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Night Falls Fast: Understanding Suicide

4.06 of 5 stars 4.06 · rating details · 2,268 ratings · 105 reviews

From the author of the best-selling memoir An Unquiet Mind, comes the first major book in a quarter century on suicide, and its terrible pull on the young in particular. Night Falls Fast is tragically timely: suicide has become one of the most common killers of Americans between the ages of fifteen and forty-five.

An internationally acknowledged authority on depressive illn...more

Paperback, 448 pages

Published October 10th 2000 by Vintage (first published 1999)

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Jan 31, 2008 Kirsten rated it 5 of 5 stars

Shelves: read-pre-12-07, from-library, non-fiction, mental-health, psych-and-neuroscience

Jamison begins this excellent book by describing suicide in the same terms that one might describe a particularly awful disease: "Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense, and unpalliated," she writes. "There is no morphine equivalent to ease the acute pain, and death not uncommonly is violent and grisly." This sets the tone for the book, which is unflinching and frequently painful to read, yet the author also infuses the inf...more Jamison begins this excellent book by describing suicide in the same terms that one might describe a particularly awful disease: "Suicide is a particularly awful way to die: the mental suffering leading up to it is usually prolonged, intense, and unpalliated," she writes. "There is no morphine equivalent to ease the acute pain, and death not uncommonly is violent and grisly." This sets the tone for the book, which is unflinching and frequently painful to read, yet the author also infuses the information and narratives with a deep sense of compassion and understanding.

After reading William Styron's excellent Darkness Visible, I was struck with the way that many memoirs and other books on depression dance around the subject of suicide. Just about every depressive's memoir describes the author's bout of suicidal ideation or his or her suicide attempt, yet at the same time many books on depression seem to go out of their way to divorce suicide from depression and manic-depressive illness. There is a strong desire, it seems, to stress that not everyone who is depressive will attempt or commit suicide, and that not everyone who commits suicide is depressive or otherwise mentally ill. While this is true, it also muddies the very strong connection between mental illness and suicide, perhaps to the detriment of many.

Jamison seeks to remedy this by very strongly stating that suicide is indeed most common in people with mental illness, diagnosed or not, and backs up this claim with a great deal of research. She also explores research into when people are at their most vulnerable, which is sometimes surprising. For example, one of the most dangerous times in terms of suicide is the period directly after a patient has been released from the hospital. At first this seems counterintuitive, but it actually makes sense -- if someone has been hospitalized for depression or another mental illness, they have been in a fairly sheltered and safe environment. Upon release, however, not only is the patient suddenly confronted with the problem of picking up their life where they left off and dealing with practicalities like returning to work and daily life, but there is also an increased risk of medication noncompliance. Jamison also elaborates on one theory as to why some suicides seem to be provoked by the use of antidepressants: in many cases, when a person is deep in the throes of depression, they lack the energy and wherewithal to carry out suicide plans. Perversely, once the antidepressants begin to work, the patient starts to feel just well enough to carry out plans they had only considered before.

Jamison is also not afraid to bring a human element to the book. Interspersed with her clear reportage of scientific research into suicide are specific accounts of individuals who committed or attempted suicide -- including Jamison herself.

Overall, I feel like this is a cruicially important book. It's especially useful to those who have come into contact in some way with mental illness and suicide, but I think pretty much everyone could benefit from reading it and achieving greater understanding of this issue.

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Jul 05, 2007 stephanie rated it 5 of 5 stars

Shelves: suicide, psychology, would-rec

one of the best books i have seen on suicide, i should go back and read it once i finish the books i am working on now.

her prose is very accessible - i can't emphasize how important and rare this is in psychological writing - in that she doesn't get caught up in jargon or theory. she knows how to personalize the subject matter, and make it relevant.

the truth is, if you haven't had a suicidal impulse, then you know someone that has. this book does an excellent job of illustrating why that urge...more

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Oct 30, 2011 John E. Branch Jr. rated it 3 of 5 stars · review of another edition

Shelves: play-project-1, suicide-studies

Read as research for a play about suicide. There's much to value here, particularly the individual cases recounted.

