BANGOR, Maine — At 52, John West was an avid outdoorsman, a respected surgeon, and a beloved husband and father. His apparent success in life, however, proved no match for his depression. Last September, West took his own life, leaving behind a shocked and grieving community of family, friends, patients and professional colleagues.
“He was a vigorous, active, young, seemingly healthy person,” said West’s widow, Bangor neurologist Stephanie Lash. “All of us were left grasping, trying to make sense of John’s death. But it didn’t make sense, and it doesn’t make sense.”
Depression is an insidious medical disorder that robs its victims of joy, serenity, hope and perspective. It can be accompanied by insomnia, loss of appetite and deep fatigue. Depression is often related to chemical imbalances in the brain and may be worsened by difficult life experiences. It can be effectively treated with medications and counseling, but individuals lost in a depressive episode may lack the ability to seek help or to trust that the darkness of their condition can ever be lifted.
Lash is determined to shed some light on her husband’s death, connect with others whose lives have been affected by a loved one’s suicide, and help fund suicide research, prevention and support. In late June, she will lace up her sneakers and step out on the 18-mile route of “Out of the Darkness Overnight,” joining thousands of others on a national fundraising walk through the streets of Boston that starts at dusk on Saturday, June 26, and wraps up at dawn the next day.
Lash first heard about the walk, an annual event organized by the American Foundation for Suicide Prevention, through a friend at the beginning of May. This is the first year Out of the Darkness Overnight will be held in Boston, close enough that many Mainers might be able to participate.
“As soon as I learned about it, I said, ‘Absolutely, I must do this,’” she said. “I think it is a natural instinct to want to find something positive to do in a situation like this.”
Already she has raised close to $4,000, primarily through a flurry of $25 and $50 contributions from friends and family. She hopes the donations will keep rolling in through her page on the foundation’s website and that others from the Bangor area will decide to participate in the national event.
Suicide is the 10th most common cause of death in Maine, responsible for an average of 163 deaths each year between 1999 and 2005, according to the Massachusetts-based Suicide Prevention Resource Center. That makes suicide a more common occurrence here than it is nationally — 13.3 deaths by suicide per 100,000 Maine residents compared with the national rate of 11.6 deaths.
Cheryl DiCara, director of the Injury Prevention Program within the Maine Center for Disease Control and Prevention, said in a recent interview that the rates are worst among Mainers who are between 25 and 34 years old and those who are 55 and older. Maine ranks significantly higher than the national average in the number of people who deliberately take their own lives using a firearm, she said. In Maine and nationally, she said, guns are the most common method for completing suicide, followed by hanging and drug overdose.
A 2005 study by researchers at the Harvard School of Public Health determined that Maine has the highest suicide rate of all states in the Northeast, and a 2007 study from the Muskie School of Public Service at the University of Southern Maine showed that national suicide rates in rural areas are higher than in urban and suburban areas — 18 deaths per 100,000 in the smallest rural areas compared with 12.6 in suburban counties.
DiCara said no one knows why rural areas have higher rates, but rural residents may be less likely to seek help and may also have poorer access to mental health services.
In addition, she said, they may be more likely than urban dwellers to own guns, which are the most aggressive, impulsive and unforgiving way to attempt suicide.
“If there’s a gun right there when you’re thinking about suicide, that’s that,” she said. It is important for gun owners to keep their weapons secured, she said, and if a gun owner is acting depressed or suicidal, friends and family should consider removing guns from the home temporarily.
“It’s sort of like taking the car keys from someone who’s had too much to drink,” DiCara said.
The Maine CDC, which has historically focused on preventing suicide among Maine youths, will soon roll out a more comprehensive program aimed at reducing the incidence of suicide within all age groups.
The statistics do little to ease the tragedy of Lash’s loss.
Her husband’s decision to end his life was influenced by an acute episode of depression that had lasted several months, she said, and by the stigma that surrounds depression and other forms of mental illness.
“He was resistant to seeking the care he needed,” she said. “Many people are.” Especially for professionals in a relatively small community like Bangor, she said, the stigma of seeking treatment for mental illness or suicidal thoughts creates a significant barrier to getting essential help — the help that could have saved West’s life.
“It’s clear to me that it is hard for physicians to get care,” she said. “We don’t like to ask for help. It’s almost like we can’t be sick; our job is to ensure health.”
Lash is committed to helping change that dysfunctional dynamic.
“We need not to be afraid to talk about depression, to get treatment for depression,” she said. “Part of doing the walk is being able to stand up and bear witness to the truth. Suicide affects strong people, healthy people, people from all walks of life, and we need to be brave in the light of that. ”
In her own medical practice, she said, she has become more attuned to signs of depression in her patients.
“All of us need to become more attentive to it, listen a little better, ask more questions if someone makes a comment,” she said.
She also considers how best to counsel her young sons, now 10 and 13 years old, as they come to terms over time with their father’s death.
“I stress to them that there is help for depression, that we feel sad because their dad didn’t get enough help,” she said.
Though age restrictions prohibit her boys from walking in the overnight fundraiser, Lash said, they may be able to join her for the last mile and to participate in the sunrise celebration at the end.
On the Web:
Out of the Darkness Overnight:
American Federation for Suicide Prevention:
Maine Youth Suicide Prevention Program: