losing zoë

This is a guest post by Walter and Dorothy SchwarzThis story is exceptionally close to my heart. It’s about the suicide of a girl who I never met, which in itself is tragic as she’s the sister of a guy who has since become one of my best friends. That guy is Zac Schwarz. He was there with me the moment I witnessed my wife die seven months ago next week. His wife Laura was there too. She had also lost her dad in a car crash some years before. “How can this be happening again?”, I heard her cry. I sometimes wonder how so much tragedy has found its way to such a small group of friends. But on the other hand I’ve come to understand that people who have felt the full force of grief can be spectacular at helping one another through it.Zac’s mum, Dorothy, wrote to me soon after Desreen died and sent me a book that would help inspire me to start writing about my grief. Here she and her husband reflect on the death of their daughter, Zoë Schwarz.  Zoë was a beautiful, intelligent, vivacious and charismatic young woman. And she suffered from manic depression. At the age of 27, after five months of deep despair, Zoë threw herself under an express train. Could her suicide have been avoided? Would her family have acted differently if they'd known that one in five people with this illness kill themselves? Walter and Dorothy Schwarz reflect on the death of their daughter.This is a quite a long guest post but I urge you to read it because the message is so important and as a piece of writing it is quite simply outstanding. Most of you won't have known Zoë, but you probably will know that Stephen Fry this week revealed that he attempted suicide in 2012. It may make it more real for you to know that such a familiar and charismatic personality has the same condition as my friend's sister.One in five people with manic depression eventually commits suicide. When Zoë did, we were not aware of that statistic, though we ought to have been. She had been ill for five months - first manic, then depressed. Her psychiatrist probably knew about the suicide rate, and he, too, might have acted more aggressively to prevent it.It is true that at 27, our youngest daughter was an adult and she chose to die. "I love you all but I can't live like this," she wrote, sitting in her car at a railway station in Essex, before throwing herself under an express train. But if she had lived, we believe that she could have found a way of coping with her treatable but incurable illness, as others have done with the help of antidepressants and therapy. Two and a half years later, our grief has grown scar tissue but remains infected with guilt and shame. Something waiting to happen was not prevented. Why? Perhaps the story of Zoë's death could help others.Bipolar affective disorder, as the ancient illness is now called, has been associated down the ages with originality and charisma, often with genius: Byron, Coleridge, Melville, Graham Greene, Virginia Woolf, Strindberg, Spike Milligan, Louis Althusser, Otto Klemperer, Stephen Fry, Vivien Leigh, Kurt Cobain, Francis Ford Coppola...The illness is now regarded as a genetic neurobiological brain disease that affects one in 100 people to some degree. Its victims swing inexorably, according to the manic depression website, between "increased energy, restlessness, racing thoughts, rapid talking, excessive or euphoric feelings, extreme irritability and distractability" and "a persistent, sad, anxious, or empty mood, feelings of hopelessness, pessimism, guilt, worthlessness". Our mistake with Zoë was our refusal to see her eccentric behaviour as a symptom of mental illness - not just the familiar neuroticism of middle-class professional families. We had plenty of excuses because parents are required, above all else, to believe in their offspring. And Zoë had emerged triumphantly "cured" from an earlier bipolar episode when she was 18.It had begun following a bout of glandular fever, just before her first term at Bristol University. She ascribed her altered mental states to a chemical imbalance. At Bristol she was wild, bizarre, promiscuous and aggressive: she was sent down. The depression which followed ended in her taking an overdose. We saved her - that time.With a minimum of drugs and two years of counselling, she considered that she was "cured". She went back to college, achieved an MSc with distinction, and told us: "I've been to the bottom. I'm strong." We believed her. We blotted out the nightmare episode.Throughout her 20s, Zoë's behaviour was mercurial - too many boyfriends, too much pot - but it always seemed on this side of acceptable. She did a pioneering job with United Response, a major charity, where her intelligence, charm and energy brought in more customers and money than anyone expected. "A sparkly, beautiful, vivacious woman with a keen sense of humour and a rare ability to engage with everyone she met," her boss