Reviewer: Leonardo Silva On the morning of May 25, 2011, I attempted suicide by tying a rope into a hangman's noose, putting it around my neck, and then jumping from a log much like the one you see in this photo. Obviously, something went wrong, and I survived. Later someone told me I was lucky, but that's not what
I was feeling at the time. I wanted to end my life that day, and I was bitterly disappointed
to find myself alive. The scars you see here
are from the ropeburn I got when the hangman's noose unraveled. As you can imagine, it hurt. What hurt even more is I didn't have
the energy or capacity to try again. It'd taken more than four hours of hiking
through the park to find a suitable spot, and before that,
months and months of anguish. I was exhausted - mentally and physically. I had nothing left. I was done. Now that you know a little of my story, let's step back and take a look
at suicide's causes, consequences, and perhaps some of the answers. Currently, there are strong cultural
taboos in discussing suicide. Secondly, nearly everyone
who attempts or dies by suicide has a mental illness at the time, which for many is seen as character flaw. As long as mental illness
and suicide are stigmatized, they'll remain a hidden,
but very real, public health threat and a source of terrible pain
for everyone who's been affected. My hope is that change can occur where suicide and mental illness
are no longer stigmatized and the cost and impact
on families and society, diminished. A reframe is the ability to see
a set of facts in a entirely new way. Let me give you an example. In the 1984 presidential election,
Ronald Reagan's age became a factor. At the time, he was 73 and Walter Mondale,
his opponent, was 56. In the first presidential debate,
Reagan didn't do very well, and it was thought to be
because of his age. In the second debate, a journalist asked Reagan
whether or not he was fit to be president and whether or not his age
was going to be an impediment to his ability to do the job. Here's how he responded. Ronald Regan: I will not make age
an issue of this campaign. I am not going to exploit,
for political purposes, my opponent's youth and inexperience. (Laughter in the video) (Applause in the video) As you can imagine, his age
was never again factor in the campaign. Can you see how
we skillfully reframed the facts so that we saw them
in an entirely different way? So now that we know about reframe, what are the facts about suicide? This pie chart shows us
the leading causes of death in the US for the most current year of 2013. And as you can see,
suicide is last on the list and the smallest wedge in our pie chart. So while suicide
is a leading cause of death, it doesn't get much of our attention. After all, all of us have been affected
in some way by heart disease, cancer and respiratory diseases, as well as all the attention these causes
get through fundraising and charities. So it's no wonder
they stand out in our minds. There are about 40,000 suicides
per year on average in the US and about 16,000 homicides. Are you surprised? Are you surprised that there are
more suicides than murders? That in fact, there are 2.5 times
more suicides than homicides? Furthermore, it's believed that,
for every suicide, there are 25 attempts, which is about a million
per year, in the US. So even though the number of suicides
is sterling enough, it's miniscule, compared to the number of people,
like me, who've attempted suicide. Suicide has an enormous cost
to our society. The Center for Disease Control
estimates that, on average, a suicide costs about a million dollars, and that totals 34 billion dollars in medical costs
and lost work productivity. Most tragic of all: 6 to 32 surviving family members,
friends and colleagues, who will suffer and grieve their loss. So the next time you hear of a murder, let me ask you to take a moment
to consider that, in that same time, there have been 3 suicides
and 75 attempts. When someone commits the murder,
it makes the news. When someone dies by suicide - nothing. It's silence. Yet, the facts are suicide
happens much more often and is much more likely to affect
our families and our society. How does someone get to a place where
suicide seems like the best option? In fact, the only option? Over 90% of people who attempt or die
by suicide have mental illness at the time and the most common
mental illness is depression. Depression makes suicide seem like
reasonable way to solve problems you face. In fact, studies have shown
that, in 100% of cases, suicide is seen as a solution
for emotional pain and hopelessness. Now, you may say
suicide is not a solution, but that's what makes
depression so insidious. When you're depressed,
suicide looks like it makes sense. You might be wondering,
"What does depression feel like?" Depression is not the same for everyone, but what everyone
with depression has in common - you don't feel like yourself. Depression, the medical term,
