In recent memory we’ve witnessed the death by suicide of numerous celebrities and public figures. To name just a few: Robin Williams, Kate Spade and Anthony Bourdain, among others. Several days ago, former Miss USA, Cheslie Kryst, took her own life. Kryst, just 30, was not only a beauty contest winner but also an attorney and a TV correspondent. She had all the trappings of success. Some of us who struggle to achieve the traditional markers of success wonder: What could drive someone to whom life seems to come so easily, who achieve so much, who have financial security and the adulation of others, to the depths of despair?
As a clinician who has spent much of my career working to prevent suicide among college students, a similar compelling question arises any time a young person dies by suicide. “How can a young person with a seemingly bright future end their life?” While I know nothing about the particular circumstances of Kryst’s death beyond what has been reported in the news, I will attempt to share some observations in response to this vexing and chilling question.
First, it is important to understand that while not a frequent occurrence, suicide is currently the second leading cause of death in the United States among those 15-35 years old. This partly reflects the fact that teens and young adults are a mostly physically healthy group, so young people this age rarely die from other physical illnesses. But this is the age at which many major mental illnesses often emerge. Depression and anxiety are common in this age group (and these problems have been exacerbated in recent years). Bipolar disorder, serious personality disorders, substance misuse and psychotic disorders all can emerge or become more obvious or serious during this age period and all can increase risk for death by suicide.
Of course, successful people are as vulnerable to mental illness as anyone else in society. But that’s not where the explanation ends.
While those of us not living in the world of celebrity see the excitement, glamour and romance associated with carefully curated personas, we don’t see or think much about the fact that people in the public eye have the same personal, family and social challenges as the rest of. Ironically, while more wealth and prominence brings greater access to many kinds of support, help and medical care, it can also feed certain kinds of interpersonal problems, and challenges getting good support and care at the same time.
Public figures can struggle with a sense of not knowing when someone is trying to be friendly, close or romantically involved because they care about them as a person or because they want to bask in reflected light, access and wealth. This can lead to real frustration in establishing caring, close and trusting relationships with others over time and can feed feelings of isolation from others and ultimately loneliness. It can indeed be “lonely at the top.”
Beyond that, people who are very accomplished and successful often experience real fear of loss of their status. Being at the “top” can leave one with an awareness and fear of the potential of a long way to fall if fortunes change. Most people experience more pain in losing fame, attention and fortune than in never having had them in the first place.
Ironically, too, while often in a position to afford excellent medical and mental health care, clinicians sometimes have a hard time treating well-known people in a clearheaded manner. In some cases, we, like other “regular” people, can have a hard time seeing the real person/patient beyond the aura of the celebrity and this can lead to bad decision making or misjudgments in care. To be clear, most of these clinicians are well-intentioned but can lose their objectivity in ways similar to what might happen when caring for a family member
What can we do? It is essential to recognize that there are evidence-based and effective treatments for most mental illnesses and interventions that lower risk for suicide. Like any medical treatment, nothing is always completely effective and we still have much to learn about predicting and assessing risk for suicide but we do know that interventions like dialectical behavior therapy, cognitive-behavioral therapy, some medications, strong and nourishing connections to others, bolstering the social safety net for those at risk and good access to care, all lower risk for suicide in individuals and communities.
And of course, we should do our best to remember that beautiful and accomplished people are people too — with the same vulnerabilities, feelings, conflicts and challenges that we all inevitably experience on our path through life.
Comentários