wrote after Zoë's death. She was charismatic, compassionate, full of laughter and love. True, she also had a famously filthy temper.Even when, as we know in retrospect, she was becoming manic again - her plans for her future became irrational and her outbursts of temper became physically violent - she willed us to believe in her. She brainwashed us. "Zoë is Zoë," we said, and so did her two brothers and two sisters and her many friends. If we questioned her, let alone criticised, she would march out and slam the door. The glass panel in our kitchen door still has a crack.So, brainwashed, we didn't think of manic depression when she punched her elder sister in a quarrel (Zoë was very strong) and, in another quarrel, bit through her younger brother's sweater and into his chest. Or when she almost killed her mother and best friend by crashing into a barrier on a motorway at 85mph in heavy rain. Zoë is Zoë.She began smoking pot as more than a recreational drug, and we later found from her diaries that she was taking cocaine as well, even while trying to build up a business of her own. A desperate attempt, we now believe, at self-medication. When her life began to disintegrate, she refused the offer of a job and went to Morocco for an indefinite stay."Over the top" was how we all described her emails - deliriously happy in Morocco with a lover she planned to marry. "To the best parents, best brothers and sisters in the world," she wrote, inviting us for a holiday, which she lovingly planned in meticulous detail.Almost as soon as we arrived at Essaouira, she turned against us. In high mania, anyone who potentially brings you down is an enemy - and who is more back-to-earth than mum and dad? She acted crazy, haranguing the entire hotel with an exalted spirituality mingled with obscene abuse, until the hotel manager gave us a choice - the police or the hospital. The local psychiatrist asked the obvious question: has she been like this before? Of course. Of course. No more denial.We had to sign a section committing our daughter to the secure mental hospital in Marrakesh. There, they treated her (we checked it out) in exactly the same way they would have done anywhere else, with the same drugs to bring her "down". With help from the British consul, we got her home after only 12 days in hospital.Ten days later, the depression we now expected set in, worsening by the week until Zoë became a hollow, silent woman. Again, the drugs to bring her "up" were routine, the ones they use everywhere. A hospital not far from our home has a state-of-the-art mental-health unit and the specialist in charge visited Zoë at home once a week. She liked him. As the weeks passed, her depression refused to lift. She sat around all day. The drugs were changed twice without effect. We believed, as many friends and relatives told us, that she would "come out of it in her own time, when she's ready". We cannot now forgive ourselves for reacting, during some of that time, like normal parents when their unsmiling child is surly and irritable.After her death, we found cardboard boxes of her diaries, cards, letters, memorabilia and photos. A bedroom full of clues. In the final depression, she wrote little. One page in tiny writing: " ...a terrifying place... very difficult to describe, which makes it harder for others to understand. The stigma is hard, too. It's hard to imagine being out of it... you feel you've gone mad even when you're lucid. Don't know what to do with myself. What to think? Where to start? Cannot envisage improvement in the future. Everything is quite frightening."Once or twice she tried desperately to break free, applied for a job, bought clothes, went for an interview. But it was hopeless: she had lost all her spark and confidence. Nothing could shake her despair. The psychiatrist had advised us to leave her alone but we wish that we had hugged her more often, even when she exasperated us. Asked how she was, she answered in monosyllables: "The same." Many times we preached to her a gospel of hope which seemed only to accentuate her hopelessness.There was talk of admitting Zoë into the ward but she hated the idea and would surely have walked out unless she had been sectioned, and nobody wanted that. There was talk of electro-shock treatment, which we discouraged, haunted by memories of One Flew Over the Cuckoo's Nest.In August, the psychiatrist took his annual three-week holiday. He assured us that Zoë would be well looked after. But in his absence she hardly spoke to anyone and was under the supervision of a junior psychiatrist her own age. When the specialist returned, on August 21 2000, he called a conference for the next day to start the "new strategy". Zoë was to be admitted as an inpatient on August 23.On August 22 at 11am, Zoë told her mother that she was going to visit a friend. We had repaired her old car, which she had neglected, to give her some