Next to Normal: an Anti-Suicide Message

There’s a world, there’s a world I know
A place we can go, where the pain will go away
There’s a world where the sun shines each day
There’s a world, there’s a world out there
I’ll show you just where, and in time I know you’ll see
There’s a world where we can be free
Come with me…
Come with me…
There’s a world where we can be free
Come with me…

These are the lyrics from a song in the Broadway musical, Next to Normal, which are heard over a slow, haunting piano and violin. These are words you would likely hear in a horrifically cheesy love song, or perhaps in a concentration camp where characters are looking to overcome an oppressive regime to build a better life.

Sound inspirational? Actually it is about suicide and it’s an eerily accurate depiction of the mind set of many who have either seriously considered or attempted to kill themselves. I’ve discussed this before but with an increase in depression, anxiety and overall stress from the economic collapse, certain points bear repeating.


People do not kill themselves because they want to be dead. They do it because they want their pain to end and cannot create any alternative solutions that are viable to achieve that goal. The song holds water because it gives an image of peace and happiness, a freedom from the daily agony that generates suicidal ideation. Is that what death is? I’m not going to pretend to know the answer but I am skeptical of the portrait painted by the lyrics [1].

Every suicidal person I have spoken with has agreed that if they could simply feel better they might want to remain alive. This admission by a client is often an opening to offer help and the possibility of thinking and feeling differently. And with time and intervention most people are able to stop thinking along these lines. And I stress the term most because it’s no secret that mental health treatment has limits, a ceiling effect, and many remain ill for their entire lives.

But a chronic illness does not necessarily translate to giving up. Many clients need a cheerleader, to be pushed to continue to fight for a decent quality of life. Instead of opting out of their life contract I encourage them to rail against the struggle and seek out meaning, create a reason for getting up in the morning. Does it always work? No of course not. But more often than not those who are chronically suicidal can make a model of something worth striving for. They can defeat the seductive nature of ending it, of “having no more problems.”

If you are one of those who are dancing with suicide as your partner, think more about what you are really trying to do. I suspect it’s not a desire to cease your existence. If I am right about this remember that when people are actively suicidal, their problem-solving skills fall through the floor. Get help, exhaust every option, don’t surrender to this sole choice. I have a strange suspicion the end result isn’t what you’re envisioning.

[1] In fairness to Next to Normal (an excellent show, by the way), the play wasn’t promoting suicide; rather it was effectively demonstrating the seductive quality of the action for those who are entertaining it.

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10 Responses to “Next to Normal: an Anti-Suicide Message”

  1. Leono says:

    I’ve been on and off meds for a while now. Tried a lot, and nothing in particular has worked for me. In the end I received some advice from a friend, find a hobby you enjoy.
    After a bit of moping, and the whole I don’t really enjoy anything, I came to a simple conclusion. Charlie Harper, while not the best show, I figured yeah, there are some things I still enjoy.
    While I’m guessing alcohol and promiscuous sex would be fairly low on the prescription list, (thumbs up for Dr. John) it’s definitely keeping me happy.

  2. Sarah says:

    I’m surprised you liked Next to Normal so much… from what I heard, it was kind of a strange depiction of bipolar, plus the idea that at the end of the play she was “all better” kind of grates my nerves. But then again, I haven’t seen it.

  3. “And I stress the term most because it’s no secret that mental health treatment has limits, a ceiling effect, and many remain ill for their entire lives.”
    Dr. Rob, are you referring more to biological illnesses such as bi-polar disorder and schizophrenia with this line?
    I ask because I’ve struggled with fairly serious depression before (from the confluence of near alcoholism, poor health, and a few psychological issues from NPD), yet now that I’ve dealt with those “causes” I’m almost manically happy on a daily basis. From my very limited experience, I would suspect that some combination of cognitive behavorial therapy and a healthy lifestyle would do wonders for a lot of folks.

  4. Dr. Rob says:

    At Sarah: it was a different depiction of Bipolar, but not entire off-base. I didn’t really see the ending as particularly feel-good, and she was definitely not “all better.”
    At Jimmy: CBT and meds are awesome for millions, but there are limits to all treatments. And while Schizophrenia and Bipolar come to mind as some illnesses that tend to be life-long, even Panic Disorder (one of the most common “psychological” conditions) only has an average success rate of around 85%.

  5. Laura says:

    This may sound strange, but I sort of am following this thought process/feeling in my PhD program right now. Not that I want to kill myself- but that I want to drop out, find another career, do something else, just for the purpose of easing the stress/anxiety/not-knowing if I will pass my qualifying exams/get the paper submitted/do the talk well.
    If I am following the same thought process, should the treatment (railing against the struggle, etc) be similar?
    Dr. Rob: It doesn’t sound strange, but you’re comparing career choices vs. life/death. It’s apples and oranges.

  6. Wayland says:

    Not too bad man.

  7. Misty says:

    http://www.postsecret.com is a great resource for those contemplating suicide.

  8. Miss Ryn says:

    What are your thoughts on ECT for MDD?
    Dr. Rob: This is a bit outside of my area, but from the little bit I know I think it’s a great option for people who have exhausted other treatment options. Most of the negative press it has gotten is simply sensationalism and ECT has a good track record for people who are biologically depressed in the literal sense. I think we need to educate ourselves on what ECT actually is and not rely on the fantasies and images seen in film the media which show bizarre and unlikely side effects. As you probably know, I’m a firm believer in not giving up when it comes to mental illness, so if there’s yet another option for those who suffer, then it should be tried.

  9. Now you are going to make me think of plays/books that have an accurate portrayal of a suicidal person.
    Overall I think you captured it pretty well.
    As for bipolar….look no farther than Britney Spears and Robin Williams.

  10. Laura says:

    You’re absolutely right Dr. Rob. I’m sorry I made that comment- I was so up in my own head about things happening I couldn’t get an appropriate perspective.

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