Mum's suicide came as no surprise to anyone

Winning the Young Agricultural Journalist of the Year award last October was a silently poignant affair

Winning the Young Agricultural Journalist of the Year award last October was a silently poignant affair. Not simply because the article in question had dealt with suicide in rural Ireland, but because 10 months after its publication, my own mother took her life, writes Darragh O'Keeffe

In May 2005 I was working in the features section of the Irish Farmers Journal. That summer we undertook an unprecedented, in-depth series of articles on suicide in rural Ireland. It came about as a result of several phone calls to the office from readers asking us to publish helpline numbers because so many rural villages were being riddled with suicide.

Leading what became an 18-page spread was my article entitled Where have all the young men gone? The piece dealt with the suicides of three young men in Dromahair, a small village in Co Leitrim. In it, the three families spoke of the devastation the suicides of Pat, Gary and Kevin had left behind.

Last October, that article earned me the award of Young Journalist of the Year from the Guild of Agricultural Journalists.

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What was being discussed in some quiet circles at the awards that night was the fact that my own mother had died the previous March. She too had died by suicide.

But unlike the young men I had written about, mum's suicide came as no surprise to anyone.

The day mum died was the day a painful and traumatic family legacy ended.

It marked the end of a battle to keep her alive. A battle with her doctors, the psychiatric system, the anti-depressant culture in Ireland and, indeed, with mum herself.

I'm 24 years old and for as long as I can remember, mum suffered from depression. But in the end, it wasn't even depression we were dealing with. The concoction of anti-depressants and sedatives she was prescribed over the years turned her into a numbed, aged and highly suicidal junkie.

In the later years, when it became apparent that the sedatives had lost effect, mum turned to alcohol to numb the obvious pain she felt. That was despite being on a concoction of tablets, which at one stage totalled 14 different drugs, several times a day.

Just over a month before mum died, I wrote a letter to her psychiatrist. The purpose of that letter was to tell the doctor and the hospital that we as a family were no longer willing to take responsibility for our mother.

The suicide attempts at home had taken its toll on all of us. We all had our horror stories of finding her. For me, it was finding her in bed with her throat cut. Imagine the ordeal of putting a wet cloth to her severed throat and holding her hand until the ambulance came.

That incident occurred two weeks after I had begged the hospital to admit her. We knew she was suicidal. But mum refused to be admitted and legally it was her decision. Families have no rights to "commit" or "section" anyone anymore so legally the hospital, like ourselves, were at the whim of my mother.

And she was in no state to make rational decisions that day.

For my younger brother it was the trauma of finding her hanging from the banisters. He was 14 years old at the time. Imagine the ordeal of running for a knife, cutting her down and lifting her onto the landing.

And there are other chapters from the horror book. Too many to mention. And sometimes you block out the darkest days from your memory in order to survive.

Eventually, we made the decision that we could not be her guardians anymore and relinquished that responsibility to the hospital, whether we could do so legally or not.

It was the only avenue open to us, as horrific and harsh as it might sound to an outsider.

In the letter I said: "Be clear about this, doctor, my mother will die by suicide in the end, whether intentionally or not. If you try something enough times, you will eventually get it right."

Over a month later, she was dead.

Now that mum is gone, and the daily mental stresses and strains of her care have passed, our thoughts are reflective.

Of course, she wasn't always depressed. And she wasn't always suicidal.

During the funeral, our house was full of people who'd known her for years. They talked about a fun-loving, vivacious and spontaneous woman. She was indeed beautiful and striking.

Above everything, my mother was a lady.

She'd left her native Longford in her early 20s and worked for Allied Irish Finance and Leasing (now AIB) in Dublin. She later moved to London to work for the bank when it set up operations there in the 1970s.

In London she met my father, Kieran, a Cavan man. Dad was also working in AIF and the irony was the two met in London when they had grown up only a few miles apart in Longford and Cavan.

After getting married and once mum became pregnant with my older sister Aoife, they moved home to Ireland, to Co Sligo, where dad got a position in AIF.

They bought a four-bedroom Georgian- style house in Strandhill, a seaside resort in Sligo. Neighbours still talk about meeting mum for the first time and how her sense of fashion and style bowled them over.

With the passage of time, memories and accounts of when the depression began are hazy. However, everyone agrees that it took hold in earnest about 18 years ago.

When it did, some thought it was post-natal depression after giving birth to my younger brother. But most of us have never believed that. Mum herself once told me she thought her unresolved issues with her father were a root cause. He had died when she was 17 and they were not on speaking terms at the time.

