After suicide: All that’s left is ‘why?’ — (Pittsburgh Post-Gazette)

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Pittsburgh Post-Gazette

Rebecca Droke/Post-Gazette
By Michael A. Fuoco Pittsburgh Post-Gazette

May 5, 2013 8:00 AM

Suicide remains a taboo topic, but understanding what drives people to end their lives is the key to prevention. Some families shattered by the act offer their insights

Suzanne Taylor noticed the glance. She couldn’t help but imagine what the woman was thinking.

“Yes,” Suzanne thought. “I’m the parent of the child who died by suicide.”

In the late afternoon of a November day, her son Grant got the .22-caliber rifle that his dad used to shoot groundhogs — the only unlocked gun in the North Huntingdon house. He found the clip and bullets in the basement. He returned to his bedroom and fatally shot himself in the head.

He was 17.

Suicides generally are not part of the public’s discourse. For privacy reasons and perhaps the stigma that surrounds them, mainstream media do not routinely report suicides committed in private — homes or garages, university dormitories or deep in the woods.

PG graphic: Firearms account for more than half of suicides
But they’re much more prevalent than most people realize. There were 38,364 people in the United States who killed themselves in 2010, the most recent statistical year. That’s more than twice the number of homicides. And that’s nearly 5,000 more deaths than occurred in traffic accidents.

And for every suicide there are 25 non-fatal attempts — a staggering 1 million people who annually try to end their lives.

A traumatic event — a job loss, a relationship breakup, a scandal, for example — is often assumed by friends or relatives as the “reason” a person committed suicide. But, researchers say, such a singular event was only the proverbial last straw.

Suzanne and her husband Keith can’t help but wonder over and over and over again why their son killed himself on Nov. 1, 2011. “What did we miss? What could we have done?”

But through counseling and support groups they know there are no simple answers. Those who commit suicide — the nation’s 10th leading cause of death — have a fatal merging of a diagnosable mental illness such as depression, characteristics such as lifelong relationship difficulties, impulsiveness or feeling hopeless, and the onset of life stressors. By themselves, those factors are usually manageable. Combined, with no mental health intervention, they can persuade an individual that life is not worth living.

For many families like the Taylors, there are no warning signs. Grant, the youngest of three boys, was a senior varsity wrestler, a show choir member and a church youth deacon who planned to go to college.

Grant was upset but not despondent, they say, when he was suspended from Norwin High School in the fall of his senior year — his very first school suspension — for looking at pornography on a friend’s smartphone and for having snuff in his backpack. On the second day of that in-school suspension, he was called into the principal’s office and was told a female student had accused him of exposing himself in class.

As Grant was on his way home on the school bus, administrators were calling Suzanne at her work to tell her about the situation, which could possibly result in expulsion. As Grant got off the bus, he told his friends, “See you tomorrow.”

Suzanne couldn’t reach her son or husband by phone and rushed home. Not knowing about the latest situation, Keith arrived home first, heard Grant upstairs in his bedroom and asked if he would help cut the grass.

“I’ll be out in a little bit,” Grant responded as Keith went outside to start mowing.

Grant taped a note to his desk. “Problem solved,” it read. He pulled the trigger.

For those in Grant’s age group — 10 to 24 — suicide was the third leading cause of death in 2010, according to the Centers for Disease Control and Prevention. It was the second leading cause of death in the 25-34 age group.

Overall, the national suicide rate increased 3.9 percent over the preceding year, making it the highest rate in 15 years.

For those between the ages of 35 and 64, there has been a 28 percent increase over the last decade. The CDC said possible contributing factors for the rise in suicide rates among middle-aged adults include difficult economic times and increased availability of prescription painkillers.

And in the military, suicide has reached epidemic proportions, with the Pentagon reporting 349 active-duty suicides last year –120 more than the combat deaths recorded in Afghanistan.

Men are nearly four times more likely to die by suicide than women, but women attempt suicide three times as often as males. Men are more likely to choose deadlier methods, such as firearms. Women are more likely to poison themselves.

Studies indicate that 90 percent of suicidal individuals suffer from a diagnosable mental illness like depression, bipolar disorder, psychosis or post-traumatic stress disorder. But since only a relatively small percentage of those will commit suicide, additional factors make someone vulnerable to suicide, noted Alexandre Y. Dombrovski and Katalin Szanto, psychiatrists at Western Psychiatric Institute and Clinic of UPMC.

The researchers, who are conducting cutting-edge studies of suicide attempters to gain insight into the psychological factors and decision-making processes, said characteristics that can put people at risk include substance abuse, impulsivity, a feeling of hopelessness, relationship difficulties, a predilection for aggression, and mental disorders.

“You can have these characteristics and be fine until you experience an episode of depression or psychosis or an alcohol binge or sometimes several things at the same time. That’s when people have the highest risk,” Dr. Dombrovski said.

“It’s a combination of vulnerability and stressors,” Dr. Szanto added. “However, if you have good protective factors, social support, good treatment for substance abuse or psychiatric illness, you may never get suicidal, even if you have these predilections.”

• •

What remains of Karla McWilliams’ essence are the photographs. In them all, her face is electric, her smile wide and welcoming, her eyes blue and sparkling.

So happy, her mother, Rita, once remarked.

“It’s an act, Mom,” Karla responded. “I’m always acting,”

Try as she may, Karla never found the happiness her photographs imply. Mental illness, first diagnosed when she was a teen, and a series of traumatic incidents robbed her of that possibility. On Nov. 20, 2012, she stopped looking and killed herself. She was 29.

“It was a struggle all her life. She tried really, really hard,” Rita said. “I thought she’d make it but she never did.”

Karla’s troubles began in the seventh grade. The straight-A student couldn’t sleep and one night woke up her parents at 3 a.m. Crying, she said, “You have to help me, Mom. I can’t go on.”

Diagnosed with severe depression, she was put on the anti-depressant Zoloft. But the next year, when Karla was 14 and starting the school year at Greensburg Central Catholic, Rita found her crying in the game room, holding her dog.

“I’m saying goodbye to Patches,” Karla said. “I’m saying good-bye to you, Mom, but don’t tell Dad because he’ll be too upset. I won’t be here in the morning. I hear voices coming out of the closet telling me to kill myself. I have to kill myself.”

Thus began a life of in-patient and out-patient treatment, various diagnoses including anxiety, depression, suicidal tendencies, and resistance to medication and several suicide attempts. For a time, she would be on the upswing but then some trauma would rip her down. Her apartment building burned, killing her dog and destroying all she owned. She was sexually assaulted twice. A boyfriend was killed at a construction site. Her fiance broke off their wedding plans.

Still, along the way, she earned her high school diploma and an associate’s degree with high honors in human services, put herself through modeling school, and worked as an intern at the non-profit agency Mental Health America of Westmoreland County, where her mother, a former teacher, also worked. She also became a statewide advocate for better transitioning of mental health services for teens moving into adulthood.

The end came last November. After Rita left for work, Karla turned on a Christian TV station and put her comforter and pillows in the bathtub. She sealed the bathroom door with tape, lit a small charcoal grill and lay down in the tub, clutched rosary beads and waited to die.

Later, when Rita broke through the screen door with the police behind her she found a note warning of toxic fumes but reassuring her the dogs were safe. “You did everything you could, Mom,” the note said. “I’m so, so sorry. I love you now and always and forever.”

Next to her heart, Rita wears a locket containing the last photo taken of Karla. In it, the woman with the sparkling blue eyes is smiling, as ever.