On the other hand, there are problems. One of the book's annoyances is Jamison's excessive fondness for statistics. A greater shortcoming is that she writes confidently from one side of a still unsettled question about the relationship between the mind and the brain, assuming that what happens at a neurochemical level in the brain is the cause of what happens in the mind in terms of...more

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May 04, 2013 Mike rated it 3 of 5 stars

I'm reluctant to commit to "paper" the thoughts and feelings that Night Falls Fast evoked. It's - obviously - going to function as a triggering experience for many depressed people. And it will be very distressing for people who have either considered, romanticized, or settled on suicide. Chronicling my emotional engagement with the book here - going through all of that again - would be too exhausting. It's something, truth be told, I want to put behind me.

An important thing for sufferers of dep...more I'm reluctant to commit to "paper" the thoughts and feelings that Night Falls Fast evoked. It's - obviously - going to function as a triggering experience for many depressed people. And it will be very distressing for people who have either considered, romanticized, or settled on suicide. Chronicling my emotional engagement with the book here - going through all of that again - would be too exhausting. It's something, truth be told, I want to put behind me.

An important thing for sufferers of depression who are considering suicide is that they know they are not alone. Night Falls Fast all too often stresses how singular the suffering is, often how difficult it is to express and impossible to communicate. That is true. But it comes very subtly with the conclusion that, well, yes, it's incredibly isolating. As a depressed person, I felt more alone and "outside." It talks at length about how the proximity of pertinent or salient suicides will often lead to "suicide clusters" or imitative behavior, and yet here we have a book that discusses all facets of the crime. It may not condone the romanticization or the arguments by which suicides come to their resolutions, but it mentions them, and I can't imagine it would be less than frightening if those arguments sounded familiar to the reader. I am by no means saying Night Falls Fast is hypocritical, or doing the wrong thing. Just be careful.

To the book's detriment it spends a lot of time on inconclusive findings but still plants the seed of possibility-of-truth, which I think can mess with your head. The phrase "is x times more likely than" occurs more often than my brain can fitfully process. The statistics and neurological components are fine, but disorienting. People seeking some answers in Night Falls Fast will find a sobering amount of inconclusiveness and debate. Once again there are confusing roadblocks due to statistical methodologies and research ethics, and it once again comes down to ferreting out the "nurture" from the "nature," as it so often is with everything. Insofar as I've come to "understand suicide" from the book, well...I don't know. A lot of it has been illuminated, for better or for worse. For worse, possibly, depending on who you are. Just be careful.

The greatness of the book is in its framing of suicide as a public health problem, and its framing of firearms control as in conjunction with mental health. Nothing so elegantly links the gun control issue to mental health quite like the amount of people who murder themselves by blowing their own heads off. Suicide kills so, so, so many people. It is violent and impulsive more often than not, and guns help that along. Yet I don't remember suicide entering the gun control debate; we're mostly concerned with if they will kill others. Sadly, the odds are that, if you are shot with a gun, it's by your own hand. The best parts of this book - the Meriwether Lewis essay is excellent, by the by - are the ones that frame suicide as a public health problem and the product of a life-threatening illness. That is a new perspective for me: it can be an offshoot of a violent, impulsive culture. I find great comfort in relinquishing the total control of the depression sufferer of his or her own life. We have so little control of anything. See what kind of head-space this book can put you in? Just be careful.

Depressed people may find themselves empathizing with the self-condemned here, and not in the healthiest way. It gives some reports about the recovery of the living and the loved ones that will probably be more "encouraging" than not. If you want to kill yourself and the only thing holding you back is how it will hurt those around you, do not read this book. It gives hope to those left behind, but if you're thinking about leaving people behind, just be careful.