Her first port of call was our family GP, who referred her on to a psychiatrist.

He would be the first of many.

Over the 18 years, mum saw many psychiatrists and doctors in the northwest and in Dublin.

During that time, she was prescribed almost every major anti-depressant. There was a period of about three "good" years when she was in generally good form. But eventually that drug lost its effect and she slipped back into what she often called "the black hole".

Apart from that, the other years were spent trying out new anti-depressants and sedatives. Anyone with any knowledge of anti-depressants will know the routine.

The drug is started in small doses and built up in the patient's system. Only after weeks of building it up does it become apparent whether it's working or not. If it's not, the drug has to be weaned down and the whole process starts again with a new drug.

Her doctors in Dublin even sent her for several rounds of electro convulsion therapy (ECT). Rather unsurprisingly, the practice of passing electric shocks to her brain did little to improve her mood.

Really, up until the past couple of years, we had never given up hope. I always looked on the depression as something she could beat, something she could overcome. I still believe that if things had happened differently, namely, if her treatment hadn't relied solely on tablets, she may have overcome it.

She at least would have had a chance.

It's incredible to think that over 18 years, after seeing so many doctors and hospitals, my mother never met a psychologist.

No one ever asked where she thought the depression was coming from. No one ever tried to get to the bottom of it. No one tried therapy or counselling as a form of treatment.

And sure, why would they? There are no sales reps promoting therapy.

Apart from just a few sessions of cognitive behavioural therapy in Sligo, which was quickly stopped because of the amount of medication mum was on, there was never any serious attempts at psychological treatments.

I remember speaking to a doctor in St Pat's in Dublin about mum. I told him she had never seen a psychologist. That none of the medical profession seemed open to that approach, despite numerous requests from the family.

"Well, Darragh, it would be lovely to think that one heart-to-heart will solve your mother's problems but that's not how it works," was his response.

If nothing else, it showed his lack of respect for his colleagues who work as psychologists and psychotherapists.

He certainly wasn't alone. In general, we found mum's psychiatrists were one-minded, arrogant and insensitive when it came to her treatment. The very notion of taking her off medication was like Armageddon.

I hated to point out the painfully obvious to them, but after 18 years, I think it was safe to say we'd tried it their way and the drugs weren't working.

Together with that mentality among the doctors, the apparent lack of psychological services, in the northwest anyway, seemed to confound the problem.

And that wasn't the only service provision with which I took issue. Despite several documented suicide attempts in our house, like the two I've mentioned earlier, not one social worker or community nurse ever called to our door.

We were left to our own, very much.

And yet, we weren't alone. I will always remember times sitting in the day room of the hospital, looking at the other patients and their families around them. The same tired, hopeless faces. And the patients didn't look in great shape either.

I will always think of the families and partners of depression patients in Ireland. Just like we had done, they rely on the word and judgment of a special few who dictate treatment. The gods are rarely questioned. And that is wrong.

For many, anti-depressants are effective. In fact, for some forms of depression, such as bi-polar, they are the best form of treatment. Nonetheless, it is very wrong that in Ireland today, the medical profession relies solely on anti-depressants to treat depression.

It is the result of a lack of training among some health professionals, economics and bad attitudes.

And while we don't talk about that in public circles, we don't talk about its link to suicide either, which brings me back to the beginning.

The media tends to portray suicide as if it's some mystery happening in our country. Indeed, my own article talked about the local shock at the three suicides in Leitrim. But we are yet to discuss openly the amount of repeated para suicides (attempted suicide) or the suicides of those people who did reach out for help and yet ended up dying. The suicides of people who were under psychiatric care. People like my mother. It is my reverent fear that until we get a grip on how to handle and treat depression, suicide will continue to hang like a black shroud over the country.

For many relatives of suicide victims there are unanswered questions. Most commonly, why did this happen? But for so many other families, there is just hurt and anger. Hurt at the loss. Anger with the system that failed.

Me? I feel robbed.

During the wake, one of mum's oldest friends said to me: "Your mother was so beautiful. Everyone in the bank loved her. She was such great craic, always up for a laugh. But Darragh, there was always something. It was like she was always looking for something. It was like she had a wanting."

What was Rosaleen's wanting?

That's just it. We'll never know.

And therein lies the biggest irony and the biggest truth. For all the doctors, and all the drugs, her suicide is still a mystery.