My brother, Jory, ended his own life and suffering yesterday through a very deliberate planned suicide. Jory fought a brave battle for many years as he struggled with major depressive disorder since his early twenties and was diagnosed in his fifties with bipolar disorder because of one major manic episode and a lifetime of rapid mood cycling with hypomania (the less severe form of mania). Sadly, his depression got much worse after being diagnosed with Parkinson’s disease a few years ago. Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer’s disease. The symptoms of PD amplified and worsened Jory’s existing depression: it stole his ability to taste food and made it difficult for him to swallow; it made it difficult for him to walk without stumbling; it caused significant hand tremors, pain, and stiffness; it caused him to socially isolate himself and eventually become suicidal.
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See my prior article here about the similarities between planned suicide and dying with dignity.
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About a year and a half ago, when Jory was living on the other side of the country and told me how bad his symptoms were and that he was feeling isolated and suicidal, Jeannie and I brought him here to live with us, which helped lift his spirits for a while. I got him a top psychiatrist in the area and one of the top neurologists in the area — a specialist in Parkinson’s disease — who got him on better PD medications. But it was a near-constant struggle for him and his doctors between trying to adjust and balance his PD medications and his medications for depression, which unfortunately interfere with each other. We got him to try out a few fun exercise activities specifically designed for Parkinson’s patients, including indoor rock climbing, which he seemed to enjoy but never enough to go to any activity more than once. He refused to participate in any Parkinson’s support groups, despite our encouragement to do so.
Ultimately, the PD and major depression caused Jory to feel as though his life had no meaning or purpose anymore, and it caused him to feel like a burden to us and his three children — feelings he vocalized to us on multiple occasions.
As a spiritual person (as was Jory), I know his soul is at peace now, yet I grieve terribly for my personal loss, and my heart aches for his three wonderful adult children — Zak, Josh, and Hannah — all of whom he was able to spend some final quality time with quite recently. I am comforted by these touching words he left for his children in the “How do you want to be remembered” section of his Advance Directive:
“I had a hard life battling depression but managed to have a decent career as a writer. I never harmed anyone. Love with all your heart all human beings because we share a connection with everyone. Be a warrior for peace. Know that you have an inner genius that is your spiritual inheritance.”
Jory also had an amazing and spiritual inner genius — and his words about having a “decent career” as a writer were a bit modest. He was actually an esteemed career journalist/columnist in music and pop culture for several large regional newspapers, a Pulitzer Prize finalist in journalism, and the author of two acclaimed books, one published by Harper Collins and one by Simon & Schuster, where his “About The Author” page briefly describes his illustrious writing career: “Jory Farr is an author and journalist. His books include Moguls and Madmen: The Pursuit of Power in Popular Music and Rites of Rhythm: The Music in Cuba. His writing has appeared in the New York Times Magazine and Op-Ed page and many other publications. He was a Pulitzer Prize finalist in the category of criticism in 1990.”
It is my hope, in the wake of my brother’s passing, that others may find the strength to leave their loved ones with something beautiful and meaningful, as he did. I also hope that anyone who suffers from a neurodegenerative disease and who is experiencing depression will seek the care and support they need to treat, as best as possible, whatever battles they are facing.
And now for some research about Parkinson’s, depression, and planned suicide:
Depression May Be the Very First Symptom of Parkinson’s Appearing Decades before a Diagnosis
Parkinson’s disease causes the loss of brain cells in a part of the brain that controls muscle movement. Symptoms can include tremors, stiffness in the arms and legs, and impaired balance and coordination, according to the National Institutes of Health.
Depression is one of the little known non-motor symptoms of Parkinson’s disease, yet as many as 50 percent of people with Parkinson’s experience the symptoms of clinical depression at some stage of the disease. Some people experience depression years before they are diagnosed, and the Parkinson’s and even the medications they take to control the symptoms can exacerbate the depression they already had. This was definitely the case for my brother.
Living with Parkinson’s presents significant challenges, and the diagnosis is frightening, especially for someone who already has a diagnosis of depression or bipolar disorder because, as mentioned earlier, the medications used to treat these two illnesses interfere with each other. Studies show that depression in people with Parkinson’s may be caused by the chemical and physical changes in the area of the brain that affect mood as well as movement. In fact, researchers believe that in some cases depression may be the earliest symptom of Parkinson’s disease, with some people experiencing depression up to a decade or more before experiencing any motor symptoms of Parkinson’s.
Depression can be one of the most disabling symptoms of Parkinson’s disease. If you have Parkinson’s or another neurodegenerative disease, try to remain socially engaged and physically active. Resist the urge to isolate yourself. Seek medical help to manage the symptoms as soon as you notice them.
Are People with Parkinson’s More Likely to Be Suicidal?
Studies have looked at whether there is a link between Parkinson’s disease and an increased risk of suicide. In a study from 2020 published in JAMA Psychiatry, patients with Parkinson’s were shown to be at greater risk of suicide than the general population.
Suicide is one of the leading causes of death in the US, affecting people of all ages. Older adults are especially vulnerable to suicide for a number of reasons, including chronic illness. Click here for several articles I have previously written on this topic. Of course there’s a very fine and blurry line between “planned suicide” and “death with dignity” — which acknowledges that persons who have a debilitating fatal disease should have the right to die on their own terms at a time they choose — with family, doctors, and friends respecting their right to autonomy and giving them the choice in a situation that is already out of their control, before the ravages of a deadly disease destroys the person that they want to be. We have written many articles on this topic, which might be of interest to any readers of this article.
Parkinson’s disease brings with it a host of physical impairments that gradually destroy quality of life. Declines in cognitive function also affect a person’s decision-making abilities and may increase impulsivity.
