During a search of the house, police found five bottles of prescription medication on the dresser in Schomp’s bedroom. They also found a note titled "Chronicles of Sinking Mental Illness" as well as letters to his family and to the staff and students of Chariho Regional middle and high schools, where Schomp worked as a teacher and guidance counselor. One letter was addressed "To All of Chariho, my dear second home."
The letters and notes paint a picture of sheer torture – of a mind rolling in frenzied loops between regret, helplessness, guilt, and shame on the one hand and upbeat musings about his sons’ futures on the other. Schomp had been struggling with depression for several years, a struggle he successfully hid from colleagues, students, and friends. But the papers he left in his bedroom show that, however sunny his public demeanor, his inner turmoil had reached an intolerable point. They are, in fact, the last cries of a man about to take his own life.
Schomp’s suicide immediately turned him into a statistic. According to the Centers for Disease Control, roughly 31,000 Americans kill themselves every year, about the same number as those who die from AIDS. Suicide is the eighth leading cause of death in the United States, but even more shocking is the estimate by the National Institute of Mental Health (NIMH) that every year in this country there are about 500,000 reported suicide attempts. Although U.S. women try to kill themselves twice as often as men, about three-fourths of the people who are successful each year are white males – men very much like Rick Schomp.
Also like Schomp, 90 percent of people committing suicide, according to the NIMH, have a history of depression or some other diagnosable mental or substance-abuse disorder. And again like Schomp, many who suffer from depression are unable or unwilling to seek help. "Despite mass marketing and despite our educational efforts," says Professor Martin Keller, chair of Brown’s Department of Psychiatry and Human Behavior, "fewer than 10 percent of people who suffer from an episode of major depression get sufficient medical treatment."
Like many college freshmen in the early 1970s, Peter Kramer sometimes thought of suicide as an existential, vaguely romantic response to an absurd world – a notion that his later training disabused him of. "One function of socialization into psychiatry is to lose all romantic notions about suicide," says Kramer, the author of Listening to Prozac and a clinical professor of psychiatry and human behavior. "Suicide today is seen as the end point of a medical illness."
Yet despite new developments in diagnosing and treating major depression and suicidality, the rate of suicide, Kramer notes, has changed very little. Better psychotropic drugs, refined psychotherapies, and more carefully controlled electric shock treatments have had little statistical effect. The suicide rate still increases with age, and drops noticeably only during wartime or some other event linking people with a common cause and interest. Recent studies in Scandinavia, where rates of depression are higher, suggest that antidepressants can have a mitigating effect on the rate of suicide, Kramer says, but such studies have yet to be conducted in the United States. – C.G.
The irony is that depression has become more treatable than ever, as scientists in recent years have made major breakthroughs in understanding how the brain works. At Brown, for example, the promise of such advances prompted the establishment last summer of the Brain Science Program to facilitate brain research across disciplines. Yet people who are deeply depressed and considering suicide are notoriously immune to such hopeful messages. Such people can also be masters at keeping their condition hidden, out of either shame or the often false belief that they will eventually pull through.
Identifying and understanding mental illness requires restoring humanity to the statistics. It requires entering the lives of the depressed and those of their families, in the hope that an evolution in attitude can accompany the recent revolution in research.
Rick Schomp arrived at Brown in 1966, "a very serious, very deep guy," according to Harold Bailey Jr. ’70. "You could know him, but then you didn’t know him. He was very private in that sense. I don’t think he ever talked about his family or his past."
Bailey and Schomp met when the two first-year students were randomly paired as roommates. "I was a little apprehensive," Bailey says, "because I’m black. Back then, one of the things Brown did was send out advance notice to white students about black roommates. Rick held up the letter they’d sent him and asked if I was comfortable sharing a room with a white guy. ‘Well,’ I told him, ‘I never had a choice, but I guess I don’t mind.’ " Bailey chuckles at the memory. "We were totally comfortable, right away."
Bailey and Schomp studied philosophy and shared a passion for music. The pair spent long hours talking about the civil rights movement, about philosophy and the war in Vietnam, about music, and about "everything in the world," Bailey says. "Rick always wanted to bring everything down to the practical, real-world level. He had absolutely no use for pretension."
Handsome, athletic, and a good dancer, Schomp competed on the track-and-field team and acted in student theater productions. He dated on and off but did not get serious until his junior year, when he met Kathleen Smith, the daughter of a naval officer from Jamestown, Rhode Island. "Pretty soon," Bailey says, "everything was about Kathie – she was all he talked about." Kathie and Rick were soon planning to marry after Commencement.