I would never kill myself. But in my copy of the book, there is a line that says suicide is a "permanent solution to a temporary problem." But I managed to write in the side, "But what if living is the problem?" Life is still temporary, of course. I don't think I've entered as dark a head-space. Sometimes looking to empathize and understand others and their actions will mess with your head more than is healthy. It's a good book, but for the love of Christ, be careful.
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Nov 26, 2011 Jennifer rated it 4 of 5 stars

Shelves: 2010-reads

A dark and absorbing read that takes a tour of the dimmer regions of the human head and heart. Jamison, whose An Unquiet Mind stands as a classic in the field, is at her best when exploring the social and historical aspects of suicide, where she excels at bringing a lovely cross-section of information to the table. Not everyone, after all, can be natting on about SSRIs and then drop in an appropriate Dylan Thomas quote. The latter part of the book, more strictly devoted to the science of brain...more

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Dec 01, 2011 Nicol rated it 4 of 5 stars

Shelves: psych-mental-illness, non-fiction

This book investigating suicide through history, literature, and interviews begins to paint an in depth picture of the culture, pathology, and biology of suicide. Jamison is able to get to the heart of suicidal thinking and in part I believe her own experiences with suicide give her another facet of understanding. One of my favorite quotes: "In short, when people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness perme...more This book investigating suicide through history, literature, and interviews begins to paint an in depth picture of the culture, pathology, and biology of suicide. Jamison is able to get to the heart of suicidal thinking and in part I believe her own experiences with suicide give her another facet of understanding. One of my favorite quotes: "In short, when people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain." Never has one sentence been so capable of understanding the mind set of a suicidal individual. Furthermore, Jamison explores which mental illness place individuals at greater risk for suicide, explored gender and geography as well as takes up the investigation of genetics.
Where Jamison falls short are in her final chapters where she looks into the effects of suicide on those left behind. She began the section strong arguing that suicidal is neither selfish or non-selfish therefore taking the most common reaction off the table. I applaud her for this because conversations centered around suicide being "selfish" ignore the complexities of mental illness. However, after this strong beginning Jamison fails to follow through. She has a great quote by Arnold Toynbee "There are two parties to the suffering that death inflicts; and, in the apportionment of this suffering, the survivor takes the brunt." However, she goes from there and attempts to argue that suicide has no lasting effects on siblings or children. Jamison acknowledges that spouses and parents suffer in the quake of suicide but states that children and siblings survive without enduring pathology. The worst part is that she is not even trying to back up these claims with evidence. I'm a psych nurse and one of the things we are taught in training is that children of parents that suicide are more likely to suicide. Children then see suicide as an acceptable coping mechanism. Jamison does at the beginning of this section say there is little research into how siblings and children of suicides survive. I would be surprised if studies showed that only parents and spouses are affected by suicide!(less)

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May 10, 2011 Heather rated it 3 of 5 stars

Lots of good information abounds in this book. I appreciated the mixture of clinical information and artistic commentary on the subject. But as a sibling of someone who committed suicide I am left with one question/concern. What of all those out there who are mentally ill and tending towards suicide who can not get help. What of the men who can not hold steady jobs, who are in and out of jail, who end up in half-way houses or on the street. What of the ill who have no health insurance, who can n...more

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Sep 12, 2009 Anne rated it 4 of 5 stars

After several teen suicides and attempted suicides in my hometown this past year, I started to feel incredibly helpless. Despite the obvious sadness of young lives lost, I felt overwhelming frustration. It is often easy for people to dismiss teen suicide as the result of immaturity or a lack of perspective - heartbreak over unrequited love or a rejection letter from Harvard. What people ignore is the reality - that the majority of suicides, those of teenagers and adults - are the result of choni...more

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May 12, 2012 Bank rated it 5 of 5 stars

As she did in An Unquiet Mind , Dr Jamison explores this subject from both the vantage point of being a medical expert in manic/ depressive disorders and suicide and also a person who has a manic/ depressive disorder and has attempted suicide .
Her book on a very personal and much misunderstood subject was comprehensive and extremely helpful in helping me understand suicide. The frequency of suicide , the stigma of mental illness and suicide , and it's concentration in young adults is sobering ....more

