Nathan Pointer, originally from Oregon, is an undergraduate at Harvard University, concentrating in social anthropology and studies of women, gender, and sexuality. He was 21 when I interviewed him in Boston, MA on April 7, 2014.
Lord. My story as I see fit to tell it. That's a dark one, or a deep one, or an old one.
I struggle with—and that's one thing—I always say struggle with, instead of suffer from, severe early-onset dysthymia, which is chronic depression. Generally understood to mean that, on a normal day, I am a little bit lower than most people, and it's punctuated by lengthy periods of between six months and eighteen months of severe depression, or what people think of when they think of depression.
The first time that this happened to me, I guess, I was about 8 years old was when it started. We didn't know it at the time. It was also early 2000s, and it's shocking how much things have changed when it comes to mental health issues or talking about depression in just that period of time, ‘cause that was something we didn't talk about at all. I remember that was when they were just starting to put out some of those ads for antidepressants, like the very first, sort of, not terrible ones.
I can remember, as a little kid, saying, "Mom, I think that I might have this, or I think that this might be good for me."
She would say, "Oh, no, that's silly. That's not a real thing. Those aren't for people, you know, like us."
That was interesting. When I was about eight, nine, ten, eleven-ish, I was going through what I would probably now say was pretty much just a period of severe depression for like four years, which I didn't know at the time. That's one thing about being so young when you start to have mental health issues is that you don't even know how to process your own emotions, much less how to articulate them in a way that makes sense to somebody else.
I knew when I was and wasn't supposed to act and feel, so I was really good about covering things up and I learned a lot of tricks. Like, if I needed to cry in the middle of the day, I would go to the bathroom and then I would do it, and then I would dilate my eyes so they wouldn't look red afterward. All of these different things. I found the best places to go where people weren't going to be looking at you all the time, and learned the right things to say and all this stuff, which is pretty resourceful for a 10 year old.
The first time that I tried to kill myself was when I was—it was just a little bit before I turned twelve, actually. Looking back, it feels a little bit like a half-hearted attempt, just ‘cause I didn't know what the fuck I was doing... My parents didn't know, so we didn't seek any medical treatment. They were going somewhere and I stayed home sick, and then when they came back, I really was sick. They didn't know for several years after that. I damaged the lining of my stomach pretty severely, we've discovered in later years. I have some difficulty now eating certain things where, very once in awhile, my stomach just goes, "Hell no, something's wrong here." That's a pretty constant reminder, every once in a while, of that.
Psychologists, depending on who you talk to, will define a suicide attempt a little bit more broadly than we would, in that it's when you're taking real steps with the intention of ending your own life... Under that expanded definition, I have tried to kill myself [many] times.The first time was the only time that I didn't stop myself. That's the difference.
It's easiest when I'm talking with people who aren't necessarily sensitive to mental health issues just to say "the one time" when, in reality, this has been an ongoing thing that keeps cropping up over and over again in my life. That first time was the worst. After that, I got a little bit better. Going into thirteen, fourteen, fifteen years old, I was higher energy at that point, so that's what my mother will say was the worst period of time because I was still definitely distinctly depressed and messing with some of these issues, but I wasn't as mopey or as off by myself; I was stirring up trouble...
Then when I was, I think, fourteen, I kind of told my parents about what had happened. I mean, it's amazing the difference a few years could make, because I think that they had kind of accepted at that point that depression was a real thing, which was a major step from four or five years before, and they sought help with me that time.
When I was 15, they put me in a little bit of counseling. They were more aware of it. When I was 15, they noticed that I was starting to slide backwards again. That's when we first went on medication for depression with some interesting antidepressants. It was pretty simple stuff the first time. I think it was Prozac, and we've done a lot of experimenting since then trying to find the right cocktail that works out for me. Haven't quite gotten it all the time, but you know.
When I was fifteen, sixteen, I had my second... "episode" is what I think of it as, I guess. After I came to college, I had another episode beginning... Let's see. It was a little bit before I turned 20, so probably [from the] end of 2012, and it's lasted through pretty much this last year. Probably because I'm an adult, this one has had, I would say, the most tangible impact in that I'm best able to process it. It's also been accompanied by probably some of the more questionable life choices.
That's where we are.