Rick Schomp may have seldom talked about his family while he was at Brown, but according to his younger sister, Marian, it was probably on his mind. During Rick’s first year at Brown, she says, their father, Robert, was diagnosed with cancer. He refused to get treatment until Rick returned from school to their home in southern New Jersey. As the oldest child, Rick was the one his father seemed to lean on most. A former U.S. Air Force pilot and salesman, Robert had eventually drifted from one employer to another, but on Saturday nights he loved to get dressed up and take his family out to a country-club dinner, where he would often drink too much. At home afterward, he would drink more, then start to talk. Rick, says Marian, "was always the one who got stuck at the kitchen table, listening to him for hours on end."
Money was a problem. Marian Schomp remembers that when her father’s drinking escalated, he asked to "borrow" her paychecks. During one of Rick’s last visits to his father in the hospital, Robert asked his oldest son to promise him two things: that he would finish college and that his mother wouldn’t lose the house. Rick promised. When his father died, at the end of Rick’s sophomore year, he left behind a mountain of unpaid bills.
Kathie Schomp remembers having to pinch pennies when she and Rick began dating. "Our dates consisted of a fifty-cent bottle of wine and maybe a fifty-cent movie on campus," she recalls. "In those days Rick hardly had enough money to use a pay phone." Kathie and Rick had originally planned to marry during their first September out of Brown, but they moved the wedding up to May so that Rick could return to New Jersey right after Commencement to deal with his family’s remaining debts.
Many people are burdened with an alcoholic parent and family debt, but few become clinically depressed and suicidal. What causes depression and what triggers suicide are two of the most difficult questions therapists and scientists face. Warning signs such as weight loss or insomnia can be natural responses to the death of a loved one or the end of a romantic relationship and not symptoms of mental illness. The challenge for therapists and their patients is to distinguish between a major, dangerous depression and a person’s coping mechanisms for dealing with a rough patch of life.
It’s not an easy task. People with all types of depression are unable to put it into perspective, says Clinical Professor of Psychiatry and Human Behavior Peter Kramer, because the organ most affected by the disease – the brain – is the same one they use to process the reality around them. "Depression is a disorder of perspective," notes Kramer, author of the 1993 best-seller Listening to Prozac. "It provides a perspective that is, internally, very convincing and can be very seductive to others."
Despite the rough patches in Rick Schomp’s life, nothing about him suggested a disorder of perspective when, fresh out of Brown, he moved with Kathie to New Jersey. After a stint at an electrical-supplies manufacturer and a period attending law school at Temple University in Philadelphia, Schomp realized that what he was truly drawn to was teaching. So after two years of working to settle his father’s debts, he returned with Kathie to Rhode Island, where, in the fall of 1975, he landed a job as a remedial-reading specialist at Chariho Junior High, a sprawl of long, low, cinder-block buildings on a winding road in a rural, remote section of the state.
Which method of treatment for depression is more effective: therapy or drugs? A new study, whose results are published in the May 18 New England Journal of Medicine, provides the most definitive answer yet. Although most mental-health practitioners have long assumed that a combination of both approaches is the best treatment, the study, which was conducted by Brown professors Martin Keller (below) and Gabor Keitner (above), along with a number of other researchers, is one of the first to rigorously test that assumption.
To do so, Keller, Keitner, and their colleagues had to find a way to measure the efficacy of a qualitative approach such as psychotherapy in a way that allowed comparison to a regimen of precisely measured medication. Using a new methodology called the Cognitive Behavioral Analysis System of Psychotherapy, which was developed by James P. McCullough of Virginia Commonwealth University, the researchers were able to study 681 chronically depressed patients in twelve locations across the United States while they underwent twelve weeks of treatment. The patients, all of whom had been continually depressed for more than two years, were divided into three groups. One was treated with only the medication nefazodone (prescribed under the brand name Serzone, whose makers funded the study); the second underwent psychotherapy; and the third group received a combination of both. The results were striking: while 55 percent of patients on the drugs-only regimen and 52 percent of those receiving psychotherapy showed positive responses to treatment, the rate was 85 percent for patients undergoing a combination of both.