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Apr 09, 2013 Linda Halverson rated it 5 of 5 stars

A deep dive into the suicidal mind, this book is a well written, well researched and insightful guide for those of us who are surviving the loss of a loved one as a result of completed suicide and forever asking the why question. Jamison provides many answers to that question and offers a broader understanding of the warning signs, the risk factors and just how quickly the impulse to choose a permanent solution to a temporary problem takes hold. For me this read was enlightening, educational, di...more

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Mar 21, 2013 Jas rated it 5 of 5 stars

Shelves: bipolar-inside-out

The applicability of this book to my life is not appropriate. This book is far too academic for my CURRENT taste. I would have chewed this one up in seconds in graduate school, but alas that was two years ago and reading this just brought about stress.

the book is finely tuned. Each chapter has numerous vignettes which support, lead into, or develop each chapter. the chapters are well researched (really, really well) and easily understood. My only recommendation is that burn out can be quite hig...more The applicability of this book to my life is not appropriate. This book is far too academic for my CURRENT taste. I would have chewed this one up in seconds in graduate school, but alas that was two years ago and reading this just brought about stress.

the book is finely tuned. Each chapter has numerous vignettes which support, lead into, or develop each chapter. the chapters are well researched (really, really well) and easily understood. My only recommendation is that burn out can be quite high if read front to cover as one would read a novel. the content is unforgiving, raw, and very easily conveyed. Study after study is explored with personal reflection (if one has read her previous books you may get a faint echo of unquiet mind). My mind, however was not quiet while reading this and is still spinning; very very fast. there is A TON of information in this book; enough so that i must purchase a copy and highlight the hell out of it.

there is information in here for anyone; clients, change agents, allies, etc!

read with caution, however for both its content is unforgiving and will, even if you have no experience with suicide, stir you and cause an overwhelming urge to scream/cry/put the book down wide eyed... or just go take a long cold shower. (i did all of the above, twice).

i enjoyed the first 150 pages the most, as they felt more personable.... and then my attention was then pulled back in during the discussion of the brain, diet, etc. Bite this one off in sections, and take your time. weave it in and out with another book, because it will consume you.

Oh and onward to one complaint. I would have enjoyed this book more if it was mirrored with something else. perhaps it it wasnt fully focused on suicide, but i really have NO idea what i would pair it with. All i know is that im exhausted and going for a long, long walk through the city.

Post notes: i actually re-read portions (particularly those related to treatment)—since my brain was fried, my emotions jagged and non-existent, and my body physically tired, from reading this—and i have to say, that revisiting these sections was rewarding.

unedited and posted seconds after finishing.

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Nov 28, 2012 Shazia rated it 5 of 5 stars

This is a profound exploration of what drives people to take their own lives. Jamison is a psychiatrist and has also dealt with her own suicidal tendencies.

Jamison employs a multi-faceted approach to her investigation of suicide and avoids making any reductionist assumptions about the reasons why, such as thinking the person killed him/herself because of financial woes. What Jamison does is offer the reader an opportunity to understand how our minds work when we are battling rigorous ailments s...more

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Oct 19, 2009 Christopher Raffa rated it 3 of 5 stars

Shelves: depression

This book was well researched and masterfully written. In the uncovering of the massive tragedy that suicide inflicts on life, these pages provided the reader with much to contemplate and treasure.

In the epilogue, however, Jamison recounts that a few weeks after a failed suicide attempt she tries to discover, if any, the vital signs of her “relationship with God.” Having prayed the prayer she only really cared about, she felt a “convulsive sense of shame and sadness.” Out of this emotional uphe...more

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Jan 02, 2010 rachel rated it 5 of 5 stars

Shelves: do-not-own, 2008, heartbreakers

Suicide, both the completed act and ideation of, is a subject that I've had to deal with much more than I'd care to. I made the mistake of reading this book while on a bus back to college and what I remember most of the experience is how embarrassing it was to be sitting next to a stranger, making a deeply personal connection with a book and crying without restraint.