As far as suicide, specifically, goes, there's a lot there. I've been in a lot more intense counseling, especially this last time, which I think is really helpful. Since I came to school, in general, I've learned a lot about myself in the way that I process and think about death because, for the most part, that's all I've been able to expect since I was about 9 years old. That's a little bit of exaggeration—10 was probably more when I really started having suicidal ideation.
It is interesting to live your life, especially that part of your life, not expecting anything else. I never thought I would get a driver’s license. I never thought I would kiss anybody, much less do anything else. I never thought I would graduate from high school, never thought I would move away from home. Not for those reasons that I think a lot of people are like, "You can't see that far in your future," but more because I didn't expect to be around for those milestones.
In a lot of ways, I know that I've already moved past a lot, but at the same time this isn't necessarily something that, for me, I can expect to be over. With the advent of this last episode, the doctor put forth a theory, and she only said it one time and she didn't say it as if it were super serious, but [she said] that maybe my brain runs on a biological cycle where about every four years it says, "Fuck you. We're going to go through this again." And if that's the case, then we'll deal with that in another few years. But, I mean, that's possibly a reality that I have to live with, so it's not like I can sit here and say, "I'm on the other side of this," like I think some other people can.
At the same time, it was important to me, when I saw your project, to say, "Well, you know, I deal with a lot and, at the end of the day, I've never imagined dying any other way than by my own admission, I guess. But I can still do things and live life—and [live it] well—and in spite of this thing that is so prevalent in my life." That's that.
...[My last attempt] was a little over a year ago, actually. This is probably—I hadn't thought about this—the first year I've probably gone since I was 10 without an actual suicide attempt, so that's a plus.
Des: What is it like being at Harvard and dealing with this?
Nathan: In a lot of respects, going to an Ivy League school did not help with my mental issues.
It is a super high stress environment. Depending on who you talk to, they say that the hard part is getting in. I would disagree. It's an incredibly high stress, high pressure environment. Everybody is so driven, and at the same time everybody is so self-centered. I don't necessarily mean that in a demeaning way—although sometimes I do—but they're very self-focused.
It makes it hard to build communities of any kind, much less around being queer or struggling with mental health challenges or being a minority or anything. It's difficult to build communities, I think, here more so than it is at other schools. It's a very poisonous environment.
I'll definitely say that, especially as somebody who has mental health issues, there's always this pressure to prove and re-prove yourself and to be perfect, and an A minus is a failure, and you don't want to be in the mean range on this curved test. All of these things that come out of having a group of people who are used to being the best put all together in one spot.
The stress is palpable a lot of times, and that's why I hate being on campus during finals because, as you're walking around, you can feel how miserable everyone is around you. Of course, you can't leave because you have finals too. You know, it's bad.
That said, I feel like I have been very well served by Harvard in my time here.
There are a lot of issues with mental health. There's been a lot of articles criticizing the mental health services.
Des: At Harvard, specifically?
Nathan: At Harvard, specifically. Although at college, in general, I think it's something that isn't paid nearly enough attention to.
I came in to the school with this diagnosis and with this set of expectations and with a need for medication, and they got right on it. They put me in with a doctor to manage my medication and they got me into counseling—which I had never really been in before—right away, with a great counselor who I love to death. They have done an excellent job of serving me personally.
I also know lots of people who they haven't. I can't sit here and say they have a great system. I think it depends.
Also, at the same time, specifically when you're dealing with mental health stuff, this is not the best way to think about it, but if you're willing to advocate for yourself, a lot of times, as a patient, you can get better treatment, I think. Which doesn't always work if people don't know what they're experiencing or haven't gone through that sort of thing before or don't know what to be looking for, but I think that you can get better results if you do. So, it's a mixed bag, I guess.
There are definitely aspects of treatment that I probably would not have explored had I not been with this particular set of physicians. There are one hundred percent definitely things I never would have discovered about myself had I not been in this particular environment in this particular situation experiencing an episode, but it is tough.
It is definitely, without question, an environment that is not conducive to good mental health.
Des: Yet you take care of yourself.
Nathan: I try. I do my best. I'm still here, so that's a victory.
Des: Exactly. What do you think about the news coverage of the "gay suicides" and the "bullying suicides"?