The physical, emotional, and cognitive struggles faced by older adults, especially those with the debilitating neurodegenerative diseases, can of course lead to feelings of depression, which over time can evolve into clinical depression, which increases the risk of adults ending their own lives.
Please Note: If someone you know is thinking about suicide, there are simple yet powerful steps you can take, including calling 988, to possibly help save their life — if there is still part of them that is willing to be saved.
What Are the Warning Signs of Suicide in Older Adults?
An important first step in preventing suicide is knowing the warning signs. There are certain behaviors that can indicate an older adult is thinking about self-harm. These can include:
- Loss of interest in activities they used to enjoy;
- Giving away beloved items;
- Avoiding social activities;
- Neglecting self-care, medical regimens, and grooming;
- Exhibiting a preoccupation with death; and/or
- Lacking concern for personal safety
How to Support Someone with Suicidal Thoughts
The National Suicide Prevention Lifeline outlines steps you can take if you know an older adult who is thinking about suicide.
- Don’t be afraid to be direct with the person at risk. Ask questions like, “Are you thinking about suicide?” and “How can I help you?” to initiate a conversation in a supportive and unbiased way. Be sure to listen carefully to their answers and acknowledge their emotional pain. Help the person stay focused on all the reasons why they should want to keep living.
- If you’re able to, be physically present for the person in order to ease feelings of isolation and provide a sense of connectedness. If a face-to-face visit is not possible, be there for them via phone or video calls. Work with the individual to identify others who may be willing to lend their help. Be sure not to make any promises that you are unable to keep.
- Find out if the person has already made any attempts on their life. Do they have a specific plan or timing in mind? Do they have access to their planned method of self-harm? Learning the answers to these questions can help you understand whether this individual is in immediate danger.
- If a senior in your life is thinking about suicide, it’s important for them to establish support systems they can rely on now and in future moments of crisis. This includes suicide prevention hotlines such as the Lifeline, as well as resources available in their local community. Find out if the at-risk person is currently seeing a mental health counselor. If not, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a searchable, confidential directory of mental health providers across the U.S.
- Once you’ve had an initial conversation with the vulnerable person and helped them establish a support network, make sure to check in. This can be done with a quick phone call, text message, or even a card. Ask if there is anything else you can do to help them get through this difficult time. The simple act of reaching out and showing you care can sometimes mean the difference between life and death.
- Most importantly, don’t blame yourself or others if all efforts fail. Ultimately, if all efforts to prevent the suicide of a loved one fail (as did ours, along with the efforts of Jory‘s psychiatrist, the team at Inova Behavioral Health Services, and the Fairfax-Falls Church Community Services Board Mobile Crisis Unit), it is important to not blame yourself or others, and to not feel guilty for not doing more to “prevent” what was clearly a non-preventable planned suicide.
Brian Hodge, editor of the Montgomery Independent, recently wrote a very thoughtful article on this topic:
The thought of a troubled teenager, a suffering veteran, or an elderly widow, who only needs a touch or a kind word from a stranger to turn them around is magical. “Maybe I can be the one,” we think, “who by little effort on my part, can save the life of a valuable soul.”
But most suicides are not like that. It is true some people can be talked out of it. Some people want and need help and, if possible, we should extend the effort to help them. But some people have, what seems to them, perfectly good reasons to kill themselves. And while we may try our best to convince them otherwise, who are we to use the mechanism of the law to try and “prevent” it?
That is where the problem lies. When should we use the law to control other people’s behavior, even behavior that by all rights should be entirely within their purview or authority, about arguably the most important decision in their life?
Here’s a recent NY Times article about Canada possibly allowing physician-assisted death for persons with mental illness
When Experiencing Grief . . .
Grief is a natural human emotion. When we mourn the death of a loved one, we experience intense emotion, and that emotion is typically grief, which comes in many forms and in many stages.
If you are experiencing grief, we offer the Farr Law Firm’s Spiritual and Grief Counseling Resources That May Help in Connection with the Loss or Illness of a Loved One.
Additional resources are available on the following websites:
How Do You Want Your Loved Ones to Remember You?
When your loved ones are grieving your death in the way that works best for them and reflecting on their time with you, what do you want them to remember about you? When we die, most of us want to leave a meaningful legacy for our families. These are some questions to consider and share with loved ones, so they can have a knowledge of meaningful things that you want them to know about you:
- What are some of your favorite memories?
- What are the most important in your life? (Family, pets, friendship?)
- What makes your life meaningful? (Making art, being outdoors and in nature, being with loved ones, spiritual practice?)
- If you could choose one or two important ways you would always be remembered by those you love, what would they be?
Having an honest, life-affirming conversation about death and end-of-life planning can be a wonderful gift for the people you will eventually leave behind in this lifetime. I’m very grateful that my brother did this. Consider using the Legacy Stories app to take pictures to tell some of the stories associated with them. Doing so can provide meaningful memories about you for your loved ones to think about when they are grieving and for when they are later recounting stories about you and your life, enabling your legacy to live on for future generations.
Make Sure Your Wishes Are Spelled Out in Your Documents, As Well
After taking the steps to discuss your legacy and what you want others to remember about you, it’s a good time to make sure your wishes are spelled out and available for your loved ones in your legal documents.
If you have not done Incapacity Planning (including our 4 Needs Advance Medical Directive® and Financial Power of Attorney), Estate Planning, or Long-Term Care Planning, or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please contact us. We can help.
Jory Farr Everloved Memorial Site
Farr Law Firm Northern Virginia: 703-691-1888
Farr Law Firm Fredericksburg, VA: 540-479-1435
Farr Law Firm Rockville, MD: 301-519-8041
Farr Law Firm Annapolis, MD: 410-216-0703
About Evan H Farr, CELA, CAP
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