Wednesday, June 6, 2018

Kate Spade, R.I.P.

It would be nice, for once, if a celebrity suicide did not elicit a slew of mindless commentaries about how sad it all was, how we do not know how troubled she was and how she would have gotten better if only she could have faced her demons and discussed her problems openly.

This swill clouds judgment and dulls our sensibility to the simple fact that a relatively young woman, 55 year old Kate Spade, the mother of a teenage daughter, hanged herself yesterday… in her home, with her husband in the next room.

Naturally, we assume that she was mentally ill, and new information, from her family tells us that she was diagnosed as bipolar, thus manic-depressive, and refused to enter a rehab facility for treatment. We do not know who diagnosed her, whether she was taking any medication for it or whether she was consulting with any professional. Surely, someone did diagnose her. Many people strongly recommended that she go into rehab, but apparently she did not think that it would be very good for her brand.

If that doesn't frighten you, nothing will.

One might ask why, if her condition was that serious, she had not been committed against her will. Spade resisted re-hab, to the point where her family members, especially her sister, gave up trying to persuade her. In America we respect the rights of individuals to make their own determinations about their health. As noted in past posts, we should perhaps make it easier to commit people involuntarily. Especially, when their condition is less about the mind and more about the brain.

One would need to have more information, but bipolar illness is treatable with medication. A patient does not need to be hospitalized to receive the treatment. I do not know whether or not she was prescribed Lithium or another treatment for the disorder and I do not know whether or not she took the medicine. (In truth, of course, Lithium is a salt that occurs naturally in the body. Presumably, those who suffer bipolar illness have a Lithium deficiency.)

Surely, the choice was not between doing nothing and being hospitalized. Outpatient treatment, as we will call it, is readily available. One does not understand why she could not accept it or whether it was offered. If her condition was so severe that she needed to be hospitalized, then involuntary commitment should have been considered.

Among the precipitating causes of the suicide were the facts that her husband had asked her for a divorce and had moved out of the house. Link here. We do not know how accurate the information is, because we have also read that he was in the house when she killed herself. Certainly, if her marriage was breaking up, her daughter would have needed her more than ever. To remove herself from the picture strikes one as grossly irresponsible.

But, she was ill. The status of bipolar illness is somewhat in question. Some authorities consider it a mental illness, but the NIMH calls it a brain disorder. My understanding—full disclosure, I am not medically trained—is that it’s a brain disorder that requires pharmacological intervention. No one pretends any more to treat bipolar illness with talk therapy, of any variety. Back in the day (in the 1970s) when I was working in mental health facilities in France, no one believed that manic depressive psychosis, as it was then called, could be treated by talk therapy.

We do not know what treatment was offered her or how effective it was. If you think that the best treatment available in New York City is naturally going to be the best, you are naive. You should disabuse yourself of the illusion.

So, Kate Spade was suffering from a medical condition, a brain disorder, and somehow, whether because she refused all treatment or because she was mistreated, she is no longer with us.



whitney said...

Nothing about the suicide note

Shaun F said...

To my knowledge there is no medical test for the diagnosis of bi-polar. I knew someone in high school when he was 16 that I do think may have been legitimately bipolar and prescribed lithium. However, his binge drinking and artistic temperament probably exacerbated his erratic behaviour. Now he doesn’t drink and is obsessed with exercising, which at least allows him to function as a full time teacher. I knew a woman who was 47 who was diagnosed bi-polar, and put on benzos. However, she had been a prostitute, madam, had many sexual partners – of both sexes and had been a heroin addict. And when she went off her meds, suffice to say – it was a difficult situation to manage. Was she bi-polar or just suffering the consequences of her choices? Didn’t Thomas Szasz say that a mental disorder was just a “Problem with living life?” Isn’t it in the Bible “As you sow you shall reap?”

Stuart Schneiderman said...

Some physicians used to diagnose bipolar illness with blood tests. They measured the lithium levels in the blood and prescribed medication to correct the imbalance. I cannot say whether this is still being used. The psychiatrist most associated with this was Dr. Ronald Fieve.

Shaun F said...

Thank you for bringing that to my attention. Based on what I had read - my understanding was that psychiatrists voted on what to include in the DSM based on behaviours and symptoms.

Stuart Schneiderman said...

That's right. Of course, Fieve was somewhat of a pioneer in this field. And his practice was based almost exclusively on performing blood tests.

Ares Olympus said...

The husband's statement is here:
"We were in touch with her the night before and she sounded happy. There was no indication and no warning that she would do this. ... I have yet to see any note left behind and am appalled that a private message to my daughter has been so heartlessly shared with the media."

Linda Fox said...

I sense that many would look at the husband's leaving as a heartless abandonment of a sick woman. Those who would criticize him need to remember that living with a mentally ill person is exhausting.

The husband might have, after many years of being surrounded by the drama that accompanies bipolar illness, just said, I need to keep my own sanity.

There is a lot of anger that lies in the suicidal. It's not just their own pain, it's also a very large anger at those around them.