could really use a different name. Today we use word "depressed" to mean
everything from feeling a bit miserable to having a clinical mental disorder which is a little like comparing
someone who's had a paper-cut to someone who's had their arm amputated. It's not the same. For me, depression
didn't feel like anything, or at least what does empty
and hopeless feel like? What it did feel like is a never-ending
and ever-smaller tunnel. What it did feel like is excruciating. After my attempt,
I received an unexpected gift: the unconditional love and support
of my partner Jennifer and two of my brothers, Roy... (Sigh) (Applause) (Cough) Roy - excuse me - Roy and Jim, with whom she shared my secret. It's with their help that I survived. At the time, I didn't think
their help was available. (Sigh) Audience member: [Unintelligible], John. (Cheers) (Applause) That was my partner, Jennifer. (Laughter) Clearly, I was wrong. It's another example of how depression
corrodes your thinking. A dilemma is a situation
where you need to make a choice between two equally unattractive options. On 9/11, many people fell to their death
from the World Trade Center. Consider their dilemma. Death by fire or by jumping. They made the choice
that jumping was preferable to excruciating pain of the fire. On May 25, 2011, I made the choice that jumping
from a log with rope around my neck was preferable to the
excruciating pain of my depression. Now you may wonder, "Is the pain of the fire and the pain
of the depression the same? I don't know. It's hard to know for sure. What I do know for sure is
in the throes of our respective dilemmas, we made the same choice. Here's the thing: I understand
the situation isn't exactly the same, but let me ask you to imagine the horror
that people in the WTC must have faced. And if you can imagine that, then you can also imagine the feeling of being trapped
in an intolerable situation, and that's what makes depression
sometimes make suicide possible. When thinking about suicide,
people often say one of three things. First, some people say
that suicide is an act of cowardice. Do you think the people
that jumped off the WTC took the coward's way out that day? My guess is you don't. No one atempts or dies by suicide
because they want to die. Suicide is not an act of cowardice. It's a desperate act
to get a relief from the pain. Secondly, some people say
suicide is selfish. Are the people who get cancer
or heart disease selfish? Of course not. Getting a clinical mental disorder
affects your ability to think, your mood and your judgement. Suicide is not the problem. Rather, it's the result
of the underlying illness. Rather than ask why the suicide, ask why the pain. And third, some people say
that suicide is a cry for help. One Harvard study of 286 people found
that 42% agree with the statement: "My suicide attempt was a cry for help,
I didn't mean to die." The majority, 58% agree
with the statement: "I made a serious attempt to kill myself. I'm lucky to be alive." In my case, I made a serious attempt, and I am lucky to be alive. Do you know that, by the late 1980s, 30 of the 50 US states
had no laws against suicide? That by 1993, suicide was
largely decriminalized? At the time of my attempt, I had a vague notion
that suicide was criminal which is part of the reason
I didn't seek or get medical attention. So how did I get the attention I needed? This is a CT scan, and just for reference the white spot you see inside
a red circle is my spine. And what you're seeing is a cross-section
of my body at the level of my liver. The dark spot with the red indicator
is a leader of an infected fluid. As a result, my liver had expanded, compressing my lungs and stomach so much
I couldn't breathe or eat. I'd lost 30 pounds in the six weeks
before this scan was taken. It was on my third attempt at emergency
that I finally got admitted to a hospital, and in doing a full medical intake, the facts of the suicide attempt
from three months earlier became known, and I was given psychiatric care. Isn't it ironic I did not get treatment
for my mental health until I got admitted to a hospital
for my physical health? My liver condition gets attention
and my mental health condition doesn't? Even me? Someone who attempted
suicide had a stigma? A stigma is a mark of disgrace associated with a particular
circumstance, quality or person. And speaking of stigmas, is depression a mental illness
or a character flaw? And secondly, who do you think of when you think of people
with mental illness? Is this what you think of? People living on the margins of society? The only people with mental health issues
are people with issues? Or perhaps you think of a man
who was thought to have a mental illness who commited a mass shooting
at Sandy Hook Elementary, in Newtown, Connecticut. Or maybe your model of mental
illness is shaped by the movies like "One Flew Over the Cuckoo's Nest," with that oppressive head nurse Ratched, and that the best way to treat