"The message here is of hope for patients and families," Keller says. "Suicide is not the end result of depression; it is what happens when people with depression don’t get the right treatment." – C.G.Schomp dove into his new job, soon supplementing it with many responsibilities outside the classroom. With his fellow teachers, Schomp started a junior-high athletics program. He coached track and field and, with the help of Larry Hall, a math teacher in the middle school, girls’ basketball. "Rick did more in one year than it would take me ten years to do," says Hall. In the late 1970s, Hall and Schomp came up with the idea of holding weekly dances at Chariho; they decided to do the disc-jockeying themselves. "His sense of humor would really come out when he was DJing," Hall notes. "It was kind of a shock to the kids. They couldn’t believe that was Mr. Schomp up there, cracking jokes." At the same time, Hall noticed the same reserve that Bailey remembers from Schomp’s days at Brown. "Rick just didn’t pour out his heart to you," Hall says. "The only way to get to know him was by what he did."
When not at work, Schomp devoted himself to his growing family. His oldest son, Ben, was born in 1976, and was followed in two-year increments by Nathaniel and Jacob. Schomp was a devoted and encouraging father. "He taught me my Latin roots when I was in kindergarten so I would be a good speller," says Ben. When he encouraged Ben to play in the school band, Rick never missed a concert. "Growing up, I’d always ask him questions," Nate says. " ‘How do you do this?’ ‘Who was president in 1958?’ He never gave me the answer; I’d have to look it up. He wanted me to have the sense of discovery for myself."
An English teacher during the day, at night Schomp earned advanced degrees in counseling, history, and education. As a result, when Chariho school officials had trouble filling a vacancy in the middle-school counseling office in 1994, they asked Schomp to accept the appointment for a year. At the end of the year, though, administrators told Schomp they couldn’t move his replacement out of his old teaching job. The only position available was as a history teacher in the adjacent high school. Schomp was told to pack his things and move into that job.
It was around this time that his friend Larry Hall noticed a change in Schomp. "I’d see him in the high school, and I could see that he just wasn’t happy," he says. "Something just wasn’t right." Kathie, who knew that her husband was not happy with his lack of job stability at Chariho, watched Schomp handle it with his usual stoicism. Also around this time, Schomp had unusual difficulty adjusting to his oldest son’s departure to attend Bucknell University in Pennsylvania. "Having our kids go off to college hit him really hard," says Kathie. "It just crushed him."
Schomp refocused his energy on Nate and Jake and threw himself back into his work. In 1995, Kathie’s mother became terminally ill, other family stresses cropped up, and then in May, just before Schomp left for his twenty-fifth Brown class reunion, three female Chariho students filed a sexual harassment complaint against him. Schomp was ultimately exonerated of any wrongdoing, and none of the complaints – such as undoing one girl’s shoelace and lifting another off a stool by her waist – were judged to be sexual harassment. But, says Kathie Schomp, even though her husband was held in near-universal regard at the school, Chariho’s administrators believed they could not be perceived as soft on such complaints. "They told Rick to suspend any contact with his students," she recalls. "Then they grilled him for two hours without telling him the names of the students or the specifics of the complaints. They said they were trying to protect the girls – totally overlooking the protection of Rick." (School administrators refused to discuss the matter for this article.)
The ordeal hit Rick Schomp so hard, Kathie says, that he wept openly on the drive up to Providence for his reunion. But when he returned to school that fall, Schomp’s colleagues noticed nothing out of the ordinary. His zeal for helping kids was undiminished, and by 1997 his professional life seemed to be back on track. Schomp had taken a coaching job at South Kingstown High School, which all his sons had attended and where Jake, his youngest, was still enrolled. His work there netted him, along with two fellow coaches, a Rhode Island coach of the year award in 1998. And, at the end of the 1997-98 school year, Schomp was given a guidance counselor position at the high school – a job he had wanted for some time. "He really seemed excited about the guidance position," says Nancy Sincoski, a fellow Chariho veteran and his colleague in the guidance office. "I was glad to have him around again."
On July 8 of that year, Sincoski and Schomp had one of those conversations that is reexamined for clues again and again after a friend commits suicide. Schomp happened to be standing in Sincoski’s office when her eleven-year-old son called. "I got a little impatient with my son," she recalls. "He was getting on my nerves that day for some reason. I remember Rick telling me: ‘Nancy, be patient with him. They grow up so fast. Mine are all going off to college. Someday you’re really going to wish they were that age again.’ That was the last thing we talked about."
While Schomp was successful in hiding the depth of his depression from his colleagues, it was becoming increasingly obvious at home. By June of 1998, Kathie Schomp couldn’t stop worrying about her husband. He hadn’t slept for more than three hours at a time in months, was losing weight, and seemed distracted and unsure of himself. Always a quiet man, Schomp seemed to be retreating more deeply into himself. He suffered from hot flashes and panic attacks. Rick no longer seemed the confident, good-looking, poetry-writing Brown man Kathie had met on a blind date twenty-nine years before.