But, if you think of all of the smart, creative, generous people whose lives have been cut short by depression culminating in suic...more

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Apr 03, 2008 Bree rated it 5 of 5 stars

I am a big fan of Dr. Jamison's other works, and Night Falls Fast was not a disappointment. She brings her usual mix of clinical accuracy and human empathy to this book, and I can't imagine any reader not having at least one moment of deep self reflection as a result. Of course she's also devilishly funny at times.

She clearly describes the magnitude of the problem, and I spent much of the book thinking to myself that the saddest aspect of these diseases is how alone and isolated the sufferers ca...more

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Jun 24, 2008 Jessica Land added it

Shelves: wanted, mental-health

I picked this book up at the library yesterday. My therapist told me it's the best book she's ever read on the subject of suicide.

I had checked this out from the library, but more promising books came my way, and I decided to return it. I did read a little and it was very interesting. It's definitely a book I will return to, and would like to own.

description from wikipedia.org:
"Her seminal works amongst laypeople are her memoir An Unquiet Mind, which details the agony of severe mania and depre...more

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May 06, 2008 Amy rated it 4 of 5 stars

If you have ever been close to someone who has completed suicide, please consider reading this book. This is the definitive book on suicide and examines the topic through many different lenses (personal, psychological, sociological, historical, legal etc) with expertise and care. Dr. Kay Jamison, who is the world's leading expert on bipolar disorder, and is also a multiple suicide attempt survivor herself, does an excellent job at examining the subject in an easily accessible manner.
I read this...more

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Apr 30, 2012 Russ rated it 5 of 5 stars

Shelves: good-police-books

I read this book a decade ago, but the information in it, has stayed with me to this day. The concept that a person who in on a self-destructive track is in fact the actual case....they are unable to leave that track without intervention. As a former crisis negotiator, I used this concept when talking down suicidal victims and when directing a team to convince a person to step back from the brink.

Good book, that gives both a historical perspective of suicide, as well as an analytical one.

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Aug 12, 2012 Shannon rated it 4 of 5 stars

Jamison gives a wise and comprehensive examination on the difficult subject and reality of suicide. As someone who is an expert in the mental health field, as well as someone who has attempted suicide herself and lost loved ones to suicide, she is able to give insight on the subject from various perspectives. This book is written without judgement and is full of extensive research, history, and personal stories which helps provide the emotional context needed.

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Jul 04, 2012 Grant Talabay rated it 5 of 5 stars

Shelves: history, memoirs, psychology

A horrific account of the author's patients who have died by their own hands. She writes of the unbearability of life in her patient's lives. Suicide is taboo in our culture, yet Jamison attacks the subject as a person who has lived this way and had these feelings. However, the book offers hope to those who have either tried or contemplated suicide not to mention offer comfort and explanation to those who have lost
Loved ones in this tragic circumstance!

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Sep 03, 2012 Luci rated it 4 of 5 stars

This was a very good book to read if you are a survivor of suicide. Jamison takes a clinical approach but her writing is very accessible to the general populace. This is definitely a go to book about understanding the suicidal mind and Jamison, perhaps due to her personal history, makes it clear that it is a cocktail of factors that result in a suicide. I would have liked more discussion as to the survivors of suicide, i.e, the family of the victim, but this was otherwise a fantastic resource.

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Aug 14, 2012 aya rated it 4 of 5 stars

Gracefully written with relevant and poignant quotes from both laypeople and writers/artists who committed suicide. Neither too academic or too emotional/cultural, it is well balanced between science and feeling. She makes some interesting points, but the strength of this book does not lie in a genius new way or technique of dealing with, looking at, or treating suicide. Rather, it is the elegance and compassion with which she describes the subject. It is tempered and thoughtful.

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Nov 22, 2011 Brady Clemens rated it 4 of 5 stars

An expert in the field (you don't work at Johns Hopkins if you're an amateur), Jamison looks at all aspects of suicide; who does it, why, how, the underlying causes, etc. An important work, if difficult at times. The case studies are often horrendous to contemplate. But still, suicide is a hidden epidemic in society, one we prefer to ignore, and this work helped me understand the topic much better than I had.