Nathan: The way that suicide is covered, in general, is very condescending, I feel like.
And one of the things is that they always look for a specific cause. Or they have, I think, in the past, looked a lot more for a specific cause, [like] he lost his job or his wife was leaving him or something, certainly, in the TV shows. That's what they're looking for. In some ways, that's changed a little bit because they're saying, "He struggled with severe depression and had a history of being bullied by all these people," but at the same time they're putting the onus onto a specific event or somebody else. They couldn't find something specific in his life, so they found something that somebody else was doing that was specific that they could attribute whatever to.
I mean, suicide doesn't work like that, in my opinion. Ironically, it's more of a culmination of life events that leads to an end of life event. It's very, very, very rarely in response to a single high stress incident. One of the things that people don't necessarily think about is that the act of suicide is, in its own way, I think, a form of adaptive resilience or a coping with your circumstances.
There's no denying that, a lot of times, people use it as an escape, because that's definitely what I always did, but it's not so much, "I'm too weak to handle this" as it is, "I've exhausted every other option. I've tried everything else and I can't find anything that works, so this is my last resort." That's just not how people think of it.
I guess, in answer to the question, I appreciate the move in the right direction by more mainstream media sources in covering suicides, and I suppose it is a step forward that they're covering them in that way, like with the onus on the bully or whatever, but I also just don't think it's the same as covering it correctly.
Des: I've been getting the feeling that they're covering it, but they're covering it from the perspective of looking at these specific groups as "other," and what I'm trying to do is show that this could be anybody. It's not just the gay kids or the bullied kids or the goth kids. That's where my frustration lies. You know, they're doing it, but are they doing it? They're misrepresenting a lot of this.
Nathan: Yeah, it's true.
Des: What do you think about the mental health system, the diagnoses? How important are they? How do you feel about meds?
Nathan: Oh, all the mixed feelings.
Des: All of them.
Nathan: It's interesting. I did a paper on this topic last semester, on the concept of [diagnoses and] meds. I have a whole thing about meds. Diagnosis is incredibly powerful. It's incredibly empowering and it's incredibly dis-empowering. I did a project where I talked with three people who I knew that struggled with health problems that had been diagnosed and were undergoing formal treatment. I interviewed one person anonymously, who I'm very close friends with, who struggles with mental health problems and refused to be diagnosed for sort of different reasons. What I ultimately concluded over the course of this research project was that there are certain benefits that you can take away, but I wasn't ready to make a judgment call on whether or not those were worth the negative aspects that you get.
There is a lot of pressure still, I think, to keep a diagnosis under wraps or to not talk about it because it's something that's wrong with you in a way that's different from any other kind of sickness. It feels a lot more like it's something that's fundamentally wrong with you, which is upsetting—even if it's true it's still upsetting. That's how it's looked at.
One of the things that came up over and over again, and that I've definitely felt personally, is that you get a certain amount of pity if you are open about it. That can be used in positive ways. I'm able to work with some of Harvard's accessibility options because mental health disorders are actually covered under the Americans with Disabilities Act, which I didn't know until just a couple of years ago. If I end up in the hospital for a couple of days and miss classes, I'm not penalized for that. But it can work the other way, if you're really open about it, in that people are a lot less willing to give you responsibilities or to delegate things to you, or they're really concerned with giving you too much or how stressed out you are. Which are nice things if they aren't condescending. But they end up not being [that way]. You end up being treated like an invalid.
The act of diagnosis is incredibly powerful, and it goes both ways. My own experience with being diagnosed was largely positive because it gave me a sense of credibility. It's maybe not the best way to put it, but it said, "This is a real thing. Here is a set of words you can use to easily describe your situation to somebody."
Nathan: Validation. Exactly.
"Hey, baby Nathan's parents, this is a thing that your child is actually going through, and he could use your support, and these are the things you need to be aware of if he starts acting like this and this and this..."
Like I said, it's been helpful for me in college, too. So, for me, yeah, the act of diagnosis and the concept of diagnosis has been helpful, but I don't think it's like that for everybody. I think I was very lucky in that regard. Particularly with other mental health disorders. Manic depressive or schizophrenia, I think it can be very much the opposite, because there's so much more of, almost like, a fear factor with those sorts of disorders, those sorts of conditions. I don't like the word "disorder." I'm very [sensitive] to the right words.
