The Mountain West is a place for dreams.
The spectacular vistas, primeval forests and the hardy, independent folks who live there are romanticized in our national history and popular culture. It seems counterintuitive that in this majestic place, the suicide rate is among the highest in the nation.
A Washington Post article recently carried in The Durango Herald says the suicide rate for middle-aged white women – my demographic when I moved to Durango – nearly doubled between 1999 and 2014. Among Colorado counties with a population of at least 30,000, La Plata’s rate was the highest.
The experiences of the women who took their lives in La Plata County were very different from my own – for lots of reasons.
The West draws people with high hopes and sometimes-unrealistic expectations. It’s not easy to earn a living in Durango. Most of the women in the suicide article held low-paying jobs. Some worked more than one in their stressful struggle to make ends meet.
I fell in love with Colorado when I was 10 years old, but when I moved to Durango four decades later, I had financial security, a professional degree and a skill set valued by society. What if I’d had none of those things?
Several of the women who took their lives abused alcohol or drugs. Suicide and addiction are as inseparable as two sides of a coin. Depressed people self-medicate with alcohol and drugs. They may feel better temporarily, but like alcohol, many abused drugs further depress the brain. They worsen the problem over time. Add that to the emotional strain of ruined relationships, lost jobs, jail terms and all the other problems that often accompany addiction.
My neurochemistry is unusual. My brain doesn’t interact with alcohol or depressant drugs in a way I perceive as pleasurable. So I’m at little risk for addiction. If that weren’t so, who knows what path my life might have taken?
All the women were clinically depressed. Some had “mood swings” that suggest the possibility of bipolar disorder. They were prescribed antidepressant medications (almost a quarter of middle-aged white women receive such prescriptions) but the medicines didn’t work.
I’m medically sophisticated. I know that antidepressant side effects are common and that about half the people who take such drugs derive little or no benefit.
If I had unrealistic expectations of medicines and one or more didn’t work, I’d be deeply disappointed. I might lose hope. In such a state, wouldn’t I be even more likely to embrace suicide as the only option?
When first-line treatments are ineffective, a professional psychiatric evaluation is called for. But psychiatrists are few and far between in sparsely populated areas. Like forensic pathologists, psychiatrists are medical subspecialists who need a large population base to support a full-time practice.
The women in the article didn’t have the means to seek subspecialty care outside the area.
I’ve never been suicidal, but depression can strike anybody. When I lived in Durango, I could have gone wherever necessary to get whatever care I needed. What if I couldn’t?
Some of the women reacted poorly to rural isolation. The article said one “didn’t like being alone.” Another lived in a remote area where the only sounds were “distant dogs barking.”
I’m a loner and an introvert. I dislike hearing my neighbors’ conversations or their music. I love nature’s stillness; I’m energized by solitude.
Living in Durango was awesome. The lifestyle fit me perfectly. I was one of the lucky ones.
Dr. Carol J. Huser, a forensic pathologist, served as La Plata County coroner from 2003 to 2012. She now lives in Florida and Maryland. Email her at email@example.com.