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Suicide
Night Falls Fast: Understanding Suicide by Kay Redfield Jamison β€” book cover

Night Falls Fast: Understanding Suicide

by Kay Redfield Jamison
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Overview

From the best-selling author of An Unquiet Mind: the first major book in a quarter century on suicide, with a particular focus on its terrible pull on the young. Night Falls Fast is both compelling and timely: in the United States and across the world there has been a frightening surge in suicides committed by children, adolescents and young adults. It is the third major cause of death in 19- to 24-year-olds, and the second in college students. Dr. Kay Redfield Jamison, an internationally recognized authority on depressive illnesses and their treatment, knows this subject firsthand. At the age of 28, after years of struggling with manic-depression, she attempted to kill herself. Her survival marked the beginning of a life's work to investigate both mental illness and self-inflicted death.

Weaving together a psychological and scientific exploration of the subject with personal essays about individual suicides, Dr. Jamison in this book brings not only her compassion and literary skill, but all of her knowledge, research and clinical experience to bear on this devastating problem. In tracing the network of reasons that underlie suicide, Dr. Jamison gives us astonishing examples of the methods and places people have chosen to kill themselves, and a startling look at their journals, drawings and farewell notes. She also brings us vivid insight into the most recent findings from hospitals and laboratories across the world; the critical biological and psychological factors that interact to cause suicide; the new strategies being evolved to combat them; and the powerful, but insufficiently used treatments from modern medicine.

Night Falls Fast dispels the silence and shame that too often surround suicide; it helps us to understand the suicidal mind, to better recognize the person at risk, and to comprehend the profound and disturbing loss created in those left behind.

About the Author:

Kay Redfield Jamison is Professor of Psychiatry at the Johns Hopkins University School of Medicine. She is the author of the national best seller An Unquiet Mind: A Memoir of Moods and Madness and co-author of the standard medical textbook on manic-depressive illness. She is also the author of Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, as well as more than a hundred scientific papers about mood disorders, psychotherapy, psychopharmacology, and suicide. Dr. Jamison, formerly the director of the UCLA Affective Disorders Clinic, is the recipient of numerous national and international scientific awards, including the American Foundation for Suicide Prevention's Research Award. She is, as well, Honorary Professor of English at the University of St. Andrews in Scotland. Dr. Jamison lives in Washington DC, with her husband, Dr. Richard Wyatt, a physician and scientist at the National Institutes of Health.

Synopsis

From the best-selling author of An Unquiet Mind: the first major book in a quarter century on suicide, with a particular focus on its terrible pull on the young. Night Falls Fast is both compelling and timely: in the United States and across the world there has been a frightening surge in suicides committed by children, adolescents and young adults. It is the third major cause of death in 19- to 24-year-olds, and the second in college students. Dr. Kay Redfield Jamison, an internationally recognized authority on depressive illnesses and their treatment, knows this subject firsthand. At the age of 28, after years of struggling with manic-depression, she attempted to kill herself. Her survival marked the beginning of a life's work to investigate both mental illness and self-inflicted death.

Weaving together a psychological and scientific exploration of the subject with personal essays about individual suicides, Dr. Jamison in this book brings not only her compassion and literary skill, but all of her knowledge, research and clinical experience to bear on this devastating problem. In tracing the network of reasons that underlie suicide, Dr. Jamison gives us astonishing examples of the methods and places people have chosen to kill themselves, and a startling look at their journals, drawings and farewell notes. She also brings us vivid insight into the most recent findings from hospitals and laboratories across the world; the critical biological and psychological factors that interact to cause suicide; the new strategies being evolved to combat them; and the powerful, but insufficiently used treatments from modern medicine.

Night Falls Fast dispels the silence and shame that too often surround suicide; it helps us to understand the suicidal mind, to better recognize the person at risk, and to comprehend the profound and disturbing loss created in those left behind.

About the Author:

Kay Redfield Jamison is Professor of Psychiatry at the Johns Hopkins University School of Medicine. She is the author of the national best seller An Unquiet Mind: A Memoir of Moods and Madness and co-author of the standard medical textbook on manic-depressive illness. She is also the author of Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, as well as more than a hundred scientific papers about mood disorders, psychotherapy, psychopharmacology, and suicide. Dr. Jamison, formerly the director of the UCLA Affective Disorders Clinic, is the recipient of numerous national and international scientific awards, including the American Foundation for Suicide Prevention's Research Award. She is, as well, Honorary Professor of English at the University of St. Andrews in Scotland. Dr. Jamison lives in Washington DC, with her husband, Dr. Richard Wyatt, a physician and scientist at the National Institutes of Health.

NY Times Book Review - Andrew Solomon

At once the most relentless and the most sympathetic book Jamison has produced, written with an edifying urgency that surpasses her previous volumes. Jamison persuasively uses numbers to demonstrate that suicide is a vast public health crisis...

About the Author, Kay Redfield Jamison

Kay Redfield Jamison is Professor of Psychiatry at the Johns Hopkins University School of Medicine.  She lives in Washington, D.C.

