Ask A Native New Yorker: How Can New Yorkers Avoid Despair?

Are you relatively new to this bustling metropolis? Don't be shy about it, everyone was new to New York once upon a time, except, of course, those battle-hardened residents who've lived here their whole lives and Know It All. One of these lifers works among us at Gothamist—publisher Jake Dobkin grew up in Park Slope and still resides there. He is now fielding questions—ask him anything by sending an email here, but be advised that Dobkin is "not sure you guys will be able to handle my realness." We can keep you anonymous if you prefer; just let us know what neighborhood you live in.

This week's question is about coping with depression.

Dear Jake,

I woke up this morning to the news that Anthony Bourdain died of suicide. This is just three days after Kate Spade's death from the same cause was announced. I struggle with depression, and in weeks like these it just seems like what hope do I have, if these people, who I really admired, and who were so rich and so famous, ended their lives in despair?

You know how this city is—the constant struggle to earn enough to pay for the basics like housing, the stress of just getting to work and back every day, and that special kind of loneliness that a person only feels when surrounded by crowds of strangers—I think that even people inclined to good mental health have tough times here occasionally, and those of us inclined towards melancholy have it even worse.

How do you natives make it through a lifetime of these pressures without getting crushed by them?

Sincerely,

Sad in Brooklyn

A native New Yorker responds...

Dear SIB,

This has been a terrible week for this kind of news, of course you're feeling upset. Kate Spade made so many people happy with her designs, and seemed to project such a bright mood, and Anthony Bourdain was so admired as someone who had struggled with drugs and God knows what else, but overcome them to have such an amazing career the last twenty years teaching people all around the world about food and other cultures. Their loss is upsetting in itself, but knowing that despite their gifts and success they were still killed by depression is a special kind horror for those of us afflicted with that difficult disease.

This group includes a lot more people that you might think: something like 7% of American adults experienced a major depressive episode this year, and almost 20% experienced a mental illness of some kind, most of which contain elements of depression. The numbers are higher for New Yorkers than our fellow Americans—the common folk wisdom here that the stress of city living leads to higher rates of mental problems appears to be correct. Discuss this with your friends; I guarantee that right now, more than one of them is afflicted with depression, up to and including thoughts about suicide. Knowing that you are not suffering alone will make you (and them) feel better.

Jake Dobkin, 2001 / 2009

Until you can do that, let me share my own story. I haven't written about this before, because it's a sensitive topic and I've always been concerned that it might make people think less of me, or make it harder to find work, but I've reached a point in my career where I think I can afford to be honest, and I really believe that if I can make one person feel less alone with this disease, or point them towards help, it's worth it. So here goes:

I was always a smart, but very sensitive kid. Changes in routine like school trips or camp always sent me into a spiral of anxiety that often led to getting picked up early from nurses' offices or camp bunks. But it wasn't until college that this anxiety began to lead to depressions, complete with all typical symptoms- insomnia, hopelessness, weight loss, constant worry. I particularly had trouble around big transitions. Going from high school to college was really tough—a breakup with a girlfriend and 12 weeks at SUNY Binghamton sent me into a real slide, and I ended up dropping out after the first term and moving back home.

Somehow, I managed to get into Columbia, and had a mostly happy time there. The next skid came when I was twenty-two, in 1999: I'd spent the year after college teaching chemistry at Stuyvesant and applying to medical school. The sneaking feeling that I didn't want to be a doctor had been growing all year, and another breakup set off the crisis. I tried to deal with it over the summer, traveling to cheer and distract myself, but by the time I showed up at Columbia's medical school, I was in a full-blown depression.

After 10 days of not sleeping and feeling increasingly miserable, I was in no shape to continue. I was in a hole so deep, and so black, that I just couldn't see any future at all. In short order I overdosed on some sleeping pills, got my stomach pumped, spent a couple of days in the hospital, and left school. It was bad. It took me almost four months, and a lot of therapy and antidepressants, to bounce back to the point where I could work again, move out of my parents' house and get an apartment downtown with a friend.

What happened next was unexpected: I ended up dating one of my friends who helped me through the depression, and eventually moved in with her. We got married a few years later and now have two great kids. On the work side, there was the dot com bubble going on, and all the agencies and startups needed workers, and I had taken a few programming classes in college, so I was able to get a job at a company that made websites. That led me to blogging, and blogging led me to Gothamist, and that ended up being an adventure that lasted 15 years and led to the column you're reading now.