Schomp knew he was in trouble, Kathie says, but he was convinced he could take care of his problems himself. He had explanations for everything. As early as 1996, he had written a long letter to Kathie and his sons in which he tried to explain what was wrong: "I’ve been facing depression and anxiety," he wrote. "I’m convinced that it’s not severe or ‘clinical,’ but it’s not just a mild case, either... I’m able to step back and look at my situation somewhat objectively; still, I haven’t been able to fight off my emotionalism fully successfully."
Kathie, a marriage and family therapist, had begun to recognize the symptoms of depression in her husband. She tried to get him to see a psychiatrist, but he flatly refused. His resistance, Kathie says, may have been due in part to his unwillingness to face a real diagnosis, but it was also because Schomp was afraid of having a psychiatric disorder on his medical record for fear this "preexisting condition" would adversely affect his health insurance. Kathie did manage to convince her husband to talk to his internist about his problems, and eventually he agreed to try antidepressants. The doctor gave him samples of Paxil and Trazedone, but the drugs offered no relief; instead, they left him with such side effects as irritability, impotence, and emotional instability.
Then, in late May, less than two months before his death, Schomp began showing what seemed like signs of recovery. "It almost felt as if we were courting again," Kathie recalls. Instead of switching on the television after dinner, the couple sat and talked. "I couldn’t be Rick’s therapist," Kathie says, "but I could help him get some insight on things." Schomp admitted to Kathie that he felt he was working too hard, that he needed to relax more and scale back on some of what he was doing at school. He was reconnecting with his younger brother and sister, both of whom had been counseled for depression. He tried St. John’s Wort and, with Kathie’s encouragement, practiced relaxation therapies when he was feeling especially anxious.When in October 1985 William Styron went to France to receive a prestigious literary award, the sixty-year-old novelist appeared to have it all: financial and critical success, a happy marriage, and good health. The only problem was his tendency to feel depressed in the late afternoon. While Styron was in Paris, he realized this annoying, difficult-to-describe problem with his moods might be serious. Fourteen months later he was in constant and excruciating agony; he was a shuffling, confused shadow of his former self, and he wanted desperately to die.
"Depression engenders a self-loathing that is for the most part illusory, almost hallucinatory," he told a packed Salomon Center crowd who’d come to hear his Harriet W. Sheridan lecture in early April. "It leads inexorably to a dementia that leads to self-murder." Aided by relatives and friends, Styron eventually recovered from his depression and in 1990 published Darkness Visible: A Memoir of Madness, a slender, eighty-four-page distillation of the agony of his ordeal.
After his recovery, the author of Confessions of Nat Turner and Sophie’s Choice tried for months to write fiction based on what he had learned, but these efforts all fell flat, he said. It wasn’t until he wrote an op-ed for the New York Times about his own grim experiences that he realized the best way to tell the story would be as a fully developed memoir.
Styron wrote Darkness Visible in about two weeks, keeping the book brief in order to keep it focused – "a memoir gains as much from what is left out as what is included," he said – and also to make it useful to those who might need it most. "Depression," he emphasized, "is a disease that is ruinous to mental concentration."
For all its brevity, the book is still a chillingly frank and candid account of depression. A desire to combat the idea that the disease is the result of a moral lapse or a defect of character propelled Styron throughout his writing, and the same desire has kept him on the road discussing the book for the past decade, describing his experiences again and again. When talking about depression, Styron said, "anything less than full disclosure is evasion." – C.G.
On her way to a meeting at work one day in June, Kathie mulled over a conversation she’d had with her husband the night before. When he’d slumped to the floor in their living room after dinner, Kathie had sat down next to him, and for the first time since she’d met him, Schomp went into detail about his father’s drinking and his father’s responsibility for their family’s financial ruin. "Before that conversation, all Rick would talk about were his happy memories," Kathie says. "I was really hopeful – it seemed like a turning point for him." She at last got Rick to agree to discuss his history and feelings with a psychiatrist. At the end of their conversation, Rick hung his head, wept, and said, "I feel so calm... I feel so calm."
Halfway to her meeting, Kathie heard those words echoing through her head and felt her stomach cinch into a knot. The meaning of Rick’s words, she says, suddenly came clear to her: her husband was going to kill himself. She raced to the nearest phone and called home. There was no answer, so she left a message, trying to sound calm. When she got back to her office half an hour later, Schomp had called her back. "He told me he was mowing the lawn," Kathie says, "and that he’d made his appointment to see a therapist. I felt relieved – and silly that I’d overreacted."
