It’s been only four months since an unexpected phone call pierced the 6:15 a.m. quiet of the Arkin household.
Only four months since the frantic car ride from their Overland Park home to Evanston, Ill., the cellphone calls to the emergency room there, the doctor telling Karen and Steve Arkin as they drove that their son, Jason, was not going to make it.
All those memories are fresh enough to still be raw as Karen Arkin recounted how, on May 19, her son lost his race to stay ahead of the dark cloud of depression that had followed him seemingly all of his 20 years. Jason died of an overdose of antidepressants taken close to the end of his third year of study at Northwestern University.
Their best efforts — and they were myriad — did not save Jason. But Jason’s death has given the Arkins a new purpose. They are raising money for suicide prevention that could help others around the metro area dealing with depression.
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Already, they have brought speaker Kevin Hines to the area. Hines, who survived a jump from the Golden Gate Bridge, speaks about his experience with depression and about maintaining good mental health.
The Arkins donated the money for him to appear recently at Blue Valley high schools.
“It’s a very positive message about life skills and living mentally well,” Karen says of Hines. It doesn’t dwell on the suicide attempt, “it’s (about) how he survives.”
Eventually, the Arkins hope to start a foundation that will bring speakers like Hines to all schools in the area.
The Arkins hope to work with Jewish Family Services, the Greater Kansas City Mental Health Coalition and the National Alliance on Mental Illness to help others who may be suffering. To get things started, they held a walk in Jason’s memory on Sunday at Congregation Beth Torah in Overland Park, and a companion one the same day in Park Ridge, Ill.
“If we don’t honor his struggle and just try to cover it up or hide it, it’s going to be so much more painful for us,” Karen said.
Besides, she noted: “We’re not people who can sit around.”
It’s hard to imagine any people who tried harder than Steve and Karen Arkin did to prevent the worst from happening.
The couple, both neurologists, has a better-than-average understanding of how the brain works. They recognized early on the trouble their son was having with the ups and downs of childhood. He had no tolerance for any of his own mistakes.
“From the time he was just very, very young it was apparent he was very hard on himself,” Karen remembered. “It was just silly things. You couldn’t play a board game with him. If he didn’t win it was just so unpleasant.”
He didn’t learn to ride a bike because of the frustration. And he didn’t play competitive sports. “The first time we took him to play soccer he went nuts because he didn’t score a goal the first game,” she said.
That was in about first grade.
The Arkins were troubled enough by Jason’s perfectionism that they brought him to a child psychiatrist when he was 10. They believed it was holding him back, making him afraid to take risks.
The doctor said Jason’s difficulties were because he was so smart, and suggested that he didn’t belong in public school, Karen said.
Having no desire to switch schools, the Arkins decided to wait and see. “He was a gifted kid; he had anger turned inwards because he’s a perfectionist. So for years I thought that’s OK, he’ll outgrow it,” Karen said.
The perfectionism didn’t extend to his friends, however. The Arkins said Jason would listen and advise his friends when they brought him their troubles, and that he had even deterred two girl friends who were talking about suicide.
“When (his friends) were exhibiting a problem, he wouldn’t shy away from it. He had the patience to sit with somebody who was hurting. Empathy was probably one of his greatest gifts,” Steve said.
Jason had empathy, his parents said, but not much resilience.
That became apparent when Jason turned 12. That year, he attended a lecture on suicide sponsored by their temple. When he came back, he pulled Karen aside and told her he had some of the very same emotional ups and downs the speaker talked about.
“Your heart just breaks into a million pieces,” Karen said. “He’s so blessed. He has these gifts, he has a great life but he doesn’t think he’s worth it.”
Jason had told his parents he had the feeling of being able to feel the collective pain of the world. “From that minute on you think OK, we’ve got to save his life. That’s all we’ve got to do. That’s job one,” Karen said.
Jason got treatment and was prescribed antidepressants from then on.
Nationally, suicide was the 10th leading cause of death for all ages in 2013, the most recent year available from the U.S. Centers for Disease Control and Prevention. Some 17 percent of students aged 9 to 12 considered suicide in the previous year and 13.6 percent made a plan about how they would attempt suicide, according to the CDC.
In the metro area, the high suicide rate has been described as a crisis.
Bill Geis, professor of psychiatry at the University of Missouri-Kansas City, said rates for all age groups are higher in both Missouri and Kansas than nationally. Suicides are up about 33 percent in Kansas and Missouri over the past five years, Geis said.
The best suicide data available comes from a number of sources and dates, Geis said. The most recent rates available are 12.4 (per 100,000 people) in the U.S in 2013. In Jackson County, a composite rate drawn from information from 2009 to 2013 is 15.8. Johnson County had a rate of 13.9 and Wyandotte County, 13.5, with both those composites from 2011 to 2013.