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Editorials

From Barnes & Noble

Looking at Suicide

"I wish I could explain it so someone could understand it," an unnamed woman scratches in her suicide note. "There's just this heavy, overwhelming despair -- dreading everything." She concludes: "I wish that I could disappear without hurting anyone. I'm sorry."

Suicide tends to overwhelm people -- victims, survivors, anyone. Our minds instinctively recoil from it. But in Night Falls Fast: Understanding Suicide, Kay Redfield Jamison guides us through the issue safely, leading us from unnamed anxieties to a broad, comprehensive perspective.

Jamison's last book, a bestselling memoir of manic depression titled An Unquiet Mind, brought the mysteries of psychopathology home through an understated, personal account. But in Night Falls Fast, Jamison bonds personal and clinical experiences even more potently. She describes individual cases poignantly but sets those tales within a grid of information.

Suicide isn't just a single, isolated pain, Jamison explains, but a societal epidemic with recognizable symptoms. Worldwide, suicide is the second leading cause of death among females aged 14 to 44, and for males it ranks fourth. In Night Falls Fast, Jamison adjusts personal experiences into these patterns, carefully accounting for the psychological, biological, and societal factors. She shows us which people are most at risk for suicide and how those people can be overwhelmed by compounded distress. The stories hurt, each one, but then they make sense.

Throughout the book, Jamison argues that suicide cannot be treated as merely a rejection of life's meager portions. In one of the book's most moving passages (the chapter on suicide notes) we hear suicide victims trying carefully to relieve their friends of responsibility. "No one is to blame for my doing this," a 20-year-old desperately assures her survivors. "It's just that I could never become reconciled with life itself. God have mercy on my soul."

Although each note stings, together they form Jamison's argument: People tend to commit suicide to end prolonged depression, not to avoid problems. Often, suicides speak of lifelong battles against forces they cannot understand or control; novelist William Styron explains, "The gray drizzle of horror induced by depression takes on the quality of physical pain...comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room." Suicide seems, then, no cowardly response to manageable issues, but the last stage of a long and debilitating disease.

By seeing suicide as an epidemic, Jamison suggests, we as a society can avoid feeling so overwhelmed by it. "My hope," she explains, "was to find a way to maintain an individual perspective -- through an emphasis on the psychology of suicide and an extensive use of the words and experiences of those who seriously attempted to, or eventually did, kill themselves -- but to keep that individual perspective firmly grounded in the sciences of psychopathology, genetics, psychopharmacology, and neurobiology."

And she has done just that. The book first invokes Jamison's friend Jack Ryan, a manic-depressive overwhelmed by suicidal urges and unable to seek help. Next, Jamison offers a historical, global perspective on suicide, helping the reader to see just how personal and how planetary suicide can be. In the bulk of the book, she then breaks the problem into three manageable chunks: the psychology of suicide, the biology of suicide, and the prevention of suicide.

In the first section, Jamison considers how people decide to self-destruct. She catalogues how a suicide explains his feelings, how muddied perspectives and life troubles collaborate in his downfall, how illnesses erode his ability to cope, and how he finds a way to end his struggle.

The second section of the book focuses on the physical characteristics of suicides. After a quick look at suicide as an evolutionary dilemma, Jamison helps us to pick through scientific data of suicides' genetics. She then patiently explains the basics of neurobiology: how various neurotransmitters can run afoul and how they can be treated.

The third section considers the social problem of suicide. Jamison sympathizes with the shame and confusion of survivors, while pressing us to recognize how we can reduce the death toll. Doctors can become more finely attuned to the warning signs, she insists. Common catalysts -- like guns, alcohol, and pills -- can be better monitored. New drugs can pull patients through the most dangerous stages of depression.

As Jamison admits at the close of Night Falls Fast: "Looking at suicide...is harrowing." But with her erudite and patient guidance, readers really can orient themselves in the confusing rush of emotion, science, and statistics that accompany suicides. Through reading Jamison's sensitive study, we can pass from feeling overwhelming confusion to feeling fortified by overwhelming evidence. The subject is difficult, but Jamison's controlled, smooth writing and sure-minded analysis make this an important book for everyone to read.

β€”Jesse Gale

Andrew Solomon

At once the most relentless and the most sympathetic book Jamison has produced, written with an edifying urgency that surpasses her previous volumes. Jamison persuasively uses numbers to demonstrate that suicide is a vast public health crisis...
β€” NY Times Book Review

