen has, she says, experienced the best and worst outcomes of clinical depression.

Just days before her 15th birthday, her father — an accomplished professor of physiology, an avid biker, skier, and gardener, a husband and a father of three — killed himself. The morning of his death, Hyvarinen answered the phone and confirmed her father’s suicide to a local reporter.

“He committed suicide after a long clinical depression that, unfortunately, he was not able to find help for,” Hyvarinen says. That one act, the one that ended his life, ultimately defined him — at least to some.

“Every time I disclosed to anyone how my father died, everything that he ever accomplished in life, which was a lot, all of a sudden got completely eclipsed by his one last desperate act,” she says.

But, she adds, “he was so much more than that.” (For more on his life and accomplishments, see Remembering My Father).

Unlike her father, Hyvarinen’s sister, who also has suffered from depression, has sought help. She now leads a productive, and a happy life, Hyvarinen says.

Those deeply personal experiences, along with media coverage of an unrelated high-profile suicide that “devalued the human being that was lost,” ultimately inspired Hyvarinen to produce Silent Screams. The documentary tells individual stories of depression and suicidal tendencies, but also gives much needed context to depression as a social problem — a shared problem.

The media have an opportunity, she says, to tell better, more complete stories — to tell stories about conquering depression.

“I think there’s a great chance of saving lives … there’s a lot of room here in terms of doing stories about mental health issues.”

In Silent Screams, Hyvarinen tells of intimate struggles with depression — including the personal stories of journalist Mike Wallace and of David Smith, former husband of Susan Smith who was convicted of killing her young sons by drowning them in her car in a South Carolina Lake in 1994. (For more, including video excerpts, order information and advice for journalists, see Silent Screams).

Both men, says Hyvarinen, have shown that severe depression can be overcome. David Smith, she says, “was able to go on with his life, battle depression, battle suicidal thoughts, and then make a new life for himself. I think that’s a very powerful message to anyone else who might have these thoughts.”

She adds: “I think Wallace and Smith both were on the leading edge of famous people being willing to talk about their private pain … because they both believe that by talking about it they can help other people.”

Hyvarinen also believes that it is crucial to place these stories into social and cultural context. Silent Screams, for instance, includes details from the 1999 Surgeon General’s Call to Action Against Suicide, information about suicide among teenagers and in the African-American Community, and about organizations formed to prevent suicide.

Indeed, studies show that suicide is a particular problem among certain segments of society. According to the National Center for Injury Prevention and Control, suicide rates generally increase with age and are highest among Americans over 65. On the other end of the age spectrum, 15 percent of suicides in 2000 were by people younger than 25. Suicide is the third leading cause of death for people between 15 and 24 years old, with gay youths being at particular risk. Suicide rates are disproportionately high among young male Native Americans and have recently increased among young black males. And, frighteningly, suicide has risen dramatically in recent years among children between 10 and 14.

Clinical psychiatrist Frank Ochberg says it’s important for journalists to understand the clinical definition of depression, effective therapies, and the populations most at risk for suicide (For more, see What Journalists Should Know).

Yet this sort of demographic context, and the problem of cultural isolation, is rarely seen in daily news coverage.

“What media coverage hasn’t done,” says Hyvarinen, “is put this very important medical story into a perspective. There are hundreds of thousands of people who attempt (suicide) every year. And these are treatable illnesses, mostly depression. Because of the stigma attached to the subject people don’t go and get help.”

Covering a Community Loss

Cynthia Doyon, a radio host at National Public Radio station KUOW in Seattle, shot herself to death last August. Her death, widely reported since she was well known in the community, continues to haunt those who knew her, and those who listened to her show, The Swing Years and Beyond.

Seattle Times reporter Michael Ko was one of the first journalists to pick up the story. “It was fairly straightforward reporting,” he remembers in an email interview with Dart. “In our daily contact with police, an officer mentioned that some ‘NPR radio host’ killed herself … from there we asked around officially, first to the Seattle Police Department, then the University of Washington Police Department, then the Medical Examiner’s Office.”

As the information gathering continued, Ko inadvertently broke the news to Doyon’s program manager.

“I called KUOW, thinking they might know (if Doyon’s identity had been confirmed),” Ko says. He asked the program director if he’d like to comment “on the Cynthia Doyon situation.”

“He said he wasn’t sure what I was talking about … we went back and forth, awkward, for awhile. He seemed to be in shock. He was very quiet. I apologized…”

Says Ko, “…it was tough.”

On that first day, the Times decided not to go with the story. “We decided we’d rather not break the news to friends and family in the newspaper,” Ko explains. “…There wasn’t any pressing desire or need to absolutely get this piece of info in the newspaper … there’s always a chance of mistaken identity.”

