Many people with depression close themselves off, and closure is their instinctive defense against the outside world. Lockdown can alleviate the patient's pain, but it can create a new psychological barrier. Suicide is another form of defense, perhaps the ultimate defense. This defense is the quickest, most effective, and most thorough, except that it brings destruction.

There are more than 30 million people with medical records of depression in China, and if you add the patients who have not seen a doctor, it is conservatively estimated to be about 90 million. The most serious consequence of people with depression is suicide. According to one statistic, 50%-70% of people who commit suicide and attempt suicide in China are depressed.

Yan Wenwei, a psychiatrist in Shanghai, once speculated that if depression patients are left untreated, about one-third will naturally return to normal, which will take about half a year to a year; The other third will go back and forth and become chronic; Another third will eventually choose to commit suicide.

In the past two years, many depressed patients or their family members have come to consult me, and I often ask them in detail whether they have had suicidal ideation. In my opinion, it is normal for people with depression to have suicidal ideation.

A friend once came to me because of severe insomnia and chronic low mood, and asked me to judge whether he was depressed. After I asked in detail, I finally asked the question: "Have you ever thought about suicide?" He replied, "Suicide...... Suicide is the only serious philosophical question......" I interrupted him: "Aside from philosophy, let's just say that you have thought about suicide in particular lately?" He replied, "No." I said, "Congratulations!" You're not depressed. ”

So, why do people with depression want to commit suicide? Depressed patients say that "life is worse than death", is it an exaggeration or reality? The answer, of course, is the latter. The reasons, let me analyze them one by one.

My personal experience (not all) is that, first of all, depression, like any other illness, suffers from physical suffering. Many people think that depression is a mental illness, but they don't know that depression is first manifested as a physical disease, and at that time, patients will not know that they have depression.

For example, headaches. This pain is a dull ache that is not severe, but it is heavy and has a feeling of heavy pressure. It's like a dark cloud that sits in your brain. Sometimes it disappears suddenly, as if blown away by the wind; But you don't dare to take it easy, because you know it will come unexpectedly, and you wait for it to come in fear......

Another example is chest tightness, stomach pain, shoulder and neck pain, tinnitus, palpitation, esophageal blockage and burning sensation, etc. Different patients will have different physical symptoms; The same patient will have different symptoms at different times. One patient once cried to me on the phone, "I don't have a single part of my body right now. ”

The most bizarre thing is that there is a patient in Guangxi who has a somatic symptom of anal pain. Later, this turned out to be a precursor to his relapse.

As the disease progresses and side effects of medication appear, patients may develop mobility impairments of varying degrees. Trembling hands, unsteady walking, sensitive sense of touch, easy to startle, and restlessness are similar to anxiety symptoms, which are medically called "psychomotor restlessness".

Later, it will develop to thinking disorders, reading disabilities, and language barriers; Afraid of wind, afraid of water, afraid of sound...... It is not an exaggeration to call the pain of the whole body like a year.

Secondly, a characteristic of depression is anhedonia. When it reaches the severe stage, all the pleasures and desires that belong to human beings disappear. The patient is extremely depressed every day and feels that there is no point in doing anything. For him, life is no longer a journey of freshness and joy, but a purgatory of pain.

There was a patient whose friends tried to make him happy, took him to good food, traveled, made him do the right amount of work to gain a sense of worth, and so on, to no avail. Later, a friend tried to ask, "Would you be happy if all your wishes were granted?" He listened, thought for a while, and shook his head weakly: "There is no desire." ”

Why is this happening? The reason is simple, organic lesions of the brain cut off the channels of his desires.

Thirdly, another characteristic associated with anhedonia is hopelessness. This is another common trait of people with depression. Self-evaluation is infinitely lowered, self-blame, and self-guilt, and patients generally feel that the future is bleak and there is no hope in sight. The pain and the great sense of worthlessness were enough to consume everything about him.

I know a patient who had serious ominous thoughts just early in the disease. She told me that at home, seeing her son jumping around in his new clothes made her heart very sad: "Mom won't see you so happy this time next year." ”

The physical pain, anhedonia, pessimism and despair of the above-mentioned depressed patients are not the most terrible. The most terrible thing is the loss of emotion.

When the disease progresses to a certain level, the patient will become numb and sluggish. One of the basic manifestations of depression is that the patient is no longer able to experience the beauty of emotions and life. Everything in the world, joys and sorrows, love and hatred, has nothing to do with him. Relatives and friends are close at hand, but he is far away. He not only lost his happiness and hope, but also lost his ability to love and aesthetics. At this time, man becomes a shell, a walking corpse.

I remember that after recovering from my illness, I once watched a movie - "Painted Skin 2". I didn't like this movie, I thought it was a bit pretentious. However, there was one episode in the movie that shook me. In the movie, Que'er complained to Xiao Wei: "What's so good about being a man? It's better to be a demon and be happy! Xiao Wei suddenly became angry and asked a series of questions: "What do you know?" Do you have a human body temperature? Have you ever had a heartbeat? Have you ever smelled a flower? Can you see the color of the sky? Have you shed tears? Is there anyone in the world who loves you and is willing to die for you? ”

At this moment, I was like being struck by lightning, and I was enlightened. Imagine that if a person suffers a lot of suffering and torture in his body, does not feel happy for a moment in the day, completely despairs of the future, and cannot perceive family affection, friendship, and color, sunshine, beauty and love, this world is not a human world, what is the meaning to him?

Late at night on February 16, 2013, a person with the online name "sie

A Sena" depressed girl committed suicide by jumping off a building. Before ushering in the last moment, she left a last word on her Weibo, calm, clear, and painful. The transcript is as follows:

Depression is too painful, the world becomes dark and distorted, no matter how hard you try, you can't feel any beauty, and you think about death when you think about anything...... I have been depressed for many years, and I have not been able to fully feel the pleasure and pursuit of normal people, but I just think that I am indifferent and passive by nature. Three days after the high fever on New Year's Day, he began to experience a depression outbreak, insomnia all night, all his interests and desires disappeared, he resisted communication, became sloppy and lazy, and his physical and mental state deteriorated comprehensively......

Before the Spring Festival, he was diagnosed with severe depression in Anding Hospital, and since he has lost most of his memory, thinking, communication and behavior abilities, he has no sense of direction, he cannot organize language and writing, his brain seems to have been kidnapped, and it is difficult to even order food and send emails smoothly...... Please understand my struggle and helplessness, and forgive me for my selfishness and cowardice. Goodbye, love you.

Sadly, life is no more, and death is not inevitable.

When it reaches the severe stage, all the pleasures and desires that belong to human beings disappear. Life is no longer a fresh and joyful journey, but a painful purgatory.