mental illness is with a lobotomy. If that's what comes to mind for you,
perhaps it'll surprise you that Jim Carrrey, who's made
a career of making us laugh, has depression and
he's battled it for decades. After returning from a Moon,
Buzz Aldrin coped with depression. After all, he'd been to the Moon and back. What was there to live for? Hey, do you know that song by Elton John,
called "Someone Saved my Life Tonight"? It's about his suicide attempt in 1969. And that Billy Joel
has long coped with depression, and in 1970, he attempted suicide? And even tough-as-nails
football players like Brandon Marshall can have a mental illness. And with the shocking death
of Robin Williams, we learned that he'd coped with depression
and mental illness for decades. So the people with mental illness are not
just people in the margins of the society. People I've met with
mental illness are just like me, and some of you. That's right, one in four people
has a mental health problem, and many more people
have a problem with that. Let me put it another way:
this room holds about 400 people, and that means about 100 of us
have had a mental illness in our lifetime. So what I'm going to ask you to do
is take a look to your left, look to your right, and as you look to your left and right,
try to identify who has a mental illness. (Laughter) If you can't identify who it is, maybe it's you. (Laughter) Now it's time to get to facts
about mental illness and suicide, because as long as mental illness
and suicide are stigmatized, they'll remain a hidden,
but very real, public health threat. The director-general of the
World Health Organization says that mental illness
is not a personal failure. If there's a failure to be found, it's in the way we've responded to people
with mental and brain disorders. Treatment is available, but nearly two-thirds of the people
with a known mental illness never seek help
from a health professional. Our society and culture will support
the people with physical illness, but often not the people
with mental illness. Gandhi famously said, "Be the change
that you wish to see in the world." And that's why I'm speaking up. That's why I'm asking
for the world to change. I've chosen to reveal something
about myself that I've hidden for to long. My mental illness and my depression
are no longer a secret. I'm owning myself on this stage. (Applause) I'm willing to face the stigma
because, if I'm silent, the stigma just continues to exist. I'll offer you three ways
to end the stigma and be the change
that you wish to see in the world. First, change your language. A lot of the stigmas we have
show up in the language we use. Using language like "psycho,"
"schizo," "retard," "nuts," "loony," "spastic"
and "screws loose" just perpetuates the myths. Social stigma is pervasive. The U.S. National Institute of Medicine
has a list of 250 labels people use to stigmatize
those with mental illness. Change your language
so that it becomes more understanding. Start that understanding
by educating yourself. Although the exact cause
of most mental illness is not known, it's becoming clear through research
that it's a combination of psychological, biological,
social and environmental factors. Mental illness is not a flaw in character. Get the facts so that
we can stop the stigma. And third, let's talk about it. The elephant in the room
is a metaphor for an obvious truth that's being ignored or unspoken. The best way to deal with an elephant? To name it! Get it out in the open! Let's talk openly about how mental illness
and suicide affects us all, either directly or through
a family member, colleague or friend. Let's talk openly about mental illness
and suicide as part of normal life. At the beginning of this talk, I described a reframe
as the ability to see the same set of facts
in an entirely new way. That's what I've been able to do,
a personal reframe. As Andrew Solomon says in his TED talk, the opposite of depression
is not a happiness. It's vitality. I've gone from wanting to die
to wanting to live, because of my renewed vitality. And that's my hope for this talk, that we as a society can reframe
how we view mental illness and suicide, because as we do, we'll make care, treatment,
help and support more accessible, and that will diminish
the costs and impact on our families and our society. Because if not us, then who? If not now, when? Let's recognize that most people
who attempt or die by suicide don't want to die. They just want relief from the pain. Rather than ask why the suicide,
ask why the pain. Let's see mental illness for what it is:
it's an illness just like any other. Everyone with an illness deserves care,
help, treatment and support. The reframe in how we view mental illness
and suicide starts with us. It starts with me. It can start with you. Are you all willing to join me? Let's change the world! (Applause)