The age range with the highest rates was 45-64, where the rates were 23.2 in Kansas and 22.1 in Missouri compared to a national rate of 18.9. For adolescents and young adults ages 15-24, the rate was 13.4 in Kansas and 13.5 in Missouri compared to a national rate of 11.1. The age breakdown was from 2009 information.
People suffering serious mental illness have an even higher risk of suicide. Their rate is estimated at 35 to 55 per 100,000.
The problem will worsen as social services are cut and patients fail to make contact with outpatient care, Geis wrote in a grant application last spring.
“Many experts highlight that once begun, suicidal thinking and crises (are) no less chronic than a health problem such as diabetes or sickle-cell anemia. Improved interventions are needed,” Geis wrote.
Suicide has been trending upward in Johnson County, said Shana Burgess, director of prevention at the Johnson County Mental Health Center. The economic downturn of a few years ago, the return of veterans from combat duty and other stressors have had an impact.
Based on coroner’s reports, a coalition formed two years ago to address the problem of suicide in the county shows that there were 100 suicides or overdoses in 2014, just slightly lower than the peak year in 2012. Most were in the 41-60 age range, with the second highest being ages 21-40.
Adolescents and young adults are often stressed about making the transition to adulthood, said Dan Livingston, who has worked as a clinician and case manager at the Johnson County Mental Health Center.
“In general, change can be challenging,” Livingston said.
Unrealistic expectations also have been blamed. A July story in The New York Times told of college students who felt they had to be popular, fit and a top academic performer all without visible effort.
When students from all over the world, who may have been top achievers in their high schools, are put together and competing against each other in college, the pressure becomes unbearable. Some schools reported “suicide clusters,” multiple suicides within short time spans.
Jason was part of one of those clusters at Northwestern, his parents said.
By the time he graduated from Blue Valley Northwest High School in 2012, Jason already had an impressive resume. He was a National Merit Scholar and Eagle Scout and had even won an essay contest on optimism by a local Optimists Club when he was 16. He had straight As.
He liked challenges, his father said. He had begun to take some of the risks of adulthood, such as moving out of state to college. Although he was an introvert, he joined a couple of clubs at Northwestern and went to a dance marathon.
Northwestern University billed itself as a school with no “grade inflation,” the Arkins said. The school’s bell curve grading model meant that even high performing students who finished in the top 10 percent could end up with a B, Steve said.
Jason was enrolled in the electrical engineering program, aimed at solar energy. But Karen sensed trouble. She asked the dean of the school about how students handle that competitive atmosphere. She was told that it would build character.
“It didn’t for Jason. It really broke his character,” she said.
Bombarded with stress about grade point averages, Jason began to feel worthless because of the tough going. Although he still managed A’s and a B, he had to drop a couple of classes, said Steve.
“He went from straight A’s to saying, ‘If I can just be above average,’ ” said Karen.
By the spring of 2014, Jason was in a bad place. He told his family he wanted to leave school and enter a psychiatric hospital. Worried that he might not be taking his medicine, Karen and his sister, Jennifer, went up to check on him.
They were shocked at his demeanor when he came down from his room, Karen said. “He looked like a zombie. He could barely stand up, he was so exhausted,” she remembers. “The first thing he said to me was, ‘You know I’m an organ donor?’ I said yes, and he said, ‘I just want to help somebody who can be happy.’ ”
The Arkins helped Jason get an immediate medical leave. He received transcranial magnetic stimulation, an aggressive treatment to stimulate connections in the left frontal cortex of the brain. The treatment is beyond the standard for depression and not often used because insurance companies don’t usually cover it, Steve said.
But it helped Jason, and the Arkins were encouraged. He began to take an interest in everyday life, and showed improvement on a “depression scale,” a test he was given weekly to measure his emotional health. He got outpatient counseling and eventually returned to Northwestern, acing a couple of make-up tests from the end of the previous year.
“We thought he’d make it,” said Karen, through tears.
But the effects of the treatment were not permanent.
At 6:15 a.m. on May 19, they got the call. A student had found Jason in the lounge having a seizure around 4:30. Paramedics took him to the hospital, where he was conscious but groggy.
“He was supposed to be OK,” Karen said. He had given a thumbs-up to the paramedics and spoken with emergency room personnel. They said they’d put him in intensive care just as a precaution.
The Arkins scrambled to find replacements for work and began the drive. They kept in contact by cellphone with the doctors and some of Steve’s family, who live in the area.
Along the way, things took a turn. Jason had a heart attack. Doctors tried for an hour and 40 minutes to get a pulse, but only succeeded for about 15 seconds, Karen said.
The Arkins kept calling in to find out the progress. Eventually, a doctor friend came on the line. “She said, ‘I’m holding his hand and telling him how much you love him,’ ” said Karen. “And he’s not going to make it.”