The next day, Seattle Times reporter Ian Ith was able to reach Doyon’s brother, who provided information about her life. Ko and Ith used the interview, along with others, to round out the Times article.

“As far as what to/what not to report, there was a fairly lengthy discussion about how we should describe her manner of death,” says Ko. “The spectrum is to simply say ‘she committed suicide’ to describing everything. We settled for she ‘shot herself.’ Even then, I received several emails criticizing the paper for revealing too much about her manner of death.”

“How did I feel?,” reflects Ko. “During the reporting process, it was simply a job.” But after he turned in the story, he adds, he and his colleagues had trouble making sense out of Doyon’s death.

Months later, Seattle Weekly writer Philip Dawdy tackled the story of Doyon’s life and death in a lengthy cover story. Like Hyvarinen, Dawdy laments the lack of context mainstream media give suicide as well as the lack of attention depression gets as a very real health issue. And like Hyvarinen, he uses individual stories to illustrate the serious medical, social, and personal issues involved.

In his January 14 article One Suicide Too Many, Dawdy bluntly writes of society’s (and media’s) narrow, unhealthy approach to suicide: “We largely accept suicide as the ultimate act of the mentally ill. Bag and tag the corpse and leave it at that. It is, after all, one of the worst social taboos.

“… How can we boldly discuss,” Dawdy asks, “much less stop, this nasty business that claims tens of thousands of lives a year, given a backdrop of social paranoia and blindness?” (For a radio discussion with Dawdy about the Doyon story, see KUOW.org).

Dawdy’s article is a clear and convincing call for better awareness and more responsible media attention when it comes to dealing with suicide. He demonstrates how effective non-objective journalism can be by interspersing his own struggle with depression and suicidal thoughts along with Doyon’s story and health, political, and cultural issues. He also includes a key element to effective trauma reporting — a list of resources for those who need help.

“I know the pathology. I know the impulse. I know the frantic searching for an end to psychological pain,” Dawdy writes. “…Someone has to speak the plain truth: Accepting suicide is wrong. And that's precisely what societal silence amounts to — acceptance.”

Reporting Suicide and Finding a Balance

Journalists, even those who must report within the time and space constraints of daily journalism, often give thought to the most truthful, yet least damaging, way to report suicide. The copycat phenomenon — the tendancy for crimes or suicides to increase after a similar event receives media attention — is certainly not unknown to reporters and editors.

Yet some studies, including a August 2003 study in American Behavioral Scientist, indicate that journalists don’t realize the full extent to which their reporting might result in imitation. The article, “The Responsible Reporting of Suicide in Print Journalism,” traces historical evidence that some news coverage of suicide prompts more attempts. Citing a dramatic increase in the suicide rate after Marilyn Monroe’s death in 1962, the authors note that “the imitative effect of press reporting appears to increase with the prominence and frequency of the story.”

Clinical psychologist Frank Ochberg agrees that this issue of "the contagion of suicide" is one of the most difficult dimensions for journalists.

On the other hand, as Hyvarinen and Dawdy point out, silence can also be lethal.

In his Seattle Weekly article One Suicide Too Many, Philip Dawdy soundly criticizes mainstream media’s coverage of Cynthia Doyon’s suicide. “While murder-suicides often prompt news coverage of ways to protect potential victims, solo acts get little additional attention,” he notes. “… Doyon’s suicide was reported in both (Seattle daily newspapers). Neither newspaper has tackled suicide as an issue. Criminal silence.”

In an email response to Dart, Seattle Times reporter Michael Ko agrees … and disagrees.

“… I definitely agree that suicide is not talked about enough,” he says. “But I'd say that's an issue with society in general, not just with the mainstream press. My friends don't often talk about death. It's awkward to talk to a friend about depression and even more to suggest they do something about it.”

Ko continues, “As Philip (Dawdy) mentioned, we don't write about suicide in the newspaper unless it's public or it involves a public figure. But I'm considering the alternatives: Should we write about every suicide? There are probably hundreds or thousands every year. It doesn't seem practical, it seems kind of morbid, and not really news.

“ … I thought we covered Doyon's suicide pretty well. She was a public figure who killed herself, and we thought our readers should know about it. I thought the story was respectful and professional. Should we have used her death specifically to illuminate the problem of suicide? We don't use every drug death to write about the city's drug problems, or every domestic violence incident to highlight that ill.”

Still, as media representatives search for ways to responsibly cover suicide — balancing between fighting the stigma, protecting privacy, and avoiding the likelihood of copycat incidents — more help is becoming available. The 1999 Surgeon General’s report, along with work like Hyvarinen’s, offers guidelines to effective and sensitive reporting.

