At the age of 30, Jake had had enough. He swigged down multiple shots of vodka and then quickly swallowed 50 pills with full intention to die. Fortunately, his friends discovered him and rushed him to the hospital in his unconscious state. After two days in the intensive care unit, he was transferred to the psychiatric ward. “I want to die, Doctor, please just let me die.” It turned that there was a significant history of depression as well as completed suicide in Jake’s family, which for me as his psychiatrist was an additional huge red flag. To be safe, I appointed a staff member to be with him at all times. I then told Jake that his depression is like being deep down in a pit where it feels impossible to escape - and then I told him that he will ultimately get better. “I don’t want to see out of any pit or get better, Dr. Guterson. Life is pointless. Everyone dies anyway, you know that. Just let me end the pain now, doctor. Please just let me escape to oblivion, forever.“ Over the years, I have seen many patients similar to Jake. They suffer intolerably from a very palpable depression, feeling utterly hopeless, seeing no way out. This is not simply having “the blues” or a bad day. This depression is fierce, oftentimes biologically based, sitting there in our DNA. Based on this reality, antidepressants have proven to be a powerful treatment - and can save lives. And so I started him on Prozac. But for Jake, there was an added issue - he labeled himself as an existential nihilist and therefore was thoroughly invested in life having no meaning. On the psych ward, Jake was in his own space and head, absorbed in his books. He hardly ever looked up. Intellectualism was his protection against the world. “Religion is for sheep”, he insisted. So - to try to loosen him up, I printed up the words to John Lennon’s song, ‘Imagine’, and offered to sing it together. Didn’t help; he said he prefers George Harrison. I next told him that simply being born means that he matters. Didn’t help; he told me he never should have been born in the first place. I then suggested to him that he reach out and help those in need on the psych ward, play chess with the younger fellows or aid the elderly in their wheelchairs. Take action and get out of his head for a bit. Didn’t help; he said nobody needs him. The weeks went on and the resistant Jake countered my every word and effort. But - wouldn’t you know it, after four weeks on Prozac and therefore with more available serotonin now swimming around his body and brain, he started to turn the corner…. After being released from the hospital, Jake and I continued to meet for years in my office. And I had the pleasure of bearing witness to a life that turned around. He started calling Prozac his good friend and buddy. He got married and had twin boys and loved reading books to them: “The ‘Frog and Toad‘ book series shows that life can have reliability and friendship”, Jake said .“My boys love it…I can’t wait to teach them chess when they get older.” Jake continued to proclaim that existential nihilism is the only real truth. But his actions showed differently, as he started doing life instead of always philosophizing life. He got out of his head. He even sang to me his favorite George Harrison song, ‘My Sweet Lord’. And he thanked me for his escape from oblivion.
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