Des: Semantics are important.
Nathan: They are. There's a big difference. There's so much of a stigma associated with those conditions that's so different from depression. To a certain extent, I guess within the mental health world, I have a form of privilege in that I have a condition that's recognized as valid: "This is a real thing that people actually go through and you're not crazy or loopy or just sick, and that's how we're going to treat you." I know not everybody gets that, so to that extent, I'm very grateful for that, I suppose.
On the topic of medications... The best thing I can say about medications is that we can't get anything better if we don't start out with stuff that kind of sucks. My understanding of the way that medications work is that, basically, the vast majority of these drugs weren't even necessarily developed for anything to do with mental health. They noticed the side effects after the fact.
It's kind of going, "We don't really know what this chemical does. We think that it might inhibit this or encourage the production of that, but it seems to make these rats not upset, so we're just going to bathe your brain in chemicals. We don't really know what they do, but we hope that it works out for you," which is shitty. That's a shitty way of going about treatment.
I kind of try to take solace in the fact that, now, I think they are paying a little bit more attention to mental health disorders, specifically. I know that you probably know better than I do, but I have friends that work in cognitive neuroscience stuff, and they are putting more resources and more academic attention toward some of those questions about emotions and mental disorders and things that they weren't paying attention to five or ten years ago. So, I guess I can appreciate that. Look forward to the future.
My own personal experience with medication has been all over the place. I've been on six to eight-ish different things over the last six years or so. Also took different dosages and combinations. Particularly, in the last year, we've been experimenting with lots of different things. One of them made me vomit any time I took a drink of water. That only lasted about three days. One made me, and it was the one that we ended up being on the longest, because it really was helpful in managing the worst of my symptoms, but every once in a while I would have hallucinations. I called them breaks in cognition. One time, we were walking across the street and I saw a walk sign change to a don't walk sign, and there was a second where I knew what it would feel like to be a computer because I was on this huge dose of this psychotropic drug.
I was on a set a few years ago that made me not want to eat. I could eat a bagel in the morning and be fine for the whole day. I dropped about eighty pounds over the course of a year, and then it stopped working, so we switched to a different one. Over the next year, I gained 80 to 100 pounds.
I mean, all over the place. Drugs suck. Medications are bad. There's not really anything out there that works well for severe mental health disorder, but I think that they're getting there, and I think that they're trying harder than they used to be. At least I hope so, and that gives me some comfort and hope, if nothing else. For the moment, I'm just kind of trying to figure out what works for me in a way that doesn't make me think I'm a computer or lose 100 pounds and still allows me to be able to function.
Des: How many times were you hospitalized? What were your overall experiences with hospitalization?
Nathan: I've only been hospitalized once on suicide watch. It was during this last time, actually. In response to a very specific trigger, I started taking pills. The fact that I had started taking pills upset me, so I went to—actually, it's Harvard's version of a hospital—and I didn't take enough pills for them to have to pump my stomach or anything, but they did put me in a room on anti-anxiety medication for the three or four days I was there. Closely monitored. Someone was checking in with me every half hour. A doctor, an actual doctor, in there every day, sometimes twice a day making sure I wasn't going to do anything. There's nothing sharp in the room, you know, all of these things.
I would have to say that that felt like a negative experience, but I'm not entirely certain how they could have gone about doing it better. The thing that bugs me the most is that, the minute I got in there, before they even evaluated the amount of medication I had already taken, they pumped me full of this anti-anxiety med. They asked me what I had taken to make sure it wouldn't react, but that was the first thing they did to calm me down. I'm not a big fan of medications anyways, much less that being your first resort. I know that when you have a large, six foot one, two-hundred something pound man coming in at two in the morning or whenever it was, incredibly upset, bawling loudly—like bible style Lamentations shit—torn up, tears streaming down his face... I understand that, as a five foot nurse, your first reaction is probably not going to be to wrestle me to the floor to make sure I don't hurt myself. So, from their perspective I don't know what they could have done differently, but that's the piece that annoys me the most: the first thing they did was zombify me.
And I was. I had friends who came to visit me who were like, "I didn't even know it was you who I was talking to." I could barely hold a conversation because I was so [out of it], like, nothing.
