Dr. Helen

Thoughts on Kate Spade, Depression, and Suicide

I know many of my readers may not care much about fashion, but hearing that Kate Spade committed suicide by hanging herself with a scarf is really tragic. Kate Spade created lovely purses and clothes and many are very bright and cheerful. I carry one of her bags and love the beauty and simplicity with the design. But much more pertinent than her fashion sense is the question: what was going on her mind that killing herself seemed like the only option?

Maybe we will never really know, though now news reports are saying she was having trouble with her relationship with her husband (it’s interesting that she killed herself with him in the next room). But a mentally healthy person would not take her life over a relationship gone bad. Kay Redfield Jamison, a clinical psychologist and author of Night Falls Fast: Understanding Suicide, has some insight:

Certainly, stress is important and often interacts dangerously with depression. But the most important risk factor for suicide is mental illness, especially depression or bipolar disorder (also known as manic-depressive illness). When depression is accompanied by alcohol or drug abuse, which it commonly is, the risk of suicide increases perilously.

Suicidal depression involves a kind of pain and hopelessness that is impossible to describe — and I have tried. I teach in psychiatry and have written about my bipolar illness, but words struggle to do justice to it. How can you say what it feels like to go from being someone who loves life to wishing only to die?

Suicidal depression is a state of cold, agitated horror and relentless despair. The things that you most love in life leach away. Everything is an effort, all day and throughout the night. There is no hope, no point, no nothing.

The burden you know yourself to be to others is intolerable. So, too, is the agitation from the mania that may simmer within a depression. There is no way out and an endless road ahead. When someone is in this state, suicide can seem a bad choice but the only one.

Was the red scarf she used to kill herself symbolic? Was fashion her beginning and her end? Or was it just expedient?

Women often use hanging as a method of suicide and it is getting more frequent:

But there is something even more surprising and strange in this report. The suicide rate has increased for women in particular during this period of time, narrowing the gap in the suicide rate between men and women (men have always taken their lives more often than women). The suicide rate is up 63% for women aged 45-65 and up 200% for girls aged 10-14.

As well, it should be noted that while suicide by firearms and poisoning has declined, suicide by suffocation, usually hanging, increased, making one in four suicides in both men and women attributable to strangulation. Suicide by suffocation is more deliberate than suicide by poison, which is the usual method chosen by women.

Maybe, like men, women are choosing methods with a higher degree of fatality. One study from the British Journal of Psychiatry found the following:

Hanging was adopted or contemplated for two main reasons: the anticipated nature of a death from hanging; and accessibility. Those favouring hanging anticipated a certain, rapid and painless death with little awareness of dying and believed it was a ‘clean’ method that would not damage the body or leave harrowing images for others. Materials for hanging were easily accessed and respondents considered it ‘simple’ to perform without the need for planning or technical knowledge. Hanging was thus seen as the ‘quickest’ and ‘easiest’ method with few barriers to completion and sometimes adopted despite not being a first choice. Respondents who rejected hanging recognised it could be slow, painful and ‘messy’, and thought technical knowledge was needed for implementation.

Whatever the reason for her suicide, it should serve as a reminder that depression does not discriminate and people who seem to have it all may not escape its grip. I will carry my handbag in your honor. RIP, Ms. Spade, you will be missed by many.

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