Publishers Weekly

Providing historical, scientific and other helpful material on suicide, Jamison (An Unquiet Mind), a Johns Hopkins psychiatry professor, makes an excellent contribution to public understanding with this accessible and objective book. There is, she asserts, a suicide every 17 minutes in this country. Identifying suicide as an often preventable medical and social problem, Jamison focuses attention on those under 40 (suicides by those who are older often have different motivations or causes). Citing research that suicide is most common in individuals with mental illness (diagnosed or not), particularly depression and manic depression, she clearly describes the role of hormones and neurotransmitters as well as potential therapies, including lithium and other antidepressants. Jamison presents fascinating facts about suicide in families and in twins, gender disparities, and the impact of the seasons and times of day. She also provides poignant portraits of those who have committed suicide--from the explorer Meriwether Lewis to a high-achieving Air Force Academy graduate--as well as stories from her own experience. Historical perspective on how different societies have viewed suicide gives context, especially on methods and common locales (in the U.S., San Francisco's Golden Gate bridge is the most popular spot). Critical of her profession for not recognizing suicidal tendencies more readily, Jamison scolds the media and firearms industry as well. The book effectively brings suicide out of the closet, gives general readers insight into symptoms and should increase national awareness of the problem. (Oct.) Copyright 1999 Cahners Business Information.

KLIATT

Author of An Unquiet Mind, Kay Redfield Jamison knows her subject. As an MD and Professor of Psychiatry at Johns Hopkins University School of Medicine, Jamison is an excellent researcher. As a manic depressive, she knows the blackness of the suicidal mind-set. She therefore approaches her subject with both organization and empathy. Her book, as she describes it, is about suicide as a social as well as a medical problem. "Specifically, it is about why suicide occurs, why it is one of our most significant health problems, and how it can be prevented" (p.21). Jamison focuses on the prevalence of suicide in those under 40. Suicide is the second leading cause of death among college students, third among the general population of the young; it is a more consistent killer of the young than either war or AIDS and is treated as a virus by the Center for Disease Control. Jamison carefully examines first the psychology, then the biology, of suicide before she tackles the problems and questions of prevention, balancing research statistics with case studies and even anecdotes from her personal experience. Because of its topic, this is a difficult book. The reader's progress, however, is eased not only by Jamison's expertise and depth of feeling, but also by the elegant flow of her prose. This is a must read for teachers of the young. KLIATT Codes: Aβ€”Recommended for advanced students, and adults. 1999, Random House/Vintage, 432p, notes, index, 21cm, 99-311227, $14.00. Ages 17 to adult. Reviewer: Patricia A. Moore; Academic Resource Ctr., Emmanuel College, Boston, MA (retired), March 2001 (Vol. 35 No. 2)

Library Journal

Jamison--herself a manic-depressive who has attempted suicide and now a professor of psychiatry at Johns Hopkins School of Medicine--brings a special urgency to this study. The personal and the professional blend seamlessly here, allowing Jamison to illuminate the darkest recesses of the human mind. The result is forthright, moving, and impressively unsensational. (LJ 10/1/99) Copyright 2000 Cahners Business Information.

Booknews

An internationally recognized authority on depressive illnesses, and a survivor of suicide, weaves together a psychological and scientific exploration of suicide with personal essays about individual suicides. She traces the reasons underlying suicide, looking into the journals, drawings, and farewell notes of suicides, and discusses biological and psychological factors in suicide and new treatments for mental illness. The author is a professor of psychiatry at the Johns Hopkins University School of Medicine, as well as honorary professor of English at the University of St. Andrews in Scotland. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Kirkus Reviews

Suicide rates for Americans under 40, the cohort on which this book focuses, have tripled in the past 45 years. Although it makes no attempt to explain why this is so, this is a superb interdisciplinary look at self-murder. Janison (Psychiatry/Johns Hopkins School of Medicine), author of the bestselling memoir An Unquiet Mind (1995) about her own struggle with manic-depressive illness, here looks at suicide through literary, historical, anthropological, psychological, biochemical, genetic, and epidemiological lenses. She emphasizes the highly disproportionate suicide rates among those suffering from the major mental and mood disorders of depression, manic-depression, and schizophrenia. Jamison also notes a continuum running from risk-taking behavior to suicidal thoughts to actually killing oneself and notes that while approximately 30,000 Americans commit suicide each year, 500,000 attempt to do so ("Ambivalence saturates the suicidal act," she writes). With much interesting anecdotal material and data from the vast scientific literature on suicide, Jamison ranges far and wide over such topics as suicide notes, national styles in killing oneself (the Germans favor hanging, while in the US, guns are used in about 60 percent of suicides), and seasonal factors (contrary to popular belief, most suicides take place not during winter but during the late spring and summer). Her study is also greatly enhanced by several essays, in which Jamison delves into the suicide of noteworthy people. She writes particularly insightfully on the difficulty of predicting suicidal behavior and on the sensibility of the suicide, who usually lives with an anguished "sense of the unmanageable, of hopelessness,of invasive negativity about the future." Although her data on suicide sometimes seem overwhelming and a few individual statistics a bit loose, Jamison's book generally is a very well written, substantial, and consistently interesting study of a wrenching existential and societal problem that has reached epidemic proportions. (First printing of 175,000)

Book Details

Published
October 1, 2000
Publisher
Knopf Doubleday Publishing Group
Pages
448
Format
Paperback
ISBN
9780375701474

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