But I want to be honest: for me, depression has been a chronic illness, and even though I've never gotten that low again, and been able to have a family and a career, at times of great personal or professional stress, I've continued to have rough patches, and not a year has gone by when I haven't battled this illness in some way. Many things have helped. I was lucky to have two great therapists; one when I was a kid, and another I found after college and still see (twenty years and counting!) I found medication that worked, and was able to change it when, inevitably, it stopped working; and I had the support of a great group of family and friends the whole time. I also exercise, eat well, focus on getting good sleep, and have rewarding hobbies—altogether, over the years this has reduced the intensity of my episodes, and though I can't predict the future, so far I've been able to live a full and productive life.

I want to talk about suicide: it is far from an inevitability, even for those of us who have serious depressions. As few as 2% of people who suffer from depression will die of it, and there are many things that you as a depressed person can do to reduce your suicide risk. The three most important protective factors are getting professional help for your disease, developing a robust support system of family and friends to whom you can turn when things get rough, and adopting a belief system that discourages despair. The first two are obvious, but I want to talk about the third in a little more depth.

Most of American popular culture, especially our television shows and movies, encourages us to believe that by accumulating wealth, or finding fame, we can achieve abiding happiness and fulfillment. This, of course, is false, and the two high-profile suicides this week are reminders that depression afflicts all humans, even the rich and famous. Yet our social media feeds continue to stuff us with these messages, and it makes us, especially those of us vulnerable to despondency, feel worse. There are plenty of alternatives; in my case, I've found that Buddhism, with its rejection of materialism, focus on the present moment, and emphasis on connection to other people, has really been a great comfort in tough times. But any belief system—Christianity, Stoicism, Judiasm, Humanism—that encourages you to think less about yourself, and more about others, will help.

Once you spend some time with one of these systems of belief, you quickly come to the idea that suicide must be categorically rejected, on the grounds that it causes suffering to others, and can actually encourage them to commit suicide themselves. Staying alive is a service to society. Especially for those of us who are parents, knowing that suicide of a mother or father triples their child's suicide risk, and that by staying alive and getting help, you are potentially saving your children's lives—that is an incredibly powerful reason to keep fighting.

Even if you don't have kids, think of your future self. A few years ago, Jennifer Michael Hecht, the author of Stay: A History of Suicide and Philosophies Against It, wrote one of the most powerful articles I've ever read about this. In it, she argues that we must consider the rights of our future selves, and "decide now not to let your worst mood kill off all the others."

Depression lies. It tells you that the misery you are now experiencing will continue forever. This is not true: your life is changing all the time, and who knows what wonderful opportunity, stroke of luck, or simply more bearable circumstance lies just around the corner? You owe it to the person you will become not to make any permanent decisions.

New York can be a challenging place to live, and though the stress might lead to higher rates of anxiety and depression, a very important fact to bear in mind this week is that our city's suicide rate is less than half that of U.S. overall. This is partially because we have strict gun control laws that keep weapons out of the hands of people in their worst moments, and because our city's government has made a positive and sustained commitment over many years to mental health programs. We've still got a lot more to do more, of course—suicides now outnumber homicides as a cause of death in New York—but collectively we are making an effort.

How can you help? Reach out now to your friends, using this week's news as a chance to discuss depression. Remember that depression usually causes social withdrawal, so it's especially important to check in on friends who have been out of touch recently. If you want to go further, consider taking on the Mental Health First Aid Trainings offered by the city; it'll teach you to recognize the "signs and symptoms of mental illness and substance abuse," and get people help.

As the famous poem says, "whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy."

Please, please, please, take care of yourselves, and each other.

-Jake

N.B.: During times like this, the media often covers suicide in a way that is unhelpful, and can actually lead to more deaths. At Gothamist, we try to follow the American Society for Suicide Prevention's reporting guidelines—before you share any articles about suicide online, please read them.

N.B.2. I was lucky that when my illness got bad, I had insurance that would pay for (most) of the treatment, and family and friends to get me help. Over the last twenty years, the Mental Health Parity Act, as well as the expansion of health insurance through Obamacare, has extended support to more Americans, but many people still have trouble affording or finding care. The National Alliance on Mental Illness is fighting to change this- consider donating to them.

Ask a Native New Yorker anything via email. Anonymity is assured.

If someone you know exhibits warning signs of suicide: do not leave the person alone; remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt; and call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) or take the person to an emergency room or seek help from a medical or mental health professional.