Ochberg stresses that knowledge about depression and suicide is crucial for good reporting on the topic — reporters must know enough about the medical aspects of depression not to fear the topic. And, he says, more coverage of larger issues connected to depression and suicide can help educate the public.

Hyvarinen suggests that media organizations develop detailed plans on what to report and what not to report. And, she says, it’s the idealized media images and tributes that are most likely to lead to copycats.

If done responsibly, she says, media reports on suicide can help to remove the stigma of depression, lead people to vital mental health resources and, perhaps, save lives.

Remembering My Father

Dart Center Fellow and documentary producer Liisa Hyvarinen lost her father to suicide a few days before her 15th birthday. Here, she remembers him as scientist, husband, father and man — far more than just a victim of suicide.

Väinö Juhani Hyvärinen was a respected professor of
physiology at the University of Helsinki who did leading research on the human brain and brains of monkeys. His reseach together with my mother, Dr. Lea Hyvarinen (a world reknowned opthalmologist and expert in vision development) led to the development of the "Lea" eye charts after his death.

The Lea charts are used worldwide to help screen young children's vision (see Lea-Test.Fi for more information about my mother's eye charts). My father also wrote textbooks in his area of expertise and contributed to many scientific studies and research projects and published articles in respectable medical publications.

He served as a Fellow at Johns Hopkins in Baltimore in the late 1960s before setting up his research lab at University of Helsinki. When I was growing up he would frequently bring home other leading researchers, even winners of the Nobel Prize.

As a man, my father was a good downhill and crosscounty skier. He loved to entertain and would always want to sing in his university department's Christmas party skits even though he was tone deaf and had a horrible voice. He figured if he made fun of himself he'd make everyone else at the party more comfortable and would thus help break the ice. He was an avid biker — from end of March/early April (when Helsinki where I grew up still has snow on the ground) until October he would ride his bike to work from the suburbs — some 30 miles round trip.

He loved boating — we would take a trip on his uncle's boat every summer. My father would always be the pilot and when in later years we switched to a sailboat, he could wait to try and pass on his love for sailing to us — his three daughters. He was also an avid gardener as well and was always planting new rose bushes and taking care of our yard.

As a father, he was incredibly strict about education. He had grown up during and after World War II and valued the education he had received. He knew what it was like to not have things because during the war there were few supplies his mother could find and his own father was out serving as a soldier.

He learned from that to work very hard — and he also learned to hate pasta. Pasta was one thing his mother could find to feed him and his three younger sister. Although my mother is an excellent cook an dloves to make Italian food, my father would always decline pasta because in his words "he ate all the pasta he could take" when he was a child during the war.

Depression: What Journalists Should Know

It’s important, says Dr. Frank Ochberg, for journalists to understand the clinical definition of depression, and the connection between depression and suicide, in order to approach the topic in a knowledgeable and responsible way.

For instance, he says the medical diagnosis of clinical depression stresses a biological base. “In the brain, something has broken in the systems of mood regulation,” he explains. “On the outside you look slow, speak more slowly, appear tired…feel hopeless and worthless.” Clinical depression may also have physical symptoms, including indigestions, headaches and backaches.

There’s an important difference, Ochberg continues, between major depressive disorder and adjustment disorder with depressed mood (for more on these differences, see Mood Disorders on the Parent and Teen Resources website). But, both may lead to suicide.

It’s also important not to directly associate suicide with clinical depression, Ochberg says. Most people who are clinically depressed will not attempt suicide, and some who attempt suicide are not depressed in the medical sense. “Certain kinds of suicidal situations need to be understood as distinct and different from other situations,” he says, noting that age, gender and other demographic factors may influence the suicidal behavior.

Understanding effective treatments is also key in understanding depression, adds Ochberg. “When the mood thermostat is damaged, it can heal itself, but it usually does best with anti-depressant medication, often with anti anxiety medication.” Cognitive Behavioral Therapy may also be an important element of the healing process.

In an interview with Gift From Within about reactions to anniversaries of tragedy, Ochberg cited the following warning signs of suicide risk: A marked change in personality, giving away things of value, withdrawing, saying, ‘I'm thinking of suicide.”

He continues: “Additional signs are the absence of clear plans or commitments for the near future. Or a sudden, irrational cheerfulness after gloom (meaning that death has been chosen as an alternative to emotional pain). Suicide is often abetted by drinking, so hoarding liquor, moving from depression to alcoholic depression to alcoholic depression with access to weapons are danger signs.”

For more facts on mental illness, depression, and suicide, visit the National Mental Health Association Fact Sheet page.