Jason died only five days shy of his 21st birthday.
The Arkins are still collecting themselves from the events of last spring, dealing with the inevitable “if onlys” that nag at surviving family members.
But they are committed to bringing some good from Jason’s and their own suffering. Getting more suicide prevention speakers and programs into the city’s school districts could save other lives, they believe, much as a similar speaker helped Jason recognize his risk back when he was 12.
Inspired by the Suicide Awareness Survivor Support group started by Mickey and Bonnie Swade after losing their son, the Arkins hope their efforts will encourage more people to talk about their feelings and get help.
Karen and Steve Arkin worry about the loss of empathy and the changes electronic gadgets and social media are bringing about.
“It’s an impersonal world where people are texting each other across the dinner table,” Steve said. “The strangest thing is that you have at our fingertips the ability to talk to so many people at once yet you’re so isolated at the same time.”
That lack of social interaction could have long-lasting effects on children as their brains develop, Karen said.
The mildly depressed person may not show that anything is wrong, and may not seek help, Steve said.
“There’s so much going against you to be outward about it,” he said.
He hopes the family’s efforts will help people lose that reticence. “We want people to be not afraid to talk about it and get the help they need before it’s too late,” he said.
They also hope more resources will be put into helping people in crisis, especially on campus. They said the campus counseling and psychological services needs to have adequate staff to handle the busy times around finals.
There’s still a stigma attached to seeking help, said Livingston of Johnson County Mental Health.
“Our society has improved over the last 10 to 15 years, but there’s still a long ways to go,” he said.
Often friends and family may know something’s wrong, but not know how to help, he said. “They have to have the willingness and courage to walk up to somebody and have a conversation. Most people want to help, they just don’t know how to do it,” Livingston said.
Livingston said he’d like to see the friends, families and acquaintances with a “listening ear” be willing to stay with a person in crisis and help him or her through the next step, perhaps finding a resource or staying with that person as the call is made.
Foundations and walks to bring awareness to depression are helpful, he said.
“A lot gets lost when somebody takes their life,” he said.
The groups can put out the message on awareness, but also give survivors a chance to celebrate the lives of their loved ones, he said.
That was the case for the Arkins earlier this month when they attended a walk around Loose Park sponsored by the Suicide Awareness Survivor Support group. The walk was followed by a ceremonial reading of names and the release of doves.
At the back of the park pavilion, survivors posted photos and mementos of their loved ones. Among them, an essay Jason had written for a class in 2009 entitled, “Change one thing.”
“If I could change one thing, one attribute I could do without, it would be my perfectionism,” he wrote. As time went on, he came to recognize that perfectionism was causing him pain.
“I NEEDED to be perfect; this was my single purpose in life. Good was not enough, great was not enough, astonishing was not enough, exemplary was not enough. I would only be appeased when I attained the rank of perfection. What would happen if I did not achieve my goal? I did not know, but in my perspective, I may as well have never been born.”
It’s heartbreaking to read those words now, though they don’t come as a surprise, Karen said.
But maybe talking about it will help someone else out there recognize the need for help, she said. If so, she has this advice: Don’t wait.
“If you see any inkling of any type of mental illness in your child, get attention while they’re young. Don’t treat it as something that’s going to pass or get better when they get out of high school.”
To reach Roxie Hammill, send email to firstname.lastname@example.org.
How to get help for loved ones
Mental health professionals and suicide awareness websites emphasize that depression is treatable and suicide is preventable. But often, people are uncomfortable talking about it.
Some warning signs include a loss of interest in formerly enjoyable activities, a change in sleeping patterns, anxiety, rage, talk of unbearable pain or wishes to kill oneself.
Seeking help is the first step. Experts encourage family, friends and caregivers to listen compassionately and without judgment.
The Kansas Suicide Prevention Resource Center advises friends to not leave the person alone, remove objects that could be used in a suicide attempt and help the person to an emergency room or mental health center.
Numbers to call:
▪ The National Suicide Prevention Lifeline: 1-800-273-8255
▪ The Veterans Crisis Line and Military Crisis Line: 1-800-273-8255 Press 1
▪ Johnson County Mental Health 24 hour Crisis Line: 913-268-0156
▪ Missouri’s Access Crisis Intervention number: 1-888-279-2132 (toll free)
▪ Kansas City VA Medical Center: (816) 861-4700
▪ In case of immediate life-threatening injury, call 911.
Online resources include:
▪ National Alliance on Mental Illness http://www.namikc.org/
▪ American Foundation for Suicide Prevention https://www.afsp.org/local-chapters/ find-your-local-chapter/ afsp-greater-kansas
▪ Active Minds, oriented toward college campuses http://activeminds.org/
▪ Suicide Awareness Survivor Support http://www.sass-mokan.com/