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Nov 13, 2011 Joni rated it 5 of 5 stars

Every 17 minutes another person commits suicide; 500 women a day in rural China commit suicide; 16 veterans commit suicide every day. The agony people find themselves in to commit suicide is never completely understood but Jamison does a pretty good job helping the reader to get a bigger picture and broader understanding of how widely spread mental illness is.

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Aug 14, 2012 Carole Yeaman rated it 3 of 5 stars

Shelves: library-loan, non-fiction

Extremely impressive, ALL INCLUSIVE research. Well written, with some interesting anecdotes (esp. Lewis of "Lewis & Clark"). An intense read -- emotionally & psychologically painful to read, insofar as anyone reading this would have been touched by mental illness. If I weren't so bummed out after reading this, it would have deserved a higher rating.

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Nov 10, 2012 Marilyn rated it 4 of 5 stars

Jamison is one of my favorite writers about bipolar and suicide. She lives with it herself and most accurately describes the "process" of the path to suicide that most ppl do not truly understand unless you have been there yourself. *When your pain exceeds your coping skills*, this is what can and does happen.

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Jun 15, 2011 Marie rated it 5 of 5 stars

I'm on page 98 of 432. So far Kay Redfiled Jamison takes you into a painful yet revealing world of suicide and the multitude of reasons why someone would choose death as a means to end pain and suffering. Dr. Jamison speaks from an intensely personal platform as she reveals her own battle with depression. What I love most about her work is the rich history and research efforts that went into it. Also, this book is for clinicians, patients, family and friends who either work with or care for some...more

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Mar 18, 2009 Lauren rated it 4 of 5 stars

Shelves: public-health-books

This is a complete historical look at suicide, also it gives a thorough picture of some of the causes. Jamison is good person to write this book because she gives a personal and scientific view. However, I do feel that the prevention part of this book still left me with a lot of questions. Also, the last chapter overviews some prevention programs but provides very little details on these programs.

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Mar 07, 2013 Carri Anderson rated it 5 of 5 stars

Recommended to Carri by: Several docters in the field of Mental Heatlh

Shelves: dymamic-truths

This is by far the best and most truthful book describing the suicidal mind and thoughts. Not only does this book bluntly let you see what drives many people and types to suicide, it also gives in depth description of how it effects each family member and friend. I have read this book 3 times.

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Dec 22, 2008 Erika rated it 3 of 5 stars

this book gives a long illustration on suicide-from the historical perspective to research and rates in present times...
very long at times the author repeats itself

the stories about suicide are very interesting..this book might make you feel uncomfortable and depressed at times...

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About Kay Redfield Jamison

Kay Redfield Jamison is an American clinical psychologist and writer who is one of the foremost experts on bipolar disorder. She is Professor of Psychiatry at the Johns Hopkins University School of Medicine and is an Honorary Professor of English at the University of St Andrews.

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Books by Kay Redfield Jamison

An Unquiet Mind: A Memoir of Moods and Madness

Touched With Fire: Manic-Depressive Illness and the Artistic Temperament

Understanding Depression: What We Know and What You Can Do about It

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“When people are suicidal, their thinking is paralyzed, their options appear spare or nonexistent, their mood is despairing, and hopelessness permeates their entire mental domain. The future cannot be separated from the present, and the present is painful beyond solace. ‘This is my last experiment,’ wrote a young chemist in his suicide note. ‘If there is any eternal torment worse than mine I’ll have to be shown.” — 97 people liked it

“It is tempting when looking at the life of anyone who has committed suicide to read into the decision to die a vastly complex web of reasons; and, of course, such complexity is warranted. No one illness or event causes suicide; and certainly no one knows all, or perhaps even most, of the motivations behind the killing of the self. But psychopathology is almost always there, and its deadliness is fierce. Love, success, and friendship are not always enough to counter the pain and destructiveness of severe mental illness ” — 53 people liked it

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