That night Kathie confessed to Schomp her sudden, desperate dread. He assured her over and over again that he wasn’t thinking of committing suicide. "He told me he’d never hurt me and the boys that way," Kathie says.
The helplessness Kathie Schomp felt during her last months with her husband is familiar territory for therapists and mental-health researchers. Yet as research has exposed the physiological side of depression, more and more scientists believe that depression is, if not curable, at least controllable. And if more and more clinically depressed people have their disorder under control, it follows that suicide might also be increasingly preventable.
But, as so often happens, discovering more answers also raises more questions. Researchers, for example, remain hampered by the question of depression’s origin. Today, doctors who find abnormal concentrations of certain neurotransmitters and their metabolites in patients’ urine can be fairly confident their patient is battling major depression. But why did the neurotransmitter levels change? According to the surgeon general’s report on mental illness in the United States published last year, "Any biological abnormality found in conjunction with any mental disorder may be a cause, a correlate, or a consequence [of disease]."
It’s a chicken-and-egg argument," says Professor of Psychiatry and Human Behavior Gabor Keitner. "The effects [of depression] can be confused with the causes." Keitner’s preferred model for thinking about the origins of the disease incorporates a person’s biological, psychological, and social circumstances and predispositions. "If you apply the same stress to twenty different people," Keitner says, "they’ll come down with twenty different diseases. There isn’t an association between any one life event and any specific illness."
On the other hand, there is, Keitner says, strong evidence that depression can run in families. (One 1990 study found that first-degree relatives of people with mood disorders were two to four times as likely to suffer from depression.) And some research "suggests that having an early abusive environment or early losses in life tend to lead to a more chronic course of depression, if you get it," Keitner says.
Most researchers, including Keitner, conclude that a mix of these risk factors combined with high levels of stress may be the formula for the onset of major depression. If someone has a genetic or developmental vulnerability to the disease, and life then deals him or her several rotten hands in a row, the risk for developing depression increases dramatically.
But whatever the cause for existing depression, treatment is far more sophisticated than it was just a few years ago (see "How to Fight Depression," page 54). Unfortunately, says psychiatrist Martin Keller, depressed people are too often ill-informed about the modern standards of psychiatric care. "Depression is as common as can be," he says, "but the stigma with it is extraordinary. There’s a lot of voodoo-like mystique with why and how it happens." Some depressed people imagine they will be asked to lie supine on a couch and describe their feelings to someone they don’t know, and who doesn’t know them – an excruciating image for them to ponder.
The story of a suicide continues long after the fatal event. In the time since her husband’s death, Kathie Schomp has sold their house in Wakefield, put many of its furnishings in storage, and rented an apartment in Portsmouth, across Narragansett Bay. She has gone back to work at the Newport County Community Mental Health Center. "I just keep striving for anonymity," she says. "My struggle is to get a sense of me – a sense of myself, moving on."
Kathie has herself undergone therapy to help sort out her feelings toward Rick. Sometimes she is angry because he took himself away from her; usually she is just saddened by the tragic waste of his loss. She is also troubled by the effect of Rick’s suicide on her sons. Kathie has managed to convince her boys – whose opposition to counseling rivals their father’s – to attend two family-therapy sessions with her. "It’s going to be a long process," she says, "and there’s never going to be any real answers. But we’re not going to stop talking about it."
Life for the Schomp family has assumed a new kind of normal. In the fall Jake will resume his studies at the University of Georgia, after spending a year at the University of Rhode Island so that he could be closer to home. Nate graduates this spring from the University of Illinois with a degree in mechanical engineering. Ben, also a student at U.R.I., was married last July. The entire family is planning a trip to Peru after Nate’s graduation.
On the first anniversary of her husband’s death, Kathie Schomp met her sons Ben and Jake for breakfast. (Nate was away on a summer internship.) Afterward, they went their respective ways – Ben played golf and Jake spent the day on Block Island with his girlfriend. Kathie drove to her brother’s cabin in New Hampshire, where she met her sister-in-law, Marian Schomp.
That evening Kathie and Marian drove to a spot with a view. They sat on the hood of the car and, as the sun disappeared below the horizon, Kathie called Nate on her cell phone. They talked about Rick, and Kathie described the sunset to her son. After Kathie got back to the cabin, she went to bed. For the first time since her husband’s death, she slept well. She dreamed of Rick.