Other than that, I mean, it was very sterile, but they let people in to see me, which I think helps. I think that's the biggest thing is not just shutting you out from everybody else. Unless you're really in danger of hurting someone, I think that's a terrible idea. They let people in to see me.
I did have contact with my doctors. My doctors, so that was good. The food was okay for hospital food. I got to shower. The day before they actually released released me, they let me go for a couple of hours into the lobby downstairs to do this thing with an interview that I had signed up for for somebody's thesis or whatever and then come right back up and stay there one more night kind of thing.
They did an okay job, I think. It just was a really negative experience for a lot of different reasons, and I am a little annoyed about the drugs, but like I said, I don't know what else they could have done. Facing the same circumstances, I don't know what I would have done. Probably, basically, the same thing.
Des: Do you feel like you lost your autonomy, or were you given any input on your care?
Nathan: No. That's one thing, but that was also sort of empowering in that moment for me. In that specific situation, I didn't have to make any decisions for a little bit.
Now, you're right. Me as a completely—well, mostly—put together person sitting here right now can look back on that experience and say, "Well, we could have done these things..."
And I didn't have a choice in them. I didn't choose what I was taking. They provided my medications for me and told me when to take them.
They said the doctors were coming in at this time, not, "Would you like to see a doctor?"
It was, especially for the first day, two days, it was very structured. It was very much, "You're doing this."
Now I can look at that and say, "That wasn't good. I should have had more input."
At the time that was probably what I needed. I didn't need to be making life decisions for myself because they wouldn't have been great ones. Again, that's just a subjective situation.
Des: All these things are, yeah.
Nathan: That's the only experience I've had being hospitalized... [I've] called someone to talk me off the ledge kind of thing, that's definitely happened before, but that's very, very different. The way I would like to think that it functions is that I either reached out, or somebody reached out to me, and that social aspect was able to kind of fix the immediate problem that was living there, but that doesn't happen every time either.
Des: Do you feel like that peer support, as it were, is more helpful or less helpful than the medical support?
Nathan: I think that the peer support piece makes a difference. Makes more of a difference than the medical support piece, personally.
It's a matter of finding the right support structures and ingraining yourself in them. That was one of my problems this last episode, actually. I had invested a lot of emotional resources in building a specific social network as I came to college, trying to replace the one that I had lost from leaving home and moving across the country, that had kind of collapsed under me without any warning. It was right around the same time that I was already kind of sliding backward, and it was just a really ill-timed thing to have happen to me.
That's really illustrative of the fact that, at least for me, the social support piece is even more important than the medical piece. At the end of the day, I really love my counselor, I have largely positive feelings from my doctor, but those aren't the people I'm going to be calling if I'm sitting in front of a train.
Des: Do you know any other people who have attempted suicide?
Nathan: I know a couple. It's the kind of thing that, for me, tends to come up in different, almost random, contexts.
I try to be very, very open about my experiences with mental health because I think it has been so stigmatized and it's so misunderstood that if somebody like me—who is, in general, pretty gregarious and fun, I like to think—can say, "Yeah, I actually have a serious depression. I'm actually really messed up! Me too, guys," then the people who aren't maybe as open about it can feel like they're not alone or they're not going through something that's unique to them. That's really important to me, and one of the reasons I really wanted to be involved is because I'm so open about it.
Its's the kind of thing that, for me, comes up over dinner. Not everybody has that luxury. By that, or by way of that outlook, a lot of people will almost confess to me sometimes that they've attempted suicide or that they've thought about suicide seriously. Like, suicidal ideations, or that they've been dealing with depression, or that they've been dealing with this and this and this, which is sometimes a lot to deal with when I find out.
I hadn't necessarily thought about it like this before until just now, but it's probably much like it is on the other side of listening to me talk [right now], where somebody that you kind of like and maybe care about a little bit suddenly says that they have these serious issues, where you're like, "Wow. Okay."
Takes a second to process that, but then you work past it and you're like, "Okay, well, I'll help you if you need it." That's kind of what it's like on my end.
When somebody that I've known for a year, suddenly, one night says to me, "I tried to kill myself two years ago," that's a lot, but I'm also glad that I can be there and know that and help them if they need it further.