independence. Her real destination was a station on the line from Colchester.Zoë had told her mother a month earlier that suicide was "not an option". Once again, we were conniving with her - once more in denial. You cannot accept - it makes no sense - that a young woman who is clever, beautiful, talented, loved and witty should be in such pain and despair that she would end her own life. Because of patient confidentiality, we were not told what she said to the specialist but she apparently gave him the same assurance.We decided that if Zoë was not home by 8pm we would call the police. At 7.45 the police arrived. Her suicide note was on the dashboard. "To my family and friends. No one is to blame for my death. I love you all but I can't live like this. I'm sorry. Please forgive me. I used to work and see friends a lot, but now I can do neither because I can't function or communicate. I've been in hell for four months and I can't bear the pain any more. Zoë. In her depression she had only read one book, which we had given her: Kay Redfield Jamison's An Unquiet Mind, the inspiring story of the author's struggle with manic depression until she became, with the aid of the drug lithium, professor of psychiatry at Johns Hopkins University.Zoë gave us back the book and said crossly: "There you are, you never get over it." She had given us a clue to her coming suicide which we hadn't recognised. Afterwards, her best friend said: "It was her pride which killed her." Her siblings and friends were all forging ahead in careers and loves. Zoë knew that, in time, she could have lived an acceptable life. But she rejected the prospect of living under the shadow of lonely horror. She did not want a life with lithium.She struggled throughout her last depression and repeated: "I'm living behind a glass wall." She contemplated a future on medication. In her last diary entry, she wrote: " ...if I don't get better, I will most probably have to accept a more humble job and more humble living arrangements than I would like. But make the most of things: I can work my way up... have to accept that at 27 I am not 'set up' job/house/relationship-wise. My friends will not reject me if I don't reject me. The challenge is to be happy and true to my nature, through deep self-esteem because I don't have any strength at the moment and may not have for a long time, if ever."Neither she nor any of us could give her that strength. So she took the wrong decision. Looking back on her own life and career, Jamison writes that she would rather have had manic depression than not, because the highs were worth the lows. Zoë, too, must have owed something of her joie de vivre, compassion and dynamism to her highs. She lit up a room when she entered.Two days after her death, 40 friends and relations came to sit round a bonfire on the lawn. They told tearful stories that we had never heard before, of how Zoë had helped, inspired and empowered timid people, especially the young. What if she herself had had better care and attention, if she had not felt so alone?Her death deeply shocked the staff at the mental health centre and they held an inquiry. We were not allowed to see the report but told its highlights informally: it called for a better anti-suicide strategy; parents who were also the carers must be given more support and told more of what passed between patient and doctor, in spite of patient confidentiality. We hope it also recommended that psychiatrists should not go on holiday, leaving at-risk patients without equivalent care, and that more attention should be paid to an outpatient's ability to plan suicide while pretending that suicide is not an option. For ourselves, we conclude that parents, siblings and friends of bipolars need, before the crisis overwhelms everyone, to see it coming and find a way to persuade the patient to seek treatment instead of smoking pot from breakfast to bedtime. Zoë had tried to cope on her own, too proud to confide in her closest friends and family.And then, when the crisis happens, family and friends should not kid themselves that "she'll come out of it when she chooses". Zoë had tried but failed to overcome her despair and that left her, she thought, no choice. Could anyone have convinced her otherwise? We will never know. If only, while she was such a bundle of morosity and self-absorption, we had kissed her more often. Samaritans helpline: 08457 90 90 90Through sharing this story I am hoping we can raise some money for The Zoë Sarojini Education Trust, which was founded in 2010 by Zoë’s family and close friends in her memory to celebrate her love of life and generosity of spirit. The trust’s purpose is to help African children, particularly girls, living in poverty to go to school. It enables donors, singly or in small groups, to fund the education of individual youngsters. You can learn more about the trust at http://www.zoetrust.org.