In the wake of the tragic suicide of legendary actor/comedian Robin Williams, after the initial wave of public shock, insight and awareness of the complexities of depression began to surface. The connections between depression, substance abuse and suicide were examined by the American media like never before.
In Indian country the connections had already been painfully obvious. The especially high suicide rates among Native Americans, compared to the rest of the U.S. population, are well documented. On some reservations and villages, the rates can be up to 10 times higher than the national average.
But even within tribal communities there is a need for depression to be studied more in depth. Reports show that 90 percent of people who kill themselves intentionally have clinical depression or a diagnosable mental disorder. Many times people who die by suicide have an alcohol or substance abuse problem as well.
“Depression and suicide are definitely linked,” said Ivan Posey, current Business Council member and former Chairman of the Eastern Shoshone Tribe on the Wind River reservation in Wyoming. “If someone doesn’t feel good about themselves it encourages them a little more to take their own life. I think most of the suicides that I can talk about from a personal and family viewpoint are substance abuse and alcohol related.”
The harsh living conditions on many reservations and villages have consistently been a focal point of the high suicide rates among Native American youth. The high percentage of families living below the poverty line, the isolation in which many reservations and villages are located, the high rates of alcoholism, unemployment and historical trauma have all been highlighted as reasons for the suicide epidemic that still exists.
“There are layers and layers of why people commit suicide. It might be because of depression, but it might be because of other factors, such as bullying to excess,” explained Mary Kim Titla of the San Carlos Apache Tribe in Arizona, who serves as Executive Director of United National Indian Tribal Youth (UNITY). “There could be a history of mental abuse or sexual abuse. There are many warning signs we have to look out for, like people talking about taking their own lives.”
Many mental health officials underline that a family history of depression is common among persons with this potentially life-threatening mood disorder that affects at least 1 in 6 Americans, or 17 million people, each year.
“There is a cycle that tends to evolve in poverty cultures; poverty, substance abuse, and dysfunction,” said Titla, who gained notoriety for her years as an award-winning reporter/anchor for the NBC-TV affiliate in Phoenix. “I grew up on an Indian reservation (San Carlos) and it was in a rural, isolated setting. It wasn’t so much the isolated setting that affected me, but rather it was the dysfunction that I was surrounded by that affected me.”
“Some families may be more susceptible to depression depending on the conditions and lifestyle they were raised within,” said Posey, who serves as Chairman of the Montana-Wyoming Tribal Leaders Council. “Some instances or cases show that (some) young people can rise above (depressing conditions), while others show that severe depression stays and people attempt taking their lives and do take their lives. But I think there’s a danger in exposing these issues to grade school children. It’s a very gray area.”
Health experts point out that persistent ignorance about depression and misperceptions of it by the public, and even some health providers, as a personal weakness or failing that can be willed or wished away lead to painful stigmatization of and avoidance of the diagnosis by many persons who are affected by the disease.
“There are many things that can cause depression. It might be a life event,” said Titla, who stressed that she is not a health expert. “What causes the anxiety? Obviously, there has to be a feeling of some sort of insurmountable pain or feeling of hopelessness. There is certainly a sense of loss. We have to research the factors and pressures when it comes to depression and feeling hopeless – and you feel like there’s nowhere to turn.”