I do know several people who have attempted suicide and then several others with other sort of mental health problems.
Des: What do you think about having a community of attempt survivors?
Nathan: I think that communities, in general, are good. I'm an anthropology concentrator, right? In particular, in communities of people with shared experiences—that's the whole thought behind queer groups and minority groups—even though we're different people who might have nothing else in common, there's this particular trait about us that makes our life experiences similar enough that we can relate to each other and learn to like, or even love, each other without actual familial ties.
I think that one of the struggles that is very similar to the one that the LGBTQ community faced a long time ago is that it's hard to tell for a lot of people. You don't go around wearing a sign usually that says, "I attempted suicide," or, "I am bipolar," for multiple reasons, not the least of which being that those are still kind of hush hush things that we don't talk about. It is this thing where you feel invisible as a member of a group of people that is not insignificant at all, but you don't know that other people are facing the same things. It's incredibly isolating to think that you're the only one who has ever tried to kill themselves.
That's one thing I know from experience. I remember thinking when I was a little kid, "No one else ever wants this. People want to live. People just objectively want to be alive, except for me. I'm the only one who feels like this," which, that's not right. That's not true, but it's because—it's exactly because we don't talk about it or aren't open about it that that is true. Or that that feeling of isolation is so prevalent.
The question becomes very similar to how it used to be for, I think, queer people: how do we form a community? Hopefully, it won't take the AIDS epidemic or something similar as a catalyst to create some cohesion there, but I wish that there was a little bit stronger of one.
It's interesting, when I was a little bit younger, I used to spend some time on different websites looking for people, like suicide support websites and chat rooms and stuff, looking for people who were talking about these issues. What I largely found is that there are suicide attempt survivors who really feel they're past their situation, and a lot of advocates who are counseling people struggling with suicidal ideation telling you, "It's going to be okay. It's going to get better, and you're going to be awesome," and all this stuff, which is a mix of not true and true.
One of the things that I've come to realize, or started to process, is that, realistically, am I ever going to be okay? I don't know. Am I ever going to be okay in the way that we think about people being okay? I can't say that for sure, but the problems and the challenges that I'm facing in those moments are not going to be there forever. I think [we need to be] more sensitive to that—that we can't tell happily ever after stories because that's not realistic.
Des: It's not real, yeah.
Nathan: I think it's important, and I think that people don't think about that, even within those communities. But by that same token, I think if you can create or find a way to bring [people] together—because [we don't necessarily need to] create, people are already out there—communities of people who understand each other or who are going through the same thing, that's another thing. I feel like, if I had been able to talk to somebody who was going through depression at that time, that would have been more helpful too. Those types of communities who can relate to each other a little bit more, I think you have a lot better chance of not only creating real cohesion in the community, but of helping people in real, tangible ways, and of actually making somebody, maybe, feel a little bit better.
Des: Is suicide still an option for you?
Nathan: Oh, yeah. Partially because I've lived so long with suicide hanging over my head, and partially because I don't know that I'll ever be completely over my mental health issues. Suicide is something that I always see as being on the table. I've always, always, as long as I can remember being able to comprehend exactly what death means, imagined that I would die of my own will or my own force. I don't think that precludes a life of good experiences for me. That's not maybe necessarily true for everybody but, in some ways, having the option of death always available is, to some degree, empowering, because it gives me the freedom to live my life.
Des: Is there anything else you'd want to say to someone who might read your story?
Nathan: I think my biggest thing is—and this is cheesy and cliche, but—you're not alone. That's the one thing that I wish, I really wish, that I could tell anybody whose ever considered suicide. Just come talk to me! I don't know you, but I would love to sit down and talk through this. One of the natures of the disease is that you feel so isolated, and it's just not true. There are so many other people who share that experience who care. Not even necessarily just about making you live another day, but about trying to make that day the best it could be. God, that's cheesy.
If you’re feeling suicidal, please talk to somebody. You can reach the National Suicide Prevention Lifeline at 1-800-273-8255 or Trans Lifeline at 1-877-565-8860. If you don't like the phone, check out Lifeline Crisis Chat or Crisis Text Line. If you're not in the U.S., click here for a link to crisis centers around the world.
Thanks to Matthew Parr for providing the transcription for Nathan's interview.
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